The Iowa orthopaedic journal最新文献

{"title":"Efficacy and Outcomes of Oxidized Regenerated Cellulose (ORC) in Total Joint Arthroplasty (TJA): A Systematic Review and Meta-Analysis.","authors":"Jenna Chrabolowski, Troy B Puga, Abanoub Attalah, Kyle P O'Connor, McKenna W Box, Ashley Stovall, Michael Muncy, John T Riehl","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Novel hemostatic agents, such as oxidized regenerated cellulose (ORC) have grown in popularity. The aim of this systematic review and meta-analysis is to evaluate the efficacy of ORC for intraoperative and postoperative blood loss in total joint arthroplasty (TJA).</p><p><strong>Methods: </strong>A search was conducted across seven databases. Titles and abstracts were screened for eligibility for inclusion criteria. Full texts were screened and included if they met eligibility criteria. Demographics and results of the studies were extracted. Meta-analysis was conducted to evaluate outcomes.</p><p><strong>Results: </strong>Eleven studies met inclusion criteria. One case report study did report a hypersensitivity reaction, however, the remaining studies showed no additional complications from the use of ORC. Five studies reported equivalent rates of blood transfusion, with one study finding that ORC led to lower rates of blood transfusions. Nine studies were included for meta-analysis. Total blood loss (Cohen's d: -0.42, CI: -0.66-0.19, p<0.001) and intraoperative blood loss (Cohen's d: -0.33, CI: -0.51-0.14, p<0.001) were significantly lower in the ORC cohort compared to using no ORC. The ORC cohort also had significantly lower hemoglobin drop on postoperative day 1, however, publication bias was present in association with this finding. There was no significant difference between the ORC cohort and the no ORC cohort for postoperative day 7 hemoglobin (Cohen's d: 1.13, CI: -0.15- 2.42, p=0.08), postoperative day 1 C-Reactive Protein (CRP) (Cohen's d: 0.09, CI: -0.10- 0.29, p=0.36), and postoperative day 7 CRP (Cohen's d: 0.04, CI: -0.50- 0.58, p=0.88)..</p><p><strong>Conclusion: </strong>ORC may help to reduce total blood loss and intraoperative blood loss in TJA, however, it does not appear to have sustained effects over the following week, nor does it appear to lower transfusion rates with the current available evidence. ORC has been shown to be safe, with CRP levels remaining constant postoperatively, and only one case report showing a self-limited hypersensitivity reaction (local rash). ORC may be a useful adjunct to help reduce blood loss for TJA, however, it is not currently clear if its usage leads to significant improvements in clinical outcomes.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"31-42"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564240","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":"Coccidioides Immitis and Mssa Brodie's Abscess of The Calcaneus in The Setting of Pulmonary Valley Fever: A Case Report.","authors":"Alex J Demers, Arya Zandvakili, Poorani Sekar, Bopha Chrea","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A 74-year-old female with a history of polycythemia vera on ruxolitinib and type two diabetes mellitus presented with a left calcaneal Coccidioides immitis and methicillin sensitive Staphylococcus aureus Brodie's abscess in the setting of pulmonary coccidioidomycosis. Patient underwent surgical debridement of the abscess with amphotericin mixed cementing of the calcaneal defect and long-term oral posaconazole leading to abscess and sinus tract resolution.</p><p><strong>Conclusion: </strong>Calcaneal Brodie's abscess is a rare osseous manifestation of disseminated Coc-cidiomycosis requiring surgical debridement and coordinated care with infectious disease. Early recognition, debridement, filling of the abscess void, and prolonged antifungals are paramount in treatment.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564202","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":"Are 3D-Printed Anatomic Haptic Adolescent Idiopathic Scoliosis Spine Models Better Resident Training Tools When Compared to Conventional Training Modalities: A Randomized Controlled Study.","authors":"Selina C Poon, Marilyn Luong, Robert H Chog, Cynthia Nguyen, Haleh Badkoobehi, Reginald Fayssoux, Ryan Finkel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Spinal deformity surgery requires a thorough understanding of complex three-dimensional pathoanatomy. Opportunities to directly interact with 3-dimensional (3D) pathoanatomy and surgical practice techniques are limited. 3D printers are able to create models that accurately mimic deformed adolescent idiopathic scoliosis (AIS). We hypothesize that a 3D-printed anatomic haptic AIS spine model will improve resident training by increasing accuracy of screw placement compared to conventional training tools.</p><p><strong>Methods: </strong>Using a historical clinical computed tomography of a patient with 50-degree Lenke 1 AIS, a three-dimensional model from T1-L5 was created. Thirty-one orthopaedic trainees from two separate training programs were recruited and randomized into three groups. Cadaver (CG) had 10 residents, Sawbones (SG) had nine and 3D model (3G) had 12 in the initial training cohort where they were taught how to insert pedicle screws in their respective models. A total of 25/31 residents completed the pedicle screw insertion test (CG=6, SG=7, 3G=12) 2-4 weeks post initial training. Breaches were recorded at each session and compared to assess each models' applicability in teaching and improving surgical technique. Trainees were also queried regarding their satisfaction (1-5) with the training model.</p><p><strong>Results: </strong>The average number of breaches >2mm are shown in Table 2. Compared to the other two methods of teaching, Sawbones had the highest number of pedicle breaches. Trainees in the SG also had significantly improved accuracy at the post-test session. There were no significant differences in the other two groups. When queried, 84% of residents chose to learn on a 3D model compared to sawbones and cadavers. Overall, the residents rated 4.7 for recommending the use of the 3D model in their training program.</p><p><strong>Conclusion: </strong>A 3D printed anatomic haptic AIS spine model can serve as a resident training tool to help improve accuracy of pedicle screw placement in of AIS when compared to sawbones.</p><p><strong>Level of evidence: </strong>I.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563600","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":"Reliability of Semi-Automated Volumetric Quantification of Knee Effusion Using MRI After Acl Injury.","authors":"Reginald O Chinweze, Neal C Weldon, Matthew A Tao, Melissa N Manzer, Elizabeth A Wellsandt","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Effusion is a frequent finding after anterior cruciate ligament (ACL) injury and reconstruction, but the reliability of its quantification on routine [non-contrast] magnetic resonance imaging (MRI) is not established. This study sought to evaluate the intra-rater and inter-rater reliability of volumetric quantitative measurements (VQM) of knee effusion volumes (EV) using axial proton density-weighted, fat-suppressed (PD-FS) sequences after ACL injury and reconstruction.</p><p><strong>Methods: </strong>Twenty deidentified MRIs (10 ACL-injured knees and 10 uninjured knees) were randomly selected from a prospective observational cohort of participants aged 15-35 years. Two independent raters analyzed EV using a custom MATLAB protocol. Intra- and inter-rater reliability was assessed using intraclass correlation coefficients (ICC_3,1) with minimal detectable changes calculated. Measurement agreement was assessed using Bland-Altman plots.</p><p><strong>Results: </strong>Mean EV were higher in the injured compared to uninjured knees (11.88±8.14 mL vs 2.03±0.76 mL). Volumetric effusion measurements demonstrated excellent intra-rater (ICC_3,1=0.993, 95% CI: 0.981-0.997, p<0.001) and inter-rater reliability (ICC_3,1=0.974, 95% CI: 0.907-0.991, p<0.001). The minimal detectable change was 0.145 mL for intra-rater measurements and 0.504 mL for inter-rater measurements. Bland-Altman plots revealed no systematic bias between raters, although variability increased with larger volumes (>8 mL).</p><p><strong>Conclusion: </strong>VQM using standard axial PD-FS MRI sequences demonstrate excellent reliability across raters. Restricting segmentation to the anterior compartment aligns with clinical assessment (e.g., sweep tests), though it does not capture whole-joint eflusion. This semi-automated approach may provide a relevant biomarker for monitoring EV in ACL research and rehabilitation trials.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"213-221"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564343","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":"Patterns and Timing of Local Recurrence in Benign Bone Tumors.","authors":"Bradley R Melvin, Yumeng Gao, Abigail Grothe, Benjamin J Miller","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Benign bone tumors represent a heterogeneous group of nonmalignant lesions often treated surgically when symptomatic or at risk of fracture. Although local recurrence is a recognized risk, comparative data on recurrence timing and presentation across histologies are limited, contributing to the lack of standardized surveillance. We aimed to examine locally recurrent benign bone tumors after surgery to define recurrence patterns by histology.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study of 329 curative-intent procedures for benign bone tumors at the University of Iowa Hospitals and Clinics (2010-2024). Included histologies were giant cell tumor (GCT), aneurysmal bone cyst (ABC), unicameral bone cyst (UBC), osteoid osteoma (OO), chondroblastoma (CB), osteoblastoma (OB), non-ossifying fibroma, and chondromyxoid fibroma. Recurrence was defined by histology or characteristic imaging. The primary outcome was mode of recurrence presentation (symptomatic vs. radiographic). Secondary outcomes included time to recurrence and recurrence by bone filler type. Analyses used Wilcoxon rank-sum, Fisher's exact, and Spearman correlation tests.</p><p><strong>Results: </strong>Forty-two recurrences (12.8%) were identified. Recurrence presentation varied by histology (p = 0.001): OO and OB recurred exclusively symptomatically (100%), CB mostly symptomatically (66.7%), while ABC (20.0%), UbC (21.1%), and GCT (37.5%) recurred predominantly asymptomatically. No recurrences occurred for non-ossifying fibroma or chondromyxoid fibroma. Recurrence timing was not associated with age, sex, tumor site, or surgical method. In GCT treated with curettage, recurrence was more common with allograft than cement (33.3% vs. 3.4%, p = 0.007). OB and OO recurred earliest, with 100% and 83.3% in the first year, respectively. By year three, all OO and most GCT, ABC, and UBC recurrences had occurred; by year five, all tumors except a single CB had fully recurred.</p><p><strong>Conclusion: </strong>Recurrence patterns in benign bone tumors are strongly influenced by histology. OO and OB recur symptomatically within the first year, suggesting limited need for routine imaging. UBC, GCT, and ABC often recur asymptomatically, justifying structured imaging surveillance for 3-5 years. Cement use in GCT may reduce recurrence risk compared with allograft.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"73-80"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611362","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":"Metallosis Disrupts Bone Healing in Posterolateral Spinal Fusion: in Vivo Modeling of Metal Particle Effects on Fusion Integrity.","authors":"Jacob S Fisher, Mitchell C Coleman, Douglas Fredericks, Cale B Dobson, Madeline R Hines, Catherine Olinger","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Metallosis is a known complication of joint arthroplasty, but its role in failures of spinal fusion procedures likely remains underrecognized. The release of metallic debris from implant interfaces may impair osteogenesis by triggering local inflammatory responses. To date, no in vivo models have been developed to investigate this process in the context of spinal fusion. Using a unique modelling system, we sought to determine whether high local concentrations of metal particles impair spinal fusion, and whether particle load correlates with inflammatory response.</p><p><strong>Methods: </strong>Twelve rabbits underwent posterolateral lumbar spinal fusion using autologous iliac crest bone grafts. Six weeks postoperatively, animals received bilateral paraspinal injections of Ti/Cr/ Co alloy at high, low, or zero concentrations immediately dorsal to the graft site. At twelve weeks, specimens were euthanized, and the grafts were assessed by radiography, manual palpation, and histopathology. A custom image analysis algorithm was used to quantify metal debris in histologic sections, and inflammatory responses were evaluated. Fusion outcomes and metal burden were compared between groups using unpaired t-tests.</p><p><strong>Results: </strong>Five of eight evaluable specimens exhibited non-fusion, most of which contained higher levels of visible metal debris than fused counterparts upon histologic analysis. Fused grafts, in contrast, demonstrated minimal particle burden and continuous trabecular bridging. Lymphocytes were found to be localized near metal particles, and fibrotic tissue was observed to replace bone at non-fused sites. No significant differences in inflammatory cell counts were observed between groups.</p><p><strong>Conclusion: </strong>Elevated metal particle burden in the posterolateral fusion environment was associated with impaired osteogenesis and increased localized inflammation, particularly in non-fused specimens. These results establish this model's utility for investigating metallosis-driven spinal fusion failure and suggest its potential as a predictive platform for assessing particle-related risk in spinal instrumentation.</p><p><strong>Clinical relevance: </strong>This study provides a reproducible in vivo model to explore how metallic debris may contribute to spinal fusion failure. It offers a platform for testing future interventions targeting metallosis-related complications in spinal fusion surgery.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564387","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":"Comparative Analysis of Patient Perspectives on Surgical Centers: A Study of Carpal Tunnel Releases Performed At An Outpatient Surgery Center Versus Clinical Procedural Suite.","authors":"Matt McIlrath, Ignacio Garcia Fleury, Erin Choi, Jill Corlette, Natalie Glass, Krit Petrachaianan, Joseph A Buckwalter V","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This study compares outcomes of carpal tunnel release (CTR) performed in a clinic procedural suite (PS) versus an ambulatory surgery center (ASC). CTR in the PS is performed using the wide-awake local anesthesia no tourniquet (WALANT) technique and does not require NPO compliance. In contrast, CTR in an ASC is performed in an operating room under either WALANT or monitored anesthesia care (MAC), the latter requiring preoperative NPO restrictions. Prior studies demonstrate that WALANT CTR performed in a PS is associated with significantly reduced in-house time, lower healthcare costs compared to MAC in the operating room (OR), less time off work, and similar patient satisfaction and infection rates. The purpose of this study was to compare patient outcomes between CTR performed in a PS versus an ASC.</p><p><strong>Methods: </strong>We performed a retrospective crosssectional study of adult patients who underwent isolated CTR by a single surgeon at an ASC or a PS between January 2022 and December 2023. Primary outcomes were validated patient-reported outcome measures, with secondary outcomes including demographics and time-based comparisons.</p><p><strong>Results: </strong>A total of 165 patients met inclusion criteria, including 29 who underwent WALANT CTR in a procedure suite and 136 who underwent CTR at an ASC. There were no significant differences in demographic characteristics or patient-reported outcome measures between groups. Patients treated at an ASC had significantly longer total in-house time compared with PS patients (mean difference 91.42 minutes; 95% CI, 76.72-106.13; p < 0.0001).</p><p><strong>Conclusion: </strong>Carpal tunnel release performed in a PS optimizes access, efficiency, and cost while maintaining patient safety, satisfaction, and clinical outcomes comparable to those achieved in an ASC.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"11-14"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440566","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":"Adhesive Capsulitis: A Comprehensive Review of Pathogenesis, Diagnosis, and Clinical Management.","authors":"Ashley Diekemper, Anthony Martinez, Hannah Gibbs, Christian Cruz, Liang Zhou, Daniel J Song","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Adhesive capsulitis (AC) is a condition characterized by progressive pain and restricted range of motion, which may significantly impact patients' quality of life. It affects 2-5% of the population, with a higher prevalence in women, individuals with diabetes, and other underlying conditions. The pathogenesis involves synovial inflammation, capsular fibrosis, and neovascularization, although the initiating factors remain unclear. AC progresses through distinct phases: freezing, frozen, and thawing: each with characteristic clinical and pathological features.</p><p><strong>Methods: </strong>This review article synthesizes findings from peer-reviewed studies on adhesive capsulitis, focusing on pathophysiology, clinical presentation, and treatment outcomes. A comprehensive literature search was conducted, selecting studies based on relevance, study design, and emphasis on randomized controlled trials, systematic reviews, and meta-analyses.</p><p><strong>Results: </strong>Management options include both conservative and surgical approaches. Conservative treatment focuses on physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and manipulation under anesthesia, with most patients experiencing resolution over time. Other interventions, such as ultrasound-guided hydrodilatation and arthroscopic release, may be indicated for recalcitrant cases, typically in patients with continued symptoms lasting longer than 9-12 months. Hydrodilatation, particularly capsule-preserving techniques, has shown promise in reducing pain and improving function. Arthroscopic release provides rapid pain relief and improved ROM, with long-term success demonstrated in clinical studies, though recurrence of postoperative pain may necessitate corticosteroid injections.</p><p><strong>Conclusion: </strong>Further research is needed to better understand the etiology and pathogenesis of AC, as well as to develop more effective, stage-based, and disease-modifying treatments. This approach may offer insights into targeted therapies and improved recovery in patients with AC.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"107-118"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440563","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":"Plate Augmentation in The Prevention of 3D-Printed Tritanium Cage Subsidence Following Anterior Cervical Discectomy and Fusion: A Retrospective Cohort Study.","authors":"Simon B Roberts, Mohammed Madi, Muhammed Iqbal, George Richardson, Irfan Anwar, Peter R Loughenbury, Vishal H Borse, Grzegorz Rudol, Nigel W Gummerson, Alistair Irwin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Interbody cage subsidence following anterior cervical discectomy and fusion (ACDF) surgery can be associated with increased pain, segmental kyphosis, accelerated adjacent segment disease, and decreased rates of fusion. This study investigated the incidence of cage subsidence following the use of cages using Tritanium technology as cage-only (CO) or cage-plate (CP) constructs in patients undergoing ACDF.</p><p><strong>Methods: </strong>This was a retrospective multicentre cohort study. Data was collected from hospital records and radiographs. All patients undergoing ACDF for cervical myelopathy or radiculopathy were included. Patients were divided into two groups by ACDF construct: CO and CP groups. Outcome measures included postoperative cage subsidence, presence of fusion, and surgical complications. Cage subsidence was calculated as the decrease in intervertebral height. Statistical analysis was performed by Student's t-test for continuous data and Fisher's exact test for categorical data.</p><p><strong>Results: </strong>76 patients were included with mean age 56.5 years at surgery (SD: + 12; range: 2981), comprising a total of 94 ACDF procedures. Single-level ACDF was performed in 61 patients and multilevel ACDF was performed in 15 patients. CO construct was used in 13 ACDFs and CP construct used in 81 ACDFs. Mean radiological followup was 8.5 months (SD: 6.3; range: 3-24). Cage subsidence rate was greater in CO group compared to CP group (CO 54% (n=7), 95% CI: 29-77%; CP 19% (n=15), 95% CI 12-28% (x² p=0.01)). There was no significant difference in fusion rates between CO and CP groups. One patient underwent revision surgery for cage subsidence. Age, indication for surgery, number of levels treated, cage size, cage lordosis, and progression to fusion were not significantly associated with cage subsidence.</p><p><strong>Conclusion: </strong>Incidence of cage subsidence was greater when Tritanium cages were used for ACDF surgery as cage-only constructs compared to cageplate constructs. Correlation of these results with patient-reported outcomes would be valuable.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"177-184"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564370","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":"Recognition and Recurrence of Aneurysmal Bone Cyst Secondary to Giant Cell Tumor: A Case Series and Review Of The Literature.","authors":"Ahmet Salduz, Michael D Russell, Benjamin J Miller","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cysts (ABCs) are rare, benign bone lesions with distinct genetic and pathological characteristics. Secondary ABCs arising from giant cell tumors (GCTs) are associated with higher recurrence rates compared to primary ABCs. This study aimed to evaluate recurrence rates and risk factors for primary ABCs, secondary ABCs in GCT, and GCTs, with a focus on radiologic and clinical predictors.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 44 patients with histologically confirmed primary ABC (n=24), secondary ABC in GCT (n=8), or GCT (n=12), treated surgically with adjuvants between 2010 and 2020. Tumors were staged using the Enneking/MSTS system, and recurrence rates were assessed using Kaplan-Meier survival analyses and Chi-square tests. The mean follow-up period was 49.4 months.</p><p><strong>Results: </strong>The overall recurrence rate was 11%, with a 5-year recurrence-free survival rate of 89%. Recurrence-free survival was 92% for primary ABCs, 92% for GCTs, and 75% for secondary ABCs. Significant risk factors included soft tissue extension in primary ABCs (p = 0.037) and mixed radiologic appearance in GCTs (p = 0.033). Secondary ABCs were more common in patients over 20 years and often presented with multiloculated cystic areas.</p><p><strong>Conclusion: </strong>Recurrence rates are similar among primary ABCs, secondary ABCs, and GCTs. However, secondary ABCs exhibit recurrence behaviors closer to GCTs, particularly in patients with advanced age and complex radiological features. These findings highlight the importance of meticulous tumor resection and the careful use of adjuvants to reduce the risk of recurrence. <b>Level of Evidence: III</b>.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"45 1","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556350","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}