JBJS Reviews最新文献

{"title":"The Effect of Femoral Component Flexion in Total Knee Arthroplasty.","authors":"Matthew J Wood, Jessica A Armitage, Yusuf Omran Hasan","doi":"10.2106/JBJS.RVW.25.00266","DOIUrl":"10.2106/JBJS.RVW.25.00266","url":null,"abstract":"<p><p>» Whilst it is widely accepted that extension of the femoral component is suboptimal, there is currently no clear consensus on the optimal degree of femoral component flexion in the sagittal plane or if optimizing component flexion translates to any clinical benefit.» Flexing the femoral total knee arthroplasty (TKA) component by 0° to 3° relative to the distal anatomic axis of the femur has been demonstrated to improve restoration of posterior condylar offset, maximal knee flexion, and patellofemoral biomechanics and aid in gap balancing by reducing excessive flexion gap.» Excessive flexion of the femoral component has been associated with worse implant survival, worse patient-reported outcomes, and fixed flexion contracture.» Early evidence suggests that using robotic-assisted TKA to align the femoral component relative to each patient's individual distal anatomic axis of the femur can reduce the rate of femoral component extension and improve the proportion of patients with optimally flexed femoral components.» Robust clinical studies are needed to establish whether 0° to 3° of femoral component flexion confers any significant clinical benefit, particularly examining the role of individualized robotic-assisted TKA in achieving reproducible component positioning.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Meniscectomy for the Degenerative Meniscus with Mild to Moderate Osteoarthritis: A Contemporary Analysis.","authors":"Amr Kaadan, John Pietro, Roy K Aaron","doi":"10.2106/JBJS.RVW.25.00258","DOIUrl":"10.2106/JBJS.RVW.25.00258","url":null,"abstract":"<p><p>» Arthroscopic partial meniscectomy (APM) for the treatment of degenerative meniscal tears has been controversial, and quantification of its benefits has been limited by methodological problems and varying clinical definitions.» Among the problems with APM are patients crossing over from the treatment arm to which they have been randomized to another treatment and analyzed by the randomized treatment, whether they received that treatment or not.» Aggregated information suggests that a program of structured exercise is a reasonable initial treatment for degenerative meniscal tears with APM reserved for patients who fail nonsurgical therapy.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391270","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 Traditional Healers in Musculoskeletal Care for Hispanic and Latino/a Americans: A Systematic Review.","authors":"Isabel Gippo, Samiya Manocha, Maria Gabriela Pino Paez, Julie Johnson, Neeraj Patel","doi":"10.2106/JBJS.RVW.25.00257","DOIUrl":"10.2106/JBJS.RVW.25.00257","url":null,"abstract":"<p><strong>Background: </strong>Hispanic and Latino/a Americans face barriers to musculoskeletal (MSK) care. Given disparities in trust in and access to mainstream care, traditional healers (THs) may provide an alternative option. Little is known about how this population uses THs for MSK care. We aimed to describe the types of conditions treated, treatments employed, and reasons for using THs for this type of care.</p><p><strong>Methods: </strong>For this systematic review, we queried PubMed, Scopus, EMBASE, the Cochrane Library, and Web of Science for the literature published between 2000 and 2025. We included studies focused on MSK care provided by THs in Hispanic or Latino/a communities in the United States. Search terms included various TH types. We collected data on study design, participants, types of THs, diagnostic and treatment practices, and reasons for using THs. Descriptive statistics were calculated and are reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>Our search yielded 4,837 articles of which 19 met inclusion criteria (21.1% quantitative, 78.9% qualitative or mixed methods). The majority focused on TH use for MSK care in adults (89.5%) and dual allopathic and TH use (73.7%). Curandero/a/x (78.9% of all articles), sobadores (52.6%), and yerberos/herbalists (36.8%) were the most frequently studied THs. The most frequently mentioned MSK conditions were atraumatic/general MSK pain (57.9% of articles), back pain (42.1%), and acute limb/joint injury (36.8%). Palpation (26.3%) and observation (21.0%) were common diagnostic practices, while physical manipulation/massage (57.9%) was the most common treatment. Dissatisfaction with allopathic medical care (57.9%), accessibility (31.6%), and affordability (26.3%) were the most frequently reported reasons for using THs.</p><p><strong>Conclusion: </strong>THs treat a variety of MSK conditions and are used by Hispanic and Latino/a American patients due to accessibility, affordability, and dissatisfaction with allopathic care. Understanding the role of THs allows allopathic clinicians to provide more culturally insightful care and consider opportunities for engagement, collaboration, and integration. This may result in more holistic, equitable orthopaedic care.</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 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391248","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":"Surgeon Experience and Patient Outcomes in Spine Surgery: A Narrative Review of Tenure, Volume, and Performance.","authors":"Arun K Movva, Rishi Jain, Rohan Govind, Ashym A C Patel, Theodore A Joaquin, Wellington K Hsu, Alpesh A Patel, Srikanth N Divi","doi":"10.2106/JBJS.RVW.25.00250","DOIUrl":"10.2106/JBJS.RVW.25.00250","url":null,"abstract":"<p><p>» Surgeon experience is a well-recognized determinant of patient outcomes, with greater experience associated with lower complication rates, improved efficiency, and better patient recovery.» Experience has variable definitions across studies, including total or annual case volume, years in practice, surgeon age, and fellowship completion.» Surgeon case volume reflects procedural repetition, and tenure encompasses judgment and decision-making that develops over time. Both independently contribute to patient outcomes.» It is unclear whether surgeon subspecialty or age has an impact on objective outcomes, suggesting that experience and case volume are more reliable indicators of performance.» Significant gaps remain in the literature, including inconsistent definitions, limited longitudinal data, a lack of statistically significant preliminary results, and an overrepresentation of complex academic cases.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291355","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":"Limited Clinical Benefit of the Subacromial Balloon Spacer in Massive Irreparable Rotator Cuff Tears: A Comprehensive Review of Clinical Outcomes and Cost-Effectiveness.","authors":"Waleed Albishi, Mishari Alanezi, Noura Alnasser, Khalid Murrad, Emad Elansary, Abdulrahman Alaseem","doi":"10.2106/JBJS.RVW.25.00231","DOIUrl":"10.2106/JBJS.RVW.25.00231","url":null,"abstract":"<p><p>» Subacromial balloon spacer (SBS) implantation has been proposed as a minimally invasive treatment for massive irreparable rotator cuff tears (MIRCTs), particularly in elderly patients with preserved glenohumeral articulation and limited functional demands.» Across observational studies, SBS has been associated with short to midterm improvements in pain and shoulder function, reflected by increases in ASES and Constant-Murley scores.» Evidence from randomized controlled trials is mixed; the SPACE trial showed SBS is noninferior to partial repair, while the START:REACTS trial found it less effective than debridement alone.» Complications are uncommon and primarily include balloon migration, synovitis, and rare infections, supporting SBS's safety profile when patient selection is appropriate.» Based on current high-level evidence, SBS is not recommended for routine treatment of MIRCT. Its use should be restricted to carefully selected elderly patients with chronic, nonarthritic MIRCT who are poor candidates for other reconstructive procedures.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291352","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":"Clinical Integration of 3-Dimensional Printing in Shoulder Surgery: Current Applications, Evidence, and Future Directions: A Narrative Review.","authors":"Nima Bagheri, Mohammadreza Guity, Omid Salkhori, Seyyed Hadi Kalantar, Seyyed Saeed Khabiri, Seyed Mohammadjavad Mortazavi, Behzad Nezhad Tabrizi, Hamed Naghizadeh","doi":"10.2106/JBJS.RVW.25.00230","DOIUrl":"10.2106/JBJS.RVW.25.00230","url":null,"abstract":"<p><p>» Three-dimensional printing improves shoulder surgery by creating precise anatomical models for better planning and visualization.» Patient-specific guides and implants enhance accuracy, shorten surgery time, and lead to better functional outcomes in complex procedures.» Used effectively in fractures, instability, joint replacement, corrective bone surgery, and tumor reconstruction to support safer and more predictable surgery.» Challenges include high cost, time required for production, and limited long-term clinical evidence; future advancements include artificial intelligence and augmented reality to improve efficiency and personalization.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Angina: An Often Overlooked Cause of Noncardiac Chest Pain.","authors":"Jonathan P Japa, Philip Zitser, Mark Ehioghae, Kevin Yoon, Linus Lee, Shankar Thiru, Addisu Mesfin","doi":"10.2106/JBJS.RVW.25.00238","DOIUrl":"10.2106/JBJS.RVW.25.00238","url":null,"abstract":"<p><p>» Chest pain is the second most common chief complaint in the emergency department.» Cervical Angina is an important cause of non-cardiac chest pain, and is often overlooked.» Cervical angina is believed to be caused by cervical radiculopathy of the C6-C7 nerve roots.» Diagnosis involves a thorough history and physical, ruling out cardiac causes of chest pain.» Both operative and non-operative management options are effective.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272410","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":"Impact of Social and Behavioral Determinants on Utilization and Outcomes of Total Ankle Arthroplasty: A Systematic Review.","authors":"Alexander Tham, Megan Calton, Jared Rubin, Anaelie Mainville, Raymond Walls, Kevin A Schafer, Lew C Schon, John G Kennedy","doi":"10.2106/JBJS.RVW.25.00228","DOIUrl":"10.2106/JBJS.RVW.25.00228","url":null,"abstract":"<p><strong>Background: </strong>Total ankle arthroplasty (TAA) provides pain relief and motion preservation for end-stage ankle arthritis, yet outcomes and utilization vary widely. Social determinants of health (SDOHs) such as socioeconomic, demographic, and behavioral factors may contribute to these disparities, but their influence on TAA has not been systematically evaluated.</p><p><strong>Methods: </strong>A systematic review was registered on PROSPERO (CRD420251156933) and performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PROGRESS-Plus framework to identify studies examining the impact of SDOH on TAA utilization and outcomes. PubMed, Embase, and Scopus were searched through 2025. Study quality was assessed with the Risk Of Bias In Nonrandomized Studies of Interventions tool, and certainty of evidence for each domain was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Data were synthesized narratively with random-effects meta-analysis where feasible.</p><p><strong>Results: </strong>Forty-four studies including more than 200,000 patients were analyzed. Social determinants were found to influence both access to TAA and postoperative outcomes. Men demonstrated slightly better postoperative function, whereas women reported more pain and higher rates of nonhome discharge. Older patients experienced more perioperative complications but achieved similar long-term implant survival compared with younger cohorts. Patients from minority racial and ethnic groups had higher complication rates and were less likely to receive TAA compared with arthrodesis. Lower income, public insurance, and treatment in rural or lower-volume hospitals were consistently linked with reduced access to TAA, longer hospital stays, and greater healthcare costs. Behavioral factors such as smoking and preoperative opioid use were strongly associated with wound complications, prolonged hospitalization, and poorer recovery.</p><p><strong>Conclusion: </strong>SDOH significantly shape access to surgery, complication risk, and recovery after TAA. Recognition of these influences and targeted strategies such as preoperative optimization, equitable referral pathways, and improved access to rehabilitation may help reduce disparities and improve outcomes in ankle arthroplasty.</p><p><strong>Level of evidence: </strong>Level III, systematic review of predominantly Level III studies.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150933","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 Review of the Biomechanical and Clinical Outcomes of Tibial-Sided Fixation for Anterior Cruciate Ligament Reconstruction.","authors":"Garrett R Jackson, Rhett Wakefield, Clayton W Nuelle, Steven F DeFroda","doi":"10.2106/JBJS.RVW.25.00186","DOIUrl":"10.2106/JBJS.RVW.25.00186","url":null,"abstract":"<p><p>» Tibial fixation remains the biomechanically weaker site in ACL reconstruction due to lower bone density and directional loading forces, making fixation choice critical for graft stability.» Interference screws provide aperture fixation close to the joint line but are limited by graft slippage, tunnel widening, and progressive loss of tension over time.» Suspensory devices engage cortical bone and reduce graft damage during insertion; when supplemented with backup fixation, such as knotless suture anchors, they demonstrate greater fixation strength and reduced graft micromotion.» Internal suture augmentation offers promising biomechanical and early clinical benefits by protecting the graft during the vulnerable early healing period, especially in young athletes and revision cases, though long-term effects remain under investigation.» Fixation strategy should be individualized, balancing graft choice, bone quality, and rehabilitation demands to optimize outcomes and reduce risk of failure.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150957","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":"Differences in Diagnosing Tarsal Tunnel Syndrome Across the Literature: A Systematic Review and a Call for Standardization.","authors":"Nadine Boers, Melanie Haverkamp, Anne Merijn Eligh, Manuel Castro Cabezas, J Henk Coert, Willem D Rinkel","doi":"10.2106/JBJS.RVW.25.00222","DOIUrl":"10.2106/JBJS.RVW.25.00222","url":null,"abstract":"<p><strong>Background: </strong>The lack of a gold standard in tarsal tunnel syndrome (TTS) diagnosis leads to diagnostic inconsistencies and variation in patient selection for treatment. Therefore, the aim of this review is to summarize the diagnostic criteria used in current studies on TTS based upon this best-evidence synthesis.</p><p><strong>Methods: </strong>Three databases were searched to identify all studies on TTS. Studies were included when they included (1) diagnosis or treatment of TTS as the primary focus, (2) a description of the diagnosis of TTS, (3) an original data set of TTS cases, and (4) a minimum of 10 adult patients diagnosed with TTS. A best-evidence synthesis was used to summarize the results.</p><p><strong>Results: </strong>In total, 4,213 patients were represented in 82 included studies. Among the varying diagnostic methods employed, aside from clinical symptoms, provocative testing was most often used (in 94% of studies, mandatory for diagnosis in 41% of studies) with the Tinel sign being the most prevalent (used in 89% of studies). Sensitivities of provocative tests, electrodiagnostic, and ultrasound measurements showed significant variability.</p><p><strong>Conclusion: </strong>We provided an overview of the diagnostic tools and workups reported in the literature on TTS. Our findings show that the lack of a standardized diagnostic approach results in considerable variability in clinical practice. Alongside typical clinical symptoms, the Tinel sign is the most frequently used diagnostic test. The varying sensitivities reported in literature underscore the need for evidence-based diagnostic guidelines on TTS diagnosis.</p><p><strong>Level of evidence: </strong>Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"14 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150908","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}