Pub Date : 2025-02-01Epub Date: 2024-09-03DOI: 10.1097/CORR.0000000000003246
Magdalena Maria Gilg
{"title":"CORR Insights®: Taper Junction Subsidence Occurs in Modular Tumor Endoprostheses: How Concerned Should We Be?","authors":"Magdalena Maria Gilg","doi":"10.1097/CORR.0000000000003246","DOIUrl":"10.1097/CORR.0000000000003246","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"303-305"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-12-31DOI: 10.1097/CORR.0000000000003360
Victor C Agbafe, David N Bernstein, Kevin J Bozic
{"title":"Value-based Healthcare: The Impact of Consolidation in Healthcare on the Field of Orthopaedic Surgery.","authors":"Victor C Agbafe, David N Bernstein, Kevin J Bozic","doi":"10.1097/CORR.0000000000003360","DOIUrl":"10.1097/CORR.0000000000003360","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"211-213"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2025-01-03DOI: 10.1097/CORR.0000000000003361
Joseph Bernstein
{"title":"Not the Last Word: Joint Replacement for Patients With Obesity is About Opinions and Incentives.","authors":"Joseph Bernstein","doi":"10.1097/CORR.0000000000003361","DOIUrl":"10.1097/CORR.0000000000003361","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"194-198"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-08-07DOI: 10.1097/CORR.0000000000003220
Bandele Okelana, Amin Razi, David Ring, Sina Ramtin
<p><strong>Background: </strong>Moral dissonance is the psychological discomfort associated with a mismatch between our moral values and potentially immoral actions. For instance, to limit moral dissonance, surgeons must develop a rationale that the potential for benefit from performing surgery is meaningfully greater than the inherent harm of surgery. Moral dissonance can also occur when a patient or one's surgeon peers encourage surgery for a given problem, even when the evidence suggests limited or no benefit over other options. Clinicians may not realize the degree to which moral dissonance can be a source of diminished joy in practice. Uncovering potential sources of moral dissonance can help inform efforts to help clinicians enjoy their work.</p><p><strong>Questions/purposes: </strong>In a scenario-based experiment performed in an online survey format, we exposed musculoskeletal specialists to various types of patient and practice stressors to measure their association with moral dissonance and asked: (1) What factors are associated with the level of pressure surgeons feel to act contrary to the best evidence? (2) What factors are associated with the likelihood of offering surgery?</p><p><strong>Methods: </strong>We performed a scenario-based experiment by inviting members of the Science of Variation Group (SOVG; an international collaborative of musculoskeletal surgeons that studies variation in care) to complete an online survey with randomized elements. The use of experimental techniques such as randomization to measure factors associated with specific ratings makes participation rate less important than diversity of opinion within the sample. A total of 114 SOVG musculoskeletal surgeons participated, which represents the typical number of participants from a total of about 200 who tend to participate in at least one experiment per year. Among the 114 participants, 94% (107) were men, 49% (56) practiced in the United States, and 82% (94) supervised trainees. Participants viewed 12 scenarios of upper extremity fractures for which surgery is optional (discretionary) based on consensus and current best evidence. In addition to a representative age, the scenario included randomized patient and practice factors that we posit could be sources of moral distress based on author consensus. Patient factors included potential sources of pressure (such as "The patient is convinced they want a specific treatment and will go to a different surgeon if they don't get it") or experiences of collaboration (such as "The patient is collaborative and involved in decisions"). Practice factors included circumstances of financial or reputational pressure (such as "The practice is putting pressure on you to generate more revenue") and factors of limited pressure (such as "Your income is not tied to revenue"). For each scenario, the participant was asked to rate both of the following statements on a scale from 0 to 100 anchored with "I don't feel it at all" at 0,
{"title":"Do Surgeons Experience Moral Dissonance When There Is Misalignment Between Evidence and Action? A Survey and Scenario-based Study.","authors":"Bandele Okelana, Amin Razi, David Ring, Sina Ramtin","doi":"10.1097/CORR.0000000000003220","DOIUrl":"10.1097/CORR.0000000000003220","url":null,"abstract":"<p><strong>Background: </strong>Moral dissonance is the psychological discomfort associated with a mismatch between our moral values and potentially immoral actions. For instance, to limit moral dissonance, surgeons must develop a rationale that the potential for benefit from performing surgery is meaningfully greater than the inherent harm of surgery. Moral dissonance can also occur when a patient or one's surgeon peers encourage surgery for a given problem, even when the evidence suggests limited or no benefit over other options. Clinicians may not realize the degree to which moral dissonance can be a source of diminished joy in practice. Uncovering potential sources of moral dissonance can help inform efforts to help clinicians enjoy their work.</p><p><strong>Questions/purposes: </strong>In a scenario-based experiment performed in an online survey format, we exposed musculoskeletal specialists to various types of patient and practice stressors to measure their association with moral dissonance and asked: (1) What factors are associated with the level of pressure surgeons feel to act contrary to the best evidence? (2) What factors are associated with the likelihood of offering surgery?</p><p><strong>Methods: </strong>We performed a scenario-based experiment by inviting members of the Science of Variation Group (SOVG; an international collaborative of musculoskeletal surgeons that studies variation in care) to complete an online survey with randomized elements. The use of experimental techniques such as randomization to measure factors associated with specific ratings makes participation rate less important than diversity of opinion within the sample. A total of 114 SOVG musculoskeletal surgeons participated, which represents the typical number of participants from a total of about 200 who tend to participate in at least one experiment per year. Among the 114 participants, 94% (107) were men, 49% (56) practiced in the United States, and 82% (94) supervised trainees. Participants viewed 12 scenarios of upper extremity fractures for which surgery is optional (discretionary) based on consensus and current best evidence. In addition to a representative age, the scenario included randomized patient and practice factors that we posit could be sources of moral distress based on author consensus. Patient factors included potential sources of pressure (such as \"The patient is convinced they want a specific treatment and will go to a different surgeon if they don't get it\") or experiences of collaboration (such as \"The patient is collaborative and involved in decisions\"). Practice factors included circumstances of financial or reputational pressure (such as \"The practice is putting pressure on you to generate more revenue\") and factors of limited pressure (such as \"Your income is not tied to revenue\"). For each scenario, the participant was asked to rate both of the following statements on a scale from 0 to 100 anchored with \"I don't feel it at all\" at 0,","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"217-224"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2025-01-16DOI: 10.1097/CORR.0000000000003376
Dajun Jiang, Jiaqing Cao, Weitao Jia
{"title":"Reply to the Letter to the Editor: Contralateral Neck-shaft Angle Lower Than 130° Is Associated With Clinical Failure in Nongeriatric Individuals: Analysis of the National Femoral Neck Fracture Database of 1066 Patients.","authors":"Dajun Jiang, Jiaqing Cao, Weitao Jia","doi":"10.1097/CORR.0000000000003376","DOIUrl":"10.1097/CORR.0000000000003376","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"364-365"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-12-03DOI: 10.1097/CORR.0000000000003333
Yi-Yen Tsai, Zhi-Hong Zheng
{"title":"Letter to the Editor: Contralateral Neck-shaft Angle Lower Than 130° Is Associated With Clinical Failure in Nongeriatric Individuals: Analysis of the National Femoral Neck Fracture Database of 1066 Patients.","authors":"Yi-Yen Tsai, Zhi-Hong Zheng","doi":"10.1097/CORR.0000000000003333","DOIUrl":"10.1097/CORR.0000000000003333","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"363"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-09-24DOI: 10.1097/CORR.0000000000003265
Pierre Hoffmeyer
{"title":"CORR Insights®: Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial.","authors":"Pierre Hoffmeyer","doi":"10.1097/CORR.0000000000003265","DOIUrl":"10.1097/CORR.0000000000003265","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"235-236"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-10-15DOI: 10.1097/CORR.0000000000003283
Lindsay Muir
{"title":"CORR Insights®: Do Patients With Dominant-side Distal Radius Fractures Have Greater Psychological Distress Than Those With Nondominant-side Fractures?","authors":"Lindsay Muir","doi":"10.1097/CORR.0000000000003283","DOIUrl":"10.1097/CORR.0000000000003283","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"286-288"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-08-13DOI: 10.1097/CORR.0000000000003212
Riley Kahan, Sean Higinbotham, Kassra Garoosi, Alexander Lauder
<p><strong>Background: </strong>Electric scooters (e-scooters) have become a widely adopted form of transportation. Information regarding the timing, conditions, and context associated with increased frequency of e-scooter-related injuries could inform policy that may potentially reduce associated injuries and healthcare costs. However, this information is lacking, as most research to date has focused on the injury patterns sustained while using e-scooters rather than context. We sought to evaluate these factors in an urban setting and describe how these are evolving over time, as such information may help guide future safety initiatives.</p><p><strong>Questions/purposes: </strong>(1) How has the epidemiology of e-scooter-related injuries in Denver, CO, USA, changed over time? (2) What are the associated hospital charges to treat patients with these injuries? (3) What circumstances are associated with an increased frequency of e-scooter-related injuries and higher accompanying hospital charges?</p><p><strong>Methods: </strong>A retrospective study at a Level 1 trauma center in Denver, CO, USA, examined trends in e-scooter-related injuries from January 1, 2020, to November 1, 2023. Patients were identified by the key terms "e-scooter crash" or "scooter" within their emergency department/urgent care visit notes. Patient demographic and injury characteristics and hospital data (admission and hospital charges) were analyzed. Patients who sustained injuries from devices other than stand-up e-scooters or who did not have complete records available for analysis were excluded. The epidemiologic data on e-scooter-related injuries were quantified for each year within the study period, and descriptive analyses were performed to assess patient and injury characteristics, including age, gender, and fracture characteristics. Hospital charges were calculated using the mean annual sum of hospital charges associated with the treatment for e-scooter-related injuries. Circumstances influencing the frequency of injury and magnitude of hospital charges were assessed based on the timing of presentation to the emergency department or urgent care. We recognize that charge may have little or no direct relationship to true cost, but we believe that within one hospital system it represents a reasonable metric for comparative resource utilization. Injury frequency by time of the day and day of the week were compared using chi-square goodness-of-fit analyses. The value of hospital charges associated with e-scooter-related injuries was compared between patients presenting with alcohol intoxication and those who were not intoxicated.</p><p><strong>Results: </strong>In all, 2424 patients were identified as having e-scooter-related injuries (58% [1405] men, 42% [1019] women, median (IQR) age 30 years [25 to 37 years]). The number of annual e-scooter-related injuries during the years 2020 to 2023 were 273 in 2020, 736 in 2021, 758 in 2022, and 657 in 2023 (only 10 months). From 2
{"title":"Electric Scooter-related Injuries Are Becoming More Frequent and Costly in Denver, CO.","authors":"Riley Kahan, Sean Higinbotham, Kassra Garoosi, Alexander Lauder","doi":"10.1097/CORR.0000000000003212","DOIUrl":"10.1097/CORR.0000000000003212","url":null,"abstract":"<p><strong>Background: </strong>Electric scooters (e-scooters) have become a widely adopted form of transportation. Information regarding the timing, conditions, and context associated with increased frequency of e-scooter-related injuries could inform policy that may potentially reduce associated injuries and healthcare costs. However, this information is lacking, as most research to date has focused on the injury patterns sustained while using e-scooters rather than context. We sought to evaluate these factors in an urban setting and describe how these are evolving over time, as such information may help guide future safety initiatives.</p><p><strong>Questions/purposes: </strong>(1) How has the epidemiology of e-scooter-related injuries in Denver, CO, USA, changed over time? (2) What are the associated hospital charges to treat patients with these injuries? (3) What circumstances are associated with an increased frequency of e-scooter-related injuries and higher accompanying hospital charges?</p><p><strong>Methods: </strong>A retrospective study at a Level 1 trauma center in Denver, CO, USA, examined trends in e-scooter-related injuries from January 1, 2020, to November 1, 2023. Patients were identified by the key terms \"e-scooter crash\" or \"scooter\" within their emergency department/urgent care visit notes. Patient demographic and injury characteristics and hospital data (admission and hospital charges) were analyzed. Patients who sustained injuries from devices other than stand-up e-scooters or who did not have complete records available for analysis were excluded. The epidemiologic data on e-scooter-related injuries were quantified for each year within the study period, and descriptive analyses were performed to assess patient and injury characteristics, including age, gender, and fracture characteristics. Hospital charges were calculated using the mean annual sum of hospital charges associated with the treatment for e-scooter-related injuries. Circumstances influencing the frequency of injury and magnitude of hospital charges were assessed based on the timing of presentation to the emergency department or urgent care. We recognize that charge may have little or no direct relationship to true cost, but we believe that within one hospital system it represents a reasonable metric for comparative resource utilization. Injury frequency by time of the day and day of the week were compared using chi-square goodness-of-fit analyses. The value of hospital charges associated with e-scooter-related injuries was compared between patients presenting with alcohol intoxication and those who were not intoxicated.</p><p><strong>Results: </strong>In all, 2424 patients were identified as having e-scooter-related injuries (58% [1405] men, 42% [1019] women, median (IQR) age 30 years [25 to 37 years]). The number of annual e-scooter-related injuries during the years 2020 to 2023 were 273 in 2020, 736 in 2021, 758 in 2022, and 657 in 2023 (only 10 months). From 2","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"318-326"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2025-01-16DOI: 10.1097/CORR.0000000000003353
Kim Madden
{"title":"Cochrane in CORR®: Rehabilitation for Ankle Fractures in Adults.","authors":"Kim Madden","doi":"10.1097/CORR.0000000000003353","DOIUrl":"10.1097/CORR.0000000000003353","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"483 2","pages":"201-207"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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