JBJS Reviews最新文献

{"title":"Postoperative Weight-Bearing Protocols Following Open Reduction and Internal Fixation of Ankle Fractures: Current Evidence, Controversies, and Future Directions.","authors":"Harjot Uppal, Donald Adams, John Tis, Annunziato Amendola","doi":"10.2106/JBJS.RVW.26.00038","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.26.00038","url":null,"abstract":"<p><p>» Early postoperative weight bearing initiated within approximately 2 weeks after open reduction and internal fixation of ankle fractures appears safe in selected patients with anatomically reduced fractures and rigid internal fixation and has not been shown to increase complication or hardware failure rates compared with delayed weight bearing in available studies. » These findings, however, should be interpreted cautiously, as most studies do not define fixation adequacy, fracture-specific mechanical characteristics, or actual postoperative loading with sufficient rigor, limiting broad generalizability across fracture patterns and implant constructs. » The most consistent benefit of earlier weight bearing is accelerated short-term recovery, including improved early function, reduced pain, and earlier return to work, while medium- and long-term functional outcomes are generally similar by 6 to 12 months. » Postoperative rehabilitation should be individualized based on fracture morphology, quality of reduction, fixation construct, soft-tissue condition, bone quality, and patient-specific factors such as age, comorbidities, and anticipated compliance, rather than on uniform time-based protocols. » Greater caution is warranted for complex fracture patterns, including trimalleolar fractures, posterior malleolar involvement, syndesmotic fixation, osteoporotic bone, and medically high-risk patients, for whom fracture-specific evidence remains limited. » Future studies should prioritize standardized fracture definitions, objective quantification of postoperative loading, and risk-stratified rehabilitation pathways to better identify which patients derive the greatest benefit from earlier weight-bearing strategies.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259987","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 History of US Medical Device Regulation and Current Regulatory Framework.","authors":"Jacob M Gluski, Max Ward, David W Polly, Kali Tileston, Patrick J Cahill, John Ratliff, Cheerag Upadhyaya, Sheng-Fu Larry Lo, Daniel M Sciubba, John M Caridi","doi":"10.2106/JBJS.RVW.26.00071","DOIUrl":"10.2106/JBJS.RVW.26.00071","url":null,"abstract":"<p><p>» The Food and Drug Administration (FDA) was created in the wake of public outcry generated by Upton Sinclair's The Jungle. The FDA gained further regulatory authority following successive public health setbacks in the 20th century. » A full review for a new device is referred to as a premarket approval (PMA), while an application for a device based on a predicate is referred to as a premarket notification (PMN) better known as a 510k. » Both for PMNs and PMAs the costs and timelines typically far exceed the statutory limits imposed by congress, running into years of review and many millions of dollars. » Real-world data (RWD) can now be used to generate evidence for use in regulatory applications; this change will hopefully reduce the cost and time-to-market for new medical devices. » RWD has significant limitations such as bias, confounding, missing data, and privacy concerns that will require the FDA to take a fit-to-purpose approach for applications using RWD.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260015","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":"Prevalence and Risk Factors of Intensive Care Unit Admission Following Joint Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Ali Salmani, Yashar Khani, Iman Elahi Vahed, Omid Bahrami, Sina Hajiaghajani, Alireza Mirahmadi","doi":"10.2106/JBJS.RVW.26.00022","DOIUrl":"10.2106/JBJS.RVW.26.00022","url":null,"abstract":"<p><strong>Background: </strong>Total joint arthroplasty (TJA) is a frequent and safe procedure; however, some patients experience complications requiring intensive care unit (ICU) admission, which increases morbidity, longer hospital stays, and healthcare costs. This study aimed to estimate the pooled prevalence of ICU admission following TJA and identify associated risk factors to aid perioperative risk stratification.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, and Web of Science were systematically searched for studies reporting ICU admission rates and risk factors after TJA. Two reviewers independently performed study selection, data extraction, and quality assessment. A meta-analysis of proportions was used to estimate the pooled prevalence of ICU admissions. Subgroup analyses were performed by surgical site, procedure type, region, and study design. Pooled odds ratios (ORs) for 17 predefined risk factors were calculated using random-effects models. Heterogeneity was assessed using I2 statistics, and publication bias was evaluated with the Egger test.</p><p><strong>Results: </strong>Ninety-six studies were included, and the pooled prevalence of ICU admission was 5.68% (95% confidence interval [CI] 4.24-7.62%, I2 = 99.98%). The strongest predictors of ICU admission were intraoperative vasopressor use (OR 5.03, 95% CI 2.78-9.1), coronary artery disease (CAD) (OR 4.31, 95% CI 2.18-8.55), chronic kidney disease (CKD) (OR 3.09, 95% CI 1.56-6.13), anemia (OR 3.20, 95% CI 1.45-7.06), and revision hip arthroplasty (OR 3.59, 95% CI 2.36-5.46). Age older than 75 (OR 2.81, 95% CI 1.5-5.26) and body mass index >35 (OR 2.42, 95% CI 1.38-4.24) were also associated with increased risk.</p><p><strong>Conclusion: </strong>ICU admission occurs in approximately 5.6% of TJA cases. Major predictors include vasopressor use, revision hip surgery, anemia, CAD, and CKD. These findings provide a foundation for evidence-based perioperative risk assessment and optimized resource allocation.</p><p><strong>Prospero registration code: </strong>CRD42024558273.</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":"14 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260039","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":"Clinical Outcomes and Survivorship After Conversion of Metal-on-Metal Hip Resurfacing to Total Hip Arthroplasty: A Systematic Review.","authors":"Ali Lari, Ali Ashkanani, Mohammed Ashkanani, Lisa C Howard, Warran Wignadasan, Bassam A Masri, Donald S Garbuz, Michael E Neufeld","doi":"10.2106/JBJS.RVW.26.00037","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.26.00037","url":null,"abstract":"<p><strong>Background: </strong>Hip resurfacing arthroplasty was developed for younger active patients to preserve bone stock and facilitate future revision; however, failure requiring conversion to total hip arthroplasty (THA) remains a recognized problem. Outcomes after conversion are variable and influenced by indication and technical factors. This systematic review evaluates survivorship, complications, and functional outcomes after conversion of hip resurfacing to THA.</p><p><strong>Methods: </strong>A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with International Prospective Register of Systematic Reviews. MEDLINE, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature were searched for studies reporting outcomes after revision of hip resurfacing to THA. Eighteen studies met inclusion criteria. Data were extracted on demographics, indications, revision strategy, complications, survivorship, and functional outcomes.</p><p><strong>Results: </strong>Nineteen studies comprising 1,698 patients and 1,719 hips were included. The mean age was 56.0 years, with mean time to conversion of 4.74 years and follow-up of 3.80 years. The most common indications were aseptic loosening (31.4%), adverse reaction to metal debris (ARMD) (27.1%), and femoral neck fracture (23.7%). Femoral only revision was performed in 36% and both components in 64%. The pooled complication rate was 10.5%, most commonly dislocation, infection, loosening, and ARMD. Survivorship ranged from 94.7% to 100% short term, 83.3% to 94.8% midterm, and 69% to 92% at 10 years, with up to 85.3% at 13 years, and was lower in ARMD. Functional outcomes improved, with mean Harris Hip Score increasing from 47.0 to 88.4.</p><p><strong>Conclusion: </strong>Conversion of failed hip resurfacing to THA provides consistent and clinically meaningful improvement in pain and function. However, complication rates remain substantial and long-term survivorship is variable and influenced by the indication for failure. Metal-related pathology and aseptic loosening were associated with less favorable outcomes than mechanically driven failures.</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":"14 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260069","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":"Loss of Reduction Following Nonoperative Management for Distal Radius Fractures: A Prognostic Factor Systematic Review and Meta-Analysis.","authors":"Geoffrey W Schemitsch, Navid Ghaderi, Emma Cooper, Audrey Champagne, Christina Cutler, Robert Koucheki, Darius L Lameire, Diane Nam, Ujash Sheth","doi":"10.2106/JBJS.RVW.26.00052","DOIUrl":"10.2106/JBJS.RVW.26.00052","url":null,"abstract":"<p><strong>Background: </strong>Loss of reduction during nonoperative management of distal radius fractures can lead to delayed operative treatment, malunion, and corrective osteotomy. This study aimed to systematically review and synthesize the available literature on predictors of loss of reduction of distal radius fractures for adult patients undergoing nonoperative treatment.</p><p><strong>Methods: </strong>MEDLINE, Embase, CINAHL, and Cochrane databases were searched from inception to June 9, 2025. Screening, data extraction, risk of bias assessment, and evidence grading were completed in duplicate. Data were pooled using random-effects models with inverse of variance weights to produce summary of effect odds ratios (ORs) with 95% confidence intervals (CIs). Bivariable prognostic factors and coefficients from multivariable models were pooled separately. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation framework.</p><p><strong>Results: </strong>A total of 7,926 citations were screened, and 30 studies (7,495 fractures) met inclusion criteria. In bivariable analyses, 5 predictors demonstrated moderate certainty associations with loss of reduction: dorsal comminution (OR 2.69, 95% CI 1.67-4.32), failure to re-establish volar cortical alignment (OR 3.22, 95% CI 1.93-5.37), prereduction dorsal angulation >20° (OR 1.90, 95% CI 1.04-3.48), displacement beyond acceptable criteria vs minimally displaced fractures (OR 6.15, 95% CI 3.35-11.31), and age older than 60 years (OR 2.24, 95% CI 1.06-4.74, moderate certainty). In multivariable analyses, age older than 60 years (adjusted OR 3.80, 95% CI 1.59-9.10) and prereduction ulnar positive variance (adjusted OR 1.49 per 1-mm increase, 95% CI 1.09-2.06) demonstrated high certainty associations with loss of reduction. The weighted proportion of patients who lost reduction was 43.4% (95% CI 38.7-48.2).</p><p><strong>Conclusion: </strong>Age older than 60 years and increasing prereduction ulnar positive variance demonstrated high certainty associations with loss of distal radius reduction from available multivariable analyses. Further well-designed prognosis studies are needed to better delineate the predictors of loss of reduction with nonoperative management of distal radius fractures.</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":"14 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260023","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":"Clinically Significant Changes in Global Cervical Range of Motion Following Anterior Cervical Discectomy and Fusion: A Systematic Review.","authors":"Rodrigo Saad Berreta, Jeevan Khanuja, Ahmed Benali, Jonathon Wang, Sang Hun Lee, K Daniel Riew, S Tim Yoon, Christopher Martin, Ashish Diwan, Amit Jain","doi":"10.2106/JBJS.RVW.26.00036","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.26.00036","url":null,"abstract":"<p><strong>Background: </strong>There remains no clear consensus regarding expected range of motion (ROM) loss after anterior cervical discectomy and fusion (ACDF) across varying level constructs. This systematic review aimed to evaluate changes in cervical ROM and the correlation between ROM and patient-reported outcomes measures (PROMs) following single-level and multilevel ACDF.</p><p><strong>Methods: </strong>A literature search was conducted across PubMed, Embase, and Scopus databases, spanning from their inception to July 2025, in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria consisted of human comparative studies reporting baseline and postoperative cervical ROM across single and multilevel ACDF. The Methodological Index for Nonrandomized Studies criteria were used to assess study quality. Primary outcome measures consisted of changes in cervical ROM from baseline after surgery. Secondary outcome measures included the modalities used to measure ROM and correlations between changes in changes in ROM and PROMs from baseline to final follow-up.</p><p><strong>Results: </strong>Ten studies (7 Level II, 3 Level III) involving 832 patients (1- to 4-level ACDF) with mean follow-up ranging from 3 to 38 months were included. ROM was assessed through radiographs (5), electromagnetic tracking (2), computed tomography modeling (1), inclinometry (1), and linkage devices (1). In single-level ACDF, sagittal ROM changes ranged from -15.0% to +19.5%, with 6 of 7 studies reporting stable or increased motion. Lateral bending (+20.2% to +23.3%) and rotation (+7.3% to +13.7%) consistently increased on dynamic analysis. In 2-level fusions, sagittal ROM changes ranged from -33.4% to +9.1% (6 decrease, 3 increase). In 3-level to 4-level fusions, changes ranged from -49.1% to +36.4%. Radiographic studies consistently reported ROM reductions in 2+ level fusions, whereas dynamic analyses demonstrated preserved baseline ROM. All studies showed significant improvements in Neck Disability Index and Visual Analogue Scale neck pain, which correlated weakly or nonsignificantly with ROM changes.</p><p><strong>Conclusion: </strong>Single-level ACDF does not significantly reduce cervical ROM from baseline. In multilevel fusions, a discrepancy exists: radiographs show modest reductions, while dynamic motion analyses suggest that baseline ROM is preserved. Dynamic motion analyses provide a more clinically accurate representation of mobility changes following single-level and multilevel fusions.</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":"14 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259992","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":"Reconstruction of the Proximal Tibia and Extensor Mechanism After Tumor Resection: A Systematic Review and Meta-Analysis.","authors":"Angad D S Bedi, Renz J Wierper, Marcos R Gonzalez, Sonia E Ubong, Paul C Jutte, Santiago A Lozano-Calderon","doi":"10.2106/JBJS.RVW.26.00016","DOIUrl":"10.2106/JBJS.RVW.26.00016","url":null,"abstract":"<p><strong>Background: </strong>Proximal tibia reconstruction after tumor resection is technically challenging due to the dual requirement of skeletal stability and extensor mechanism restoration. Multiple reconstruction methods exist, but comparative data on complications, survival, and functional outcomes remain limited. This study aimed to compare complication rates and implant survival across different proximal tibia reconstruction methods (megaprostheses, osteoarticular allografts [OAs], intercalary allografts [ICAs], and allograft-prosthetic composites [APCs]) and to evaluate how extensor mechanism reconstruction technique influences functional outcomes.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and Embase databases were searched through September 2025. Studies reporting outcomes of proximal tibia and/or extensor mechanism reconstruction for oncologic indications were included. Complications were classified using the Henderson system. Random-effects meta-analysis was performed for complication rates, implant survival, and extension lag. Subgroup analyses were performed by reconstruction type.</p><p><strong>Results: </strong>Seventy-eight studies including 2,825 patients were analyzed (mean age 25.9 years, mean follow-up 84.7 months). Prosthetic reconstruction demonstrated the lowest overall complication rate (39.2%, 95% confidence interval [CI] 32%-45%) compared with OAs (69.6%, 95% CI 55%-82%), APCs (52.7%, 95% CI 32%-73%), and ICAs (53.4%, 95% CI 34%-70%) (p = 0.004). Biological reconstructions had significantly higher structural failure rates (OA 31.0%, ICA 24.5% vs. prosthesis 5.5%, p < 0.001). Five-year implant survival showed no significant differences between prosthesis (75.3%), OA (67.4%), and APC (74.3%). At 10 years, survival rates converged across all methods (63%-71%). Extensor mechanism reconstruction technique significantly influenced extension lag: direct tendon-to-metal reattachment (11.0°) resulted in worse outcomes than synthetic augmentation (5.7°), allograft reattachment (4.6°), or autograft reconstruction (2.3°) (p < 0.001).</p><p><strong>Conclusion: </strong>While prosthetic reconstruction offers lower short-term complication rates, long-term implant survival is comparable across reconstruction methods. Extensor mechanism reconstruction technique is a critical determinant of functional outcome. Surgeons should consider techniques beyond simple direct reattachment, particularly synthetic augmentation or biological reconstruction, when feasible to optimize extension function. Individual patient factors should guide selection between prosthetic and biological reconstruction.</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":"14 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036311","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":"Treatment of Greater Tuberosity Fracture: Evidence-Based Strategies for Treatment and Best Practices.","authors":"Tej Joshi, Dario Fucich, Swara R Kalva, Arthur J Perry, Jie J Yao, Mandeep S Virk","doi":"10.2106/JBJS.RVW.26.00013","DOIUrl":"10.2106/JBJS.RVW.26.00013","url":null,"abstract":"<p><p>» Isolated greater tuberosity (GT) fractures account for approximately 20% of all proximal humerus fractures. » Displaced GT fractures can compromise the rotator cuff biomechanics and behave as rotator cuff deficient shoulders, leading to weakness (external rotation and scaption strength), loss of range of motion (elevation, abduction, external rotation), and subacromial impingement. » Most nondisplaced to minimally displaced fractures (<5 mm) can be treated nonsurgically with good outcomes. Secondary displacement of GT fractures is low, but the presence of associated shoulder instability predisposes patients to a higher risk, and thus, these patients should be monitored closely. » Displaced fractures benefit from surgical treatment. A tension band construct or buttressing mechanism is required to neutralize the deforming force of the posterior and superior rotator cuff on fracture fixation. » There is no consensus on the surgical approach (arthroscopic vs. open) and type of fixation (plate, screws alone, suture anchor repair, or hybrid fixation) for the surgical treatment of these fractures. Each fixation option has its own unique profile of advantages and risks, emphasizing the importance of individualized management. » Small (<1 cm) avulsion or depressed type fractures are amenable to arthroscopic treatment with suture anchor repair, with or without screw fixation, resulting in good outcomes. » Open repair is more common in split type fracture patterns or fractures with a large fracture fragment. There is no consensus on the surgical approach (deltopectoral vs. anterolateral or lateral deltoid approach) for open repair.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036283","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":"Team Approach: Diagnosis and Management of Pediatric Pelvic Ewing Sarcoma.","authors":"Zev Karvé, Aditi Dhir, Derek Isrow, Fireneh N Beshah, Andrew E Rosenberg, Emanuela Palmerini, Francis J Hornicek, H Thomas Temple, Brooke Crawford, Erik J Geiger","doi":"10.2106/JBJS.RVW.25.00271","DOIUrl":"10.2106/JBJS.RVW.25.00271","url":null,"abstract":"<p><p>» Pelvic Ewing sarcoma presents unique challenges as pelvic tumors can grow to large sizes before detection and can require complex reconstructionsaffecting long-term functional outcomes. » This review highlights a case of a 10-year-old boy with iliosacral Ewing sarcoma. Throughout, the review details the collaborative approach integrating orthopaedic oncology, radiation oncology, medical oncology, pathology, radiology, and rehabilitation staff that is critical to successful treatment. » Important considerations for therapeutic combinations, timing, and duration are explored for each specialty across a typical treatment timeline.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036338","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":"Carbon Fiber Implants in Spine Surgery.","authors":"Mahmoud N Abu-Alkebash, Charles H Crawford, John R Dimar, Steven D Glassman, Andrew Windhorst, Leah Y Carreon","doi":"10.2106/JBJS.RVW.26.00026","DOIUrl":"10.2106/JBJS.RVW.26.00026","url":null,"abstract":"<p><p>» Traditional metallic implants used in spinal surgery, such as stainless steel, cobalt chrome, and titanium (Ti), can generate artifacts during magnetic resonance imaging and computed tomography, impeding visualization of the adjacent anatomy and impacting clinical decision-making. » Carbon fiber-reinforced polyether ether ketone (CFR-PEEK) spinal instrumentation is now commercially available. The reported benefits include minimal artifact with radiographic imaging while providing similar biomechanical properties when compared with traditional metallic implants. » CFR-PEEK may be beneficial, following spinal separation surgery, by allowing more precise delivery of high-dose therapeutic radiation (stereotactic body radiation therapy) to the remaining tumor margins and avoid overdosing of the spinal cord. » Long-term follow-up is needed to better understand the clinical durability of these newly available implants.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983755","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}