JBJS Reviews最新文献

{"title":"Upper Extremity Ballistic Nerve Injury: A Scoping Review and Algorithm for Management.","authors":"G Jacob Wolf, Kevin Chen, Jason A Strelzow, Jeffrey G Stepan","doi":"10.2106/JBJS.RVW.24.00069","DOIUrl":"10.2106/JBJS.RVW.24.00069","url":null,"abstract":"<p><p>» Gunshot injuries to the upper extremity (UE) have high likelihood for causing peripheral nerve injury secondary to the high density of vital structures. Roughly one-fourth of patients sustaining a gunshot wound (GSW) to the UE incur a nerve injury. Of these nerve injuries, just over half are neurapraxic. In cases of surgical exploration of UE nerve injuries, nearly one-third demonstrate a transected or discontinuous nerve.» Existing literature regarding surgical management of nerve injuries secondary to GSWs comes from both military and civilian injuries. Outcomes are inconsistently reported, and indications are heterogeneous; however, reasonable results can be obtained with nerve reconstruction.» Our proposed management algorithm hinges on 4 treatment questions: if there is a nerve deficit present on examination, if there is a concomitant injury in the extremity (i.e., fracture or vascular insult), whether the injured nerve would be in the operative field of the concomitant injury, and whether there was an identified nerve lesion encountered at the time of surgery by another surgeon?» Early exploration rather than continued expectant management may offer improved recovery from GSW nerve injuries in particular situations. When an UE nerve deficit is present, establishing follow-up after the initial GSW encounter and early referral to a peripheral nerve surgeon are pivotal.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298516","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":"Bone Radiation-Induced Sarcomas: Outcomes Based on Histology and Surgical Treatment: A Systematic Review of the Literature.","authors":"Maria L Inchaustegui, Felipe Larios, Jean-Patrick Buteau, Marcos R Gonzalez, Juan Pretell-Mazzini","doi":"10.2106/JBJS.RVW.24.00066","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00066","url":null,"abstract":"<p><strong>Background: </strong>Bone radiation-induced sarcomas (B-RIS) are secondary neoplasms with reportedly worse overall survival than de novo bone sarcoma. Treatment strategy for these neoplasms remains uncertain. Our systematic review sought to assess overall survival based on histology and surgical intervention.</p><p><strong>Methods: </strong>A systemic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered in PROSPERO (438415). Studies describing oncologic outcomes of patients with B-RIS in the appendicular and axial skeleton were included. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for quality assessment. Survival analysis by histologic subtype and surgery type was performed in a subset of 234 patients from 11 articles with individualized data. A total of 20 articles with a total of 566 patients were included. The most frequent location was the pelvis (27.7%), and the main histological types were osteosarcoma (69.4%), undifferentiated pleomorphic sarcoma (14.1%), and fibrosarcoma (9.2%). Limb-salvage and amputation were performed in 68.5% and 31.5% of cases, respectively.</p><p><strong>Results: </strong>Local recurrence was 13%, without difference between limb-salvage surgery and amputation (p = 0.51). The metastasis rate was 42.3%. Five-year OS was 43.7% (95% confidence interval [CI], 33.3%-53.5%) for osteosarcoma, 31.5% (95% CI, 11.3%-54.2%) for UPS, and 28.1% (95% CI, 10.6%-48.8%) for fibrosarcoma. Five-year OS was 49.2% (95% CI, 35.3%-61.6%) for limb-salvage and 46.9% (95% CI, 29.1%-62.9%) for amputation. There was no difference in 5-year OS between histologic subtypes (p = 0.18) or treatment type (p = 0.86).</p><p><strong>Conclusion: </strong>B-RIS demonstrated poor OS at 5 years after initial management regardless of histology. Limb-salvage surgery was not associated with lower 5-year OS compared with amputation. Future studies should compare both groups while controlling for confounders.</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 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894540","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":"Injuries in Male and Female Wrestlers.","authors":"Zoe Abrahamson, Phara Ross, Mia V Rumps, Mary K Mulcahey","doi":"10.2106/JBJS.RVW.24.00062","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00062","url":null,"abstract":"<p><p>» With historical exclusion from the sport and lack of research on the subject, there is a paucity of data regarding the injury incidence, treatment, and recovery of female wrestlers as compared with their male counterparts.» Data demonstrate that female wrestlers are more likely to experience sprains/strains, whereas male wrestlers experience more concussions and fractures.» Variations in behavior and physiology including risk-taking habits and ligament laxity may contribute to differences in injury incidence between male and female wrestlers.» Rapid weight loss and eating disorders are important areas of future investigation for male and female wrestlers alike.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894541","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":"Nutritional Considerations in Hip and Knee Arthroplasty: A Critical Analysis of Current Evidence.","authors":"Avianna E Arapovic, Fong H Nham, Hussein Darwiche, Mouhanad El-Othmani","doi":"10.2106/JBJS.RVW.24.00033","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00033","url":null,"abstract":"<p><p>» Initial screening for malnutrition can be initiated with a fibrinogen-albumin ratio threshold <11.7.» Protein supplementation to goal (1.2-1.9 g/kg), along with essential amino acid augmented with beta-hydroxy-beta-methylbutyrate and resistance training have shown benefit, especially in sarcopenic patients.» Omega-3 and omega-6 polyunsaturated fatty acid supplementation has a strong antioxidant role and gain of muscle mass.» Supplementation with adenosine triphosphate and magnesium sulfate provides an avenue to decrease postoperative pain and opioid consumption.» Motivational interviewing and multidisciplinary teams to achieve preoperative weight loss >20 lbs in morbidly obese patients can decrease complication rates.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894591","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":"Neurocognitive Concepts of Arthroscopic Surgical Training.","authors":"Edward J Testa, Andrew Green","doi":"10.2106/JBJS.RVW.24.00058","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00058","url":null,"abstract":"<p><p>» Arthroscopy is used to treat a broad variety of orthopaedic conditions.» The technical aspects of arthroscopic surgery are distinct from traditional open surgery and require different approaches to education and training.» There are neurocognitive concepts related to learning, memory, and performance that are recognized and understood in many fields and relevant but not commonly and specifically considered in orthopaedic surgery.» The purpose of this review was to introduce and discuss neurocognitive principles and concepts of visuospatial motor skill acquisition and proficiency to provide a background to support the development of arthroscopy educational curricula and training.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727949","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":"An Update on Emerging Techniques and Considerations in Revision Anterior Cruciate Ligament Reconstruction.","authors":"Matthew Quinn, Nicholas Lemme, Patrick Morrissey, Paul Fadale, Brett D Owens","doi":"10.2106/JBJS.RVW.24.00047","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00047","url":null,"abstract":"<p><p>» The rate of primary anterior cruciate ligament reconstruction (ACLR) failure in at-risk populations remains unacceptably high and necessitates thorough evaluation of native alignment and concomitant injuries.» Posterior tibial slope of >12° is a substantial risk factor of ACLR failure and should be corrected through anterior closing wedge osteotomy.» Varus malalignment of >5° exacerbates stress on the ACL graft, increases ACLR failure risks, and should be considered for correction through high tibial osteotomy at the time of revision ACLR.» Injuries to the anterolateral ligamentous complex are prevalent in ACL ruptures, and high-risk patients have shown benefit from anterolateral ligament reconstruction or lateral extra-articular tenodesis in the revision setting.» Addressing posterolateral corner, collateral ligament, and meniscal injuries, during revision ACLR, is vital to mitigate increased graft forces and optimize knee stability and functional outcomes.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634960","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":"Imaging Modalities in the Preoperative Assessment of Femoroacetabular Impingement and Hip Dysplasia: Determining Best Practices.","authors":"Caleb J Bischoff, David R Woodard, Lauren Clough Pringle, Steven F DeFroda","doi":"10.2106/JBJS.RVW.24.00070","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00070","url":null,"abstract":"<p><p>» In the last decade, significant progress has been made in understanding hip pain, especially related to femoroacetabular impingement (FAI) and hip dysplasia (HD), which collectively affect over 20% of the population.» Preoperative imaging, including plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US), plays a pivotal role in diagnosing FAI and HD. Imaging precision, standardized techniques, and accurate interpretation are crucial for effective treatment planning.» The continual advancements in imaging techniques, especially seen in MRI (arthrograms, application of leg traction, and delayed gadolinium-enhanced MRI of cartilage), represent important strides in the precise assessment of pathology associated with FAI and HD.» By incorporating these advancements into routine imaging protocols, healthcare providers can ensure a comprehensive understanding of hip joint dynamics, enabling more accurate diagnosis and effective management strategies for patients with FAI and HD, ultimately leading to improved clinical outcomes.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591704","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":"Machine Learning-Assisted Decision Making in Orthopaedic Oncology.","authors":"Paul A Rizk, Marcos R Gonzalez, Bishoy M Galoaa, Andrew G Girgis, Lotte Van Der Linden, Connie Y Chang, Santiago A Lozano-Calderon","doi":"10.2106/JBJS.RVW.24.00057","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00057","url":null,"abstract":"<p><p>» Artificial intelligence is an umbrella term for computational calculations that are designed to mimic human intelligence and problem-solving capabilities, although in the future, this may become an incomplete definition. Machine learning (ML) encompasses the development of algorithms or predictive models that generate outputs without explicit instructions, assisting in clinical predictions based on large data sets. Deep learning is a subset of ML that utilizes layers of networks that use various inter-relational connections to define and generalize data.» ML algorithms can enhance radiomics techniques for improved image evaluation and diagnosis. While ML shows promise with the advent of radiomics, there are still obstacles to overcome.» Several calculators leveraging ML algorithms have been developed to predict survival in primary sarcomas and metastatic bone disease utilizing patient-specific data. While these models often report exceptionally accurate performance, it is crucial to evaluate their robustness using standardized guidelines.» While increased computing power suggests continuous improvement of ML algorithms, these advancements must be balanced against challenges such as diversifying data, addressing ethical concerns, and enhancing model interpretability.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591705","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":"Cementless Total Knee Arthroplasty: A State-of-the-Art Review.","authors":"Yasir AlShehri, Panayiotis D Megaloikonomos, Michael E Neufeld, Lisa C Howard, Nelson V Greidanus, Donald S Garbuz, Bassam A Masri","doi":"10.2106/JBJS.RVW.24.00064","DOIUrl":"10.2106/JBJS.RVW.24.00064","url":null,"abstract":"<p><p>» The demographic profile of candidates for total knee arthroplasty (TKA) is shifting toward younger and more active individuals.» While cemented fixation remains the gold standard in TKA, the interest is growing in exploring cementless fixation as a potentially more durable alternative.» Advances in manufacturing technologies are enhancing the prospects for superior long-term biological fixation.» Current research indicates that intermediate to long-term outcomes of modern cementless TKA designs are comparable with traditional cemented designs.» The selection of appropriate patients is critical to the success of cementless fixation techniques in TKA.» There is a need for high-quality research to better understand the potential differences and relative benefits of cemented vs. cementless TKA systems.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538773","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":"Appropriateness and Quality of Composite Endpoint Use and Reporting in Spine Surgery: A Systematic Review.","authors":"Markian Pahuta, Mohamed Sarraj, Varun Muddaluru, Pranjan Gandhi, Fawaz Alshaalan, Jason Busse, Daipayan Guha, Mohit Bhandari","doi":"10.2106/JBJS.RVW.24.00039","DOIUrl":"https://doi.org/10.2106/JBJS.RVW.24.00039","url":null,"abstract":"<p><strong>Background: </strong>A composite endpoint (CEP) is a measure comprising 2 or more separate component outcomes. The use of these constructs is increasing. We sought to conduct a systematic review on the usage, quality of reporting, and appropriate use of CEPs in spine surgery research.</p><p><strong>Methods: </strong>A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Articles reporting randomized controlled trials of a spine surgery intervention using a CEP as a primary outcome were included. We assessed the quality of CEP reporting, appropriateness of CEP use, and correspondence between CEP treatment effect and component outcome treatment effect in the included trials.</p><p><strong>Results: </strong>Of 2,321 initial titles, 43 citations were included for analysis, which reported on 20 unique trials. All trials reported the CEP construct well. In 85% of trials, the CEP design was driven by US Food and Drug Administration guidance. In the majority of trials, the reporting of CEP results did not adhere to published recommendations: 43% of tests that reported statistically significant results on component outcomes were not statistically significant when adjusted for multiple testing. 67% of trials did not meet appropriateness criteria for CEP use. In addition, CEP treatment effect tended to be 6% higher than the median treatment effect for component outcomes.</p><p><strong>Conclusion: </strong>Given that CEP analysis was not appropriate for the majority of spine surgery trials and the inherent challenges in the reporting and interpretation of CEP analysis, CEP use should not be mandated by regulatory bodies in spine surgery trials.</p><p><strong>Level of evidence: </strong>Level I. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538772","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}