JBJS Reviews最新文献

{"title":"Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty: A Primer for Clinical Practice.","authors":"Ryan C Palmer, Ian A Jones, Peter K Sculco, Charles P Hannon, Yale A Fillingham, Nathanael D Heckmann","doi":"10.2106/JBJS.RVW.24.00107","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00107","url":null,"abstract":"<p><p>» Perioperative corticosteroids are strongly recommended for reducing the incidence and severity of postoperative nausea and vomiting following elective total hip or total knee arthroplasty.» Corticosteroids may reduce postoperative pain and opioid requirements. Similarly, corticosteroids appear to have a neutral-to-positive effect on length of stay, venous thromboembolism, mobility, delirium, acute kidney injury, and bone cement implantation syndrome (i.e., decreased length of stay).» Perioperative corticosteroids may induce hyperglycemia among both diabetic and nondiabetic patients; however, there is no strong evidence indicating that these transient corticosteroid-induced glycemic derangements may increase the risk of postoperative infectious complications.» The dosage and frequency of perioperative corticosteroid administration play a critical role in optimizing postoperative outcomes, with higher doses showing promise in reducing opioid consumption, postoperative pain, and length of stay.» The optimal dosage and frequency of corticosteroids remain unclear; however, the perioperative administration of 8 to 16 mg dexamethasone, or equivalent steroid, appears reasonable and safe in most cases.</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":"142298535","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 Accuracy of Artificial Intelligence Models in Hand/Wrist Fracture and Dislocation Diagnosis: A Systematic Review and Meta-Analysis.","authors":"Chloe R Wong, Alice Zhu, Heather L Baltzer","doi":"10.2106/JBJS.RVW.24.00106","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00106","url":null,"abstract":"<p><strong>Background: </strong>Early and accurate diagnosis is critical to preserve function and reduce healthcare costs in patients with hand and wrist injury. As such, artificial intelligence (AI) models have been developed for the purpose of diagnosing fractures through imaging. The purpose of this systematic review and meta-analysis was to determine the accuracy of AI models in identifying hand and wrist fractures and dislocations.</p><p><strong>Methods: </strong>Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Diagnostic Test Accuracy guidelines, Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched from their inception to October 10, 2023. Studies were included if they utilized an AI model (index test) for detecting hand and wrist fractures and dislocations in pediatric (<18 years) or adult (>18 years) patients through any radiologic imaging, with the reference standard established through image review by a medical expert. Results were synthesized through bivariate analysis. Risk of bias was assessed using the QUADAS-2 tool. This study was registered with PROSPERO (CRD42023486475). Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation.</p><p><strong>Results: </strong>A systematic review identified 36 studies. Most studies assessed wrist fractures (27.90%) through radiograph imaging (94.44%), with radiologists serving as the reference standard (66.67%). AI models demonstrated area under the curve (0.946), positive likelihood ratio (7.690; 95% confidence interval, 6.400-9.190), and negative likelihood ratio (0.112; 0.0848-0.145) in diagnosing hand and wrist fractures and dislocations. Examining only studies characterized by a low risk of bias, sensitivity analysis did not reveal any difference from the overall results. Overall certainty of evidence was moderate.</p><p><strong>Conclusion: </strong>In demonstrating the accuracy of AI models in hand and wrist fracture and dislocation diagnosis, we have demonstrated that the potential use of AI in diagnosing hand and wrist fractures is promising.</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":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141396","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 Proximal Patellar Realignment vs. Medial Patellofemoral Ligament Reconstruction: A Review of the Literature.","authors":"James T Layson, Kenneth Choy, Randy M Cohn, Giles R Scuderi","doi":"10.2106/JBJS.RVW.24.00112","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00112","url":null,"abstract":"<p><p>» Patellar instability is challenging to address, and although there are many surgical options, proximal patellar realignment (PPR) and medial patellofemoral ligament (MPFL) reconstruction are both used-recently, the MPFL reconstruction has become more popularized.» Both procedures have demonstrated similar recurrent dislocation rates and rates of arthritic progression.» PPR is a cost-efficient procedure using just suture alone as compared with MPFL reconstruction, which uses different grafts and methods of fixation.» PPR has demonstrated durable results, with a lower overall complication rate, much of which is caused by the MPFL reconstruction having unique complications due to fixation methods.» The PPR is a beneficial procedure and should still be considered when dealing with patellar instability.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141395","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 Bone Grafting vs. Bone Cement in the Treatment of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis on the Risk of Recurrence in 1,454 Patients.","authors":"Joseph P Costello, Levi M Travis, Jacob Jahn, Juan A Pretell-Mazzini","doi":"10.2106/JBJS.RVW.24.00080","DOIUrl":"10.2106/JBJS.RVW.24.00080","url":null,"abstract":"<p><strong>Background: </strong>Giant cell tumor of bone (GCTB) presents a challenge in management due to its invasive nature and propensity for local recurrence. While either bone grafting (BG) or bone cement (BC) can be utilized to fill defects after intralesional curettage, the optimal treatment remains contested. The purpose of this study was to examine the impact of defect filling with BC compared with BG on recurrence rates in patients with GCTB following intralesional curettage.</p><p><strong>Methods: </strong>A random-effects model binary outcome meta-analysis was performed utilizing recurrence rate for the BC and BG groups to evaluate the risk ratio (p < 0.05 considered significant). There were 1,454 patients included.</p><p><strong>Results: </strong>Intralesional curettage with BG had a recurrence risk ratio of 1.68 (95% confidence interval [CI], 1.22-2.31, p = 0.001) when compared with BC. The overall rate of recurrence for GCTB after intralesional curettage with BC was 20.05% vs. 29.74% with BG (95% CI, 0.17-0.23 vs. 0.26-0.33, p < 0.001).</p><p><strong>Conclusion: </strong>Intralesional curettage with BC for the treatment of GCTB demonstrated lower recurrence rates than intralesional curettage with BG. However, the rates of recurrence remain substantial for both groups, necessitating careful consideration of the benefits and potential pitfalls associated with BC vs. BG when considering salvage options after recurrences.</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":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141397","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":"Choice of Acromioclavicular Dislocation Treatment Should Not Be Influenced by Risk of Development of Acromioclavicular Osteoarthritis: A Systematic Review With Meta-Analysis.","authors":"Roderick J M Vossen, Daniel Verstift, Faridi S Van Etten-Jamaludin, Bryan J Hamans, Michel P J van den Bekerom, Lukas P E Verweij","doi":"10.2106/JBJS.RVW.24.00085","DOIUrl":"10.2106/JBJS.RVW.24.00085","url":null,"abstract":"<p><strong>Background: </strong>It is currently unknown to what degree surgical or nonoperative treatment of acromioclavicular (AC) dislocation influences the development of osteoarthritis (OA). The aim of this study was to evaluate AC OA after surgical and nonoperative treatment for AC dislocations, compare OA prevalence between treatment options, and compare OA prevalence between the injured and contralateral shoulder.</p><p><strong>Methods: </strong>Articles reporting on the prevalence of OA after surgical or nonoperative treatment of an AC dislocation with a minimal 2-year follow-up were included. AC OA presence was extracted for the injured and contralateral shoulder. Treatment categories were defined based on anatomical variation in the reattachment of ligaments: AC fixation, coracoclavicular (CC) fixation, AC and CC fixation, Bosworth screw synthetic graft, tendon graft, and conservative. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.</p><p><strong>Results: </strong>Ninety-four articles were included for qualitative analysis, and 7 articles were included for meta-analysis (n = 3,812; follow-up = 2.0-24.2 years; mean age 37.6 ± 10.4 years). A total of 3,483 patients underwent surgical treatment, and 329 patients underwent conservative treatment. OA prevalence ranged from 6.7%-29.3% between 7 pooled treatment categories. Most included studies had a follow-up <10 years (94%) and OA prevalence increased with time, regardless of treatment option. There was no difference in OA prevalence between the injured and contralateral shoulder (p = 0.120). MINORS scores were varied, ranging from poor to very good.</p><p><strong>Conclusion: </strong>The pooled AC OA prevalence of the 7 treatment categories ranged from 6.7% for the CC fixation surgical group to 29.3% for the conservative treatment group. However, the included studies were predominantly of low quality and had varying follow-up periods, with most having relatively short follow-up durations. No difference in AC OA prevalence was found between the injured and contralateral shoulder. Based on the available evidence, treatment choice for AC dislocation should not be influenced by the potential development of AC AO.</p><p><strong>Level of evidence: </strong>Level IV. 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":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126983","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":"Extended Postoperative Antibiotic Prophylaxis Is Associated with No Clinical Value and Higher Projected Cost Following Adult Spinal Surgery: A Stratified Meta-Analysis and Probability-Based Cost Projections.","authors":"Mohamed E Awad, Nicole A Griffin, Aaron B Epperson, Nicholas A Alfonso, David Ou-Yang","doi":"10.2106/JBJS.RVW.24.00068","DOIUrl":"10.2106/JBJS.RVW.24.00068","url":null,"abstract":"<p><p>» We aimed to determine the cost-effectiveness of different protocols of extended postoperative antibiotic prophylaxis (E-PAP) following adult spinal surgery.</p><p><p>» Both stratified (randomized controlled trials only) and nonstratified (all studies) analyses demonstrated that E-PAP has no significant value in reducing the rate of surgical site infection (SSI), deep SSI, or superficial SSI.</p><p><p>» Notably, the E-PAP protocols were associated with a significant increase in the length of hospital stay, resulting in an additional expenditure of $244.4 per episode for the E-PAP 72 hours protocol compared with PAP 24 hours and $309.8 per episode for the E-PAP >48 hours protocol compared with PAP <48 hours.</p><p><p>» E-PAP does not demonstrate any significant reduction in the rate of SSIs following spine surgery. However, these extended protocols were significantly associated with an increase in the length of hospital stay and higher overall projected costs.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126984","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":"Mitigating the Risk of Instability After Reverse Shoulder Arthroplasty: A Critical Analysis Review of Patient and Surgical Factors.","authors":"Victoria E Bindi, Timothy R Buchanan, Robert J Cueto, Keegan M Hones, Thomas W Wright, Bradley S Schoch, Joseph J King, Kevin A Hao","doi":"10.2106/JBJS.RVW.24.00095","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00095","url":null,"abstract":"<p><p>» Instability and dislocation after reverse shoulder arthroplasty may occur in up to 31% of patients.</p><p><p>» Clinical risk factors for instability include younger age, male sex, increased body mass index, preoperative diagnosis of proximal humerus fracture or rotator cuff pathology, history of instability of the native shoulder or after surgery, and a medical history of Parkinson's disease.</p><p><p>» Patients with rheumatoid arthritis and decreased proximity to the coracoid may also be at greater risk.</p><p><p>» In patients at a high risk of instability, surgeons should consider a more lateralized prosthesis (particularly in patients with an incompetent rotator cuff), repairing the subscapularis (particularly when using a medialized prosthesis), and upsizing the glenosphere (>40 mm in male and 38-40 mm in female patients).</p><p><p>» While potentially useful, less evidence exists for the use of a constrained liner (particularly with a lateralized glenosphere and/or in low-demand patients) and rotating the polyethylene liner posteriorly to avoid impingement.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126985","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 Impact of Social Determinants of Health on the Prognosis of Primary Bone Tumors: A Systematic Review.","authors":"Alireza Ebrahimi, Sahar Hosseini, Saeed Shahabi, Soheil Ashkani-Esfahani, Santiago Lozano-Calderon","doi":"10.2106/JBJS.RVW.24.00071","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00071","url":null,"abstract":"<p><strong>Background: </strong>Although the prevalence of primary bone tumors (PBTs) was reported to be relatively low, they represent a difficult category of tumors for appropriate prediction, prevention, diagnosis, and treatment. Among different factors contributing to the prognosis and treatment outcomes of patients with these tumors, it is assumed that social determinants of health (SDOH) have not been well investigated nor applied in the process of decision making for these patients.</p><p><strong>Methods: </strong>In this systematic review, databases including PubMed, Web of Science, Scopus, Embase, Science Direct, and CINAHL were used. To ensure the quality of the studies and assess them for bias, we used the Methodological Index for Nonrandomized Studies scaling tool. The relevant data were extracted from the included studies and reported.</p><p><strong>Results: </strong>Twenty-five studies were included in our review based on the inclusion criteria. Age, socioeconomic status, education, and employment status; place of living and neighborhood; race and ethnicity; and insurance coverage were found to impact the outcomes and prognosis of PBTs.</p><p><strong>Conclusion: </strong>Literature has shown correlations of various SDOH with the outcomes of PBTs. SDOH are not independent of each other; including and interpreting them in the process of decision making should be in a multifactorial and intercalated manner. We suggest prospective studies on finding the effect of inventing with SDOH through changes in health care policies, educating patients and care providers, improving socioeconomic conditions, and providing better insurance support, on the outcomes of PBTs.</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":"12 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126986","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":"Partial-Thickness Rotator Cuff Tears: Current Concepts.","authors":"Andrew S Bi, Allison M Morgan, Michael O'Brien, Brian R Waterman, Eric J Strauss, Alexander Golant","doi":"10.2106/JBJS.RVW.24.00063","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00063","url":null,"abstract":"<p><p>» Partial-thickness rotator cuff tears (PTRCTs) are a common pathology with a likely high asymptomatic incidence rate, particularly in the overhead athlete.» The anatomy, 5-layer histology, and relationship to Ellman's classification of PTRCTs have been well studied, with recent interest in radiographic predictors such as the critical shoulder angle and acromial index.» Depending on the definition of tear progression, rates of PTRCT progression range from 4% to 44% and appear related to symptomatology and work/activity level.» Nearly all PTRCTs should be managed conservatively initially, particularly in overhead athletes, with those that fail nonoperative management undergoing arthroscopic debridement ± acromioplasty if <50% thickness or arthroscopic conversion repair or in situ repair if >50% thickness.» Augmentation of PTRCTs is promising, with leukocyte-poor platelet-rich plasma having the most robust body of supportive data. Mesenchymal signaling cell biologics and the variety of scaffold onlay augments require more rigorous studies before regular usage.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Cementless Total Knee Arthroplasty: A State-of-the-Art Review.","authors":"","doi":"10.2106/JBJS.RVW.24.00064ER","DOIUrl":"10.2106/JBJS.RVW.24.00064ER","url":null,"abstract":"","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044184","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}