Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews最新文献

{"title":"Growth Mixture Modeling of Patient-reported Outcomes After Total Knee Arthroplasty: No Recovery Trajectory Shows Postoperative Decline or Stagnation.","authors":"Kareem Omran, Colleen Wixted, Daniel Waren, Joshua C Rozell, Ran Schwarzkopf","doi":"10.5435/JAAOSGlobal-D-25-00107","DOIUrl":"10.5435/JAAOSGlobal-D-25-00107","url":null,"abstract":"<p><strong>Background: </strong>Recovery after total knee arthroplasty (TKA) shows considerable variability in both pain relief and functional improvement. The Knee Injury and Osteoarthritis Outcome Score (KOOS-JR) is a widely used measure for evaluating these outcomes. This study aimed to identify distinct latent recovery trajectories, which represent underlying, unobserved patterns of postoperative recovery inferred from KOOS-JR scores, and to explore patient characteristics associated with these trajectories.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed patients who underwent primary TKA for osteoarthritis at a tertiary academic center from January 2020 to March 2023. Inclusion criteria required patients to have completed a preoperative KOOS-JR questionnaire and at least two postoperative follow-ups at 1, 3, 6, or 12 months. Exclusion criteria included bilateral or revision procedures. Collected characteristics included age, sex, Body Mass Index, American Society of Anesthesiologists physical status classification, race, smoking status, procedure type, anesthesia type, length of hospital stay, and discharge disposition. Growth mixture modeling was used to model recovery trajectories, with associations evaluated using the \"three-step approach.\" Model fit was assessed using the Akaike and Bayesian Information Criteria, Vuong-Lo-Mendell-Rubin likelihood ratio, posterior probabilities, and entropy values.</p><p><strong>Results: </strong>Of 700 eligible patients, growth mixture modeling identified two recovery trajectories: 95.4% of patients (trajectory 1 [T1]) demonstrated steady improvement, while 4.6% (trajectory 2 [T2]) began with lower KOOS-JR scores (mean 9.7 vs. 47.9 for T1) but recovered to near T1 levels by 1 month. Trajectory 2 patients were markedly younger (mean 64 vs. 67 years), had higher Body Mass Index (36 vs. 31), included more Black or African American individuals (38% vs. 20%), and were more frequently discharged to rehabilitation facilities (16% vs. 3.3%; all P < 0.05). Each additional year of age reduced the likelihood of following T2 by 4% (odds ratio = 0.96, 95% confidence interval, 0.92 to 0.99; P = 0.016), while discharge to rehabilitation increased the likelihood 6-fold (odds ratio = 6.22, 95% confidence interval, 1.89 to 17.8; P = 0.001).</p><p><strong>Conclusion: </strong>This study identified two distinct recovery trajectories after TKA, with notably no trajectory emerging showing decline or stagnation from preoperative levels. Despite lower baseline scores, patients in T2 achieved substantial recovery, suggesting TKA provides meaningful improvement even for those with substantially compromised function. The findings also highlight the need to explore whether rehabilitation discharge directly influences the observed postoperative gains.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Radiological Outcomes of Schatzker Type V and VI Tibial Plateau Fractures Treated With Internal Fixation and External Fixation.","authors":"Usman Ali, Muhammad Younus Khan Durrani, Fizzah Mariam, Syed Muhammad Aqeel Abidi, Rizwan Haroon Rashid, Haroon Ur Rashid, Yasir Mohib","doi":"10.5435/JAAOSGlobal-D-24-00244","DOIUrl":"10.5435/JAAOSGlobal-D-24-00244","url":null,"abstract":"<p><strong>Introduction: </strong>Tibial plateau fractures are complex injuries involving the articular surface of the proximal tibia and often accompanied by soft-tissue damage. These fractures are challenging due to their potential to disrupt knee joint stability and function. Schatzker classification is widely used to categorize these fractures globally. Several different treatment modalities, focused on stabilizing the knee joint while restoring pain-free motion, are used for treatment. Schatzker type V and VI tibial plateau fractures are treated with two different approaches: open reduction and internal fixation (ORIF) and closed reduction and external fixation (CREF). The primary objective is to assess and compare the clinical and radiological outcomes of ORIF versus CREF for Schatzker type V and VI tibial plateau fractures.</p><p><strong>Methods: </strong>This research was done retrospectively at the Aga Khan University Hospital. This study comprised 60 patients with type V and VI tibial plateau fractures who underwent internal fixation or external fixation from 2016 to 2022. Patients were divided into two groups with 30 patients each: the CREF group (patients treated with closed reduction and external fixation using Ilizarov as external fixator), and the ORIF group.</p><p><strong>Results: </strong>The CREF group consisted of 1 type V and 29 type VI fractures, whereas the ORIF group included 20 type V and 10 type VI fractures. The Oxford Knee Score was 40 points for each group at the 6-month follow-up. At the last follow-up, the Oxford Knee Score was 45 points for the CREF group and 44 points for the ORIF group.</p><p><strong>Conclusion: </strong>In conclusion, our study highlights the benefits of CREF over ORIF for proximal tibial fractures in low- and middle-income countries. CREF showed shorter surgical duration and wait times, reduced blood loss, and fewer complications, particularly infections. Both groups had comparable radiological and functional outcomes, with a slight preference for CREF. These findings emphasize the potential of CREF in resource-constrained settings.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Meniscal Cyst Diagnosed After Acute Onset of Common Peroneal Nerve Palsy.","authors":"Mako Okumura, Masatake Matsuoka, Tomohiro Onodera, Koji Iwasaki, Riku Miyaishi, Dai Sato, Taku Ebata, Yoshiaki Hosokawa, Eiji Kondo, Norimasa Iwasaki","doi":"10.5435/JAAOSGlobal-D-24-00397","DOIUrl":"10.5435/JAAOSGlobal-D-24-00397","url":null,"abstract":"<p><p>Common peroneal nerve palsy is often caused by compression at the fibular head, with ganglion cysts being the most common etiology. Although rare, meniscal cysts can also compress the nerve. We report a case of common peroneal nerve palsy due to a lateral meniscal cyst, successfully treated with surgery. A 38-year-old man presented with progressive pain and numbness in the right lateral knee and foot, along with difficulty dorsiflexing the ankle without any apparent history of trauma. Examination revealed a palpable mass on the lateral knee and sensory deficits in the superficial peroneal nerve distribution. Magnetic resonance imaging demonstrated a cystic lesion originating from the lateral meniscus. Nerve conduction studies showed reduced conduction velocity, confirming a diagnosis of common peroneal nerve palsy secondary to a lateral meniscal cyst. The patient underwent surgical excision of the cyst and arthroscopic meniscal repair. Intraoperatively, the cyst was compressing the common peroneal nerve. Postoperatively, motor function recovered over 1 year, with minor residual sensory deficits. No recurrence was observed at 1-year follow-up. Lateral meniscal cysts are a rare cause of common peroneal nerve palsy. Early diagnosis and surgical intervention can prevent permanent nerve damage and ensure functional recovery.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Methodological Advancements in the 2024 AMA Guides for Rating Lower Limb Impairment.","authors":"J Mark Melhorn, Barry Gelinas, Douglas W Martin, Kurt T Hegmann, Matthew S Thiese","doi":"10.5435/JAAOSGlobal-D-25-00072","DOIUrl":"10.5435/JAAOSGlobal-D-25-00072","url":null,"abstract":"<p><strong>Objective: </strong>To determine the ease of use, accuracy, consistency, reliability, and reproducibility for rating lower limb conditions when transitioning to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) Sixth Edition 2024 developed using the RAND/UCLA modified Delphi Appropriateness Method compared with the AMA Guides Sixth Edition 2008.</p><p><strong>Methods: </strong>Three physician experts and four premedical students completed two rounds of impairment ratings using methods from the AMA Guides Sixth Edition 2008 versus the AMA Guides Sixth Edition 2024. Impairment values and completion times for each method were compared across groups.</p><p><strong>Results: </strong>For experts, the average time to complete an impairment rating was 4.1 minutes using the AMA Guides Sixth Edition 2024 compared with 16.7 minutes using the AMA Guides Sixth Edition 2008, maintaining 100% accuracy and reliability for both methods. Premedical students averaged 5.3 minutes with the AMA Guides Sixth Edition 2024 and 24.0 minutes with the AMA Guides Sixth Edition 2008, showing increased accuracy, consistency, reliability, and reproducibility with AMA Guides 2024.</p><p><strong>Conclusion: </strong>The AMA Guides Sixth Edition 2024 represents a notable advancement in impairment evaluation, offering a more efficient, accurate, and reliable system for lower limb impairment assessments. This update not only benefits healthcare providers and patients but also sets a new standard in occupational health by preserving the accuracy, consistency, reliability, and reproducibility of impairment ratings while streamlining the evaluation process.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Revised Risk Analysis Index as a Predictor of Mortality and Morbidity in Orthopaedic Trauma.","authors":"Chirag Soni, Victor Koltenyuk, Nithin Gupta, Haad A Arif, Aruni Areti, Taylor Manes, Luke A Lopas, Jan P Szatkowski, Christian A Bowers, Benjamin C Taylor, Jack W Weick","doi":"10.5435/JAAOSGlobal-D-25-00086","DOIUrl":"10.5435/JAAOSGlobal-D-25-00086","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to determine the applicability of the Revised Risk Analysis Index (RAI-Rev) in orthopaedic trauma and compare the predictive discrimination for the RAI-Rev and the 5-Item Modified Frailty Index (mFI-5) for 30-day postoperative outcomes.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Setting: </strong>The American College of Surgeons National Surgical Quality Improvement database was used.</p><p><strong>Patient selection: </strong>All patients aged 18 or older who underwent surgical treatment for forearm, humerus, pelvis, acetabulum, femur, tibia, and hindfoot fractures from 2015 to 2020 were included.</p><p><strong>Outcome: </strong>30-day postoperative mortality, major complications, and wound complications consisting of surgical site infection, and wound dehiscence were measured.</p><p><strong>Results: </strong>A total of 206,352 patients met inclusion criteria. The mean age was 69 years, with 64.2% (n = 132,514) being female. Multivariate regression analysis showed that increasing frailty tiers in both RAI-Rev and mFI-5 were independent predictors of mortality, major complications, readmission, and wound complications. The cohort with the highest degree of frailty in both RAI-Rev and mFI-5 had the greatest risk of poor outcomes. RAI-Rev had significantly superior predictive discriminatory thresholds compared with mFI-5 for predicting 30-day mortality (C-statistic: RAI-Rev [0.84] and mFI-5 [0.67], P < 0.001), major complications (C-statistic: RAI-Rev [0.73] and mFI-5 [0.65], P < 0.001), and readmission (C-statistic: RAI-Rev [0.68] and mFI-5 [0.63], P < 0.001). However, mFI-5 outperformed RAI-Rev when predicting wound complications (C-statistic: RAI-Rev [0.52] and mFI-5 [0.55], P < 0.001).</p><p><strong>Conclusion: </strong>The RAI-Rev tool demonstrated superior predictability of postoperative morbidity, mortality, and readmission rates compared with mFI-5 but was less effective in predicting surgical site complications. These findings demonstrate the utility of RAI-Rev in anticipating postoperative complications in the setting of orthopaedic trauma, where optimizing surgical candidate selection is not always possible. Assessing the predicted morbidity and mortality through RAI-Rev enables surgeons to accurately identify patients at high risk of complications, which can further research investigation to mitigate this risk.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Stem Design for Conversion Total Hip Arthroplasty From Previous Short Intramedullary Nail Predispose to Fracture?","authors":"Kevin F Purcell, Taylor P Stauffer, Shawn Kaura, Michael P Bolognesi, Samuel S Wellman, Thorsten M Seyler, Sean P Ryan","doi":"10.5435/JAAOSGlobal-D-25-00029","DOIUrl":"10.5435/JAAOSGlobal-D-25-00029","url":null,"abstract":"<p><strong>Introduction: </strong>Conversion to total hip arthroplasty (THA) from prior short intramedullary nail (IMN) is an increasingly common procedure. Currently, there are no studies investigating if distal interlock screws serve as stress risers contributing to perioperative fractures, or whether primary stems can be used in previously reamed and fractured femurs. We hypothesized that conversion would be successful regardless of stem design.</p><p><strong>Methods: </strong>Nineteen patients who underwent short IMN to THA conversion were retrospectively identified from 2013 to 2022, with a mean 13 months between the procedures. Patient demographics, as well as intra- and postoperative variables, including stem design, length of stay, fractures, unplanned readmissions, and revisions, were collected. Mean follow-up was 13 months.</p><p><strong>Results: </strong>A diaphyseal-engaging revision stem was used in 13 cases, with metaphyseal press-fit stems and cemented stems each used in 3 cases. Two patients (one diaphyseal stem, one cemented stem) sustained intraoperative greater trochanteric fractures. No postoperative fractures were found. Four emergency department visits (21%) and one unplanned readmission (5%) were reported within 30 days, with 1 emergency department visit (5%) and two readmissions (11%) within 90 days. Stratified by stem type, we observed no notable difference in length of stay or procedure length.</p><p><strong>Discussion: </strong>This is the first study to investigate conversion to THA from short IMN. Overall, there were two intraoperative fractures, but no distal fractures or revisions. Although the distal interlock screw was commonly bypassed with a revision-type diaphyseal stem, this was not universal. Further research is needed to determine if primary arthroplasty stem designs can be used in this setting.</p><p><strong>Level of evidence: </strong>Level III Treatment Study.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally-Invasive Dega Osteotomy in Ambulatory Pediatric Patients With Residual Developmental Dysplasia of the Hips-A Technique and Prospective Case Series.","authors":"Saleh AlSaifi, Ali Lari","doi":"10.5435/JAAOSGlobal-D-25-00023","DOIUrl":"10.5435/JAAOSGlobal-D-25-00023","url":null,"abstract":"<p><strong>Purpose: </strong>This study describes the minimally invasive Dega osteotomy for treating residual acetabular dysplasia in ambulatory pediatric patients. The focus is on assessing the safety, feasibility, and early outcomes of this minimally invasive technique.</p><p><strong>Methods: </strong>A prospective series was conducted in a single tertiary orthopaedic center. The procedure involved an initial examination of hip joint stability using intraoperative arthrography. The surgical procedure involved a small transverse incision distal and lateral to the anterior superior iliac spine, followed by a Dega osteotomy and bone allografting. Variables such as surgical time, blood loss, incision length, and acetabular index were measured.</p><p><strong>Results: </strong>In healthy ambulatory patients, 16 osteotomies were performed on 12 patients with an average age of 32 months. The mean incision length was 2.3 cm, average blood loss was 17 mL, and mean surgical time was 21 minutes per side. Preoperative and postoperative acetabular indices averaged 40.3° and 18.6°, respectively. The mean follow-up period was 13 months. No complications were seen in this series.</p><p><strong>Conclusion: </strong>The minimally invasive Dega osteotomy technique is a safe and effective method for treating residual acetabular dysplasia in ambulatory patients. It offers advantages of minimal invasiveness, reduced surgical time, and less blood loss, with outcomes comparable to standard methods. However, further studies with larger cohorts and longer follow-up are necessary to fully establish its efficacy and safety profile.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Healing Index and Complications of a Magnetic Internal Lengthening Nail: A Retrospective Series of 286 Bone Lengthening Events.","authors":"Taylor J Reif, Nathan Khabyeh-Hasbani, Joshua Buksbaum, Gerard A Sheridan, Jason S Hoellwarth, Austin T Fragomen, S Robert Rozbruch","doi":"10.5435/JAAOSGlobal-D-25-00118","DOIUrl":"10.5435/JAAOSGlobal-D-25-00118","url":null,"abstract":"<p><strong>Background: </strong>The time required to form new bone is a critical aspect of bone lengthening but is not constant depending on the osteotomy location. The objective of this study was to establish the bone healing index (BHI) after femur and tibia bone lengthening procedures. Additional objectives included identifying procedure-related complications and implant reliability.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on all consecutive internal lengthening nails (Precice; Nuvasive) implanted in the femur or tibia at a single institution from September 2012 to November 2019. Groups were delineated by surgical approach (antegrade femur [AF], retrograde femur [RF], or antegrade tibia [AT]). The primary outcome was the BHI (days to consolidate regenerate per centimeter bone lengthened). Additional outcomes included iatrogenic bone deformity, implant complications, and nail reliability. Comparative analysis of demographic characteristics and complications was conducted using chi-square tests, and BHI was compared using independent t-tests. Multivariate analysis was used to evaluate independent outcomes among the groups. Statistical significance was set at P < 0.05.</p><p><strong>Results: </strong>Of 286 bone lengthening events (164 AF, 67 RF, 55 AT), BHI was significantly lower for AF at 24.5 ± 9.5 d/cm than for RF at 33.5 ± 14.5 d/cm and AT at 41.0 ± 17.4 d/cm (P = 0.001) and lower for RF than for AT (P = 0.012). After multivariate analysis, nail approach (AF), younger age (≤16), and lengthening for stature (versus deformity) were significantly associated with a lower BHI. Lengthening > 3 cm was also associated with better BHI. Iatrogenic deformity was induced in 8/164 = 4.9% AF, 2/67 = 3.0% RF, and 5/55 = 9.1% AT. Implant reliability was 92.7% for AF, 93.1% for RF, and 94.8% for AT. Complications requiring another surgery were observed in 39 of 286 (13.6%), and failure to achieve the lengthening goal was observed in 1 of 286 (0.3%).</p><p><strong>Conclusion: </strong>AF lengthening, younger age, stature lengthening, and lengthening > 3 cm lead to better bone healing indices using the Precice internal lengthening nail. Complications and iatrogenic deformity can be partially mitigated with surgeon-controlled decisions (surgical approach, blocking screws, distraction rate, weight-bearing restrictions) and rarely lead to a failure in achieving the lengthening goal if treated promptly.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision Olecranon Fixation: Is Tension Band Wiring the Solution? A Case Series and Review of the Literature.","authors":"Marcus C Appleton, Sohan K Jakkaraju, Paul C Appleton, Anil K Dutta","doi":"10.5435/JAAOSGlobal-D-25-00049","DOIUrl":"10.5435/JAAOSGlobal-D-25-00049","url":null,"abstract":"<p><strong>Background: </strong>The optimal revision construct for failed olecranon fracture fixation is controversial. Here, we aim to review existing revision techniques and describe tension band wiring as a surgical option for these challenging scenarios and to evaluate its clinical and radiographic outcomes.</p><p><strong>Methods: </strong>This retrospective case series was performed at an urban, university-based, level-1 trauma center. Patients aged 18 to 65 years who underwent revision fixation of their olecranon fracture using tension band wiring were included. The study data were collected through a retrospective chart review and review of the existing radiographic studies. Primary outcome measure was mechanical failure. Secondary outcome measures included nonunion, malunion, medical, and surgical complications. Functional outcome was determined by range of motion and restoration of extensor mechanism strength.</p><p><strong>Results: </strong>A total of five patients were included in this study. Causes for revision were acute implant failure (n = 2), aseptic nonunion (n = 1), and infected nonunion (n = 2). All patients eventually achieved bony union after revision. Two patients required an additional surgery because of Kirschner wire migration (n = 1) and symptomatic implant (n = 1). Average flexion was 126° (range 110 to 135) and average extension was 18° (range 5 to 30). All patients experienced restoration of extensor mechanism with full strength and returned to their previous working status. No other mechanical failures, surgical complications, or medical complications occurred.</p><p><strong>Conclusions: </strong>Early results of revision open reduction and internal fixation for failed olecranon fracture fixation using tension band wiring demonstrated favorable outcomes and low complication rates. This technique may be used for revision of failed olecranon fixation.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic Orthopaedic Surgeon Financial Compensation in the United States: Trends and Distribution.","authors":"Rahul H Jayaram, Dheeman Futela, Wesley Day, Ajay Malhotra, Jonathan N Grauer","doi":"10.5435/JAAOSGlobal-D-25-00112","DOIUrl":"10.5435/JAAOSGlobal-D-25-00112","url":null,"abstract":"<p><strong>Introduction: </strong>The overall trends in academic orthopaedic surgery compensation are not well studied. The aim of this study was to assess trends and distribution of academic orthopaedic surgery financial compensation and consider in relation to academic rank, sex, and race/ethnicity.</p><p><strong>Methods: </strong>The 2017 to 2023 American Association of Medical Colleges Faculty Salary Surveys were used, which collect information for full-time faculty at US medical schools. Financial compensation data for orthopaedic faculty, across subspecialities, were stratified by year, academic rank, sex, race/ethnicity, and geographic region. Trends in median, 25th, and 75th percentile compensation were assessed.</p><p><strong>Results: </strong>Responses for 2,601 faculty members across orthopaedic departments were available, including 82 instructors, 1,176 assistant professors, 668 associate professors, 487 full professors, 104 chiefs (lead a division within the larger department), and 84 chairs (head an entire academic department). Median faculty compensation increased on an average of 1.80% to 6.93%, with the greatest increase at the chief and chair levels and smaller increases for instructors and professors of varying rank. From 2017 to 2013, women were consistently compensated less than men at all ranks except chairs. In 2023, women in academic orthopaedic surgery made less cents-on-the-dollar relative to men of equal rank across all ranks. Asian assistant professors made 0.90 cents-on-the-dollar, and Hispanic/Latino and Black/African American assistant professors made 0.87 cents-on-the-dollar compared with White faculty of equal rank. However, among professors, these groups had higher median compensation (1.06 to 1.1 cents-on-the-dollar) compared with White professors. The geographic variations of compensation were within the range of 15k for assistant professors, 32k for associate professors, 196k for chiefs, 95k for professors, and 83k for chairs.</p><p><strong>Conclusion: </strong>This study summarizes trends of academic orthopaedic faculty compensation and shows salaries barely keeping pace with inflation and persistent compensation inequities, which highlights the need for fair, transparent compensation models and additional studies of factors impacting physician compensation.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}