Journal of the American Academy of Orthopaedic Surgeons最新文献

{"title":"Patient Encounter Cards Improve Physician and Patient Engagement for New Patient Visits in Orthopaedic Oncology.","authors":"Charlotte F Wahle, Nicole J Newman-Hung, Mikayla R Mefford, Mathangi Sridharan, Alexander B Christ, Nicholas M Bernthal, Duretti T Fufa, Lauren E Wessel","doi":"10.5435/JAAOS-D-25-00822","DOIUrl":"10.5435/JAAOS-D-25-00822","url":null,"abstract":"<p><strong>Introduction: </strong>New patient visits in the orthopaedic oncology clinic are medically complex and emotionally nuanced. Previous orthopaedic literature has shown that clear communication of the diagnosis and plan can be difficult, resulting in worse outcomes. This study aimed to validate the use of a novel patient encounter card (PEC) to improve patient/physician postencounter satisfaction.</p><p><strong>Methods: </strong>All new patients who presented to the clinics of three fellowship-trained orthopaedic oncologists from September 2023 to March 2025 were included. In the preintervention phase, visits were conducted without modification. Patients were queried on satisfaction, whether concerns were addressed, understanding of the treatment plan, and perceived patient/physician connection. During the intervention phase, a PEC was implemented. The \"patient\" side was completed in the waiting room; the \"physician\" side during the visit. Patients then completed the same postvisit survey. Residents and fellows were surveyed at the end of each clinic. All statistical analysis was done using STATA V18.</p><p><strong>Results: </strong>A total of 245 patients were surveyed. During the intervention phase, patient scores improved across all 12 patient satisfaction and competency metrics. Following the intervention, 94% of patients strongly agreed that the doctor listened to what they had to say and 93% felt that their main concern had been addressed. Compared with the control group, markedly more patients reported being \"very satisfied\" with their visit ( P = 0.048) and \"very confident\" that they made the most of their visit ( P = 0.041). Markedly more patients also reported that they were involved in their treatment plan as much as they wanted to be ( P = 0.046). Finally, 100% of surveyed physicians believed that the intervention improved clinical efficiency.</p><p><strong>Conclusion: </strong>PECs improve patient experience and strengthen patient-physician communication while maintaining clinical efficiency in orthopaedic oncology consultations. This simple, low-cost intervention may be effective across a range of medical and surgical specialties.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e1375-e1381"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811040","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":"Results of Dome-shaped Proximal Tibial Osteotomy in Varus and Axial Malalignment of Tibia.","authors":"Hamidreza Yazdi, Dorsa Bahrami Zanjanbar, Mehrzad Solooki","doi":"10.5435/JAAOS-D-25-00667","DOIUrl":"10.5435/JAAOS-D-25-00667","url":null,"abstract":"<p><strong>Background: </strong>Anterior knee pain, with varus deformity and excessive external tibial torsion, can markedly impair function and quality of life. Although various surgical techniques address these deformities, dome-shaped osteotomy offers a promising approach for correcting malalignment while preserving joint integrity. This study evaluated clinical and radiological outcomes of dome-shaped osteotomy in patients with these combined deformities.</p><p><strong>Methods: </strong>Twenty-eight knees from 21 patients with anterior knee pain, varus deformity (more than 5°), and excessive external tibial torsion (more than 30°) but acceptable hip anteversion (anteversion 30°) underwent dome-shaped tibial osteotomy proximal to the tibial tubercle. The group comprised nine male (32.1%) and 19 female patients (67.9%) with an average age of 28.5 years (17 to 45 years) and a mean body mass index of 19.9 kg/m 2 . Sixteen surgeries were done on right knees and the rest on left knees. Five female and two male patients were operated on bilaterally. Surgical steps included internal tibial rotation to correct axial deformity, medial translation as needed, valgus correction for optimal coronal alignment, and stabilization with a medial locking plate. Postoperative protocols included early mobilization with range-of-motion exercises. Outcomes were assessed using Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC scores) and The Knee injury and Osteoarthritis Outcome Score and radiographic evaluations of varus correction and patellar position.</p><p><strong>Results: </strong>Postoperative Q-angle and thigh-foot angles normalized. WOMAC and pain scores markedly improved, with most patients reporting complete or high satisfaction ( P value <0.001). Complications were minimal, including transient peroneal nerve paresis in two knees and a small peroneal arterial aneurysm in one knee, which was managed conservatively. No infections, compartment syndrome, patella baja, or delayed/nonunion were observed.</p><p><strong>Conclusion: </strong>Dome-shaped osteotomy above the tibial tubercle is an effective surgical option for improving pain, function, and satisfaction in patients with anterior knee pain, varus deformity, and excessive external tibial torsion.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e1432-e1441"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574868","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 Key and the Door: Universal Concepts of Reduction in Fracture Surgery.","authors":"Dane Brodke, Graham DeKeyser, Zachary Working, Darin Friess","doi":"10.5435/JAAOS-D-25-00956","DOIUrl":"10.5435/JAAOS-D-25-00956","url":null,"abstract":"<p><p>Anatomic reduction is fundamental to successful osteosynthesis, yet it remains one of the most challenging surgical skills to teach and master. Although no framework can encompass the full complexity of fracture surgery, this article distills some aspects of the \"art\" of reduction into foundational concepts to guide surgical strategy. We review these principles through intuitive metaphors: the \"key\" (distract, reorient, compress), the \"door\" (establish a hinge and close), and the \"puzzle\" (reduce the easiest piece first). These concepts are integrated with the biomechanical distinction between tension-sided failures, which are often amenable to direct reduction, and compression-sided failures, sometimes better suited for indirect reduction through ligamentotaxis. The practical application of this conceptual framework is demonstrated across a spectrum of common fractures, including those of the proximal and distal humerus, acetabulum, femoral neck, and tibial plateau. By providing a systematic toolkit, these principles aim to transform fracture reduction from an abstract challenge into a more logical, approachable problem for surgeons at all levels of training.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e1329-e1336"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935992","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":"Mortality Trends Following Geriatric Hip Fractures in New York State Between 2010 and 2019: An Examination of the New York Statewide Planning and Research Cooperative System Database.","authors":"Utkarsh Anil, Charles C Lin, Maxwell T Trudeau, Abhishek Ganta, Kenneth A Egol, Sanjit R Konda","doi":"10.5435/JAAOS-D-25-00380","DOIUrl":"10.5435/JAAOS-D-25-00380","url":null,"abstract":"<p><strong>Objectives: </strong>Increased mortality following geriatric hip fractures is well reported. However, population-level analysis of mortality trends over time are not common. This study aimed to evaluate the 3- and 12-month mortality after geriatric hip fractures from 2010 to 2019.</p><p><strong>Methods: </strong>The New York Statewide Planning and Research Cooperative System database from 2010 to 2020 was retrospectively queried for patients aged >65 years with a femoral neck or intertrochanteric hip fracture. Kaplan-Meier survival analysis was used to calculate mortality rates for each year. Cox proportional hazard multivariable regression controlling for sex, age, race, obesity, smoking, and Elixhauser comorbidity index was used to compare mortality hazard ratios for each year. Secondary outcomes included length of stay, discharge disposition, and 3-month readmission and emergency department visits.</p><p><strong>Results: </strong>From 2010 to 2019, 142,540 patients aged ≥65 years had a diagnosis of femoral neck fracture (62%) or intertrochanteric hip fracture (38%). The mean age was 83.29 years (SD 8.22). The mean Elixhauser comorbidity index was 7.35 (SD 7.60). Kaplan-Meier survival analysis revealed that for the complete cohort 3-month mortality rate was 9.82% (95% confidence interval 9.65% to 9.98%) and 12-month mortality rate was 16.06% (95% confidence interval 15.84% to 16.27%). The 3-month mortality rate went from 10.8% in 2010 to 8.6% in 2019 and the 12-month mortality rate went from 17.7% in 2010 to 14.8% in 2018 before rising to 16.9% in 2019. Cox multivariate proportional hazard regression demonstrated statistically significant decreased hazard ratio from 2012 to 2019 compared with reference hazard in 2010 (all P < 0.05). Reductions were also observed for length of stay (7.8 to 6.4 days, P < 0.001), 3-month readmissions rate (34% to 22%, P < 0.001), and 3-month emergency department visit rate (45% to 34%, P < 0.001).</p><p><strong>Conclusion: </strong>Mortality after geriatric hip fractures has demonstrated a reduction in the past decade with 3-month mortality continuously decreasing from 2010 to 2019 and 12-month mortality decreasing from 2010 to 2018 before increasing in 2019.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e1450-e1458"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776372","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 Versus Posterior Lumbar Fusion for Adult Isthmic Spondylolisthesis.","authors":"Ashley Frei, Hania Shahzad, Josh Callaway, Rahul Bhale, Devan Higginbotham, Wyatt Vander Voort, Rolando Roberto, Safdar Khan, Yashar Javidan, Hai Le","doi":"10.5435/JAAOS-D-25-00610","DOIUrl":"https://doi.org/10.5435/JAAOS-D-25-00610","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical management for isthmic spondylolisthesis (IS) can be accomplished with either an anterior, posterior, or combined approach. This study compares 90-day medical and surgical complications of anterior, posterior, and combined lumbar fusion for adults with single-level IS.</p><p><strong>Methods: </strong>Deidentified patient data were obtained through the PearlDiver database using relevant ICD and current procedural terminology codes from 2015 to 2022. Patients ≥18 years with single-level IS who had undergone either anterior lumbar fusion (ALIF), posterior lumbar fusion (PLF), or combined AP lumbar fusion (CLF) were evaluated. Patients undergoing more than one level lumbar fusion were excluded, and 90-day postoperative complications were compared across cohorts.</p><p><strong>Results: </strong>Of 43,619 patients who underwent surgery for IS, 4,622 (10.6%) had ALF, 35,550 (81.5%) PLF, and 3,447 (7.90%) CLF. At 90 days postoperatively, multivariate analysis controlling for demographics, tobacco use, and obesity reveals that odds of readmission were significantly lower in patients who underwent PLF (odds ratio [OR] 0.81, P < 0.01) compared with ALF. A markedly higher odds of revision surgery was observed in patients undergoing PLF (OR 2.65) or CLF (OR 2.40) compared with ALF. Both PLF (OR 0.35) and CLF (OR 0.62) cohorts had lower odds of developing postoperative ileus. No significant difference was noted in rate of postoperative hematoma, pneumonia, sepsis, cauda equina syndrome, or deep vein thrombosis at 90 days between PLF or CLF cohorts compared with ALF (P value >0.05).</p><p><strong>Conclusion: </strong>Among adult patients with IS undergoing single-level lumbar fusion, 81.5% had posterior surgery while 7.9% had combined AP surgery. Compared with the anterior approach, patients undergoing the posterior approach had lower 90-day readmission rates and postoperative ileus rates. However, patients undergoing posterior or combined surgery had higher odds of requiring revision surgery within 90 days. These differences in complication profile may help surgeons in surgical decision making on which approach to consider in their patients with IS.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":"34 10","pages":"e1400-e1406"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823234","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":"Nail Versus Plate for Distal Femur Fracture: A Propensity-matched Analysis.","authors":"Dane Brodke, Brian K Zukotynski, Sai Devana, Adolfo Hernandez, Nathan O'Hara, Cynthia Burke, Jayesh Gupta, Natasha McKibben, Robert O'Toole, John Morellato, Hunter Gillon, Murphy Walters, Colby Barber, Paul Perdue, Graham Dekeyser, Lillia Steffenson, Lucas Marchand, Marshall James Fairres, Loren Black, Zachary Working, Erika Roddy, Ashral El Naga, Matthew Hogue, Trevor Gulbrandsen, Omar Atassi, Thomas Mitchell, Stephen Shymon, Christopher Lee","doi":"10.5435/JAAOS-D-25-00575","DOIUrl":"10.5435/JAAOS-D-25-00575","url":null,"abstract":"<p><strong>Introduction: </strong>Distal femur fractures are commonly treated with retrograde intramedullary nails or lateral locked plates. Although enthusiasm is growing for dual-implant constructs, most fractures are still treated with a single implant, though it remains unclear whether one implant type offers superior outcomes. This study compared revision surgery rates as well as clinical and radiographic outcomes between matched cohorts of distal femur fractures treated with intramedullary nails or lateral plates.</p><p><strong>Methods: </strong>This multicenter retrospective study included adult patients with OTA/AO 33A or 33C distal femur fractures treated with isolated retrograde intramedullary nails or lateral locked plates with a minimum 3-month follow-up at 10 level-1 trauma centers. Outcomes were compared between propensity-matched nail and plate groups including all-cause revision surgery, unplanned revision surgery to promote union, revision surgery for deep surgical site infection, and modified Radiological Union Scale for Tibia scores.</p><p><strong>Results: </strong>A total of 245 fractures treated with intramedullary nails were propensity score-matched 1:1 to 245 fractures treated with a single locked lateral plate. At a mean follow-up of 16 months, no significant differences were found in all-cause revision surgery (24% vs. 19%, P = 0.2), revision surgery to promote union (8.2% vs. 10%, P = 0.5), revision surgery for infection (5.7% vs. 5.7%, P > 0.9), or modified Radiological Union Scale for Tibia scores at 3 months (9 vs. 9, P = 0.6). No notable differences were observed in radiographic postoperative reduction parameters, surgical duration, follow-up duration, or qualitative clinical outcomes between the nail and plate groups.</p><p><strong>Conclusion: </strong>Distal femur fractures treated with retrograde intramedullary nails or lateral locked plates showed no notable differences in revision surgery rates, radiographic healing, or qualitative clinical outcomes. Surgeons should choose nails or plates based on experience, fracture type, and perceived ease of achieving a good reduction with the specific implant.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e1442-e1449"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574880","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":"Insurance Denials: A Comprehensive Review and Navigating the Peer Review Process.","authors":"Ryan J Berger, Michael A Gaudiani, Paul T Fortin, Kevin Taliaferro","doi":"10.5435/JAAOS-D-25-01359","DOIUrl":"https://doi.org/10.5435/JAAOS-D-25-01359","url":null,"abstract":"<p><p>Insurance companies and third-party reviewers use the peer review process including prior authorization (PA) and the peer-to-peer (P2P) process to manage healthcare costs and ensure appropriate care, citing principles of value-based care. As the volume of initial denials increases, physicians face notable time burdens and increased administrative costs while patients can incur delays and possibly worse health outcomes. We aim to explore the legal and ethical framework of utilization management; examine the effect on treating physicians, patients, and reviewers; offer suggestions for navigating peer-to-peer reviews; and propose future directions and improvement opportunities.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":"34 10","pages":"e1368-e1374"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823285","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":"Assessment of Inappropriate Questions Asked by Program Directors and Faculty During Orthopaedic Residency Interviews.","authors":"Emily Jones, Erin Everett, Samantha Morin, Shreya M Saraf, Mia V Rumps, Brent Ponce, S Elizabeth Ames, Lauren McKown, Kim Templeton, Mary K Mulcahey","doi":"10.5435/JAAOS-D-24-01410","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01410","url":null,"abstract":"<p><strong>Introduction: </strong>Notable strides have been made in reducing inappropriate questions during residency interviews. However, this trend has not reached orthopaedic surgery. The purpose of this study was to evaluate the level of knowledge of orthopaedic surgery residency program directors and faculty about the appropriateness of residency interview questions.</p><p><strong>Methods: </strong>An anonymous 18-question survey was distributed to program directors and other faculty involved in orthopaedic surgery residency interviews. Data analysis was completed using Statistical Package for the Social Sciences.</p><p><strong>Results: </strong>A total of 86 respondents (66 men, 17 women, 3 N/A) were included. Most respondents (34, 36.8%) had 0 to 5 years of experience. Questions on applicant health and disability were most likely to be incorrectly identified.</p><p><strong>Conclusion: </strong>The results of this study revealed gaps in knowledge about appropriateness of interview questions. Frequent training for conducting interviews could help standardize the interview process and eliminate inappropriate questions.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":"34 10","pages":"e1472-e1479"},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823311","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":"An Investigation of Chronic Pain Prevalence and Severity Among Spine Surgeons and Trainees.","authors":"Samuel Blake, Alexa R Lauinger, Alan Fullenkamp, Helen Kemprecos, Wedam Nyaaba, Gregory M Polites, Paul M Arnold","doi":"10.5435/JAAOS-D-26-00004","DOIUrl":"https://doi.org/10.5435/JAAOS-D-26-00004","url":null,"abstract":"<p><strong>Background: </strong>Operating room ergonomics uniquely predispose spine surgeons to chronic musculoskeletal pain. We surveyed the Lumbar Spine Research Society to better characterize the prevalence, surgical challenges, institutional response, and nonoccupational factors of chronic pain among spine surgeons as well as its effects on their careers and well-being.</p><p><strong>Methods: </strong>A survey of demographic, lifestyle, occupational, and symptomatic information was distributed at the 2024 Lumbar Spine Research Society Annual Meeting. Univariate and multivariate analyses were conducted to assess chronic pain prevalence and severity. Owing to the sample size, a P value of 0.10 was considered statistically significant.</p><p><strong>Results: </strong>Forty surgeons responded; chronic pain affected 82.5%, limited daily activities in 58%, and affected overall fitness in 33%. All reported that ergonomic advancement could improve their practice. Institutions had addressed ergonomic challenges for 5% of respondents and made improvements for 2.5%. In univariate analysis, age correlated with pain prevalence (P = 0.016), while height (P = 0.021), weight (P = 0.050), sleep (P = 0.089), work hours (P = 0.070), and robotic assistance (P = 0.010) were inversely correlated with pain prevalence. Age (P = 0.027), weight (P = 0.0054), and robotic assistance (P = 0.0030) were also inversely correlated with pain severity. Multivariate analysis showed that sleep was inversely correlated with pain (P = 0.062).</p><p><strong>Conclusions: </strong>Chronic musculoskeletal pain is up to four times more common among spine surgeons than it is among other adults. Sleep and robotic assistance may represent protective factors, but other risk factors and protective factors remain unclear. Ubiquitous symptoms and lack of institutional interventions underscore opportunities to better support spine surgeons and improve career longevity.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845789","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":"Bone Graft Substitutes Used in Non-spinal Orthopaedic Arthrodesis Surgery: A Systematic Review.","authors":"John MacDonald, Haley Glazebrook, Joel Morash, Bernard Burgesson, Mark Glazebrook","doi":"10.5435/JAAOS-D-25-01307","DOIUrl":"https://doi.org/10.5435/JAAOS-D-25-01307","url":null,"abstract":"<p><p>Bone graft is commonly used to promote joint arthrodesis. Currently, the bone graft options used surgically include autograft, allograft, and bone graft substitutes (BGS). Limited availability, potential morbidity (associated with autograft harvest), efficacy concerns, costs, and the theoretical risk of disease transmission have led to an increased use of BGS. Although there are numerous BGS available, it remains unclear which BGS provide the best clinical outcomes. This systematic review is intended to evaluate the quantity and quality of published BGS clinical outcome studies in non-spinal orthopaedic arthrodesis surgery. A comprehensive literature search of PubMed, Embase, and the Cochrane Library identified 1,751 studies of which 15 met inclusion criteria. All of these studies were of the foot and ankle and represented eight commercially available BGS. Among them, Augment had the most evidence and received a grade A recommendation. All other BGS received grade I recommendations due to insufficient published clinical outcome data. These findings highlight the limited published evidence on the clinical outcomes associated with the use of BGS in non-spinal orthopaedic arthrodesis surgery. Surgeons should continue to use the best available evidence when selecting BGS while recognizing the need for additional high-quality clinical studies.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845778","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}