Journal of the American Academy of Orthopaedic Surgeons最新文献

{"title":"Low-Molecular-Weight Heparin Combined With Somatosensory Evoked Potential Monitoring for Prevention of Postoperative Lower Extremity Deep Vein Thrombosis in Patients With Spinal Fracture.","authors":"Junjun Liao, Guangliang Lu, Zhihua Wang","doi":"10.5435/JAAOS-D-24-01437","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01437","url":null,"abstract":"<p><strong>Background: </strong>To assess the effect of low-molecular-weight heparin (LMWH) combined with evoked potentials somatosensory evoked potential (SEP) on the prevention of deep vein thrombosis (DVT) in patients undergoing spinal surgery.</p><p><strong>Methods: </strong>One hundred twenty-eight patients who underwent spinal surgery from August 2022 to August 2023 were chosen, and the patients were randomly classified into the control group and the observation group, with 64 cases in each group. The control group received LMWH injections.The observation group received SEP monitoring on the basis of the control group. The blood flow velocity of popliteal veins of both lower limbs was measured by Color Doppler ultrasonography. The D-dimer concentration was measured using intravenous blood samples taken 1 day before surgery, after surgery, and 24 hours after surgery. The incidence of lower extremity DVT was diagnosed by ultrasonography during surgery and 24 hours after surgery.</p><p><strong>Results: </strong>Compared with the control group, the blood flow velocity of the popliteal veins in both lower limbs in the observation group increased at T2-4 (P < 0.001), and the D-dimer and FIB concentrations in the observation group were decreased (P < 0.001); the occurrence of DVT in the observation group was lower than that in the control group (P < 0.05).</p><p><strong>Conclusion: </strong>LMWH combined with SEP monitoring can effectively prevent the occurrence of lower limb DVT in patients with spinal surgery.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The New Centers for Medicare and Medicaid Services Patient-Reported Outcome-Based Performance Measure: What It Means and How Can I Align.","authors":"Lauren M Shapiro, Kevin J Bozic, Mark McClellan, Kurt Spindler","doi":"10.5435/JAAOS-D-24-01000","DOIUrl":"10.5435/JAAOS-D-24-01000","url":null,"abstract":"<p><p>The recognition of the benefits of the measurement and utilization of patient-reported outcome measures (PROMs) in clinical care continues to increase. Furthermore, the Centers for Medicare and Medicaid Services recently mandated a patient-reported outcome-based performance measure (PRO-PM) supporting the measurement of PROMs pre- and postoperatively for patients undergoing primary hip and knee arthroplasty. Under this new policy, hospitals not measuring and reporting complete data on 50% or more of included patients are at risk for substantial loss of Medicare Part A reimbursement. As with any new policy, there are nuances, barriers, possible undesirable consequences, and opportunities for improvement that should be considered and mitigated for said policy to have the greatest potential benefit on the population. In this article, we review the implications of the new policy, barriers to successful implementation, and possible undesirable consequences, and aim to provide guidance and strategies to assist surgeons, health systems, and other stakeholders in understanding, aligning with, and improving care based on the new Centers for Medicare and Medicaid Services PROM-PM.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Intrapelvic Approach: A Comprehensive Understanding of the Anatomy.","authors":"Guillaume David, Claude H Sagi, Pierre Guy, Cyril Mauffrey","doi":"10.5435/JAAOS-D-24-01050","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01050","url":null,"abstract":"<p><p>The anterior intrapelvic (AIP) approach has become a standard technique for the fixation of acetabular fractures. While the critical steps for performing the AIP approach are well described in the literature, a comprehensive overview of the anatomical structures at risk remains limited. This review aims to provide an in-depth understanding of the AIP approach with a focus on the historically \"nonorthopaedic\" surgical anatomy and associated risks. Ultimately, this knowledge empowers orthopaedic trauma surgeons to perform acetabular surgery with improved exposure, safety, and confidence.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Crossing the Cervicothoracic Junction on Opioid Consumption, Readmission, and Revision Rates.","authors":"Gregory Toci, Rajkishen Narayanan, Michael Carter, Jonathan Dalton, Rachel Huang, Andrew Vanichkachorn, Andrew Kim, Asad Pasha, Nathaniel Pineda, Mark Kurd, Ian David Kaye, Thomas Cha, Barrett Woods, Jose Canseco, Alan Hilibrand, Alexander Vaccaro, Christopher Kepler, Gregory Schroeder","doi":"10.5435/JAAOS-D-24-01197","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01197","url":null,"abstract":"<p><strong>Introduction: </strong>The risks and benefits of extending posterior cervical decompression and fusion (PCDF) constructs across the cervicothoracic junction (CTJ) remain controversial. Previous studies have used fusions beginning at different levels and varying in construct length. There are no studies that examine the effect of crossing the CTJ on opioid consumption. This study aims to compare short-term and long-term postoperative outcomes among patients undergoing PCDF at C3 and ending at C7, T1, or T2.</p><p><strong>Methods: </strong>Adult patients who underwent C3-C7, C3-T1, and C3-T2 PCDF from 2017 to 2022 were identified. All patients were retrospectively reviewed for demographic and surgical information. Perioperative opioid utilization from 1 year preoperatively to 1 year postoperatively was obtained from the Pennsylvania Prescription Drug Monitoring Program (PDMP). Acute postoperative outcomes included rates of 30-day and 90-day readmission and any revision surgery.</p><p><strong>Results: </strong>This study included 72 (C3-C7: 30.2%), 143 (C3-T1: 60.1%), and 23 (C3-T2: 9.7%) patients-groups were demographically similar. The average length of follow-up was 503 ± 433 days. Cut-to-close time differed between groups (166 ± 37.9 [C3-C7] vs. 182 ± 43.2 vs. 199 ± 40.9 minutes [C3-T2]; P = 0.003). Total in-hospital morphine milligram equivalents (205 ± 136 [C3-C7] vs. 247 ± 191 vs. 285 ± 136 [C3-T2]; P = 0.007) and average daily in-hospital morphine milligram equivalents (59.5 ± 29.9 [C3-C7] vs. 73.2 ± 52.1 vs. 81.0 ± 22.9 [C3-T2]; P = 0.008) were highest among C3-T2 fusions. Patients who underwent C3-T2 fusion consumed higher MMEs from 0 to 90 days postoperatively (148 ± 197 [C3-C7] vs. 223 ± 307 vs. 260 ± 363 [C3-T2]; P = 0.027). Length of stay, opioid use beyond 90 days, 30-day and 90-day readmission rates, revision surgery rates, and revision rates were similar between groups.</p><p><strong>Conclusion: </strong>Crossing the CTJ increased cut-to-close time and early postoperative opioid consumption but did not affect length of stay, readmission rates, long-term opioid misuse, or revision surgery rates.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GPT-4 as a Source of Patient Information for Carpal Tunnel Surgery: A Comparative Analysis Against Google Web Search.","authors":"Paul G Mastrokostas, Aaron B Lavi, Bruce B Zhang, Leonidas E Mastrokostas, Scott Liu, Katherine M Connors, Jennifer Hashem","doi":"10.5435/JAAOS-D-24-00249","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00249","url":null,"abstract":"<p><strong>Introduction: </strong>Carpal tunnel surgery (CTS) accounts for approximately 577,000 surgeries in the United States annually. This high frequency raises concerns over the dissemination of medical information through artificial intelligence chatbots, Google, and healthcare professionals. The objectives of this study are to determine whether GPT-4 and Google differ in (1) the type of questions asked, (2) the readability of responses, and (3) the accuracy of numerical responses for the top 10 most frequently asked questions (FAQs) about CTS.</p><p><strong>Methods: </strong>A Google search was conducted to identify the top 10 FAQs related to CTS, which were then queried in GPT-4. Responses were categorized using the Rothwell classification system and evaluated for readability using Flesch Reading Ease and Flesch-Kincaid grade level scores. Statistical analyses included Cohen kappa coefficients for interobserver reliability and Student t-tests for comparing response characteristics. Statistical significance was set at the 0.05 level.</p><p><strong>Results: </strong>This study found that 70% of Google's FAQs were fact based, predominantly focusing on technical details (40%) and specific activities (40%). GPT-4's FAQs were mainly factual (50%), with technical details (40%) being the most queried topic. Complete agreement in interobserver reliability was observed. Google's answers were more readable than GPT-4's, with a Flesch Reading Ease score of 56.40 vs. 34.19 (P = 0.001) and a Flesch-Kincaid grade level of 9.93 vs. 12.85 (P = 0.007). Google responses were shorter, with an average word count of 91.50 compared with GPT-4's 162.90 (P = 0.013). For numerical responses to FAQs, GPT-4 and Google differed in nine out of 10 questions, with GPT-4 often providing broader time frames.</p><p><strong>Conclusion: </strong>GPT-4 offers a more detailed and technically oriented approach to addressing patient queries about CTS when compared with Google. This suggests that GPT-4 can offer detailed insights where patients seek more in-depth information, enhancing the quality of healthcare education.</p><p><strong>Level of evidence: </strong>NA.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Ankle Arthritis: Joint-Preserving and Joint-Sacrificing Strategies.","authors":"James R Lachman, Steven L Haddad","doi":"10.5435/JAAOS-D-24-00955","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00955","url":null,"abstract":"<p><p>The disability caused by ankle arthritis is notable. The challenges in management of ankle joint degeneration are attributed to greater load transmission during activity and unique joint kinematics when compared with the hip and knee. Furthermore, characteristics of ankle cartilage pose unique challenges when compared with other weight-bearing joints. Joint-sacrificing procedures dominated historic management of ankle joint arthritis. In this review, both joint-preserving and joint-sacrificing techniques will be discussed.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FastFrame Knee Spanning External Fixation Associated With Lower Cost Than Modular Frame Configurations: A Comparative Cohort Study.","authors":"Luke A Myhre, Elleanor H Sato, Lillia Steffenson, Zachary Olsen, David L Rothberg, Lucas S Marchand, Justin Haller","doi":"10.5435/JAAOS-D-24-00372","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00372","url":null,"abstract":"<p><strong>Introduction: </strong>External fixation costs have been identified as a primary driver of initial cost in the care of tibial plateau fractures. Because hospital systems and institutions pursue value-based care, external fixation choices become a uniquely surgeon-dependent driver of cost. Our objective was to determine differences in cost in a prepackaged, single-use, external fixation system compared with standard, modular, knee spanning frames. Secondary objectives were to determine differences in surgical time and loss of distraction between the two types of fixation.</p><p><strong>Methods: </strong>This was a retrospective cohort study at an academic level 1 trauma center. Fifty-nine patients were treated with knee spanning external fixation over a 7-year period (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopedic Trauma Association 41-B/C). Patients received either the Zimmer FastFrame external fixator or a conventional-style, modular, external fixator. The primary outcome was implant and supply cost. The secondary outcomes were operating room facility cost, surgical time, and percent of distraction lost.</p><p><strong>Results: </strong>The FastFrame cohort demonstrated a 24.9% decrease in surgical times (29.2 vs. 38.9 minutes, P = 0.002), with a 37% decrease in supply and implant cost of conventional cohort (0.63x vs. 1x, P < 0.001). Operating room facility cost was less than the conventional cohort (0.72x vs. 1x, P = 0.41), and total cost was 21.8% less (0.78x vs. 1x, P = 0.07), although these did not reach statistical significance. The Fastframe cohort lost less distraction (72.6% vs. 62.8%, P = 0.02).</p><p><strong>Conclusion: </strong>The FastFrame demonstrates a lower supply and implant cost, faster surgical times, and demonstrated clinical equivalence in regard to loss of distraction when compared with conventional, modular, external fixator.</p><p><strong>Level of evidence: </strong>Diagnostic-Level III.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"FATAL Graft\": A Diagnostic Algorithm for the Workup of Anterior Cruciate Ligament Reconstruction Graft Failure.","authors":"Andrew S Bi, Mark A Pianka, Laith M Jazrawi, Michael J Alaia","doi":"10.5435/JAAOS-D-24-00974","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00974","url":null,"abstract":"<p><p>There are multiple etiologies for revision anterior cruciate ligament reconstruction (ACLR), including but not limited to infection, arthrofibrosis, and graft failure, which should be distinguished before revision ACLR. Graft failure occurs when the reconstructed ligament does not restore knee stability, and it includes both graft rupture and functional failure in the setting of an intact graft. The causes of graft failure following ACLR can be divided into surgeon-controllable factors (ie, tunnel position, graft choice, alignment) and patient-centric factors (ie, patient age, tissue quality from systemic disease or smoking, compliance/traumatic reruptures). The purpose of this review is to propose an organized, easy-to-remember algorithm for the workup of surgeon-controlled ACLR graft failure etiologies, represented by the acronym \"FATAL Graft.\"</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors of Diaphyseal Femoral Nonunions: A Systematic Review and Meta-analysis.","authors":"Tyler K Williamson, Jonathan G Eastman, Timothy Achor, Stephen J Warner","doi":"10.5435/JAAOS-D-24-01064","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01064","url":null,"abstract":"<p><strong>Background: </strong>Intramedullary nailing of diaphyseal femur fractures often results in reliable union, with union rates ranging from 96% to 100%. However, femoral nonunions (FNUs) can be a debilitating clinical condition for patients. The purpose of this review was to identify and characterize the predictors of nonunion after femoral midshaft fractures.</p><p><strong>Methods: </strong>A systematic search was conducted using key terms \"femoral shaft non-union,\" \"femoral diaphyseal non-union,\" \"femoral shaft fracture,\" \"femoral diaphysis fracture,\" and \"femoral midshaft fracture\" published before June 2024. Human studies describing risk factors associated with development of FNUs were included. Articles were excluded if not able to assess risk factors of FNUs. Data synthesis summarized outcome measures and study designs appropriately in the results. SPSS meta-analysis function was used to calculate the mean effect size estimate (MESE) and 95% confidence intervals for each outcome.</p><p><strong>Results: </strong>This search yielded a total of 7,879 studies, and after exclusion criteria were assessed, 26 articles comprising 14,170 patients with diaphyseal femoral fractures were included. These studies included 973 fractures developing nonunions after surgical intervention. A total of 25 factors were assessed. Age (MESE = 1.33 [0.92 to 1.74]; P < 0.001) and type 2 diabetes (MESE = 1.77 [1.03 to 2.52]; P < 0.001) were significant patient-specific risk factors. Arbeitsgemeinschaft Osteosynthesefragen/Orthopaedic Trauma Association 32B (MESE = 0.94 [0.35 to 1.53]; P < 0.001) and Winquist-Hansen type 3 (MESE = 1.45 [0.63 to 2.26]; P < 0.001) were significant injury-specific factors, along with butterfly fragment size and displacement and open fractures. Open reduction (MESE = 0.80 [0.30 to 1.30]; P < 0.001) and postoperative nonsteroidal anti-inflammatory drug use (MESE = 1.17 [0.08 to 2.27]; P = 0.04) were significant surgical-specific and management-specific risk factors, along with external fixation and iatrogenic comminution.</p><p><strong>Discussion: </strong>Age, diabetes, fracture classification grading, and postoperative nonsteroidal anti-inflammatory drug use were among the factors placing patients at the highest risk of femoral diaphyseal nonunions, including other patient-specific, injury-specific, surgical, and management factors. Future studies are warranted to use a prospective study design, identify diaphyseal nonunion-specific risk factors, and implement evidence-based prevention strategies.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Subcutaneous Fat Depth Is Associated With Increased Complications After Total Shoulder Arthroplasty.","authors":"Lucas R Haase, Molly M Piper, Margaret A Sinkler, John T Strony, Kira L Smith, Robert J Gillespie, Raymond E Chen","doi":"10.5435/JAAOS-D-24-01288","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01288","url":null,"abstract":"<p><strong>Background: </strong>Increased body mass index (BMI) is a well-documented risk factor for complications after lower extremity arthroplasty. The literature in total shoulder arthroplasty (TSA) displays notable variation. The utility of BMI in predicting complications in TSA may be limited because of differences in weight distribution. Prior studies in spine surgery have demonstrated increased complications based on subcutaneous fat depth at the incision site. The purpose of this study was to determine whether tissue depth may be associated with an increased risk of complication after primary TSA.</p><p><strong>Methods: </strong>A retrospective study was done on all patients undergoing primary TSA between January 2018 and December of 2021. Postoperative complications of superficial surgical site infection, prosthetic joint infection stress fracture, and implant instability were recorded. Preoperative advanced imaging was used to measure total tissue depth and subcutaneous fat depth at the level of the coracoid and bicipital groove. A combination of univariate and multivariate statistics was used to determine association between tissue depth and postoperative complication.</p><p><strong>Results: </strong>A total of 219 patients were included in the study. Twenty-nine patients experienced a total of 31 complications. The complication group had a higher percentage of reverse TSA to anatomic. The complication group had a markedly higher depth of subcutaneous fat tissue at the coracoid and bicipital groove (18.82 and 17.53 mm, respectively) compared with the control group (15.05 mm and 11.77; P = 0.046 and P = 0.005). On multivariate analysis, these differences remained statistically significant.</p><p><strong>Conclusion: </strong>Local subcutaneous fat depth at the coracoid process and bicipital groove was associated with increased rates of complications. In addition, BMI did not demonstrate an association with complications. It is possible that different weight distributions within the upper extremity limit the utility of BMI in risk stratification.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}