JBJS Reviews最新文献

{"title":"Myths and Facts About Allograft Use in Anterior Cruciate Ligament Reconstruction: A Detailed Review of the Literature.","authors":"Benjamin R Paul, Joey Robaina, Romir Parmar, Thomas Carter, Anup Shah","doi":"10.2106/JBJS.RVW.25.00013","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00013","url":null,"abstract":"<p><p>» Patient-Specific Graft Selection: Graft selection for anterior cruciate ligament reconstruction (ACLR) requires a nuanced approach that considers various patient-specific factors, such as age, activity level, comorbidities, and surgical goals. Generally, allografts are preferred for older patients with less active lifestyles, whereas autografts are more suitable for younger, active patients because of autografts' lower retear rates.» Impact of Sterilization Techniques: Sterilization and processing techniques significantly affect the biomechanical properties and outcomes of allografts. While high-dose irradiation reduces allograft strength and compromises healing, low-dose irradiation or nonirradiated grafts offer superior biomechanical and clinical outcomes. However, standardized sterilization protocols are yet to be established.» Comparative Outcomes of Allografts and Autografts: Evaluating the literature on allografts vs. autografts in ACLR remains challenging because of the significant variability in patient characteristics, outcome measures, graft strength testing, and sterilization techniques across studies.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050174","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":"When Is It Safe for Patients to Air Travel After Total Hip and Knee Arthroplasty: A Comprehensive Review.","authors":"Khaled A Elmenawi, Janita Basit, Ignacio Pasqualini, Shujaa T Khan, Neil Nero, John P McLaughlin, Jorge Manrique, Nicolas S Piuzzi","doi":"10.2106/JBJS.RVW.25.00014","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00014","url":null,"abstract":"<p><p>» Despite many patients traveling by air for total hip arthroplasty (THA) and total knee arthroplasty (TKA), there are limited data to guide recommendations for air travel after these procedures.» It is unknown whether the timing of postoperative air travel contributes to the risk of developing venous thromboembolism (VTE) after THA and TKA.» The existing limited data do not suggest a difference in VTE risk between those who did and did not travel by air after THA and TKA surgery, mostly within 7 days.» As more patients travel by air seeking THA and TKA, there is an increasing need for a thorough evaluation of associated risks. This assessment should account for patient-specific risk factors, duration of air travel, and the timing of flights in relation to the postoperative period to ensure optimal safety and outcomes.» There is no consensus on the ideal VTE prophylaxis for patients who travel by air after THA and TKA. However, long-haul flights (>4 hours) are associated with a higher VTE risk and are likely to require stronger prophylactic measures.» Some airlines and regulatory agencies may enforce regulations for passengers who travel by air soon after THA and TKA. Patients may be asked to present proof of medical clearance from the treating surgeon before boarding the airplane in addition to being on appropriate VTE prophylaxis.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019631","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":"Increased Operative Time yet Enhanced Accuracy in Computer-Assisted vs. Mechanical Hip Resurfacing Arthroplasty: An Updated Systematic Review and Meta-Analysis.","authors":"Jean Shanaa, Shaheryar Asad, William Mitchell, Malik Oda, Akash Pathak, Scott Marwin","doi":"10.2106/JBJS.RVW.24.00202","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00202","url":null,"abstract":"<p><strong>Background: </strong>Hip resurfacing arthroplasty (HRA) is considered a highly complex procedure, requiring advanced specialization and training beyond that of conventional total hip arthroplasty (THA). With the advent of computer-assisted navigation in HRA, some surgeons have adopted this technology to improve accuracy, whereas others continue to rely on traditional mechanical jig techniques. This study aims to assess radiographic positioning data and clinical outcomes to evaluate the effectiveness of computer-assisted navigation in HRA.</p><p><strong>Methods: </strong>A literature search was conducted using PubMed, Embase, and Scopus databases with specific search terms related to HRA, computer navigation, and outcomes. Data extraction focused on demographic and study variables such as complication rates, radiographic data, and patient-reported outcomes. A meta-analysis was performed using a random effects model to compare operative time, odds of complications, and odds of outliers between patients undergoing HRA with and without the use of computer-assisted navigation. Statistical significance was defined as a 95% confidence interval that does not include one.</p><p><strong>Results: </strong>From an initial pool of 223 articles, 13 met inclusion criteria, encompassing 1,287 patients. Analysis revealed a complication rate of 5.29% for the mechanical group vs. 3.35% for the navigation group. Outlier rates were 31.96% for the mechanical group and 8.76% for the computer-assisted group. The average operative time was 110.95 minutes for procedures using navigation compared with 101.16 minutes for traditional HRA. Meta-analysis revealed no statistically significant difference in overall complications. However, the navigation-based HRA cohort demonstrated a significantly lower likelihood of prosthetic placement outliers and a longer operative time.</p><p><strong>Conclusion: </strong>As reported over a decade ago by Liu et al., the use of navigation continues to result in a more accurate prosthetic positioning. Unfortunately, no significant difference was found in clinical outcomes. Future research is needed to demonstrate that the increased accuracy offered by navigation translates into superior postoperative outcomes. Such evidence could advocate for a complete transition from mechanical techniques to computer-assisted navigation as the standard approach for HRA.</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":"13 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056397","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":"Augmentation Techniques for Rotator Cuff Repairs.","authors":"Thomas M Hoffmeister, Patrick J Denard, Robert Z Tashjian, Paul M Sethi","doi":"10.2106/JBJS.RVW.25.00007","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.25.00007","url":null,"abstract":"<p><p>» Despite enhanced understanding of risk factors for failure and enhanced surgical repair techniques, the risk for failure of the rotator cuff to heal after surgery is still substantial.» A patient-specific approach to augmentation is essential, with decisions based on tear and patient characteristics.» Augmentation can improve repair strength and promote cellular infiltration, which collectively contribute to better healing outcomes.» Augmentation strategies may improve outcomes in rotator cuff repairs, particularly in high-risk cases; however, there is a lack of consensus among surgeons on the most effective strategies for each scenario.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030325","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":"Femoroacetabular Impingement: Critical Analysis Review of Current Nonoperative Treatments.","authors":"Malik E Dancy, Victoria Oladipo, Prince Boadi, Angela Mercurio, Andrew S Alexander, Mario Hevesi, Aaron J Krych, Kelechi R Okoroha","doi":"10.2106/JBJS.RVW.24.00211","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00211","url":null,"abstract":"<p><p>» Femoroacetabular impingement (FAI) is the premature contact of the femoral head-neck junction with the superior acetabular rim during hip range of motion, which may further damage intra-articular soft tissue structures and lead to the accelerated development of osteoarthritis.» FAI syndrome is diagnosed by a triad of symptoms, clinical signs, and imaging findings, and is a common cause of hip pain in young patients that have a significant impact on patient hip-related function and quality of life.» The treatment of FAI syndrome begins with noninvasive nonoperative modalities such as patient education and supervised exercise-based physical therapy. For recalcitrant symptoms, various injections have been explored for both diagnostic and therapeutic purposes; however, the efficacy of these interventions have generally not been demonstrated outside of the short term» In this article, we examine the available literature regarding the nonoperative treatment of FAI and provide insight into the effectiveness of current treatment modalities.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020150","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":"Team Approach: An Interdisciplinary Framework for Weight Loss Before Total Joint Arthroplasty Surgery.","authors":"Tiffany Lee, Nihar Pathare, Shawn Okpara, Abdullah Ghali, Melvyn A Harrington, Joseph R Young","doi":"10.2106/JBJS.RVW.24.00002","DOIUrl":"10.2106/JBJS.RVW.24.00002","url":null,"abstract":"<p><p>» Obesity is a public health concern, with 41.9% of the US population classified as obese. Obesity increases the risk of chronic disease, type II diabetes, cardiovascular diseases, etc., leading to increased morbidity and mortality. Obesity has been identified as an independent risk factor of postoperative complications, including infection and impaired wound healing, following elective surgery. In total joint arthroplasty, it has been well elucidated that obese patients are predisposed to higher rates of postoperative complications, longer hospital stays, and increased cost of stay.» Obesity is influenced by the interplay between many societal, behavioral, and socioeconomic factors and requires a multidisciplinary approach to treatment. The patient's care team should be well versed in nutritional counseling, behavioral health counseling, medication management, and surgery to allow for a comprehensive approach.» Orthopaedic surgeons, dietitians, nutritionists, weight-loss physicians, and bariatric surgeons all play a critical role in treating this patient population. This review highlights the roles of these practitioners in developing an interdisciplinary framework to help patients with hip and knee arthritis lose weight before joint replacement surgery. Not only will this afford more patients the quality-of-life benefits that come with a hip or knee replacement but will also serve to decrease the complication rates associated with this patient cohort.» The aim of this review was to educate orthopaedic surgeons on various strategies that can be used to best optimize these patients for successful joint replacement surgery.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701815","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":"High-Tensile Strength Suture Materials in Orthopaedics.","authors":"Naga Suresh Cheppalli, Sreenivasulu Metikala, Prabhudev Prasad Purudappa, Geneva Tranchida, Daniel C Washer","doi":"10.2106/JBJS.RVW.24.00193","DOIUrl":"10.2106/JBJS.RVW.24.00193","url":null,"abstract":"<p><p>» High-tensile strength suture materials (HTSSMs) have significantly advanced the field of orthopaedic surgery by providing superior strength, enhanced handling characteristics, and improved durability compared with first-generation sutures.» These sutures are critical for ensuring repair integrity during the healing process of tendon-to-bone or tendon-to-tendon constructs.» While second-generation HTSSMs such as FiberWire, Orthocord, and Force Fiber offer higher tensile strength, better knot security, and reduced creep, their mechanical and biological properties vary, making it essential for surgeons to tailor their choice based on the tissue type, surgical technique, and patient-specific factors.» The incorporation of advanced materials such as ultra-high molecular weight polyethylene and innovative designs such as core-plus-braid configurations has further minimized risks of failure from abrasion, knot slippage, or tissue cut through.» Despite these advancements, challenges such as potential tissue irritation, granuloma formation, and suture cutout remain. Selecting the appropriate HTSSM involves balancing mechanical strength with handling properties and biological responses.» Flat sutures distribute load more evenly and are less prone to tissue cutout, making them ideal for delicate tissues, while round sutures offer better abrasion resistance in high-stress repairs.» In addition, understanding key properties such as stiffness, creep, and knot security can help optimize outcomes and minimize complications.» Surgeons should remain vigilant about the trade-offs associated with material coatings and knot volume, as these factors can influence both repair success and postoperative tissue health.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701809","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":"Intertrochanteric Fractures in the Elderly Treated with Different Intramedullary Devices: A Systematic Review and Meta-Analysis Based on Comparison Studies.","authors":"Noah David Miller, Thomas Cho, Laya Gokula, Jiayong Liu","doi":"10.2106/JBJS.RVW.24.00203","DOIUrl":"10.2106/JBJS.RVW.24.00203","url":null,"abstract":"<p><strong>Background: </strong>Intertrochanteric fractures in the elderly present significant management challenges, with intramedullary (IM) nails increasingly used for fixation. However, the optimal implant type remains debated. Third-generation IM nails, including proximal femoral nail antirotation (PFNA), Gamma 3 (G3), and Intertan (IT), feature helical blades, single lag screws, and dual integrated lag screws, respectively. This meta-analysis evaluates functional outcomes, healing status, and complication rates of intertrochanteric fractures treated with these devices.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted using PubMed, Embase, CENTRAL, and Google Scholar until November 2024. Randomized controlled trials (RCTs) and observational comparative studies involving patients older than 65 years were included. Outcomes assessed functional scores, healing status, and complications.</p><p><strong>Results: </strong>Twenty-four studies (6 RCTs, 5 prospective cohort studies, and 13 retrospective cohort studies) involving 2,999 patients were analyzed. The G3, IT, and PFNA groups included 617, 1,124, and 1,258 patients, respectively. Results showed similar functional recovery across devices. Perioperative parameters favored PFNA, while IT demonstrated lower complication and revision rates. No outcomes favored G3, suggesting it is interchangeable with other devices. PFNA was easier to use and required shorter operation times but had higher cutout and revision rates. IT, despite longer operation times, promoted faster fracture healing and had fewer complications. G3 did not outperform other devices in any measured outcome.</p><p><strong>Conclusion: </strong>PFNA, G3, and IT provide comparable functional outcomes and overall complication rates, making device selection largely dependent on surgeon preference. However, IT may be the superior choice for complex fractures requiring more excellent stability due to its lower complication and revision rates. This analysis highlights the importance of tailoring implant selection to individual patient needs and fracture complexity.</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":"13 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701813","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":"Postoperative Foot Drop After Spinal Surgery: Etiology, Presentation, and Management Strategies.","authors":"Bryce A Basques, Alejandro Perez-Albela, John Hanna, Ashley Knebel, Mohammad Daher, Manjot Singh, Eren O Kuris, Alan H Daniels","doi":"10.2106/JBJS.RVW.24.00191","DOIUrl":"10.2106/JBJS.RVW.24.00191","url":null,"abstract":"<p><p>» The incidence of postoperative foot drop after spine surgery is estimated at 3.33%, with higher rates reported in complex procedures such as high-grade spondylolisthesis correction (up to 30%). Risk factors include disc-space distraction, deformity corrections, prolonged surgery, and advanced patient age.» The primary mechanisms of postoperative foot drop include direct nerve trauma, stretch injuries from retraction or distraction, compression from hematomas or implants, and ischemic damage because of disrupted blood flow.» Preoperative counseling, intraoperative precision, appropriate disc space distraction, and careful nerve retraction are key to mitigating the risk of foot drop, with ongoing research needed to standardize preventive and management guidelines.» Treatment strategies are tailored to the underlying cause, ranging from conservative options (physical therapy, ankle-foot orthoses, and functional electrical stimulation) to surgical interventions (hematoma evacuation, implant removal, neurolysis, nerve transfer, and tendon transfer), although outcomes are highly variable.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"13 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736161","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":"Anterior Cervical Discectomy and Fusion vs. Anterior Cervical Corpectomy and Fusion for 2-Level Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis.","authors":"Aman Verma, Anil Kumar, Utsav Anand, Siddharth Sekhar Sethy, Aakash Jain, Vibhor Abrol, Kaustubh Ahuja, Bhaskar Sarkar, Pankaj Kandwal","doi":"10.2106/JBJS.RVW.24.00204","DOIUrl":"10.2106/JBJS.RVW.24.00204","url":null,"abstract":"<p><strong>Background: </strong>Cervical spondylotic myelopathy (CSM) is a common cause of progressive neurological decline in elderly patients, often necessitating surgical decompression. Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are commonly used procedures. However, there is no consensus on the superior approach, particularly in cases involving 2-level CSM.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Cochrane, Scopus, and Embase databases were searched for studies comparing perioperative, clinical, and radiological outcomes of ACDF and ACCF in 2-level CSM. Fourteen studies with 4,449 patients (ACDF: 2,265, ACCF: 2,184) met the inclusion criteria. Outcomes analyzed included operating (OR) time, blood loss, hospital stay, patient-reported outcomes (Neck Disability Index [NDI], Visual Analog Scale [VAS], modified Japanese Orthopaedic Association [mJOA], Odom criteria), radiological parameters, complications, and fusion rates. Statistical analysis was performed using Review Manager 5.4, with heterogeneity assessed using I2 statistics.</p><p><strong>Results: </strong>ACDF was associated with significantly shorter OR time, reduced blood loss, shorter hospital stays, and lower overall complication rates compared with ACCF. Both procedures showed comparable improvements in NDI, VAS, and mJOA scores. ACDF demonstrated superior postoperative cervical alignment, with greater improvements in global and segmental lordosis. Complication rates, including implant-related issues, were higher in the ACCF group, while reoperation and fusion rates were similar.</p><p><strong>Conclusion: </strong>Both ACDF and ACCF significantly improve functional outcomes in 2-level CSM. However, ACDF demonstrated advantages in perioperative outcomes, complications, and cervical alignment. While ACDF is associated with shorter OR time and fewer complications, ACCF may be necessary in cases with extensive disk herniation or other pathologies requiring direct decompression posterior to the vertebral body. Surgical decisions should be individualized based on patient-specific pathology.</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":"13 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701790","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}