JBJS Reviews最新文献

{"title":"Medialized vs. Lateralized Reverse Total Shoulder Arthroplasty for Proximal Humerus Fractures: A Systematic Review and Meta-Analysis.","authors":"Kara E Holt, Victoria E Bindi, Timothy R Buchanan, Akshay R Reddy, Abtahi Tishad, Persis Desai, Keegan M Hones, Thomas W Wright, Bradley S Schoch, Joseph J King, Kevin A Hao","doi":"10.2106/JBJS.RVW.24.00160","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00160","url":null,"abstract":"<p><strong>Background: </strong>Reverse shoulder arthroplasty (RSA) is increasingly used in the treatment of proximal humerus fractures (PHFs) with reliable clinical improvement. Lateralized RSA implants have conferred superior outcomes compared with the original Grammont design in patients with nontraumatic indications. However, in the setting of a PHF, lateralized components can place increased tension across the tuberosity fracture site and potentially compromise tuberosity healing and outcomes. This systematic review and meta-analysis sought to determine the effect of implant design on clinical 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 implant manufacturer details. Our primary outcomes included postoperative external rotation (ER), forward elevation (FE), abduction, Constant score, rate of greater tuberosity (GT) healing, and the incidence of complications compared between medialized vs. lateralized global implant design.</p><p><strong>Results: </strong>Globally lateralized RSA cohorts (478 RSAs total with cumulative lateral offset achieved through humeral or glenoid lateralization or both humeral and glenoid lateralization) were found to have a greater mean postoperative Constant score compared with globally medialized (medialized glenoid and medialized humerus) RSA cohorts with 1,494 total medialized RSAs (66 vs. 59, p = 0.006), but there was no significant difference regarding mean postoperative ER (30° vs. 22°, p = 0.078), FE (117° vs. 119°, p = 0.708), or abduction (103° vs. 107°, p = 0.377). On meta-regression, neither implant design nor tuberosity status significantly influenced postoperative ER, FE, abduction, or Constant score on meta-regression independent of mean follow-up and age at surgery. The rate of GT healing was greater in lateralized compared with medialized RSAs (88% vs. 72%, p < 0.001). On meta-regression, medialized RSA design was associated with a 73% lower odds of GT healing (odds ratio = 0.27, 95% confidence interval = 0.11-0.68, p = 0.007) independent of mean follow-up and age at surgery.</p><p><strong>Conclusion: </strong>Lateralized RSA implants conferred no significant functional benefit over medialized implants when used in patients with PHFs.</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":"13 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013760","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":"Knee Pain Is Not Always the Knee.","authors":"Katherine A Lygrisse, Michael A Mont, Giles R Scuderi","doi":"10.2106/JBJS.RVW.24.00182","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00182","url":null,"abstract":"<p><p>» Lumbar spine pathology is a known cause of referred pain to the lower extremities and should be investigated as a possible source of knee pain, especially with patients in their sixth decade.» While primary knee pathology is common, spinal pathology should always be considered in older patients presenting with knee pain, especially in atraumatic cases where knee imaging does not correlate with complaints or examination findings.» Lumbar (L) 3-4 pathology is most commonly affected in referred knee pain, with the 2 most common pathologies being spinal stenosis and disc herniation.» If knee radiographs do not demonstrate major pathology that correlates with a patient's history and examination, a thorough spine examination should then be performed with attention paid to patellar tendon reflex, quadriceps muscle strength, and any loss of sensation, as these can be hallmarks of L3-4 pathology.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013796","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":"Injury-Associated Anemia in Orthopaedic Trauma: A Comprehensive Review.","authors":"Andrea L Landers, Danielle F Peterson, Natasha S McKibben, Catherine E Hutchison, Talia Trapalis, Graham J DeKeyser, Darin M Friess, Zachary M Working","doi":"10.2106/JBJS.RVW.24.00167","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00167","url":null,"abstract":"<p><p>» Anemia is a common comorbidity in orthopaedic trauma patients with important clinical consequences, significantly negatively affecting a patient's course following orthopaedic trauma.» Anemia remains relatively understudied in the orthopaedic trauma population with a large amount of current literature focused solely on geriatric hip fracture patients.» Greater investigation into alternatives to blood transfusions such as iron therapy or cell salvaging for treatment of anemia in the orthopaedic trauma population is needed.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013794","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":"Elevating Orthopaedic Excellence Through Professional Coaching.","authors":"Subin Cho, Sarah Panico, Shreya M Saraf, Mia V Rumps, Mary K Mulcahey","doi":"10.2106/JBJS.RVW.24.00176","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00176","url":null,"abstract":"<p><p>» Increased professional, personal, and emotional stress can have compounding negative effects on physicians, which can be detrimental to teamwork dynamics, workplace environment, productivity, and personal well-being. Orthopaedic surgery, in particular, is a medical specialty that demonstrates high workplace demands, elevated rates of burnout, and low workplace diversity.» Professional coaching can help combat these challenges and facilitate professional success by providing an outlet for discussion and planning toward one's career development and goals. Coaches, generally nonphysicians, are trained and certified to advise and guide physicians in their professional career paths.» There has been demonstrated success in the utilization of professional coaching in various medical specialties and groups, including anesthesiology, primary care, general surgery, and female surgeon organizations.» The purpose of this review is to evaluate existing models of professional coaching to inform its use within orthopaedic surgery as a means of promoting well-being, physician success, and workforce diversity.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013846","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":"Perioperative Management, Complications, and Outcomes of Shoulder Arthroplasty in Patients with Diabetes Mellitus.","authors":"Marissa Viqueira, Ryan D Stadler, Suleiman Y Sudah, Daniel B Calem, Joseph E Manzi, Ryan Lohre, Bassam T Elhassan, Mariano E Menendez","doi":"10.2106/JBJS.RVW.24.00181","DOIUrl":"10.2106/JBJS.RVW.24.00181","url":null,"abstract":"<p><p>» Patients with diabetes mellitus (DM) undergoing shoulder arthroplasty (SA) have a unique risk profile, which must be considered by clinicians.» The presence of DM as a comorbidity is associated with longer length of stay following SA, greater likelihood of nonhome discharge, and a higher rate of 90-day readmission.» Though the incidence is low, patients with DM are at an increased risk of serious postoperative cardiovascular complications, such as pulmonary embolism, venous thromboembolism, and myocardial infarction.» DM has generally been associated with increased risk of postoperative infection. The optimal hemoglobin A1c threshold in patients undergoing SA remains inconclusive. When extrapolating from lower limb arthroplasty, the literature indicates that this threshold is most likely in the range of 7.5% to 8%.» Patients with DM are more likely to require revision surgery after SA and report lower postoperative satisfaction.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013763","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":"Iliopsoas Injections: A Systematic Review of Patient Outcomes and Progression to Surgery.","authors":"Luca Katz, Griffin Feinberg, Victoria Kent, Matthew Quinn, John D Milner, Ramin Tabaddor","doi":"10.2106/JBJS.RVW.24.00162","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00162","url":null,"abstract":"<p><strong>Background: </strong>Iliopsoas injuries are a common cause of anterior hip and groin pain and can be successfully managed with conservative treatment. Corticosteroid and local anesthetic injections can also be offered in conjunction with nonoperative management. Given the variability in reported injection guidelines, composition, and techniques, the purpose of this study was to systematically review the literature to assess progression to surgery and patient outcomes following iliopsoas injections.</p><p><strong>Methods: </strong>Four online databases (PubMed, Cochrane Library, MEDLINE, and Scopus) were searched for studies investigating the outcomes of iliopsoas injections from database inception until January 2024 in accordance with the Preferred Reporting Items for Systematic Meta-Analyses guidelines. Three reviewers screened titles, abstracts, and full-text articles independently and in duplicate. Recorded data included demographic data, patient-reported outcomes, complications, injection traits, and progression to surgery.</p><p><strong>Results: </strong>Six articles were included in the review (follow-up time = 28.6 months). These studies included patients with iliopsoas bursitis, tendinopathy, and snapping hip. Five studies used the iliopsoas bursa as the injection target. All studies used local anesthetics in their injection formulations, with 5 also adding a corticosteroid. In 3 studies, the Numeric Rating Scale improved from preinjection (mean = 7.33) to postinjection (mean = 2.47). Three studies demonstrated an improvement in Harris Hip Score from a mean of 58.49 preinjection to 89.91 postinjection. Following injections, 28.9% (68/235) of patients progressed to surgery, with psoas tenotomy (38.3%, 26/68) being the most common procedure. There were no complications reported in all of the included studies.</p><p><strong>Conclusion: </strong>This study demonstrates that iliopsoas injections are a clinically effective treatment of a variety of pathologies, including bursitis, tendinopathy, and snapping hip, and have a low rate of complications. Physicians should consider using iliopsoas injections in patients whose symptoms are refractory to conservative management, including physical therapy.</p><p><strong>Level of evidence: </strong>Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013790","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":"Endosinotarsal vs. Exosinotarsal Subtalar Arthroereisis in Treating Pediatric Flexible Flat Feet: A Systematic Review and Meta-Analysis of Comparative Studies.","authors":"Ahmed O Sabry, Mohamed K A Genedy, M Hennidi, Mohamed A Shebl, Ahmed Zaky, Osama E M Selim, Menna A Shebl, Mohamed T G Hassan, Osama Almohani, Merna Arid, Amr A Abdelgawad","doi":"10.2106/JBJS.RVW.24.00178","DOIUrl":"10.2106/JBJS.RVW.24.00178","url":null,"abstract":"<p><strong>Background: </strong>Pediatric flexible flatfoot (FFF) is a common condition characterized by the collapse of the medial longitudinal arch, which can lead to pain and functional impairment in a subset of patients. Subtalar arthroereisis (AR) is a minimally invasive procedure that corrects FFF by limiting excessive pronation of the subtalar joint. Two main techniques exist: endosinotarsal AR, which involves placing an implant in the sinus tarsi, and exosinotarsal AR, which uses a screw external to the sinus tarsi. This systematic review and meta-analysis compares the clinical outcomes and complication rates of these 2 techniques.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in Scopus, Web of Science, and PubMed. Only comparative clinical studies comparing endosinotarsal and exosinotarsal AR in pediatric patients with FFF were included.</p><p><strong>Results: </strong>A total of 6 studies involving 791 feet were analyzed. The exosinotarsal group showed a statistically significant improvement in talocalcaneal (Kite) angle (mean difference = -1.14; p = 0.04), although the difference may not be clinically significant. Calcaneal pitch angle analysis revealed no significant difference, but sensitivity analysis favored the exosinotarsal technique when 1 study was excluded (mean difference = -2.21; p = 0.004). Postoperative pain was reported with higher rates in the exosinotarsal group, as well as screw breakage, while the endosinotarsal group had higher rates of implant dislocation.</p><p><strong>Conclusion: </strong>Both techniques effectively treat pediatric FFF, but exosinotarsal AR may offer better structural correction. However, it may be associated with higher rates of pain that tend to recede after 6 months from the operation.</p><p><strong>Level of evidence: </strong>Level II. 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":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910856","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":"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}