JBJS Reviews最新文献

{"title":"JBJS Reviews 2.0.","authors":"Sanjeev Sabharwal","doi":"10.2106/JBJS.RVW.26.00082","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.26.00082","url":null,"abstract":"","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983765","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":"Evaluating Virtual and Hybrid Mentorship in Orthopaedic Surgery: Perceived Benefits, Challenges, and Impacts in the Post-COVID Era.","authors":"Melissa Romoff, Akhil Chandekar, Ryan Beyer, Michael S Kim, Sultan Baz, Emily S Mills, Don Y Park, Yu-Po Lee, Nitin Bhatia, Sohaib Hashmi, Hao-Hua Wu","doi":"10.2106/JBJS.RVW.26.00014","DOIUrl":"10.2106/JBJS.RVW.26.00014","url":null,"abstract":"<p><p>» Virtual and hybrid mentorship models have transitioned from temporary coronavirus disease 2019 pandemic responses to durable, scalable components of the orthopaedic training curriculum. » Despite high trainee satisfaction, most orthopaedic virtual mentorship programs rely on short-term, self-reported metrics and lack the objective, longitudinal tracking of research productivity or career advancement seen in other specialties. » While virtual pipelines demonstrate the potential to broaden access for underrepresented groups, inconsistent collection of detailed demographic and socioeconomic data limits the assessment of their true impact on diversity. » Neurosurgery and plastic surgery provide instructive models for virtual collaboratives that successfully use standardized expectations and longitudinal outcome tracking to measure success. » To ensure these programs drive equitable change rather than just broader participation, future orthopaedic virtual mentorship programs should incorporate standardized outcome frameworks, mentor perspectives, and longitudinal, multi-institutional follow-up.</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":"147983769","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":"Injectable Peptides in Sports Medicine: A Structured Narrative Review of Evidence, Safety, and Antidoping Implications.","authors":"Alan D Villegas Meza, Michael Nocek, Brendon C Mitchell, Miguel Lizarraga, Mikalyn T DeFoor, Joseph J Ruzbarsky, Johnny Huard, Marc J Philippon","doi":"10.2106/JBJS.RVW.26.00027","DOIUrl":"10.2106/JBJS.RVW.26.00027","url":null,"abstract":"<p><strong>Background: </strong>Injectable peptides are increasingly promoted for musculoskeletal recovery, tissue repair, and performance enhancements; however, clinical adoption has outpaced high-quality evidence and regulatory consensus.</p><p><strong>Purpose: </strong>To summarize contemporary human and translational evidence (January 1, 2020-August 31, 2025) for injectable peptides relevant to orthopaedics and sports medicine, and to clarify safety, product quality, regulatory, antidoping implications, and clinical outcomes.</p><p><strong>Study design: </strong>Structured narrative review.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Embase, and Web of Science were searched (January 1, 2020-August 31, 2025). Eligible studies included randomized controlled trials, prospective human studies, and translational investigations directly applicable to musculoskeletal care; noninjectable formulations and nonmusculoskeletal indications were excluded. Results were synthesized qualitatively; risk of bias for human trials was appraised using standard tools.</p><p><strong>Results: </strong>Five functional peptide classes were identified. Glucagon-like peptide-1 receptor agonists (e.g., semaglutide) are the only class supported by reproducible randomized evidence of symptomatic improvement in knee osteoarthritis, with benefits primarily mediated by clinically meaningful weight loss and putative anti-inflammatory effects, whereas structural cartilage modification remains unproven. Collagen-derived injectable preparations show preliminary postoperative symptom/early recovery benefits in small, single-center prospective human studies. Regenerative peptides (e.g., body protection compound-157 and thymosin derivatives) and growth hormone axis secretagogues (e.g., CJC-1295, ipamorelin, and tesamorelin) remain investigational, with uncertain safety profiles, product quality concerns, and widespread antidoping restrictions.</p><p><strong>Conclusions: </strong>Injectable peptides for sports medicine remain largely experimental. Clinical use should be confined to approved metabolic agents for indicated conditions and to rigorously designed research protocols. Clinicians caring for athletes must counsel patients regarding uncertain efficacy, product quality, safety risks, and antidoping implications.</p><p><strong>Level of evidence: </strong>Level V. See Instructions for Authors for a complete description of levels of evidence.</p><p><strong>Strength of recommendation taxonomy: </strong>Predominantly C.</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":"147983825","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":"Medial Parapatellar vs. Transpatellar Approach in Tibial Intramedullary Nailing: A Systematic Review and Meta-Analysis of Pain and Function.","authors":"Sina Javidmehr, Mohammad Reza Ramezanpour, Omid Bahrami, Yasin Ramezanpour, Mohammad Mahdi Haji Rahim Kashi, Behnaz Behzadi, Arash Sharafat Vaziri","doi":"10.2106/JBJS.RVW.25.00276","DOIUrl":"10.2106/JBJS.RVW.25.00276","url":null,"abstract":"<p><strong>Background: </strong>Tibial intramedullary nailing (IMN) is the standard treatment for tibial shaft fractures, yet anterior knee pain (AKP) remains common, affecting nearly 47% of patients. Despite the reported advantages of suprapatellar techniques, infrapatellar approaches-medial parapatellar (MPP) and transpatellar (TP)-remain the most commonly used methods for tibial IMN. This systematic review and meta-analysis compares MPP and TP approaches regarding pain, AKP incidence, range of motion (ROM), knee function, and fracture healing.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Embase, Scopus, and Web of Science were searched up to November 2024. Randomized clinical trials (RCTs) and comparative observational studies in adults undergoing tibial IMN via MPP or TP approaches were included. Outcomes were AKP incidence, pain intensity, knee function, ROM, and union-related variables. Pooled mean differences (MDs) and risk ratios (RRs) were calculated using random-effects and common-effects models.</p><p><strong>Results: </strong>Twelve cohort studies (782 patients) and 9 RCTs (462 patients) were included. Across cohort studies, MPP was associated with a significantly lower AKP risk at latest follow-up (RR = 0.76 [0.63; 0.90]) and at 6 months. Visual analog scale pain at 3-month postoperative also favored MPP (MD = -1.27 [-1.94; -0.60]) but did not reach the minimal clinically important difference. RCTs demonstrated similar trends toward lower pain and AKP with MPP, but without statistical significance. Functional outcomes and ROM generally favored MPP across both study designs, though findings were inconsistent and unsuitable for pooling. Fracture healing and union rates were comparable between approaches.</p><p><strong>Conclusion: </strong>The MPP approach for tibial IMN was linked to a lower incidence of AKP compared with the TP approach, while offering comparable or better functional outcomes, ROM, and pain intensity. These findings suggest MPP as the preferred infrapatellar approach in appropriate clinical settings. Nonetheless, high-quality studies with standardized outcome measures are essential to validate these findings.</p><p><strong>Level of evidence: </strong>Level III (systematic review of RCTs and retrospective comparative studies). See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983842","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":"Fracture Management and Care in Pregnancy.","authors":"Kiran Sharma, Zina Smadi, Mohammad Munir Zaitoun, Fahad Nadeem, Abdullah Ghali, Toufic R Jildeh","doi":"10.2106/JBJS.RVW.25.00275","DOIUrl":"10.2106/JBJS.RVW.25.00275","url":null,"abstract":"<p><p>» Pregnancy alters calcium balance, hormone regulation, and mechanical loading, which together lowers bone mineral density and increases risk of fractures. » Trauma during pregnancy carries significant maternal and fetal risk as low-mechanism injuries can trigger placental abruption, preterm labor, and fetal loss. » Imaging, anesthesia, and surgery require coordinated teams to provide care safely and optimize maternal and fetal outcomes. » Providers must verify pregnancy safety stratifications before medication selection.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718275","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":"Management of Pyogenic Flexor Tenosynovitis.","authors":"George M Anderson, Joshua D Proal, Christopher S Crowe, Stephen A Kennedy","doi":"10.2106/JBJS.RVW.26.00015","DOIUrl":"10.2106/JBJS.RVW.26.00015","url":null,"abstract":"<p><p>» Pyogenic flexor tenosynovitis (PFT) is an uncommon closed-space infection of the hand that can result in severe stiffness and other sequela. » When PFT is recognized and treated with antibiotics before advanced disease, surgery is often unnecessary to achieve a cure. » Physical examination features are helpful in differentiating PFT from other finger infections, particularly when considered together in aggregate. » Laboratory values such as systemic inflammatory markers are usually normal in early cases of PFT and are more likely to be elevated in other diagnoses like cellulitis. » Imaging findings such as x-ray, ultrasound, and computed tomography scan remain investigational and are not routinely used to make the diagnosis. » Stiffness and contracture are the most common sequela and benefit from early motion and hand therapy.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718375","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 Distal Clavicle Fractures in Adults: Evidence-Based Strategies for Treatment.","authors":"Dennis A DeBernardis, Tej Joshi, Swara R Kalva, Dario Fucich, Mandeep S Virk","doi":"10.2106/JBJS.RVW.25.00260","DOIUrl":"10.2106/JBJS.RVW.25.00260","url":null,"abstract":"<p><p>» Distal clavicle fractures are less common, accounting for 10% to 30% of all clavicle fractures. » The presence of radiographic nonunion does not correlate with symptomatic nonunion, with a variable percentage of patients necessitating subsequent surgical intervention (20%). » Fracture displacement is associated with a higher risk of nonunion (31%-37%), particularly in Neer type II and V fracture patterns. » Nondisplaced distal clavicle fractures can be treated with nonoperative management (Neer types I, III, and IV). » Surgical treatment is indicated for displaced Neer type II and V fractures. Increased radiographic coracoclavicular (CC) distance in type II and V fractures is an indication for CC stabilization. However, there is no consensus on ideal fixation techniques for fracture fixation and CC stabilization. » Surgical treatment may require secondary implant removal, regardless of the fixation construct used (28%-55%) but especially common with hook plate fixation.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718390","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":"Revisiting Intranasal Salmon Calcitonin: Historical Osteoporosis Evidence and a Potential Role in Acute Orthopaedic Pain Management.","authors":"Areeb Ahmad, Kassem Ghayyad, Elisabeth Davis, Daniel Goltz, G Russell Huffman, Olamide Oshikoya","doi":"10.2106/JBJS.RVW.26.00021","DOIUrl":"10.2106/JBJS.RVW.26.00021","url":null,"abstract":"<p><p>» Intranasal salmon calcitonin (IN-CAL) is a well-tolerated, noninvasive antiresorptive agent with reproducible pharmacodynamic activity, despite lower systemic bioavailability than parenteral formulations. » In preosteoporotic postmenopausal women, IN-CAL provides small, spine-limited preservation of bone mass, with minimal hip or forearm benefit; treatment response depends more on baseline bone turnover than on dose escalation. » In established postmenopausal osteoporosis, IN-CAL produces early biochemical suppression (1-3 months) and small but consistent lumbar spine bone mineral density (BMD) gains with sustained therapy (≥6-12 months). » IN-CAL is less effective than bisphosphonates and modern anabolic agents for increasing BMD and reducing fracture risk; accordingly, its use is best reserved for patients who cannot take first-line therapies due to contraindications, intolerance, or personal preference. » IN-CAL provides short-term pain relief for vertebral fractures in osteoporosis and offers a similarly time-limited analgesic benefit in acute orthopaedic settings, with pain reduction often within days and biochemical or skeletal effects evolving over subsequent weeks.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634828","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":"Treatment Outcomes for Distal Radius Fractures: A Meta-Analysis.","authors":"Ki Woong Yoon, Jiayong Liu, Martin Skie","doi":"10.2106/JBJS.RVW.25.00254","DOIUrl":"10.2106/JBJS.RVW.25.00254","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures (DRFs) are among the most prevalent in upper-extremity injuries, particularly in older adults and individuals with osteoporosis. The common treatment options include surgical interventions such as volar locking plate (VLP) fixation and percutaneous pinning, as well as conservative strategies like splinting and bracing. However, the comparative effectiveness of these modalities remains unclear. This study aims to compare the functional outcomes and complication rates associated with VLP, percutaneous pinning, bracing, and splinting in the treatment of DRFs.</p><p><strong>Methods: </strong>A systematic search of PubMed, Google Scholar, and the Cochrane Library (September 2001-February 2025) identified randomized controlled trials, prospective cohort studies, and retrospective cohort studies comparing DRF treatments. Functional outcomes and complication rates (superficial infection, malunion, nonunion, delayed union) were analyzed. Data were analyzed using Review Manager Web with significance set at p ≤ 0.05.</p><p><strong>Results: </strong>Twenty-seven studies involving 3,200 patients met inclusion criteria: VLP fixation (n = 896), percutaneous pinning (n = 666), splinting (n = 718), and bracing (n = 903). No significant differences were observed between VLP and splinting or between bracing and splinting for Disabilities of the Arm, Shoulder, and Hand (DASH); Patient-Rated Wrist Evaluation (PRWE); or grip strength. Compared with VLP, percutaneous pinning demonstrated better PRWE scores but a higher infection rate. Compared with bracing, percutaneous pinning showed significantly better DASH, PRWE, and grip strength outcomes, although with substantial heterogeneity. Compared with bracing, VLP fixation yielded significantly better DASH, PRWE, and grip strength outcomes and a lower malunion rate.</p><p><strong>Conclusion: </strong>All 4 treatments achieved acceptable outcomes, but with key trade-offs: Percutaneous Pinning had the best functional results but a higher infection risk. VLP provided better function and lower malunion rates than bracing. Splinting and bracing were effective conservative options, often yielding results similar to VLP, but were inferior in some specific measures. The findings suggest that a perfect anatomic repair is not always necessary for a good recovery. Ultimately, the choice of treatment must be individualized, weighing the functional benefits against the risks of complications, while considering patient health factors and preferences.</p><p><strong>Level of evidence: </strong>Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634887","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":"Evaluation and Surgical Management of Adult Spastic Hip and Knee Deformities.","authors":"Kitty Y Wu, Emmanouil Grigoriou, Peter C Rhee","doi":"10.2106/JBJS.RVW.25.00227","DOIUrl":"10.2106/JBJS.RVW.25.00227","url":null,"abstract":"<p><p>» Thorough patient presurgical counseling should emphasize individual patient goals, which may include improving ambulation, reducing reliance on orthoses, alleviating pain, or facilitating caregiver support.» Careful physical examination is essential to differentiate whether the primary cause of dysfunction is weakness, spasticity, or both.» Diagnostic adjuncts including botulinum toxin, short-acting blocks, instrumented gait analysis, and dynamic electromyography provide valuable insight and guide operative decisions.» Surgical treatment must be individualized, with nerve-based procedures indicated for pure spasticity and tendon lengthening, tenotomy, or joint procedures being required to treat soft tissue and joint contractures.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481966","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}