JBJS Reviews最新文献

{"title":"The Seasonality of Childhood Bone and Joint Infection with Focus on Kingella kingae: A Systematic Review.","authors":"Sarah Hunter, Haemish Crawford","doi":"10.2106/JBJS.RVW.24.00149","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00149","url":null,"abstract":"<p><strong>Background: </strong>Seasonal trends in hospitalization for childhood bone and joint infection (BJI) are reported inconsistently. True seasonal variation would suggest an element of disease risk from environmental factors. This review evaluates all reported seasonal variations in childhood BJI, with additional analysis of seasonal trends for diseases secondary to Kingella kingae.</p><p><strong>Methods: </strong>A systematic review of the literature was undertaken from January 1, 1980, to August 1, 2024. Data were extracted on the hospitalization rate by season and/or month. Pathogen-specific studies for BJI secondary to K. kingae were examined separately.</p><p><strong>Results: </strong>Twenty studies met inclusion criteria encompassing 35,279 cases of childhood BJI. Most studies reported seasonal variation (n = 15, 75%). Eight studies specifically considered disease secondary to K. kingae, and all reported more frequent hospitalization in autumn and/or winter. This is in keeping with the role of respiratory pathogens and seasonal viruses in disease etiology for K. kingae BJI. Findings from other studies on the seasonality of childhood BJI were inconsistent. There were reported seasonal peaks in autumn/winter (4 studies), summer/spring (5 studies), or no variation (5 studies). Where microbiologic data were available, Staphylococcus aureus was the primary pathogen. The quality assessment demonstrated confounding and heterogeneous inclusion criteria affecting the seasonal analysis.</p><p><strong>Conclusion: </strong>For childhood BJI caused by K. kingae, there appears to be a higher risk of hospitalization in autumn and/or winter months. This may relate to the seasonal circulation of respiratory viruses. There is currently insufficient evidence to support other forms of seasonal variation. Reported findings are likely affected by regional disease and pathogen characteristics.</p><p><strong>Level of evidence: </strong>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.</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":"142510284","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":"Comparative Efficacy and Safety of Intramedullary Lengthening Nails vs. Alternative Techniques for Femoral Limb Lengthening: A Systematic Review and Meta-Analysis.","authors":"Amirali Azimi, John E Herzenberg, Shayan Roshdi Dizaji, Philip K McClure, Fatemeh-Sadat Tabatabaei, Amir Farbod Azimi","doi":"10.2106/JBJS.RVW.24.00113","DOIUrl":"10.2106/JBJS.RVW.24.00113","url":null,"abstract":"<p><strong>Background: </strong>Limb lengthening procedures are performed for various indications, including limb length discrepancies (LLDs) and short stature. This systematic review and meta-analysis compares the efficacy and safety of the newer motorized intramedullary lengthening nails (MILNs) with the traditional alternative techniques (ATs) for femoral limb lengthening.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search in the Medline, Embase, Cochrane, Web of Science, and Scopus databases, inclusive of all dates through July 1, 2023, and without language restrictions. Factors mediating outcomes included problems, obstacles, complications, total adverse events, healing/consolidation index, time to full weight-bearing, lengthening accuracy, percentage of lengthening goal achieved, and duration of hospital stay. Effect sizes were quantified using STATA 17.0. Statistical algorithms employed were random effects model standardized mean differences (SMDs) for continuous outcomes and log risk ratios (RRs) for dichotomous outcomes, both with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Our meta-analysis included 10 studies comparing MILN with AT: 180 femurs in the MILN group and 160 femurs in the AT group. This was exclusively comprised of retrospective cohort studies. When compared with AT, limb lengthening procedures utilizing MILNs had significantly lower problems (log RR, -1.35; 95% CI, -1.93 to -0.77; p < 0.001), complications (log RR, -0.56; 95% CI, -0.90 to -0.22; p = 0.001), and total adverse events (log RR, -0.69; 95% CI, -1.17 to -0.21; p = 0.005), as well as a superior bone healing index (SMD, -0.80; 95% CI, -1.32 to -0.28; p = 0.003). However, no significant differences were found in obstacles, percentage of lengthening goal achieved, lengthening accuracy, time to full weight-bearing, and duration of hospital stay.</p><p><strong>Conclusion: </strong>Limb lengthening with MILNs vs. AT may offer more favorable patient outcomes, lowering risk for problems, complications, and total adverse events, while optimizing the bone healing/consolidation index. However, the limitation of nonrandomized retrospective studies and high heterogeneity should be acknowledged.</p><p><strong>Level of evidence: </strong>Level II (meta-analysis of cohort studies). See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510283","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":"Metabolic Functions of the Infrapatellar Fat Pad: Implications for Knee Health and Pathology.","authors":"Lee S Chou, James Zhang, Toufic R Jildeh","doi":"10.2106/JBJS.RVW.24.00110","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00110","url":null,"abstract":"<p><p>» Despite being historically viewed as a vestigial structure, the infrapatellar fat pad (IPFP) is now recognized as a metabolically active structure, influencing knee health through cytokine production and metabolic pathways.» With distinct anatomical regions, the IPFP contains diverse cell types including adipocytes, fibroblasts, and immune cells, influencing its functional roles, pathology, and contributions to knee disorders.» The IPFP acts as an endocrine organ by releasing adipokines such as adiponectin, leptin, and tumor necrosis factor α, regulating energy balance, immune responses, and tissue remodelling, with implications for knee joint health.» The IPFP's metabolic interactions with neighboring tissues influence joint health, clinical conditions such as knee pain, osteoarthritis, postoperative complications, and ganglion cysts, highlighting its therapeutic potential and clinical relevance.» Understanding the multifaceted metabolic role of the IPFP opens avenues for collaborative approaches that integrate orthopaedics, endocrinology, and immunology to develop innovative therapeutic strategies targeting the intricate connections between adipokines, joint health, and immune responses.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373240","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":"Generative Artificial Intelligence and Prompt Engineering: A Primer for Orthopaedic Surgeons.","authors":"Amber N Carroll, Lewis A Storms, Chaitu Malempati, Ridah V Shanavas, Sameer Badarudeen","doi":"10.2106/JBJS.RVW.24.00122","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00122","url":null,"abstract":"<p><p>» Generative artificial intelligence (AI), a rapidly evolving field, has the potential to revolutionize orthopedic care by enhancing diagnostic accuracy, treatment planning, and patient management through data-driven insights and personalized strategies.» Unlike traditional AI, generative AI has the potential to generate relevant information for orthopaedic surgeons when instructed through prompts, automating tasks such as literature reviews, streamlining workflows, predicting health outcomes, and improving patient interactions.» Prompt engineering is essential for crafting effective prompts for large language models (LLMs), ensuring accurate and reliable AI-generated outputs, and promoting ethical decision-making in clinical settings.» Orthopaedic surgeons can choose between various prompt types-including open-ended, focused, and choice-based prompts-to tailor AI responses for specific clinical tasks to enhance the precision and utility of generated information.» Understanding the limitations of LLMs, such as token limits, context windows, and hallucinations, is crucial for orthopaedic surgeons to effectively use generative AI while addressing ethical concerns related to bias, privacy, and accountability.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373239","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":"Arthroscopic Management of Moderate-to-Severe Osteoarthritis of the Knee: A Systematic Review.","authors":"Stephanie C Petterson, Jasmine E Brite, Emily S Jelen, Karina H Wang, Melanie M Reyes, Karen K Briggs, Kevin D Plancher","doi":"10.2106/JBJS.RVW.24.00100","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00100","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Total knee arthroplasty (TKA) is the procedure of choice for osteoarthritis of the knee (OAK) when conservative treatment fails; however, high rates of dissatisfaction and poor implant longevity dissuade younger patients from TKA. There is a paucity of evidence that report outcomes and clinical effectiveness of arthroscopic knee procedures in patients with end-stage (grade 3-4) OAK. The purpose of this systematic review was to evaluate the efficacy of arthroscopic treatment for patients with moderate-to-severe (grade 3-4) OAK.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review of the literature was performed with the terms \"Knee,\" \"Osteoarthritis,\" and/or \"Arthroscopic debridement,\" \"Arthroscopic lavage,\" \"Arthroscopic microfracture,\" \"Arthroscopic chondroplasty,\" \"debridement,\" \"lavage,\" \"chondroplasty,\" \"microfracture,\" and/or \"arthroscopy\" in PubMed (MEDLINE), Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases in November 2023 according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Databases were searched for studies that evaluated outcomes (e.g., pain, function, and conversion to TKA) for patients with Kellgren-Lawrence grade 3 to 4 OAK after knee arthroscopy (including debridement, lavage, microfracture, or chondroplasty) at a minimum 6-month follow-up. Percent improvement from preoperative score was the primary outcome measure. Secondary outcome measures included achievement of minimal clinically importance difference and conversion to TKA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine studies (410 knees with grades 3-4 OAK) were included. Arthroscopic debridement and lavage resulted in a 18.8% to 53.1% improvement at short-term follow-up (e.g., 6 months to 3 years) and a 50.0% improvement at long-term follow-up (e.g., 10 years) in knees with grade 3 OAK and a 15.0% to 41.3% improvement at short-term follow-up and a 46.9% improvement at long-term follow-up in knees with grade 4 OAK. Arthroscopic debridement and microfracture resulted in 1.6% to 50.8% improvement at short-term follow-up in knees with grade 3 OAK. No studies included long-term outcomes or evaluated knees with grade 4 OAK after arthroscopic debridement and microfracture. Conversion to TKA after arthroscopic debridement and lavage occurred in 21.9% of patients with grade 3 OAK and in 35.0% of patients with grade 4 OAK at short-term follow-up and in 47.4% of patients with grade 3 OAK and in 76.5% of patients with grade 4 OAK at long-term follow-up. Conversion to TKA after arthroscopic debridement and microfracture occurred in 10.9% of patients with grade 3 and 4 OAK at long-term follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Arthroscopic debridement, lavage, and microfracture can provide short- and long-term symptomatic relief and improvement in function by up to 50.0% in patients with grade 3 to 4 OAK. These procedures may result in fewer patients with grade 3 OAK undergoing TKA compared ","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336852","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 Schroth Method for Pediatric Scoliosis: A Systematic and Critical Analysis Review.","authors":"Anthony N Baumann, Robert J Trager, Omkar S Anaspure, Lorena Floccari, Ying Li, Keith D Baldwin","doi":"10.2106/JBJS.RVW.24.00096","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00096","url":null,"abstract":"<p><strong>Background: </strong>The Schroth method is the most commonly used patient scoliosis-specific exercise paradigm for treating pediatric scoliosis. The aim of this study is to systematically and critically examine the evidence for the Schroth method for pediatric scoliosis.</p><p><strong>Methods: </strong>PubMed, MEDLINE, CINAHL, and Web of Science were searched through April 5, 2024, for articles examining the Schroth method for pediatric scoliosis (<18 years old). Thirteen review questions were created spanning the study aim. Each included article was independently assessed for the level of evidence (I-IV). Research questions were given a grade of recommendation (A, B, C, and I [insufficient]).</p><p><strong>Results: </strong>A total of 29 articles (41.4% Level I, 31.0% Level II, 13.8% Level II, and 13.8% Level IV) met inclusion criteria out of 845 initially retrieved, describing 1,555 patients with scoliosis aged 4 to 18 years. There was grade A evidence that the Schroth method is most commonly used for adolescent idiopathic scoliosis (AIS), can improve the angle of trunk rotation, and is safe; grade B evidence for improvement in posture; and grade I evidence for improvement in Cobb angle, cosmetic deformity, quality of life, ideal treatment parameters, economic value, utility in delaying/preventing surgery, effectiveness in relation to patient characteristics (e.g., skeletal maturity or curve size), and comparative effectiveness to other conservative interventions.</p><p><strong>Conclusion: </strong>While there is good evidence that the Schroth method is commonly and safely used in AIS and can minimally improve the angle of trunk rotation and fair evidence of improvement in posture, there is insufficient evidence regarding multiple important clinical and economic outcomes, such as comparative effectiveness to other conservative interventions and improvement of Cobb angle. Although clinicians may consider the Schroth method as 1 option of several conservative strategies, clinical benefit may be limited, and further high-quality research is needed to evaluate its performance in areas of insufficient evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336853","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":"Ultrasound Diagnosis of Upper Extremity Peripheral Entrapment Neuropathies: A Narrative Review.","authors":"James E Gardner, Hannah Jones, Eric R Wagner, Robert L Bowers","doi":"10.2106/JBJS.RVW.24.00099","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00099","url":null,"abstract":"<p><p>» Diagnostic ultrasound evaluation has become an important adjunct to electrodiagnostic studies in the diagnosis of upper extremity entrapment neuropathy. » For the common median and ulnar entrapment neuropathies, published normative values for nerve cross-sectional area at the wrist and elbow have demonstrated a high degree of diagnostic validity of diagnostic ultrasound. » Expert consensus on best practice for the clinical use of these reference is lacking and should be a logical next step in the deployment of ultrasound for upper extremity neuropathy evaluation.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336854","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":"Cervical Collar Use Following Cervical Spine Surgery: A Systematic Review.","authors":"John F McKeon, Paul M Alvarez, Diego Martinez Castaneda, Uchechukwu Emili, James Kirven, Anthony D Belmonte, Varun Singh","doi":"10.2106/JBJS.RVW.24.00114","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00114","url":null,"abstract":"<p><strong>Background: </strong>The utility and risks associated with the use of cervical collars in the postoperative period after cervical spine surgery have been of debate. The purpose of this study was to systematically review the currently available evidence on the use of cervical collars after cervical spine surgery to assess their impact on outcomes.</p><p><strong>Methods: </strong>A literature search of the PubMed database was performed using keywords \"cervical collar,\" \"anterior cervical discectomy and fusion (ACDF),\" \"posterior cervical decompression and fusion,\" \"laminoplasty,\" \"post-operative orthotic bracing,\" \"cervical decompression,\" and \"cervical orthosis\" in all possible combinations. All English studies with the level of evidence of I to IV that were published from May 1, 1986, to December 3, 2023, were considered for inclusion.</p><p><strong>Results: </strong>A total of 25 articles meeting the inclusion criteria were identified and reviewed. Regarding anterior and posterior fusion procedures, cervical collar use demonstrated improved short-term patient-reported outcomes and pain control. While surgeon motivation for collar use was to increase fusion rates, this is not well drawn out in the literature with the majority of studies demonstrated no significant difference in fusion rates between patients who wore a cervical collar and those who did not. Regarding motion-preserving procedures such as cervical laminoplasty, patients with prolonged postoperative cervical collar use demonstrated increased rates of axial neck pain and decreased final range of motion (ROM).</p><p><strong>Conclusion: </strong>Surgeon motivation for postoperative cervical collar immobilization after completion of fusion procedures is to increase fusion rates and improve postoperative pain and disability despite this not being fully drawn out in the literature. After completion of motion-sparing procedures, the benefits of collar immobilization diminish with their prolonged use which could lead to increased rates of axial neck pain and decreased ROM. Cervical collar immobilization in the postoperative period should be considered its own intervention, with its own associated risk-benefit profile.</p><p><strong>Level of evidence: </strong>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298533","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":"A Comparison of Incisional Dressings and Negative-Pressure Wound Therapy for the Prevention of Infection and Wound Complications After Primary Total Hip and Knee Arthroplasty: A Network Meta-Analysis of Randomized Controlled Trials.","authors":"Charles Gusho, Wayne Hoskins, Elie Ghanem","doi":"10.2106/JBJS.RVW.24.00115","DOIUrl":"10.2106/JBJS.RVW.24.00115","url":null,"abstract":"<p><strong>Background: </strong>Incisional dressings may decrease wound complications and joint infection after total hip and knee arthroplasties (THA; TKA). However, there is no consensus on the superiority of a particular product. This study compared infection and wound complications among randomized controlled trials (RCTs) across various dressing types after primary THA and TKA.</p><p><strong>Methods: </strong>Scopus, Ovid/MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials were queried in May 2024. A frequentist model network meta-analysis of eligible prospective RCTs compared minor and major wound complications and dressing changes using P-scores.</p><p><strong>Results: </strong>Of 3,067 compiled studies, 12 RCTs of 1,939 patients with median (interquartile range) follow-up of 42 (382) days undergoing primary THA (n = 880, 45.4%) or TKA (n = 1,059, 54.6%) with alginate (n = 208; 10.7%), absorbent (n = 236; 12.2%), gauze (n = 474; 24.4%), or hydrofiber (n = 683; 35.2%) dressings or negative-pressure wound therapy (NPWT; n = 338; 17.4%) were included for meta-analysis. Compared with gauze, alginate and hydrofiber dressings were associated with fewer postoperative changes (mean difference [MD], -12.1; 95% confidence interval [CI], -15.08 to -9.09, p < 0.001; MD, -3.5; 95% CI, -6.30 to -0.74, p = 0.013, respectively). In a subanalysis, silver-ion hydrofiber also was associated with fewer changes (MD, -5.0; 95% CI, -5.70 to -4.39; p < 0.001). Overall, there was no statistically significant risk of increased minor nor major wound complications including superficial and deep infections among all dressing types and NPWT compared with gauze.</p><p><strong>Conclusion: </strong>Despite no association between wound complications nor infection risk among various incisional dressings and NPWT vs. gauze, the alginate, hydrofiber, and silver hydrofiber dressings had statistically fewer mean postoperative changes. Future studies are required to assess whether these dressings confer reduced infection risk.</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 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298532","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":"Nuclear Imaging in Orthopaedic Practice: A Critical Analysis Review.","authors":"Alvaro Ibaseta, Ahmed Emara, Ignacio Pasqualini, Benjamin Jevnikar, Ceylan Colak, Oguz Turan, Shujaa T Khan, Matthew E Deren, Nicolas S Piuzzi","doi":"10.2106/JBJS.RVW.24.00090","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00090","url":null,"abstract":"<p><p>» Nuclear imaging techniques, including bone scintigraphy, labeled leukocyte scintigraphy, positron emission tomography (PET), and single-photon emission computed tomography (SPECT) combined with computed tomography (CT), have wide applications in orthopaedics for evaluating trauma, painful total joint arthroplasty, musculoskeletal infection, and orthopaedic oncology.» Three-phase bone scintigraphy is a first-line, highly sensitive nuclear medicine study for evaluating orthopaedic pathology when initial studies are inconclusive. However, its specificity is limited, and findings may be falsely positive for up to 2 years after total joint arthroplasty because of physiologic bone remodeling.» Labeled leukocyte scintigraphy or gallium scintigraphy can improve diagnostic accuracy in patients with a positive bone scan and suspected musculoskeletal or periprosthetic joint infection.» 18-Fluorodeoxyglucose PET/CT demonstrates high sensitivity and specificity for diagnosing bone neoplasms, infections, and metabolic disorders. Emerging PET/magnetic resonance imaging technology offers reduced radiation exposure and greater soft-tissue detail but presents technical and cost challenges.» SPECT/CT provides valuable functional and anatomic detail for characterizing the extent and location of bone pathology, serving as an important adjunct to other imaging modalities.» Ultimately, the choice of nuclear imaging modality should consider the specific clinical context, diagnostic accuracy, impact on management, and cost-effectiveness on a case-by-case basis.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298534","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}