JBJS Reviews最新文献

{"title":"Assessment and Management of the Painful Reverse Total Shoulder Arthroplasty.","authors":"Omar Abdalla, Jon Novosel, Chloe Tucker, Toufic R Jildeh","doi":"10.2106/JBJS.RVW.25.00111","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00111","url":null,"abstract":"<p><p>» Reverse total shoulder arthroplasty (rTSA) has become the standard surgical treatment for rotator cuff arthropathy, offering reliable improvements in function and pain relief. However, postoperative shoulder pain remains a complex and clinically significant challenge.» The differential diagnosis of a painful rTSA includes infectious, mechanical, and neurological or immunological complications. Key etiologies include periprosthetic joint infection (0.5%-6.7% incidence, 13.8% of all complications), instability, aseptic loosening (glenoid loosening 2.3%, humeral loosening 1.4%), polyethylene wear, scapular notching (reported as high as 96%), postoperative fractures, neurologic injury (up to 3.6%), and metal hypersensitivity (prevalence of 10%-15% in the general population).» Diagnostic workup requires a structured approach combining clinical examination, radiographic analysis, serologic markers, advanced imaging, and intraoperative assessment when necessary. Several etiologies, particularly infection, metal allergy, and polyethylene wear, may present with overlapping symptoms, necessitating a systematic evaluation.» Management of the painful rTSA is diagnosis-specific and ranges from nonoperative interventions (physical therapy, benign neglect, nonsteroidal anti-inflammatory drugs, corticosteroids, or bracing) to surgical revision procedures such as debridement, component exchange, fracture fixation, or tendon lengthening.» Understanding the biomechanical principles of rTSA design, implant positioning, and soft tissue balance is critical for both prevention and treatment of postoperative pain. While biomechanical innovations have improved joint stability and the efficiency of surrounding soft tissue, the expanding use of rTSA continues to pose challenges for complication rates and long-term outcomes, necessitating clinical vigilance and individualized patient management strategies.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team Approach: Reverse Shoulder Arthroplasty in the Setting of a 4-Part Proximal Humerus Fracture with Vascular Compromise.","authors":"Lindsey G Droz, Alex M Meyer, Matthew J Brown, Hope E Weissler, Chandler A Long, Tina D Tailor, Robert French, Christian A Pean","doi":"10.2106/JBJS.RVW.25.00047","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00047","url":null,"abstract":"<p><strong>Background: </strong>Proximal humerus fractures (PHFs) are increasingly prevalent, particularly in the geriatric population, where they represent a significant burden both individually and societally. Vascular injury, though rare, can have profound implications for management and outcomes. The presence of these concomitant injuries has been shown to be associated with an increased length of hospital stay, total cost, and patient mortality underscoring the critical need for accurate identification of both osseous and vascular injuries to provide appropriate, comprehensive care. Despite extensive research, controversy remains regarding the optimal management of these injuries. Nonoperative management is suitable for fractures meeting specific criteria, while operative options vary based on fracture characteristics, patient factors, and surgeon expertise. The rise in reverse total shoulder arthroplasty (RSA) as a treatment of complex fracture patterns reflects evolving trends in clinical practice.</p><p><strong>Clinical scenario: </strong>This report presents the case of a 76-year-old woman with a complex, 4-part PHF dislocation sustained secondary to a ground-level fall. On examination, she exhibited diminished radial nerve sensation with wrist extension weakness but was otherwise neurovascularly intact. Cross sectional imaging demonstrated significant medialization of an anterior fracture dislocation of the proximal humerus. Computed tomography angiography of the left upper extremity showed a markedly tortuous axillary artery with possible intimal injury, prompting a multidisciplinary approach.</p><p><strong>Treatment approach: </strong>A shared decision-making model led to combination surgical case with vascular and orthopaedic surgery for subclavian artery exposure followed by RSA. Postoperatively, the patient recovered without complication, demonstrating the importance of an individualized, multidisciplinary strategy for managing complex PHF with associated vascular insult.</p><p><strong>Conclusion: </strong>This case highlights the critical role of recognition of potential neurovascular injuries due to traumatic events and coordinated management of osseous and vascular injuries in complex PHF. We also describe a combined surgical approach and interdisciplinary coordination for PHF dislocations with concern for vascular compromise. Glenohumeral fracture dislocations are high-risk injuries where RSA offers predictable outcomes for complex fracture patterns but demands careful consideration in the setting of possible vascular trauma.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Evaluation of Autograft Contamination in Anterior Cruciate Ligament Reconstruction and Its Clinical Impact: A Systematic Review and Meta-Analysis.","authors":"Sai Viswan Thiagarajah, Joshua Henry, Venkat Sivaprakasam, Paul M Sutton, Charalambos P Charalambous","doi":"10.2106/JBJS.RVW.ER.25.00108","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.ER.25.00108","url":null,"abstract":"","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Athlete's Mental Health and Quality of Life After Sports Injuries.","authors":"Waleed Albishi, Fahad Alajlan, Salem Alshehri, Nasser M AbuDujain","doi":"10.2106/JBJS.RVW.25.00123","DOIUrl":"10.2106/JBJS.RVW.25.00123","url":null,"abstract":"<p><p>» Psychological factors significantly influence both the risk and recovery process of sports injuries, with inadequate coping skills and high life stress levels identified as key preinjury risk factors.» Postinjury psychological distress, including symptoms of anger, depression, and anxiety, can hinder an athlete's rehabilitation and prolong recovery time.» Female athletes demonstrate a higher incidence of sports injuries and tend to experience more severe psychological responses after injury compared with male athletes.» Incorporating psychological support and interventions into rehabilitation programs improves outcomes and supports holistic recovery for injured athletes.» Recognizing and addressing mental health as a central component of injury management is essential for optimizing athlete well-being and performance.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126090","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":"Conversion of Unicompartmental to Total Knee Replacement: A Comprehensive Review of Technical Considerations and Surgical Outcomes.","authors":"Alexander Dash, Michael Mastroianni, Richard A Ruberto, Anastasia Gazgalis, Jeffrey A Geller","doi":"10.2106/JBJS.RVW.25.00075","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00075","url":null,"abstract":"<p><p>» Unicompartmental knee arthroplasty (UKA) has seen significant growth and development over the last 15 years with improved outcomes for patients, but many of these patients may require subsequent surgeries to address failure of their UKA.</p><p><p>» There are 3 main strategies for treatment of a failed UKA: (1) revision UKA (rUKA), (2) staging to a bicompartmental knee arthroplasty (sBiKA), and (3) conversion of UKA to total knee arthroplasty (cTKA).</p><p><p>» Each has specific indications and contraindications, but currently, the cTKA is the gold standard for surgical treatment, and the goal of that surgery is to have equivalent outcomes to primary TKA.</p><p><p>» There are several technical difficulties that have historically made this procedure more challenging than primary TKA with the literature showing inconsistent outcomes in terms of equivalence to primary TKA. sBiKA and rUKA are much less frequently used and more rarely represented in the literature.</p><p><p>» Each surgical option has its own drawbacks and unique difficulties, and these surgeries likely do not yield equivalent outcomes to simple primary TKAs yet. There are a number of emerging technologic tools and modern techniques that can be implemented in the hopes of improving outcomes for this cohort of patients and have shown preliminary promise in this area.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Function in Early-Onset Scoliosis: A Literature Review.","authors":"Abigail E Manning, Gregory Redding, Jennifer Bauer, Burt Yaszay, Scott Yang","doi":"10.2106/JBJS.RVW.25.00122","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00122","url":null,"abstract":"<p><p>» Early-onset scoliosis (EOS) causes restrictive lung disease, secondary to deformation of the thoracic cavity, stiffening of the chest wall, and weakening of the respiratory muscles.» Early spinal fusion has been shown to limit thoracic growth and be associated with poor pulmonary outcomes. This has led to the rise of growth-friendly surgical techniques to maximize thoracic growth.» Radiographic improvements occur, but lung functions do not predictably improve in proportion to normal growth after growth-friendly spine surgery for EOS.» Outcome measures in combination with lung function tests should be explored to better define the impact of EOS and its treatments.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kim's Lesion of the Shoulder: A Critical Analysis Review.","authors":"Oliver D Forst, Daniel C Touhey, Edward M Barksdale Rd, Matthew V Smith, Jay D Keener, Derrick M Knapik","doi":"10.2106/JBJS.RVW.25.00126","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00126","url":null,"abstract":"<p><p>» Kim's lesion of the shoulder is characterized by incomplete tearing of the junction between the posteroinferior labrum and the glenoid, with the superficial labral tissue remaining intact, and generally requires arthroscopic evaluation for accurate confirmation.» Kim's lesion represents an under-reported subtype of posterior labral injury and a source of activity-related posterior shoulder discomfort and instability.» Kim's lesions are frequently observed in young, active individuals involved in overhead and contact sports, often resulting from traumatic mechanisms with the shoulder in flexion and adduction, as well as from repetitive microtrauma and overuse.» Patients often present with posterior or posteroinferior instability and discomfort with provocative physical examination maneuvers stressing the posterior labrum, accompanied by pain during activities of daily living and/or sports.» For patients with persistent discomfort and/or instability despite nonoperative management, arthroscopic fixation is generally recommended to restore pain-free mobility and posterior labral stability.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swelling Management in Total Knee Arthroplasty: A Systematic Review.","authors":"Luke McGarry, Jack Kearney, Jessica Rotaru, Rajitha Gunaratne","doi":"10.2106/JBJS.RVW.25.00109","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00109","url":null,"abstract":"<p><strong>Background: </strong>Postoperative swelling is a common complication after total knee arthroplasty (TKA), associated with pain, limited mobility, and delayed recovery. This study aimed to systematically review the literature on interventions that reduce postoperative swelling, categorized into preoperative, intraoperative, and postoperative phases.</p><p><strong>Methods: </strong>A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant search of PubMed, Medline, Embase, and Cochrane databases was performed for clinical studies evaluating interventions to reduce swelling after primary TKA. Data were grouped by intervention timing. Methodological quality was appraised using the Modified Jadad Score, Methodological Index for Non-Randomized Studies, and AMSTAR 2 tools.</p><p><strong>Results: </strong>A total of 140 clinical studies were included, encompassing 7 meta-analyses, 125 randomized controlled trials, and 8 cohort studies. Tranexamic acid (TXA) was the most consistently effective intervention, particularly in repeated or combined regimens. Avoiding or limiting tourniquet (TQ) use, maintaining postoperative knee flexion (30°-90° for 6-72 hours), and applying cryotherapy during the first 2 weeks were consistently associated with reduced swelling. Other promising strategies included prehabilitation, aspirin cessation, cold intra-articular irrigation, mechanical compression, and adjunctive therapies like diosmin, acupuncture, and kinesiotaping. Interventions such as manual lymphatic drainage, continuous passive movement, and static compression bandaging showed inconsistent or no significant effects.</p><p><strong>Conclusion: </strong>Several perioperative strategies reduce postoperative swelling after TKA, with the strongest evidence supporting TXA, TQ minimization, knee flexion, and cryotherapy. These findings should inform the design of multimodal enhanced recovery protocols optimized for swelling management. Future research should prioritize standardized outcome reporting and assess synergistic effects of combined interventions.</p><p><strong>Level of evidence: </strong>Level I, systematic review. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Socioeconomic Deprivation in Orthopaedic Trauma: A Scoping Review.","authors":"Edith G Otalike, Andrew D Firth, Alanna Marson, Emil H Scheimitsch, Gagnier J Joel","doi":"10.2106/JBJS.RVW.25.00087","DOIUrl":"10.2106/JBJS.RVW.25.00087","url":null,"abstract":"<p><p>» There is wide variability in the measurement tools used to assess socioeconomic deprivation status (SDS) in orthopaedic trauma research, including single-item, multi-item, and area-based indices.» Area-based SDS measures are commonly used because they can be readily linked to geographic identifiers in administrative data; however, they are limited by ecological fallacy and may misclassify individual-level socioeconomic status.» The lack of standardization in SDS measurement limits comparability across studies, highlighting the need for core measurement domains to support equity-focused research.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024426","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":"Understanding Burnout in Orthopaedic Surgery Residency: A Guide to Making Impactful Changes.","authors":"Michael M Shipp, Paul D Fadale, Edward Akelman","doi":"10.2106/JBJS.RVW.25.00129","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00129","url":null,"abstract":"<p><p>» Physician burnout is an occupational crisis that consists of emotional exhaustion, depersonalization, and reduced perceived sense of personal accomplishment. It is highly prevalent among orthopaedic surgeons, with the highest rate seen in residents.» Burnout can have a detrimental impact on resident mental and physical health, patient care through medical errors and poor patient interactions, and the healthcare system.» Orthopaedic residency programs should direct resources toward initiatives that can combat burnout and improve well-being through screening, education, cultural changes, and access to physical, social, and mental health resources.» Orthopaedic surgery residents should recognize the signs of burnout and its impact, take responsibility for their physical and mental health, support their peers, collaborate with faculty leadership to identify areas of improvement, and propose tangible solutions that will benefit the residency.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}