Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Risk Factors for Lateral Trochanteric Pain Following Anterior Approach Total Hip Arthroplasty.","authors":"Rex W Lutz, Danielle Y Ponzio, Hope S Thalody, Qudratullah S Qadiri, Alvin C Ong, Zachary D Post","doi":"10.22038/ABJS.2024.74576.3456","DOIUrl":"10.22038/ABJS.2024.74576.3456","url":null,"abstract":"<p><strong>Objectives: </strong>The principal aim of our study is to investigate risk factors for lateral trochanteric pain (LTP) after direct anterior approach (DAA) primary total hip arthroplasty (THA).</p><p><strong>Methods: </strong>A retrospective case control study was developed from 542 patients who underwent primary THA over a 9-year period to form two patient cohorts. Two hundred and seventy-one patients diagnosed with LTP were matched with 271 controls. Chart review revealed patient demographics, surgical approach, and femoral components utilized. Change in limb length and offset were assessed through preoperative and postoperative radiographic measurements.</p><p><strong>Results: </strong>There was a higher proportion of current or former smokers in the LTP group (34.5% vs 21.74%, p=0.003). There was no significant difference in use of high offset stems vs. standard offset stems between groups (15.9% vs. 18.5%, p=0.494). However, the LTP group had significantly higher increase in both femoral offset (+3.55mm vs +1.79mm, p<0.001) and total offset (+0.16mm vs -1.16mm, p=0.031) in comparison to controls.</p><p><strong>Conclusion: </strong>An increase in total offset, femoral offset, and smoking history are factors associated with LTP after DAA primary THA.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 9","pages":"631-636"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577447","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":"Strategies to Reduce Missed Fracture Diagnoses: Insights from Medical Malpractice Cases in China.","authors":"Xue-Dong Tian","doi":"10.22038/ABJS.2023.76051.3513","DOIUrl":"10.22038/ABJS.2023.76051.3513","url":null,"abstract":"","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 1","pages":"78-79"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693226","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":"Biofilm Related Total Knee Arthroplasty Infection: Prevention, Diagnosis and Treatment.","authors":"E Carlos Rodriguez-Merchan","doi":"10.22038/ABJS.2024.77560.3583","DOIUrl":"10.22038/ABJS.2024.77560.3583","url":null,"abstract":"<p><p>Biofilm related implant infection is undoubtedly a relevant challenge in total knee arthroplasty (TKA) with our comprehension steadily progressing and novel management approaches being developed. The aim of this article was to review the most important advances in approaches to combat infections due to biofilm-forming bacteria in TKA. The main conclusions were the following: 1) Fundamental management techniques for infected TKA include open DAIR (debridement, antibiotics, and implant retention), and one and two-stage revision TKA; 2) Continuous local antibiotic perfusion (CLAP) appears to diminish the risk of periprosthetic joint infection (PJI); 3) Restraint of quorum sensing seems to avert PJI after TKA; 4) A recent in vitro study showed promising results in the prevention and management of PJI after TKA using PMMA [poly(methyl methacrylate)] loaded with up to 100 mg of rifampin.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 7","pages":"531-534"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789366","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":"Outcomes of Megaprosthesis ‎Reconstruction for the Salvage of ‎Failed Osteoarticular Allograft ‎‎Around the Knee implanted before ‎Skeletal Maturity in Primary Bone ‎Sarcoma: A Case-Series.","authors":"Khodamorad Jamshidi, Wael Ammar, Khalil Kargar Shooroki, Alireza Mirzaei","doi":"10.22038/ABJS.2023.74212.3434","DOIUrl":"https://doi.org/10.22038/ABJS.2023.74212.3434","url":null,"abstract":"<p><strong>Objectives: </strong>Functional expectations following the salvage of a failed osteoarticular allograft are poorly described. In this study, we aim to evaluate functional outcomes, implant survival, and complications of the megaprosthesis in salvaging a failed osteoarticular allograft around the knee.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical profiles of 21 skeletally mature patients who underwent megaprosthesis reconstruction to salvage a failed osteoarticular allograft around the knee implanted before skeletal maturity. The location of reconstruction was the proximal tibia in 13 patients and the distal femur in eight patients. Knee function was evaluated by the Musculoskeletal Tumor Society (MSTS) ‎score and the Toronto Extremity Salvage Score (TESS).</p><p><strong>Results: </strong>The mean age of patients was 16±1.7 years. The mean interval between the primary (allograft) and secondary (megaprosthesis) reconstructions was 59.4±23.6 months. At an average follow-up of 51.2 months, the mean knee range of motion was 101.2±15.6°. The mean MSTS score and TESS were 83.6±7 and 86.6±7.9, respectively. The mean limb length discrepancy was 2.5±1 cm before and 0.36±0.74 cm after the operation (P<0.001). Six postoperative complications (28.6%) occurred in this series, including one wound dehiscence, one periprosthetic fracture, two acute infections, one aseptic loosening, and one delayed periprosthetic infection. Only the last two complications required revision. Accordingly, the two- and five-year implant survivals were 95.7% and 90%, respectively.</p><p><strong>Conclusion: </strong>Megaprosthesis is a viable option for salvaging failed osteoarticular allografts around the knee. It also provides the opportunity to correct the limb length discrepancy.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 3","pages":"211-218"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869395","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":"Cantilever Failure of Modular Uncemented Femoral Revision Stem in Patients with Poor Proximal Femoral Support; How to avoid it?","authors":"Rahul Mohan, Nithin Unnikrishnan, Ravindra Gudena","doi":"10.22038/ABJS.2023.75373.3485","DOIUrl":"10.22038/ABJS.2023.75373.3485","url":null,"abstract":"<p><strong>Objectives: </strong>Revision hip arthroplasty is a major surgical challenge and is even more difficult in cases with a deficient proximal femur. Modular uncemented cone body revision femoral stems were introduced as a solution. They have the advantage of optimising joint kinematics by allowing the variable degrees of version, offset and leg length. However, we noticed cantilever failure of such stems, particularly in patients with deficient proximal femoral support. Fatigue fracture of the revision femoral stems should raise questions about its use in patients with insufficient proximal femoral bone support.</p><p><strong>Methods: </strong>We present a case series of five patients with the cantilever failure of Stryker restoration modular stem conical distal femur prosthesis. These cases were identified during a retrospective review of revision hip surgeries performed at our trust.</p><p><strong>Results: </strong>The stem failed after an average of 22.6 months post-revision surgery. Primarily, poor proximal femur bone support with a well-fixed distal stem and secondarily high BMI led to this catastrophic failure in the absence of trauma. All five cases were re-revised to Stanmore proximal femoral replacement and achieved good functional outcomes after an average follow-up of seven years.</p><p><strong>Conclusion: </strong>Proximal femoral bone support should be restored to prevent early cantilever failure of distally fixed proximal modular revision femoral stems. Consider a proximal femoral replacement if we cannot ensure proximal bone support.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 4","pages":"240-244"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877633","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":"Simultaneous High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction in knees with Bony Frontal and/or Sagittal Deformities: Review of the Current Literature.","authors":"E Carlos Rodriguez-Merchan, Carlos Kalbakdij-Sanchez, Carlos A Encinas-Ullan, Ahmed Labib-Zarad","doi":"10.22038/ABJS.2024.78440.3610","DOIUrl":"https://doi.org/10.22038/ABJS.2024.78440.3610","url":null,"abstract":"<p><p>Simultaneous anterior cruciate ligament (ACL) reconstruction (ACLR) and valgus high tibial osteotomy (HTO) alleviates pain in 70% of individuals with ACL deficiency and varus femorotibial osteoarthritis, allows for sustainable stabilization of the knee at the 10-year follow-up and a return to sport (RTS) in 33%-80% of cases, but femorotibial osteoarthritis progression occurs in 39% of cases. The complication rate ranges from 0% to 23.5% (6.5% revision valgus HTO, 17.5% ACL graft failure, 7.7% venous thrombosis). Simultaneous ACLR and HTO leads to satisfactory results in patients with ACL deficiency and varus femorotibial osteoarthritis associated with a high posterior tibial slope (PTS) and appears to have a protective effect on further ruptures in the reconstructed ACL. The younger the patient and the more sporting demands he/she poses, the more we should be inclined to perform a combined intervention (ACLR and valgus HTO).</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 8","pages":"603-607"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11353143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113325","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":"Subtrochanteric Fractures of The Femur: May a Short Nail Be a Reliable Option?","authors":"María Berta Alonso Polo, Claudio Peix, Paula Velasco, Sergio Marcos, Francisco Borja Sobrón, José Cordero Ampuero","doi":"10.22038/ABJS.2024.67182.3194","DOIUrl":"10.22038/ABJS.2024.67182.3194","url":null,"abstract":"<p><strong>Objectives: </strong>Treatment of subtrochanteric fractures of the proximal femur may be challenging due to their anatomical and biomechanical features. Intramedullary nails are the most frequently used devices, although there is no consensus concerning their optimal length. The aim of this study is to compare the functional and radiological outcomes of the fragility subtrochanteric fractures treated with short versus long cephalomedullary nails.</p><p><strong>Methods: </strong>A retrospective cohort study was performed including all over-65-year-old patients that underwent surgery with a cephalomedullary nail between January 2013 to December 2020 due to a subtrochanteric fracture. The primary outcome was the presence of mechanical complications (cut out, cut in, varus consolidation, nonunion and nail breakage). Accuracy of the reduction, distance from the fracture line to most proximal distal screw, operative time and Palmer Mobility score were also analyzed.</p><p><strong>Results: </strong>Ninety-five patients were included. There were not significant differences in complication rate, Parker mobility score nor quality of reduction between both cohorts. Patients with a good radiological reduction presented no complications, those with an acceptable reduction presented a complication rate of 35.5% and it raised to 53.3% in poorly reduced ones (P=0.002). The complication rate was higher in the <5cm distance group (58.33%) than in the >5cm distance group (22.64%) (P=0.014).</p><p><strong>Conclusion: </strong>Anatomical reduction may be the key factor in the management of subtrochanteric fractures, in order to avoid complications. The chosen device working length should also be taken into account to treat these challenging injuries.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 11","pages":"798-804"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030035","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 Presentation of Adults with Traumatic Orthopedic Injuries Enrolled in a Multisite Psychosocial Trial.","authors":"Julia E Hooker, Kate N Jochimsen, Ryan A Mace, James D Doorley, Julie R Brewer, Ana-Maria Vranceanu","doi":"10.22038/ABJS.2024.76953.3559","DOIUrl":"10.22038/ABJS.2024.76953.3559","url":null,"abstract":"<p><strong>Objectives: </strong>Traumatic orthopedic injuries are a top cause of hospital visits in the U.S. The Toolkit for Optimal Recovery (TOR) is a brief mind-body intervention that targets catastrophic thinking and pain anxiety following orthopedic injury. This study examines the baseline presentation of adults with traumatic orthopedic injuries who were enrolled in our recent multisite feasibility RCT of TOR versus usual care at four geographically distinct Level 1 trauma centers. We also examine whether patient presentation varies by site.</p><p><strong>Methods: </strong>We recruited 181 adults (M_age=44.16, SD=16.5) from four Level I trauma centers located in the northeast (Site A; <i>N</i>=63), southwest (Site B; <i>N</i>=44), southeast (Site C; <i>N</i>=44), and southeast (Site D; <i>N</i>=30). At baseline, participants provided information about sociodemographic factors, pain and physical function, and physicians completed the Abbreviated Injury Scale (AIS). Descriptive statistics were used to characterize the sample, and one-way analysis of variance (ANOVA) and Chi-square tests were used to compare variables between sites.</p><p><strong>Results: </strong>The majority of the sample (88.4%) sustained a fracture, and the mean AIS score was 2.31 (<i>SD</i>=0.55). Age, race, sex, gender, occupation, or marital status did not differ across sites (<i>ps</i>>.05). Over half (63%) of the sample was treated surgically, and 28.7% endorsed taking narcotic pain medications. More participants at Sites B (75%) and D (96.7%) received surgery than participants at Sites A (41%) and C (61.4%). More participants at Sites D and B reported narcotic usage than participants at Sites C and A. Participants at Site D demonstrated greater functional impairment than participants at the other sites.</p><p><strong>Conclusion: </strong>Although sites were largely comparable, we did find key differences in surgical management, narcotic use, and functional disability which may have important implications for treatment response. This information will be used to iterate and refine TOR for a future multisite efficacy trial.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 12","pages":"826-834"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885602","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":"Is Preoperative Bevacizumab Associated with Increased Complications After Urgent Hip Fracture Surgery? A Retrospective Review.","authors":"Soheil Sabzevari, Bernadelle Boateng, Jessica A Lavery, Meredith K Bartelstein","doi":"10.22038/ABJS.2024.75222.3478","DOIUrl":"10.22038/ABJS.2024.75222.3478","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether patients with impending or completed fracture of the proximal femur who were treated with bevacizumab in the six weeks prior to surgery are at higher risk of surgical complications than patients given bevacizumab outside of the six-week period.</p><p><strong>Methods: </strong>We retrospectively reviewed cases of hip fracture treated between 1995 and 2020 at our institution. Patients were included if they were age 18 years or older, underwent hip surgery for impending or completed fracture, and received bevacizumab preoperatively but not postoperatively. Charts were reviewed for demographic, surgical, and postoperative details. A Cox model was applied to assess whether the timing of preoperative bevacizumab administration (≤6 weeks vs. >6 weeks) was associated with the risk of a postoperative complication.</p><p><strong>Results: </strong>Two of the 23 patients who received bevacizumab ≤6 weeks before surgery experienced complications (deep vein thrombosis [n=1] and intraoperative fracture related to progression of disease [n=1]). Of the 53 patients who received bevacizumab more than six weeks preoperatively, five experienced complications (wound drainage [n=2] and deep vein thrombosis [n=3]). In the Cox model, timing of bevacizumab was not associated with postoperative complications (univariable hazard ratio, 0.92; 95% confidence interval, 0.18-4.73).</p><p><strong>Conclusion: </strong>In this cohort of patients who underwent surgery for hip fractures, we did not observe an increased risk of postoperative complications among those who received bevacizumab within six weeks of surgery relative to those who received bevacizumab more than six weeks before surgery. The retrospective nature of the study and small sample size are limiting factors in this study.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 9","pages":"645-651"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577049","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":"Effect of Medial Longitudinal Arch Height of the Foot on Static and Dynamic Balance in 7-10-Year-Old Boy Gymnasts.","authors":"Mohammad Seyedahmadi, Karim Khalaghi, Sahar Hazrati, Fahimeh Keavanloo","doi":"10.22038/ABJS.2024.79775.3645","DOIUrl":"10.22038/ABJS.2024.79775.3645","url":null,"abstract":"<p><strong>Objectives: </strong>This research aims to investigate the relationship between the height of the internal longitudinal arch of the foot and the static and dynamic balance of 7-10-year-old boy gymnasts.</p><p><strong>Methods: </strong>This study was descriptive-correlational, and its statistical population included male gymnast students aged 7 to 10 in the city of Gouchan. These gymnasts were screened for flat feet using the Brady test. Ninety gymnasts were purposefully selected based on the Brody test to assess the arch of the foot and were divided into three groups: pronation (n=30), supination (n=30), and normal (n=30). The Flamingo test assessed static balance, and the Y Balance test assessed dynamic balance. The Shapiro-Wilk test was used to check the normality of data distribution, and a one-way analysis of variance was employed to compare the results obtained among the groups. Data analysis was performed using SPSS software (version 21).</p><p><strong>Results: </strong>The results showed a significant difference between static and dynamic balance in male gymnasts with pronation, supination, and natural foot conditions (P=0.001 and P=0.013, respectively). The results demonstrated no significant difference in static balance between gymnastic boys with pronation and suspension (P=0.930); however, there was a significant difference in static balance between gymnastic boys with suspension and those with a natural state (P=0.0001) and between gymnastic boys with pronation and those with a natural state of the foot (P=0.001).</p><p><strong>Conclusion: </strong>Based on the results, gymnastic boys with different arch heights (pronated, supinated, natural) showed static and dynamic balance variations. Boys with pronated or supinated feet had poorer static and dynamic balance than those with natural arches. Based on these results, coaches and corrective movement specialists can help boy gymnasts with different arch heights to optimize their balance performance and reduce the risk of injury.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 12","pages":"846-853"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886161","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}