JBJS Reviews最新文献

{"title":"Influence of Humeral Component Cement and Bone Grafting on Greater Tuberosity Healing and Functional Outcomes After Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: A Systematic Review and Meta-Analysis.","authors":"Andrew H A Kaiser, Timothy R Buchanan, Victoria E Bindi, Kara E Holt, Akshay R Reddy, Abtahi Tishad, Keegan M Hones, Jonathan O Wright, Thomas W Wright, Bradley S Schoch, Joseph J King, Kevin A Hao","doi":"10.2106/JBJS.RVW.24.00148","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00148","url":null,"abstract":"<p><strong>Background: </strong>Reverse shoulder arthroplasty (RSA) is increasingly used in the treatment of displaced proximal humerus fractures (PHFs) with reliable clinical improvement. However, the preferred techniques for humeral stem fixation are varied and may be influenced by patient and injury characteristics, including bone quality and fracture pattern. This systematic review and meta-analysis sought to determine the effect of humeral component cementing and bone grafting on tuberosity healing rates and functional outcomes after RSA for PHFs.</p><p><strong>Methods: </strong>A systematic review was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane were queried for clinical studies on RSA performed for PHFs that reported on the use of cemented humeral stems and autograft bone. The primary outcome was the rate of greater tuberosity healing between the various techniques. Secondarily, the authors compared clinical outcomes including postoperative external rotation, forward elevation, abduction, Constant score, and the incidence of complications and revision surgery. Outcomes were compared based on the use of an uncemented press-fit stem, a fully cemented stem without bone graft, or a partially cemented stem with humeral head autograft (i.e., black and tan technique).</p><p><strong>Results: </strong>Forty-eight studies reporting on 1,797 RSAs were included (mean patient age, 75 years; follow-up, 34 months; 81% female). Tuberosity healing was highest in the uncemented cohort, then the black and tan cohort, and lowest in the cemented cohort (80% vs. 70% vs. 61%, p = 0.006). No significant differences in postoperative range of motion, Constant score, complication rates, or revision rates were found.</p><p><strong>Conclusion: </strong>Uncemented fixation with a press-fit stem was associated with superior greater tuberosity healing rates; however, functional outcomes and complications did not differ among techniques.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814564","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":"Suture Button Fixation in Shoulder Instability Surgery to Achieve Bone Healing: A Critical Analysis Review.","authors":"Pascal Boileau, Garrett V Christensen, Brendan M Patterson, James V Nepola, Carter M Lane, Maria F Bozoghlian, Xinning Li, Joseph W Galvin","doi":"10.2106/JBJS.RVW.24.00165","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00165","url":null,"abstract":"<p><p>» Suture button fixation has emerged as an effective surgical construct in arthroscopic and open Latarjet and anterior glenoid reconstruction with free autograft bone with high rates of bone block healing.» Biomechanical data suggest that screw and suture button mechanical fixation constructs provide similar load to failure and stability for the Latarjet procedure.» Preliminary bone healing models have identified that flexible fixation may exhibit a higher degree of bone callus maturation, whereas rigid fixation results in excessive callus hyperplasia» Mechanical tensioner use provides consistent tensioning of suture button constructs and improves bone-to-bone healing rates when used for anterior glenoid reconstruction surgery.» Evidence is lacking regarding the reliability of bone-to-bone healing of allografts to native bone with use of suture button constructs.» Suture button fixation provides good short- and mid-term clinical outcomes for the arthroscopic Latarjet and anterior glenoid reconstruction with free autograft bone.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789715","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":"The Role of Virtual Reality in Training Orthopaedic Surgery Residents.","authors":"Tommy Boland, Danae Alexandrou, Elizabeth Yirga, Mia V Rumps, Shreya M Saraf, Mary K Mulcahey","doi":"10.2106/JBJS.RVW.24.00152","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00152","url":null,"abstract":"<p><p>» Virtual reality (VR) is increasingly used across surgical specialties in training, offering a safe, immersive environment for skill development.» Studies show that VR significantly improves surgical performance making it an effective training tool for orthopaedic residents; however, effects may be more pronounced in junior trainees and may not be seen in senior trainees or attendings.» As VR technology evolves, it promises broader applications in surgical training, though further research is needed to establish its superiority over traditional methods.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789736","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":"Orthopedic Surgery Meets Serious Illness Care: Palliative Care and Advance Care Planning for the Orthopedic Surgeon.","authors":"Davinder Mand, Donya Mand, Laurel Kilpatrick, Robert A Probe","doi":"10.2106/JBJS.RVW.24.00132","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00132","url":null,"abstract":"<p><p>» Advance care planning and palliative care can improve care for orthopedic patients.» The \"surprise question\" is a useful prognostication tool and trigger for palliative care referral.» Engage in routine advance care planning conversations.» Confirm code status before surgery.» Any surgeon can determine capacity and need for a surrogate decision maker.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773572","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":"Management and Outcomes of Metastatic Disease to Intra-articular Synovium, Literature Review.","authors":"Al Yaqadhan Al Kindi, Yayha Al Kindi, Moosa Al Harasi, Al Khalil Al Kindi, Mohammed Al Yahyai, Majid Al Oufi, Humaid Al Farii","doi":"10.2106/JBJS.RVW.24.00127","DOIUrl":"10.2106/JBJS.RVW.24.00127","url":null,"abstract":"<p><strong>Background: </strong>Intra-articular metastatic disease is a rare and unique manifestation of cancer metastasis, often originating from primary tumors such as lung adenocarcinoma, colorectal carcinoma, and malignant melanoma. The clinical symptoms frequently mimic chronic inflammatory arthritis, complicating diagnosis and treatment. This study aims to provide a comprehensive review of the incidence, clinical presentation, management strategies, and outcomes for patients with primary diagnosed cancers that metastasize to intra-articular locations, underscoring the specialized nature of this field.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Medline, and Embase databases in July 2024, yielding 239 articles on intra-articular metastasis in cancer patients. Twenty-one studies met the inclusion criteria after screening. Five reviewers abstracted and analyzed data on patient demographics, metastatic details, diagnostic evidence, treatment modalities, and outcomes.</p><p><strong>Results: </strong>The search yielded 239 articles, from which 21 studies met the inclusion criteria. The patient cohort is 24 cases with a mean age of 58.8 years. Of the 24 patients included, 18 (75%) were males and 6 (25%) were females. Colorectal carcinoma was the most frequent primary tumor (33.3%), followed by lung cancer (25%). The knees were predominantly affected by the metastases. Diagnostic modalities varied; magnetic resonance imaging, arthrocentesis, and biopsy were the most commonly used procedures. Treatment approaches were again varied and included chemotherapy, radiation therapy, and surgery in some instances.</p><p><strong>Conclusion: </strong>Intra-articular metastases, though rare, present significant diagnostic and therapeutic challenges. The clinical manifestations often mimic inflammatory arthritis, complicating timely diagnosis. As underscored by this study, effective management requires a multidisciplinary approach tailored to the patient's primary cancer type and overall health status. This highlights the complexity of the disease and the need for collaborative care. Future research should focus on increasing awareness and early detection to improve patient outcomes.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607004","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":"No Difference in Outcomes, Complications, or Revision Rate for Obese vs. Nonobese Patients Following Hip Resurfacing Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Jean Shanaa, Shaheryar Asad, Guneet S Bindra, Robert Augustynski, Scott Marwin","doi":"10.2106/JBJS.RVW.24.00133","DOIUrl":"10.2106/JBJS.RVW.24.00133","url":null,"abstract":"<p><strong>Background: </strong>Hip resurfacing arthroplasty (HRA) offers numerous benefits over total hip replacements such as increased preservation of natural bone, improved range of motion, and lower dislocation risks. However, patient selection is crucial, with factors such as bone quality, activity level, and body mass index (BMI) playing significant roles. Obesity in particular poses challenges, potentially increasing mechanical load on the joint, complicating surgical techniques, and affecting both immediate and long-term outcomes. The aim of this systematic review was to evaluate outcomes of HRA in obese vs. nonobese patients to determine if obesity should be considered a contraindication to HRA or if similar treatment approaches can be applied.</p><p><strong>Methods: </strong>A literature search was conducted using PubMed, Embase, and Scopus databases with specific search terms related to HRA and obesity. Articles were screened by title and abstract, followed by full-text review. Data extraction focused on demographic and study variables such as sex, age, BMI, complication and revision rates, and patient-reported outcomes. A meta-analysis was performed using a random-effects model to compare University of California Los Angeles (UCLA) scores, Harris hip scores, complication rates, and revision rates between obese and nonobese patients, with significance set at p < 0.05.</p><p><strong>Results: </strong>From an initial pool of 39 articles, 4 met inclusion criteria, encompassing 1,385 patients. Analysis revealed a pooled mean age of 50.92 years and a complication rate of 9.83% in obese vs. 4.7% in nonobese patients. Revision rates were 1.15% for obese and 3.70% for nonobese patients. The difference in postoperative UCLA scores, complication rates, and revision rates were deemed not statistically significant.</p><p><strong>Conclusion: </strong>The comparability in patient-reported outcomes, complication rates, and revision rates between obese and nonobese cohorts suggests that although heightened vigilance and tailored approaches may be warranted in obese patients, obesity alone should not preclude patients from undergoing HRA. These findings advocate for a more nuanced approach to patient selection, emphasizing individualized assessment over generalized BMI cutoffs. Future HRA research should focus on long-term follow-up and larger cohort studies to further validate these results.</p><p><strong>Level of evidence: </strong>Level III, systematic review of Level II and III studies. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607008","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":"Concomitant Arthroscopic Superior Labral and Rotator Cuff Repair: A Systematic Review.","authors":"Dana G Rowe, Eoghan T Hurley, Mikhail A Bethell, Tom R Doyle, Alex M Meyer, Samuel G Lorentz, Christopher S Klifto, Brian C Lau, Jonathan F Dickens","doi":"10.2106/JBJS.RVW.24.00138","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00138","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to systematically review the literature on concomitant repair of superior labral and rotator cuff tears, in light of the paucity of published clinical evidence.</p><p><strong>Methods: </strong>A Preferred Reporting Items for Systematic Reviews and Meta-Analyses compliant search of PubMed, Embase, and Cochrane Library databases was performed for clinical studies of patients undergoing combined repairs of the rotator cuff and superior labrum.</p><p><strong>Results: </strong>Ten studies comprising 241 shoulders were included, with a mean age of 52.6 years and mean follow-up of 29.0 months; 67.9% were male patients. Functional outcomes included the mean postoperative American Shoulder and Elbow Surgeons Standardized Shoulder Score of 88.6, University of California at Los Angeles Shoulder Score of 30.6, constant score of 90.4, Simple Shoulder Test score of 8.6, and visual analog scale score of 1.1. Range of motion outcomes demonstrated mean postoperative forward flexion of 159°, external rotation of 68°, and internal rotation of 17°. The overall return-to-play rate was 76.8%, with 67.9% returning to preinjury level. The overall complication rate was 4.1% with an 18.9% rate of rotator cuff retear and 2.4% reoperation rate.</p><p><strong>Conclusion: </strong>Arthroscopic concomitant repair of superior labral and rotator cuff tears results in good functional outcomes and range of motion, along with a low reoperation rate. Among athletes, there are moderate rates of return but lower rates of return to the same level of play.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584320","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":"Current Concepts in Orthobiologics for Achilles Tendon Injuries: A Critical Analysis Review.","authors":"Varun Gopinatth, Tanya Boghosian, Julia M Perugini, Matthew V Smith, Derrick M Knapik","doi":"10.2106/JBJS.RVW.24.00144","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00144","url":null,"abstract":"<p><p>» Platelet-rich plasma and hyaluronic acid are low-risk and potentially high-reward treatments for Achilles tendinopathy, although clinical studies have yielded mixed results with questionable methodological quality» Case series and reports have reported that bone marrow aspirate, stem cells, and amniotic membrane products can improve functional outcomes, alleviate pain, and facilitate return to sport and activities, but high-level evidence studies are lacking» Exosomes are a promising novel biologic with laboratory studies showing improved collagen organization and cell proliferation, greater tendon mechanical properties, and prevention of extracellular matrix breakdown.» Standardization of protocols with clear reporting is necessary for future studies evaluating orthobiologic therapies for Achilles tendon injuries.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584323","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":"Comparison of Implant Placement Accuracy Between Manual, Robot-Assisted, Computer-Navigated, Augmented Reality Navigated, Patient-Specific Instrumentation, and Accelerometer Navigated Total Hip Arthroplasty: A Systematic Review and Network Meta-Analysis.","authors":"Takanori Miura, Norio Yamamoto, Akihiro Shiroshita, Takahiro Tsuge, Akihiro Saitsu, Junya Yoshitani, Shuri Nakao, Ken Takami","doi":"10.2106/JBJS.RVW.24.00120","DOIUrl":"10.2106/JBJS.RVW.24.00120","url":null,"abstract":"<p><strong>Background: </strong>Malpositioning of the acetabular cup during total hip arthroplasty (THA) can lead to complications. Robotic surgery and navigation techniques aim to address this issue, but there is limited evidence regarding which method can achieve better clinical outcomes. Therefore, this network meta-analysis (NMA) aimed to compare the efficacy of various navigation methods.</p><p><strong>Methods: </strong>This NMA of prospective randomized controlled trials compared robot-assisted systems (RAS), computer-assisted navigation systems (CAS), augmented reality-based portable navigation (AR), patient-specific instrumentation (PSI), portable accelerometer-based navigation (PN), and conventional methods (C) for THA procedures. We searched MEDLINE, EMBASE, Cochrane, Central Register of Controlled Trials, International Clinical Trials Platform Search Portal, and ClinicalTrials.gov. databases. The primary outcomes included revision surgery and postoperative clinical scores, and the secondary outcomes encompassed cup placement accuracy, acetabular cup placement outliers from the Lewinnek safe zone, surgical time, and complications. We used a Bayesian random-effects NMA, and confidence of evidence was assessed using confidence in NMA.</p><p><strong>Results: </strong>We identified 45 studies including 2,122 patients. We did not find large differences in revision surgery, clinical outcome scores, cup inclination, or anteversion angle accuracy among the modalities. AR, CAS, and PSI exhibited a lower risk of outliers from safe zones than C. In addition, RAS and CAS had a longer surgical time than C.</p><p><strong>Conclusions: </strong>Robotic and navigation tools did not reduce the revision risk or enhance clinical outcomes. AR, CAS, PSI, and PN may decrease the risk of cup placement outliers in safe zones. However, the cup placement accuracy was equivalent, and the surgical time may be longer in RAS and CAS than in C.</p><p><strong>Level of evidence: </strong>Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584307","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":"An Update on Spinal Cord Injury and Current Management.","authors":"Austin H Carroll, Edward Fakhre, Alejandro Quinonez, Oliver Tannous, Addisu Mesfin","doi":"10.2106/JBJS.RVW.24.00124","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00124","url":null,"abstract":"<p><p>» Spinal cord injury is associated with increased lifelong cost and decreased life expectancy.» Current treatment guidelines have been limited to studies of small effect sizes and limited availability of randomized control trials.» Recovery is best correlated with the initial American Spinal Injury Association impairment scale grade with A and B less likely to recover regarding ambulation as compared with C and D grades.» Surgical intervention within less than 24 hours, especially in the cervical spine, has been associated with some motor improvement.» The use of mean arterial pressure goals and steroids to maintain perfusion and decrease secondary injury requires further study to elucidate clearer evidence-based results.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510282","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}