Bone & Joint Journal最新文献

{"title":"Long-term results of lateral unicompartmental knee arthroplasty with a mobile-bearing device.","authors":"Tilman Walker, Julius Freericks, Paul Mick, Raphael Trefzer, Andre Lunz, Kevin-Arno Koch, Tobias Renkawitz, Mustafa Hariri","doi":"10.1302/0301-620X.107B3.BJJ-2024-0859.R1","DOIUrl":"10.1302/0301-620X.107B3.BJJ-2024-0859.R1","url":null,"abstract":"<p><strong>Aims: </strong>Unicompartmental knee arthroplasty (UKA) is one option in the treatment of isolated unicompartmental advanced osteoarthritis (OA). While long-term results exist for medial mobile-bearing (MB) UKA, evidence regarding lateral MB-UKA is still limited. The Oxford Domed Lateral (ODL) implant aims to reduce the bearing dislocation rate in lateral MB-UKA through enhanced bearing entrapment. However, the long-term performance of this implant remains unclear. This study evaluated the long-term survival and clinical outcomes of the ODL in a non-designer centre.</p><p><strong>Methods: </strong>This single-centre retrospective analysis included 115 lateral MB-UKAs using the ODL performed between January 2006 and December 2014. The primary endpoint of the study was implant survival, defined as the time until a revision procedure was required for any reason. Secondary outcomes included Oxford Knee Score (OKS), Forgotten Joint Score (FJS), pain, satisfaction, and Tegner Activity Scale (TAS). Survival was assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>At ten years, the cumulative implant survival rate was 74.8% (95% CI 65.2 to 82.1; number at risk = 71), with bearing dislocation (8.5%) and OA progression (10.4%) as leading revision causes. In 55 non-revised knees with a mean follow-up of 13.4 years (SD 1.8), the mean postoperative OKS improved significantly to 37.8 (SD 9.1) (p < 0.001). Additionally, 85.5% of patients (n = 47) reported satisfaction, with a mean FJS of 65.9 (SD 32.2) and TAS of 2.8 (SD 1.1). However, only 76.4% (n = 42) attained the patient-acceptable symptom state for OKS and FJS.</p><p><strong>Conclusion: </strong>This is the first long-term ODL study from a non-designer centre; our results demonstrated high failure rates due to bearing dislocation and OA progression, despite satisfactory clinical outcomes in non-revised patients. The disproportionately high risk of failure suggests that the MB design should be abandoned in favour of a fixed-bearing device for lateral UKA.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 3","pages":"322-328"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the role of arthroscopy in hand and wrist trauma?","authors":"Paul H C Stirling, Andrew D Duckworth, Julie E Adams, Sanj Kakar","doi":"10.1302/0301-620X.107B3.BJJ-2024-1183.R1","DOIUrl":"10.1302/0301-620X.107B3.BJJ-2024-1183.R1","url":null,"abstract":"<p><p>The use of arthroscopy of the hand and wrist has recently increased sharply in the elective setting and this, not surprisingly, has been followed by an increasing use in the trauma setting. Advocates for the use of arthroscopy in these patients cite the improved assessment of the displacement and reduction of fractures and the early diagnosis of associated injuries, while others temper this with concerns about increased operating time and possible complications. The data relating to patient-reported benefits and costs are limited. The aim of this review was to discuss the current available literature for the use of arthroscopy in the management of injuries of the hand and wrist.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 3","pages":"291-295"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IntraMedullary nailing Versus EXternal ring fixation for the treatment of tibial shaft fractures (IMVEX): a multicentre randomized controlled clinical trial.","authors":"Rasmus Stokholm, Peter Larsen, Jan D Rölfing, Juozas Petruskevicius, Morten K Rasmussen, Steffen S Jensen, Rasmus Elsøe","doi":"10.1302/0301-620X.107B3.BJJ-2024-0812.R1","DOIUrl":"10.1302/0301-620X.107B3.BJJ-2024-0812.R1","url":null,"abstract":"<p><strong>Aim: </strong>One of the most common patient-reported complaints following intramedullary nailing (IMN) of tibial shaft fractures is anterior knee pain reported by 10% to 80% of patients. The present study aimed to compare the 12-month Knee injury and Osteoarthritis Outcome Score (KOOS) sport and recreation activities subscale (sport/rec) scores after IMN with external ring fixation (RF) to adult patients with tibial shaft fractures.</p><p><strong>Methods: </strong>This study was a pragmatic multicentre randomized, non-blinded trial, with two-group parallel design. Included were adult patients (aged ≥ 18 years) presenting with an acute tibial shaft fracture deemed operable with an intramedullary nail. The primary outcome was the KOOS sport/rec, ranging from 0 (worst score) to 100 (best score) at 12-month follow-up. Secondary outcomes included the Foot and Ankle Outcome Score (FAOS), health-related quality of life assessed by EuroQol five-dimension five-level health questionnaire, and pain scores.</p><p><strong>Results: </strong>A total of 67 patients were included in the study. In all, 33 patients were randomized to standard IMN and 34 patients to RF. The mean age of the patients was 47.7 years (SD 19.2; 18 to 84) and 34% were female (n = 23). The primary analysis revealed no statistically significant difference in KOOS sport/rec between the IMN and RF groups at the 12-month follow-up (adjusted mean difference -18.1 (95 % CI -43.4 to 7.2); favouring RF).</p><p><strong>Conclusion: </strong>No statistically significant differences in the KOOS sport/rec were observed between RF and IMN at 12-month follow-up. However, these results should be interpreted with caution, due to high risk of a type II error.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 3","pages":"353-361"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of complications after hip fracture.","authors":"En Lin Goh, May Ee Png, David Metcalfe, Juul Achten, Duncan Appelbe, Xavier L Griffin, Jonathan A Cook, Matthew L Costa, Michael Barrett, Peter Hull, David Melling, Jonathan Kosy, Charalambous P Charalambous, Oliver Keast-Butler, Paul Magill, Rathan Yarlagadda, Girish Vashista, Terence Savaridas, Seb Sturridge, Graham Smith, Kishore Dasari, Deepu Bhaskar, Stefan Bajada, Ewan Bigsby, Ansar Mahmood, Mark Dunbar, Andrea Jimenez, Ryan Wood, James Penny, William Eardley, Robert Handley, Suresh Srinivasan, Matt Gee, Ashwin Kulkarni, John Davison, Mohammad Maqsood, Amit Sharma, Chris Peach, Ahsan Sheeraz, Piers Page, Andrew Kelly, Iain McNamara, Lee Longstaff, Mike Reed, Iain Moppett, Ayman Sorial, Theophilus Joachim, Aaron Ng, Kieran Gallagher, Mark Farrar, Ad Ghande, Jonathan Bird, Shyam Rajagopalan, Andrew McAndrew, Andrew Sloan, Rory Middleton, Ian Dos Remedios, Damian McClelland, Benedict Rogers, James Berstock, Sharad Bhatnagar, Owen Diamond, Paul Fearon, Inder Gill, Doug Dunlop, Tim Chesser, Mehool Acharya, Deepak Sree, Johnathan Craik, David Hutchinson, David Johnson, Mosab Elgalli, Paul Dixon, Pregash Ellapparadja, Guy Slater, Jakub Kozdryk, Jonathan Young, Ben Ollivere, Khitish Mohanty, Mohammad Faisal, Callum Clark, Baljinder Dhinsa, Ibrahim Malek, Sam Heaton, Oliver Blocker, Kanthan Theivendran","doi":"10.1302/0301-620X.107B3.BJJ-2024-0858.R1","DOIUrl":"10.1302/0301-620X.107B3.BJJ-2024-0858.R1","url":null,"abstract":"<p><strong>Aims: </strong>The risk of mortality after a hip fracture has been extensively investigated, but there is little high-quality information available dealing with the overall risk of complications. The aim of this study was to report the risk of complications in the first 120 days after a hip fracture.</p><p><strong>Methods: </strong>This was a multicentre, prospective cohort study of patients aged > 60 years with a hip fracture, involving 77 hospitals in England, Wales, and Northern Ireland, between January 2015 and 2022. The primary outcomes of interest were mortality and surgery-specific and general complications, at 120 days postoperatively.</p><p><strong>Results: </strong>A total of 24,523 patients with a hip fracture were enrolled. The 120-day risk of mortality was 12.4% (95% CI 12.0 to 12.8). The 120-day risks of surgery-specific complications were: for dislocation, 1.5% (95% CI 1.3 to 1.7); failure of fixation, 1.0% (95% CI 0.8 to 1.2); for peri-implant or periprosthetic fracture, 0.3% (95% CI 0.3 to 0.4); for reoperation for any indication, 2.7% (95% CI 2.5 to 2.9); and for surgical site infection, 3.4% (95% CI 3.2 to 3.6). The 120-day risks of general complications were: for acute kidney injury, 3.4% (95% CI 3.1 to 3.6); for the requirement of a blood transfusion, 7.0% (95% CI 6.7 to 7.3); for lower respiratory tract infection, 9.1% (95% CI 8.7 to 9.4); for urinary tract infection, 7.0% (95% CI 6.7 to 7.3); for cerebrovascular accident, 0.7% (95% CI 0.6 to 0.8); for myocardial infarction, 0.7% (95% CI 0.6 to 0.9); and for venous thromboembolism, 1.8% (95% CI 1.6 to 2.0).</p><p><strong>Conclusions: </strong>Although the risk of mortality has declined in recent years, older patients with a hip fracture remain at a high risk of surgery-specific and general complications.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 3","pages":"362-367"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitating clinical trials in hip fracture in the UK : the role and potential of the National Hip Fracture Database and routinely collected data.","authors":"James Webster, Raphael Goldacre, Jennifer C E Lane, Marion Mafham, Marion K Campbell, Antony Johansen, Xavier L Griffin","doi":"10.1302/0301-620X.107B2.BJJ-2024-0846.R1","DOIUrl":"10.1302/0301-620X.107B2.BJJ-2024-0846.R1","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to evaluate the suitability, against an accepted international standard, of a linked hip fracture registry and routinely collected administrative dataset in England to embed and deliver randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>First, a bespoke cohort of individuals sustaining hip fractures between 2011 and 2016 was generated from the National Hip Fracture Database (NHFD) and linked to individual Hospital Episode Statistics (HES) records and mortality data. Second, in order to explore the availability and distribution of outcomes available in linked HES-Office of National Statistics (ONS) data, a more contemporary cohort with incident hip fracture was identified within HES between January 2014 and December 2018. Distributions of the outcomes within the HES-ONS dataset were reported using standard statistical summaries; descriptive characteristics of the NHFD and linked HES-ONS dataset were reported in line with the Clinical Trials Transformation Initiative recommendations for registry-enabled trials.</p><p><strong>Results: </strong>Case ascertainment of the NHFD likely exceeds 94%. The assessment of the robustness, relevance, and reliability of the datasets was favourable. Outcomes from the HES-ONS dataset were concordant with other contemporaneous prospective cohort studies with bespoke data collection frameworks.</p><p><strong>Conclusion: </strong>Our findings support the feasibility of the NHFD and HES-ONS to support a registry-embedded, data-enabled RCT.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"229-238"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tossed around in a stormy sea : regulation, market forces, and changes to implants.","authors":"James T Patton, Fares S Haddad","doi":"10.1302/0301-620X.107B2.BJJ-2024-1578","DOIUrl":"10.1302/0301-620X.107B2.BJJ-2024-1578","url":null,"abstract":"","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"133-134"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous recovery in the majority of stable dysplastic hips treated with active surveillance.","authors":"Wesley W E S Theunissen, Marieke C van der Steen, Thom Klerkx, Charlotte Schonck, Arnold T Besselaar, Florence Q M P van Douveren, Jaap J Tolk","doi":"10.1302/0301-620X.107B2.BJJ-2024-0331.R1","DOIUrl":"10.1302/0301-620X.107B2.BJJ-2024-0331.R1","url":null,"abstract":"<p><strong>Aims: </strong>Worldwide controversy exists on the optimal treatment of stable dysplastic hips. The most common treatment options are abduction brace treatment and active surveillance. The primary aim of this study was to assess the effect of active surveillance in stable hip dysplasia, by investigating the percentage of Graf IIb stable dysplastic hips that recover spontaneously without abduction brace treatment. The second aim was to identify prognostic factors for spontaneous recovery of stable dysplastic hips.</p><p><strong>Methods: </strong>A single-centre, prospective cohort study was conducted at the Máxima Medical Center between 1 March 2019 and 1 March 2023. Infants aged three to 4.5 months at the first outpatient clinic visit, diagnosed with Graf IIb hip dysplasia, and treated with active surveillance were included. Spontaneous recovery was defined as infants who had a normalized hip on ultrasound (α-angle ≥ 60°) after six weeks of active surveillance without receiving abduction brace treatment. Baseline infant characteristics and ultrasound measurements were used as potential predictor variables for spontaneous recovery in logistic regression analyses.</p><p><strong>Results: </strong>A total of 508 infants with Graf IIb stable dysplastic hips were included. Overall, 473 infants (93.1%) recovered spontaneously with active surveillance. Of the remaining 35 infants, 25 infants (4.9%) received six weeks and ten infants (2.0%) received 12 weeks of additional Pavlik harness treatment until hip normalization. In univariate and multivariate analyses, an impaired hip abduction was negatively associated (OR 0.43 (95% CI 0.20 to 0.93); p = 0.033) and being a firstborn child positively associated (OR 2.20 (95% CI 1.04 to 4.63); p = 0.042) with spontaneous recovery.</p><p><strong>Conclusion: </strong>The majority of Graf IIb stable dysplastic hips recover spontaneously in infants aged three to 4.5 months after six weeks of active surveillance. We recommend active surveillance with ultrasound as primary treatment for these infants. However, care must be taken with active surveillance in infants with a limited hip abduction.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"261-267"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying consensus and areas for future research in chondrosarcoma : a report from the Birmingham Orthopaedic Oncology Meeting.","authors":"Lee M Jeys, Guy V Morris, Vineet J Kurisunkal, Eduardo Botello, Richard A Boyle, Walid Ebeid, Matthew T Houdek, Ajay Puri, Pietro Ruggieri, Bernadette Brennan, Minna K Laitinen, Santiago Abad Repiso, Hesham Abdelbary, Alejandro Abiad Mejia, Ahmed A Abood, Juan C Abril Martin, Adesegun Abudu, Ayman Abu Elhamd, Marthelena Acosta, Keisuke Ae, Manish Agarwal, Vivek Ajit Singh, Toru Akiyama, Ibrahim Alshaygy, Jose I Albergo, John Alexander, Patricio A Alfaro, Bugra Alpan, Jose Amaya-Valero, Megan Anderson, Dimosthenis Andreou, Lucas Annabell, Christopher Anthony, Ahmed Aoude, Iraia Arteagoitia-Colino, Apichat Asavamongkolkul, William Aston, Libe Asua Mentxaka, Christine Azzopardi, Thomas Baad-Hansen, Ismail T Badr, Francisco Baixauli-Garcia, Gavin Baker, Tessa Balach, Giacomo G Baldi, Janie Barry, Georges Basile, Stefano Bastoni, Mohammad Basuki, Henrik Bauer, Lee Bayliss, Ricardo G Becker, Angad Bedi, Joseph Benevenia, Francisco Bengoa, Peter Bergh, Marko Bergovec, Nicholas Bernthal, Odion Binitie, David Boddie, Michele Boffano, Patricia Bonilla Huertas, Anna B Borgognoni, Rajesh Botchu, Jos Bramer, Rahat Brar, Harriet Branford-White, Demien Broekhuis, Samuel E Broida, Tymoteusz Budny, Zachary D Burke, Jorge Cabrolier, Jose A Calvo-Haro, Jorge R Calvo Tapies, Rodrigo Cardoso, Richard Carey Smith, Pedro I Carvallo, Nicolas Casales Fresenga, Jose M Casanova, Oscar Ceballos, Juan L Cebrian Parra, Sara Chacon Cartaya, Chung M Chan, Yoon Joo Cho, Peter Choong, Yang-Guk Chung, Dawid Ciechanowicz, Miguel A Clara-Altamirano, David Clever, Sebastian M Colina, Luis Consuegra, Cory Couch, Gillian Cribb, Carlos Cuervo, Laurence A Cusick, Solomon Dadia, Tanios Dagher, Dietmar Dammerer, Mark Davies, Nerys Davies, Luis P de la Rosa Martino, Francisco J de Santos de la Fuente, Marieke de Vaal, Claudia Deckers, Javier Delgado Obando, Shaneel Deo, Niklas Deventer, Claudia Di Bella, Gregory Domson, Davide M Donati, Desiree M Dorleijn, Jacques Du Toit, Debra Dunne, Rodolfo Duran Ciarrochi, Elina Ekman, Ahmed M El Ghoneimy, Makoto Endo, Levent Eralp, Mahmoud Etaiwi, Scott Evans, Robin Evrard, Will Eward, Alberto Farese, Peter C Ferguson, Pedro F Ferreira Cardoso, Fabrice Fiorenza, Michael Flint, Hector Flores, Joao Freitas, Bruno Fuchs, Tomohiro Fujiwara, Philipp T Funovics, Marcos Galli Serra, Zakareya Gamie, Carlos Garces-Zarzalejo, Aaron Gazendam, Carsten Gebert, Jasper G Gerbers, Craig Gerrand, Ghaith Abou-Nouar, Michelle Ghert, Kanishka M Ghosh, Max Gibbons, Luis C Gomez-Mier, Jesus Gomez-Vallejo, Anne Gomez-Mascard, Marcos R Gonzalez, Fausto Gonzalez-Lizan, Georg Gosheger, Stuart Goudie, Krista Goulding, Stavros D Goumenos, Anthony Griffin, Ashish Gulia, Sanjay Gupta, Amit Gupta, Maurice Guzman, Mohammed Haitham, Jendrik Hardes, Francisco Hardoy, Yusuf Hasan, Georg Hauer, Helard Havard, Rex Haydon, John Healey, Nerea Hernandez Gonzalez, Adriana Hernandez-Lopez, Asle Hesla, Matthew Hess, Thomas Hilton, Chindanai Hongsaprabhas, Francis Hornicek, Keith Hosking, Eleanor Houghton, Oluwaseyi K Idowu, Joseph Ippolito, Marc Isler, Shintaro Iwata, Jake Jagiello, Neil Jenkins, Thomas Jenkins, Charlotte Jeys, Tom Jeys, Luke Johnson, Andy Johnston, Min Wook Joo, Paul C Jutte, Kadri Kaldas, Amar Kamat, Sudhir Kannan, Bilal Kapanci, Zeeshan Khan, Hiroshi Kobayashi, Yehuda Kollender, Sebastian Koob, Daniel Kotrych, Richard Kyte, Jose M Lamo de Espinosa, Alexander L Lazarides, Louis-Romee Le Nail, Pawel Legosz, Burkhard Lehner, Andreas Leithner, Maryse Lejoly, Valerae O Lewis, Peng Lin, Francisco Linares, Santiago A Lozano-Calderon, Ashish Mahendra, Ferdiansyah Mahyudin, Fermin J Mandia Mancebo, Sara M Torrejon, Christian Marx, Eric Mascard, Jean-Camille Mattei, Louise McCullough, Sam McMahon, Manuel R Medellin Rincon, Benjamin Miller, Shinji Miwa, Gustavo Molina Uribe, Bryan Moon, Rhidian Morgan-Jones, Diego J Moriel Garcesco, Carol Morris, Steward Morrison, Sophie Mottard, Marcio Moura, Linde Muster, Robert Nakayama, Prashant Narhari, Ana Navas, Prakash Nayak, Johannes Neugebauer, Erik T Newman, Jyrki Nieminen, Emmy Nyqvist, Lukas Nystrom, Sarah O'Reilly-Harbidge, Gary O'Toole, Vania Oliveira, André Olivier, Mohamed Omar, Eduardo J Ortiz-Cruz, Harzem Ozger, Korhan Ozkan, Elisa Pala, Emanuela Palmerini, Grant Pang, Panayiotis Papagelopoulos, Giovanni Paraliticci, Michael C Parry, Sam Patton, David Peake, Ana Peiro Ibanez, Israel Perez Munoz, Ganapathy R Perianayagam, Michael M Petersen, Joris Ploegmakers, Robin Pollock, Gerard Powell, Juan Pretell, Jan Puetzler, Faisal Qamar, Anand Raja, Raja B Rajasekaran, Dipak Ramkumar, R L Randall, Kenneth S Rankin, Kevin A Raskin, Kumaran Rassppan, Lauris Repsa, Mickael Ropars, Peter Rose, Wael Sadek, German Salcedo, Aasim Saleemi, Andrea Sambri, Hartej Sar, Roberto Scanferla, Thomas Schubert, Jan Schwarze, Guido Scoccianti, Ashley Scrimshire, Tetsuya Sekita, Ahmad Shehadeh, Ahmed Shoaib, Bhim Shreemal, Felix Shumelinsky, Geoffrey Siegel, Claudio Silveri, Robert Silverwood, Friedl Sinnaeve, Jerome Sison, Andrea Slade, Maria A Smolle, Franz Snyman, Scott Sommerville, Sahil Sood, Andre Spiguel, Hugo St-Yves, Eric L Staals, Silvia Stacchiotti, Nikolas Stavropoulos, Peter Steadman, Jonathan D Stevenson, Mikaela Sullivan, Gwen Sys, Bartlomiej Szostakowski, Angela Tamburini, Yuta Taniguchi, Thomas Temple, Christoph Theil, Joachim Thorkildsen, Meagan Tibbo, Roger Tillman, Yu Toda, Kaspar Tootsi, Ferran Torner Rubies, Frank Traub, Ioannis Trikoupis, Panagiotis Tsagkozis, Kim Tsoi, Hiroyuki Tsuchiya, Veli-Matti Vainio, Antonio Valcarcel, Juan Valencia, Annelies Van Beeck, Michel Van de Sande, Thomas Van Den Berghe, Ingrid Van de Geest, Lizz Van der Heijden, Robert Van der Wal, Kirsten Van Langevelde, Gualter Vaz, Roberto Velez Villa, Floortje Verspoor, Koenraad Verstraete, Julia Visgauss, Oleg Vyrva, Hazem Wafa, Sebastian Walter, Wan F Wan Ismail, Edward Wang, Patrick Q Wang, David Warnock, Joel Werier, Wolfram Weschenfelder, Kwok-Chuen Wong, Marjan Woulthuyzen-Bakker, Jay Wunder, Indica Wysinghe, Norio Yamamoto, Zhaoming Ye, Seung-Jae Yoon, Suraya Zainul Abidin, Tomas Zamora, Pierluca Zecchetto, Liuzhe Zhang, Juan P Zumarraga, Domenico A Campanacci","doi":"10.1302/0301-620X.107B2.BJJ-2024-0643.R1","DOIUrl":"10.1302/0301-620X.107B2.BJJ-2024-0643.R1","url":null,"abstract":"<p><strong>Aims: </strong>The Birmingham Orthopaedic Oncology Meeting (BOOM), held in January 2024, convened 309 delegates from 53 countries to discuss and refine 21 consensus statements on the optimal management of chondrosarcoma.</p><p><strong>Methods: </strong>With representation from Europe (43%; n = 133), North America (17%; n = 53), South America (16%; n = 49), Asia (13%; n = 40), Australasia (5%; n = 16), the Middle East (4%; n = 12), and Africa (2%; n = 6), the combined experience of treating bone sarcomas among attendees totalled approximately 30,000 cases annually, equivalent to 66 years of experience in the UK alone. The meeting's process began with the formation of a local organizing committee, regional leads, and a scientific committee comprising representatives from 150 specialist units across 47 countries. Supported by major orthopaedic oncology organizations, the meeting used a modified Delphi process to develop consensus statements through online questionnaires, thematic groupings, narrative reviews, and anonymous pre-meeting polling.</p><p><strong>Results: </strong>Strong (> 80%) consensus was achieved on 19 out of 21 statements, reflecting agreement among delegates. Key areas of consensus included the role of radiology in diagnosis and surveillance, the management of locally recurrent disease, and the treatment of dedifferentiated chondrosarcoma. Notably, there was agreement that routine chemotherapy has no role in chondrosarcoma treatment, and radiological surveillance is safe for intraosseous chondrosarcomas. Despite the overall consensus, areas of controversy remain, particularly regarding the treatment of atypical cartilage tumours and surgical margins. These unresolved issues underscore the need for further research and collaboration within the orthopaedic oncology community.</p><p><strong>Conclusion: </strong>BOOM represents the largest global consensus meeting in orthopaedic oncology, providing valuable guidance for clinicians managing chondrosarcoma worldwide. The consensus statements offer a reference for clinical practice, highlight key research priorities, and aim to improve patient outcomes on a global scale.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"246-252"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late fracture-related infections in HIV-positive patients : a prospective cohort study.","authors":"Simon M Graham, Samuel Masterson, Maritz Laubscher, Nando Ferreira, William J Harrison, A Hamish R W Simpson, Sithombo Maqungo","doi":"10.1302/0301-620X.107B2.BJJ-2024-0660.R1","DOIUrl":"10.1302/0301-620X.107B2.BJJ-2024-0660.R1","url":null,"abstract":"<p><strong>Aims: </strong>HIV and musculoskeletal injuries both disproportionately affect individuals living in low- and middle-income countries (LMICs), leading to a significant number of fractures in HIV-positive patients. Despite this, little is known about the long-term outcomes for these patients. This prospective cohort study investigated whether HIV infection is associated with fracture-related infections (FRIs).</p><p><strong>Methods: </strong>All adult patients between September 2017 and December 2018 who received intramedullary nail fixation of lower limb fractures in two tertiary referral hospitals in Cape Town, South Africa, were deemed eligible. In total, 358 participants were recruited for this study, 33 of whom were lost to follow-up. Of the 325 participants, 37 (11.4%) developed a total of 39 FRIs over the study period; 25 were early FRIs (64.1%) and 14 were late FRIs (35.9%). Participants were followed up for a minimum of 24 months. Throughout follow-up, participants were monitored for FRIs. These were categorized as early FRIs (< 90 days) and late FRIs (> 90 days).</p><p><strong>Results: </strong>Overall, 71 participants (21.8%) were HIV-positive and 254 participants were HIV-negative (78.2%). In the HIV-positive population, 15 participants (21.1%) suffered 16 FRIs: seven early FRIs (9.9%) and nine late FRIs (7.0%). In the HIV-negative population, 22 participants (8.7%) experienced 23 FRIs, 18 were early FRIs (7.1%), and five participants experienced late FRIs (2.0%). On univariate and multivariate regression, being HIV-positive increased a participant's likelihood of suffering late FRIs, and FRIs overall. HIV status made no significant difference to early FRI rates.</p><p><strong>Conclusion: </strong>Contrary to recent evidence, this study demonstrates an association between HIV and an increased risk of a patient developing late FRIs. However, there was no significant difference in early FRI rates.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"221-228"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Wrightington Classification System for elbow fracture-dislocations : an external reliability study.","authors":"Shannon Tse, An-Sofie Van de Kelft, Samuel K Simister, Danielle A Forster, Marcus Lee, Aditya Prinja, Kannan Rajesparan, Abbas Rashid","doi":"10.1302/0301-620X.107B2.BJJ-2024-0294.R1","DOIUrl":"10.1302/0301-620X.107B2.BJJ-2024-0294.R1","url":null,"abstract":"<p><strong>Aims: </strong>Complex elbow fracture-dislocations often result in suboptimal outcomes and necessitate a thorough understanding of injury patterns to guide effective management and reduce adverse sequelae. The Wrightington Classification System (WCS) offers a comprehensive approach and considers both bony and soft-tissue disruption, providing clearer guidance for treatment. This is the first external study to assess the reliability of the WCS for elbow fracture-dislocations.</p><p><strong>Methods: </strong>A blinded study of patients with elbow fracture-dislocations at a single institution between December 2014 and December 2022 was conducted. Five assessors with a range of experience, including orthopaedic surgeons and radiologists, independently classified injuries using the WCS across three image methods: plain radiograph, 2D CT, and 2D and 3D CT reconstruction images, on two occasions with an eight-week interval. Interobserver and intraobserver reliability were evaluated using kappa statistics and the Landis and Koch criteria.</p><p><strong>Results: </strong>A total of 73 patients were included in the study. Interobserver reliability was moderate, with mean kappa values of 0.518 (95% CI 0.499 to 0.537), 0.557 (95% CI 0.537 to 0.577), and 0.582 (95% CI 0.562 to 0.601), for radiographs, 2D CT, and 2D and 3D CT reconstructions, respectively. Intraobserver agreement was substantial (mean kappa 0.695 (SE 0.067), 0.729 (SE 0.071), and 0.777 (SE 0.070) for radiographs, 2D CT, and 3D CT reconstructions, respectively).</p><p><strong>Conclusion: </strong>The WCS is a reliable and valuable tool for characterizing elbow fracture-dislocations and guiding surgical interventions. This study found moderate reliability in using the WCS, with higher reliability with combined 2D and 3D CT imaging. Further refinement within the WCS in differentiating between coronoid avulsions, basal, anteromedial, and/or anterolateral facet injuries may help improve reliability and reproducibility.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"188-192"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}