Bulletin of the Hospital for Joint Disease (2013)最新文献

{"title":"Current practices of infection prevention for primary shoulder arthroplasty: A survey of American Shoulder and Elbow Surgeons Society members.","authors":"C Lucas Myerson, Jacquelyn J Xu, Brian O Molokwu, Joseph D Zuckerman, Mandeep S Virk, Dennis A DeBernardis","doi":"10.1097/bh9.0000000000000040","DOIUrl":"10.1097/bh9.0000000000000040","url":null,"abstract":"<p><strong>Introduction: </strong>Prosthetic joint infection is a serious complication after primary shoulder arthroplasty, yet no standardized infection prevention protocol exists. This study evaluated current trends in infection prevention among members of the American Shoulder and Elbow Surgeons.</p><p><strong>Methods: </strong>A 25-item cross-sectional survey was developed to capture commonly used preoperative, intraoperative, and postoperative infection prevention strategies in primary shoulder arthroplasty. The finalized instrument was administered electronically through REDCap to all active American Shoulder and Elbow Surgeons members in November 2024, with 1 reminder sent 2 weeks later. Anonymized responses were categorized by years in practice (<5, 5-10, 10-20, and >20 years). Statistical analyses assessed variability across experience groups.</p><p><strong>Results: </strong>Of 229 responses, 224 were complete and included for analysis. Most surgeons reported using hemoglobin A1c cutoffs (77%), avoiding corticosteroid injections within 3 months of surgery (86%), performing preoperative skin cleansing (78%), using chlorhexidine for preparation (94%), switching scalpel blades (80%) or using electrocautery (79%) after skin incision, and administering perioperative IV antibiotics (76%). Surgeons with <5 years of experience were more likely to use hydrogen peroxide or alcohol-based skin preparation, vancomycin powder, topical skin glue, silver-impregnated dressings, and apply stricter hemoglobin A1c cutoffs, reaching statistical significance in all cases ( P < .05). A body mass index cutoff was used by 25% of respondents, with a mean threshold of 42 kg/m 2 .</p><p><strong>Conclusion: </strong>Substantial variation exists in infection prevention strategies for primary shoulder arthroplasty (SA) across experience levels, highlighting the need for standardized protocols.</p><p><strong>Level of evidence: </strong>IV, epidemiological study.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"1-9"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk-stratified perioperative tranexamic acid utilization for total hip and knee arthroplasty: Analysis of trends of the past decade.","authors":"Jad Lawand, Sanjay Kubsad, Ivan Liu, Amil R Agarwal, Alex Gu, Andrew B Harris, Savyasachi C Thakkar","doi":"10.1097/bh9.0000000000000038","DOIUrl":"10.1097/bh9.0000000000000038","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate changes in perioperative tranexamic acid (TXA) utilization among patients undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA), based on patient demographics and comorbidities, including those at higher and lower risk of venous thromboembolism (VTE).</p><p><strong>Methods: </strong>Patients who underwent THA or TKA between 2012 and 2021 were identified using the TriNetX electronic health record database. Perioperative TXA use was evaluated among patients stratified according to risk of VTE. Utilization rates were analyzed using compound annual growth rates (CAGRs) and linear regression analysis.</p><p><strong>Results: </strong>From 2012 to 2021, TXA use increased by 406% (CAGR: +17.66%; P < 0.001) for THA and 459% for TKA (CAGR: +18.86%; P < 0.001). Among patients with at least 1 factor placing them at high risk of VTE, TXA use increased by 1277% for THA (CAGR: +30.0%; P < 0.001) and by 966% for TKA (CAGR: +26.7%; P < 0.001). During the final study year (2021), surgeons overall used TXA in 67.8% of THA cases and 62.5% of TKA cases. In the high-risk group, TXA use was lowest among patients with a history of myocardial infarction (THA, 48.7%; TKA, 51.4%), cerebrovascular accident (THA, 51.0% and TKA, 50.6%), bleeding or clotting disorder (THA, 57.4% and TKA, 57.1%), or previous VTE (THA, 57.3%; TKA, 53.6%).</p><p><strong>Conclusion: </strong>Despite the rapid growth in TXA utilization over the past decade in THA and TKA, patients at high risk of VTE and ischemia are still less likely to receive perioperative TXA.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"10-14"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of external pressure and muscle contraction on soft tissue oxygenation measured with near infrared spectroscopy.","authors":"Ernest N Chisena, Yudell Edelstein, Afshin Anoushiravani, Ernest C Chisena","doi":"10.1097/bh9.0000000000000041","DOIUrl":"10.1097/bh9.0000000000000041","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this in vivo study was to determine whether localized external compression of muscle combined with physiologic muscle contraction leads to muscle deoxygenation. The hypothesis was that a cyclic hypoxic environment was created when localized external compression was combined with muscle contraction.</p><p><strong>Methods: </strong>Near infrared spectroscopy was used to measure soft tissue oxygenation in 9 patients while applying 40 mm Hg (mercury) of external pressure simultaneously with muscle contraction.</p><p><strong>Results: </strong>A statistically significant decrease in oxygenated hemoglobin was demonstrated in muscle with utilization of a specialized brace to apply a localized pressure, simultaneous with muscle contraction. The decrease in oxygenation was more than 3 times greater than the decrease seen with muscle contraction alone without external pressure (-22.58 vs. -5.82 µM).</p><p><strong>Conclusion: </strong>Application of external pressure combined with muscle contraction can be used to produce decreased soft tissue oxygenation.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"15-20"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of primary synovial chondromatosis of the elbow.","authors":"Yixuan Tong, Janos Barrera, Liana Tedesco, Omri B Ayalon","doi":"10.1097/bh9.0000000000000039","DOIUrl":"10.1097/bh9.0000000000000039","url":null,"abstract":"<p><strong>Abstract: </strong>This case is a 37-year-old man with diffuse primary synovial chondromatosis of the elbow, with associated ulnar nerve compression and flexion contracture at the elbow. An open synovectomy with removal of loose bodies and an ulnar nerve decompression with anterior subcutaneous transposition were performed. Postoperatively, the patient's elbow mobility and nerve compression symptoms improved steadily, which significantly improved his function. Primary synovial chondromatosis of the elbow is a rare disease that can result in pain, swelling, decreased range of motion, and mechanical symptoms. Treatment usually involves synovectomy and removal of loose bodies to address patients' pain and joint motion.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"21-25"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: The impact of adding a tibial tubercle osteotomy to medial patellofemoral ligament reconstruction in the treatment of patellar instability.","authors":"","doi":"10.1097/bh9.0000000000000035","DOIUrl":"10.1097/bh9.0000000000000035","url":null,"abstract":"","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"200"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allogeneic blood transfusion after hip fracture: risk factors and associated outcomes.","authors":"Sanjit R Konda, Cody R Perskin, Rown Parola, R Jonathan Robitsek, Abhishek Ganta, Kenneth A Egol","doi":"10.1097/bh9.0000000000000036","DOIUrl":"10.1097/bh9.0000000000000036","url":null,"abstract":"<p><strong>Background: </strong>Acute blood loss anemia is a common complication of hip fractures. Due to this complication, the rate of allogenic blood transfusions remains high in this patient population. More recently, surgeons have utilized intraoperative tranexamic acid as a strategy to minimize blood loss.</p><p><strong>Purpose: </strong>The purpose of this study was to identify risk factors and associated outcomes of blood transfusions in hip fracture patients.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>A trauma database from one academic medical center was queried for hip fracture patients (OTA/AO 31A or 31B). Demographic, clinical, quality, and cost data were obtained for each patient. A Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), a validated risk predictive and matching tool, was calculated for each patient. Patients receiving blood transfusions during their hospitalization were identified. Multivariate logistic regression analysis identified independent risk factors for transfusion during admission. Patients receiving transfusions were matched to patients not receiving a transfusion based on STTGMA. Comparative analyses of matched cohorts were performed.</p><p><strong>Results: </strong>In total, 1,344 hip fracture patients (29.8% male and 70.2% female) with mean age 81.04 ± 10.18 were identified. Four hundred ninety-nine (37.1%) patients received a transfusion during their admission. Risk factors for transfusion included higher STTGMA scores (P = .006), lower hemoglobin levels on admission (P < .001), anticoagulation or antiplatelet use on admission (P = .019), and fracture repair with a long cephalomedullary nail (P = .005). Trauma risk score-matched cohort outcomes show transfusions correlated with increased mortality, complications, readmission, and longer, more costly hospital stays.</p><p><strong>Conclusion: </strong>Surgeons should be cognizant of transfusion risk factors such as repair with long cephalomedullary nail and poorer matched outcomes correlated with patients receiving transfusions.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"191-196"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative planning for posttraumatic lower limb deformity correction.","authors":"Nina D Fisher, Toni M McLaurin","doi":"10.1097/bh9.0000000000000009","DOIUrl":"10.1097/bh9.0000000000000009","url":null,"abstract":"<p><strong>Abstract: </strong>Lower limb deformities encompass a wide range of problems, and the work-up and management of these patients is quite complex. The purpose of this review was to define the essential considerations of preoperative planning for lower limb deformity correction. This can be somewhat simplified into the who, what, where, how, and why, which includes the patient evaluation, defining the deformity, finding the center of rotation of angulation, the osteotomy, the technique of distraction osteogenesis, and the goals of surgery, respectively. The goal of this review was to establish a framework of the fundamentals for preoperative planning of lower limb deformity corrections.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"49-55"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebound incidence of anterior cruciate ligament reconstructions in the peripandemic coronavirus disease era: An audit of centers experience.","authors":"Isabel Wolfe, Andrew S Bi, Ryan Isber, Michael R Moore, Eric J Strauss, Laith M Jazrawi, Mehul R Shah","doi":"10.1097/bh9.0000000000000017","DOIUrl":"10.1097/bh9.0000000000000017","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease (COVID)-19 pandemic led to shutdowns of organized sporting activity. Prolonged periods of inactivity lead to deconditioning and may increase one's risk for injury. The purpose of this study was to quantify the incidence of anterior cruciate ligament (ACL) injuries requiring reconstruction during the peripandemic period.</p><p><strong>Methods: </strong>The electronic medical record of a single university teaching hospital was queried for current procedural terminology codes for ACL reconstructions (ACLR; 29,888) from January 2017 to December 2022. Date of injury was collected from clinic notes if it could be estimated within 2 weeks. The years 2017-2019 were used as a proxy for \"pre-COVID,\" the year 2020 for \"COVID,\" and the years 2021-2022 for \"post-COVID.\"</p><p><strong>Results: </strong>In total, 2178 patients had an ACL injury and underwent reconstruction from 2017 to 2022. Date of injury could be estimated for 1,617 patients (51.3% male, average age 30.9 ± 11.0 years). There was a decrease in the number of ACL surgeries observed during the COVID era, followed by a post-COVID rebound. The proportion of female patients who underwent ACLR increased from the pre-COVID to the post-COVID period (42.7% vs. 49.4%, P < .001). The proportion of patients with American Society of Anesthesiologists (ASA) score 2 increased from the COVID to the post-COVID period in relation to the proportion of patients with ASA score 1 (P = .007).</p><p><strong>Conclusion: </strong>ACLRs decreased at our institution during the COVID-19 pandemic, followed by an increase in ACLRs from 2021 to 2022. The proportion of female patients and patients with higher ASA scores increased in the post-COVID era.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"115-119"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Winning the arms race: Optimizing upper extremity amputations and advancements in prosthetic technology.","authors":"William Neal, Megan R Donnelly, Omri B Ayalon","doi":"10.1097/bh9.0000000000000005","DOIUrl":"10.1097/bh9.0000000000000005","url":null,"abstract":"<p><strong>Abstract: </strong>Since the beginning of documented medical history, amputation procedures, limb loss, and the myriad creative solutions attempted to care for these individuals have been reported. With the coalescence of multiple World Wars resulting in an ever-increasing number of individuals with limb loss and advancing medical technology, a need to innovate in this field has always been present. The complexity of the hand and upper extremity in self-care, communication, vocation, and exercise results in more demands of prostheses to mimic or replace these functions as opposed to the lower extremity, which is focused mostly on weight bearing and ambulation. As such, this need has pushed technological advances past the simpler passive or body-powered prostheses alone, now with externally powered and hybrid devices revolutionizing the way these appliances were implemented in everyday life. Despite the ever-advancing field of prosthetic technology, upper and lower extremity amputees alike still battle common challenges of pain, phantom limb sensation, and lack of prosthetic control and sensation. Targeted muscle reinnervation and regenerative peripheral nerve interface offer new surgical solutions to some of these challenges and are proving invaluable. As technology and surgical options continue to advance at an ever-rapid pace, a more thoughtful and individualized approach to the care of upper extremity limb loss is available. In this study, we review the history and evolution of upper extremity prostheses and discuss considerations in making optimal surgical and prosthetic decisions for upper extremity amputees.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"29-34"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simplified algorithm to work up graft re-rupture following anterior cruciate ligament reconstruction.","authors":"Andrew S Bi, Mark A Pianka, Daniel J Kaplan, Eric J Strauss, Laith M Jazrawi, Michael J Alaia","doi":"10.1097/bh9.0000000000000012","DOIUrl":"10.1097/bh9.0000000000000012","url":null,"abstract":"<p><strong>Abstract: </strong>The need to perform revision anterior cruciate ligament reconstruction (ACLR) has several etiologies such as infection, arthrofibrosis, cyclops lesions, and graft failure, which should be distinguished before revision ACLR. Even the definition of graft failure varies within the literature. ACLR graft failure falls into modifiable, surgeon-controlled factors, such as tunnel position, graft choice, and alignment, and nonmodifiable factors, such as patient age, tissue quality, or secondary traumatic reruptures. In this review, we describe a facile framework for the workup of modifiable ACLR graft failure.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"63-72"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}