Pub Date : 2026-01-16DOI: 10.1097/corr.0000000000003815
Neel Vallurupalli,Benjamin Padon,Jie J Yao
{"title":"CORR Synthesis: How Should PROM Thresholds Be Determined and Interpreted to Reflect Clinically Meaningful Change in Orthopaedic Surgery?","authors":"Neel Vallurupalli,Benjamin Padon,Jie J Yao","doi":"10.1097/corr.0000000000003815","DOIUrl":"https://doi.org/10.1097/corr.0000000000003815","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"95 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015124","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}
Pub Date : 2026-01-15DOI: 10.1097/CORR.0000000000003830
Joseph Bernstein
{"title":"Letter to the Editor: Editorial: Fully Compromised, but Thanks All the Same to Our Peer Reviewers.","authors":"Joseph Bernstein","doi":"10.1097/CORR.0000000000003830","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003830","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050661","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}
Pub Date : 2026-01-09DOI: 10.1097/CORR.0000000000003823
John D Kelly
{"title":"Your Best Life: Care for Your Brain and Put Your Phone Away!","authors":"John D Kelly","doi":"10.1097/CORR.0000000000003823","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003823","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050642","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}
Pub Date : 2026-01-08DOI: 10.1097/corr.0000000000003818
Alan David Lam,Jessica H Leipman,Samantha S Meacock,Nihir Parikh,Matthew B Sherman,Yale A Fillingham,Chad A Krueger
BACKGROUNDAlthough deficits in social determinants of health (SDOH) have been previously associated with adverse clinical outcomes after primary THA and TKA, their role in the perioperative communication workload remains poorly characterized. Even though it remains essential to appropriately identify and address modifiable SDOH before a procedure, orthopaedic practices must also have the resources to handle the coordination of care effectively. Understanding how deficiencies in SDOH can impact communication workload would help support effective resource planning and equitable patient engagement strategies, particularly as more perioperative management takes place outside the hospital setting.QUESTIONS/PURPOSES(1) What are the differences in touchpoint utilization in patients who live in locations with varying Area Deprivation Index (ADI) scores, a surrogate measure for social deprivation? (2) Does social deprivation have an association with the length of stay (LOS) during primary total joint arthroplasty? (3) How are readmission rates and patient-reported outcome measures (PROMs) different in patients living in areas with varying degrees of social deprivation?METHODSIn this retrospective, comparative study, there were 92,801 patients who underwent primary, elective THA (43% [39,963]) or TKA (57% [52,837]) for osteoarthritis at one high-volume, urban, academic institution between January 2016 and December 2022. Of those, exclusions consisted of indications other than osteoarthritis (2% [1595]), no available ADI data (13% [12,302]), or loss to minimum 90-day postoperative follow-up and incomplete data (29% [26,836]). In all, 52,068 patients were included in the final analysis, with 43% (22,363) of patients undergoing primary THA and 57% (29,705) undergoing primary TKA. To determine the degree of social deprivation, the 2022 ADI was used and linked to patients' street addresses. Using the ADI national ranking from 1 to 100, with 1 representing the lowest level of disadvantage and 100 representing the highest level of disadvantage, patients were compared by ADI quartiles; Quartile 1 represented the least disadvantaged cohort and Quartile 4 represented the most disadvantaged cohort. Overall, the mean ± SD age was 66 ± 10 years, and the population consisted of 56% (29,333 of 52,068) women. Thirty-three percent (17,391 of 52,068) of patients were in ADI Quartile 1, 44% (22,944 of 52,068) were in Quartile 2, 17% (8650 of 52,068) were in Quartile 3, and 6% (3083 of 52,068) were in Quartile 4. The primary outcome measure was the number of touchpoints per patient, defined as the communication points (telephone or electronic messages) sent or received on behalf of the patient in relation to the total joint arthroplasty procedure. Touchpoints within the 30-day preoperative or 90-day postoperative periods of the primary THA or TKA were included. Secondary outcome measures included LOS, 90-day readmissions, and PROMs consisting of the Knee Injury and Osteoarthr
{"title":"Higher Area Deprivation Index Is Associated With Greater Practice-initiated Perioperative Communication Workload in Patients With Primary Total Joint Arthroplasty.","authors":"Alan David Lam,Jessica H Leipman,Samantha S Meacock,Nihir Parikh,Matthew B Sherman,Yale A Fillingham,Chad A Krueger","doi":"10.1097/corr.0000000000003818","DOIUrl":"https://doi.org/10.1097/corr.0000000000003818","url":null,"abstract":"BACKGROUNDAlthough deficits in social determinants of health (SDOH) have been previously associated with adverse clinical outcomes after primary THA and TKA, their role in the perioperative communication workload remains poorly characterized. Even though it remains essential to appropriately identify and address modifiable SDOH before a procedure, orthopaedic practices must also have the resources to handle the coordination of care effectively. Understanding how deficiencies in SDOH can impact communication workload would help support effective resource planning and equitable patient engagement strategies, particularly as more perioperative management takes place outside the hospital setting.QUESTIONS/PURPOSES(1) What are the differences in touchpoint utilization in patients who live in locations with varying Area Deprivation Index (ADI) scores, a surrogate measure for social deprivation? (2) Does social deprivation have an association with the length of stay (LOS) during primary total joint arthroplasty? (3) How are readmission rates and patient-reported outcome measures (PROMs) different in patients living in areas with varying degrees of social deprivation?METHODSIn this retrospective, comparative study, there were 92,801 patients who underwent primary, elective THA (43% [39,963]) or TKA (57% [52,837]) for osteoarthritis at one high-volume, urban, academic institution between January 2016 and December 2022. Of those, exclusions consisted of indications other than osteoarthritis (2% [1595]), no available ADI data (13% [12,302]), or loss to minimum 90-day postoperative follow-up and incomplete data (29% [26,836]). In all, 52,068 patients were included in the final analysis, with 43% (22,363) of patients undergoing primary THA and 57% (29,705) undergoing primary TKA. To determine the degree of social deprivation, the 2022 ADI was used and linked to patients' street addresses. Using the ADI national ranking from 1 to 100, with 1 representing the lowest level of disadvantage and 100 representing the highest level of disadvantage, patients were compared by ADI quartiles; Quartile 1 represented the least disadvantaged cohort and Quartile 4 represented the most disadvantaged cohort. Overall, the mean ± SD age was 66 ± 10 years, and the population consisted of 56% (29,333 of 52,068) women. Thirty-three percent (17,391 of 52,068) of patients were in ADI Quartile 1, 44% (22,944 of 52,068) were in Quartile 2, 17% (8650 of 52,068) were in Quartile 3, and 6% (3083 of 52,068) were in Quartile 4. The primary outcome measure was the number of touchpoints per patient, defined as the communication points (telephone or electronic messages) sent or received on behalf of the patient in relation to the total joint arthroplasty procedure. Touchpoints within the 30-day preoperative or 90-day postoperative periods of the primary THA or TKA were included. Secondary outcome measures included LOS, 90-day readmissions, and PROMs consisting of the Knee Injury and Osteoarthr","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"39 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015308","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}
<p><strong>Background: </strong>The C2-7 Cobb angle is an important parameter in evaluating cervical sagittal alignment, which is widely used for preoperative planning, identifying surgical indications, and postoperative assessment. However, this angle becomes unmeasurable in 28% to 49% of clinical radiographs because of poor visualization of the C7 inferior endplate, limiting treatment planning and radiographic follow-up in cervical alignment assessment. The C2-6 Cobb angle has been proposed as a substitute in previous research, but these studies were limited by small symptomatic cohorts from a single center and lacked both subgroup-specific and external validation. Furthermore, there is currently a lack of reference standards for the clinical use of the C2-6 Cobb angle, and no established machine-learning models are available to accurately predict the C2-7 Cobb angle.</p><p><strong>Questions/purposes: </strong>(1) Can the C2-6 Cobb angle serve as a reliable substitute for the C2-7 angle? (2) Can machine-learning models accurately predict the C2-7 Cobb angle?</p><p><strong>Methods: </strong>We conducted a retrospective, multicountry imaging study from January 2020 to January 2025, utilizing standing lateral cervical spine radiographs from a large hospital data set in China and public data sets from Vietnam and India. In China, 11,800 radiographs were initially screened. The inclusion criterion was cervical radiographs of sufficient clarity. The exclusion criterion was cervical radiographs with incomplete visualization of anatomic structures. Following these exclusions, 10,571 radiographs from China were included, comprising 10,000 standard standing lateral radiographs plus 284 implant and 287 flexion-extension radiographs. From the public data sets, 470 radiographs from Vietnam and 62 from India were reviewed, with no radiographs excluded. A total of 11,103 radiographs were available for final analysis. Key variables included demographics (age, sex), symptomatic status, implant status, and radiographic sagittal parameters derived from standing lateral views. Four orthopaedic specialists labeled keypoints on the original radiographs, including the corner points of C2 to C7 and the centroid of C2. An algorithm was employed for precise measurement of the C2-6 and C2-7 Cobb angles. The Pearson correlation coefficient was calculated to assess the strength of the correlation between the C2-6 and C2-7 Cobb angles, and a linear regression analysis was applied to derive a predictive equation for the C2-7 Cobb angle based on the C2-6 Cobb angle. Subsequently, the 10,000 standard Chinese standing lateral radiographs were randomly assigned to the training set (80%) and the testing set (20%). An independent validation set (n = 1103) was established to assess robustness, comprising 284 implant radiographs and 287 flexion-extension radiographs from China, together with 470 from Vietnam and 62 from India.</p><p><strong>Results: </strong>Correlation analysis dem
{"title":"What Substitution and Prediction Strategies Address the Challenge of an Unmeasurable C2-7 Cobb Angle?","authors":"Zerui Qin, Yu Ran, Zongshuo Sha, Lingmin Wu, Haodong Xiong, Qianzi Zhao, Zhongze Li, Jinsong Chen, Dongran Han, Yixing Liu, Jinyu Li, Jiang Chen","doi":"10.1097/CORR.0000000000003812","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003812","url":null,"abstract":"<p><strong>Background: </strong>The C2-7 Cobb angle is an important parameter in evaluating cervical sagittal alignment, which is widely used for preoperative planning, identifying surgical indications, and postoperative assessment. However, this angle becomes unmeasurable in 28% to 49% of clinical radiographs because of poor visualization of the C7 inferior endplate, limiting treatment planning and radiographic follow-up in cervical alignment assessment. The C2-6 Cobb angle has been proposed as a substitute in previous research, but these studies were limited by small symptomatic cohorts from a single center and lacked both subgroup-specific and external validation. Furthermore, there is currently a lack of reference standards for the clinical use of the C2-6 Cobb angle, and no established machine-learning models are available to accurately predict the C2-7 Cobb angle.</p><p><strong>Questions/purposes: </strong>(1) Can the C2-6 Cobb angle serve as a reliable substitute for the C2-7 angle? (2) Can machine-learning models accurately predict the C2-7 Cobb angle?</p><p><strong>Methods: </strong>We conducted a retrospective, multicountry imaging study from January 2020 to January 2025, utilizing standing lateral cervical spine radiographs from a large hospital data set in China and public data sets from Vietnam and India. In China, 11,800 radiographs were initially screened. The inclusion criterion was cervical radiographs of sufficient clarity. The exclusion criterion was cervical radiographs with incomplete visualization of anatomic structures. Following these exclusions, 10,571 radiographs from China were included, comprising 10,000 standard standing lateral radiographs plus 284 implant and 287 flexion-extension radiographs. From the public data sets, 470 radiographs from Vietnam and 62 from India were reviewed, with no radiographs excluded. A total of 11,103 radiographs were available for final analysis. Key variables included demographics (age, sex), symptomatic status, implant status, and radiographic sagittal parameters derived from standing lateral views. Four orthopaedic specialists labeled keypoints on the original radiographs, including the corner points of C2 to C7 and the centroid of C2. An algorithm was employed for precise measurement of the C2-6 and C2-7 Cobb angles. The Pearson correlation coefficient was calculated to assess the strength of the correlation between the C2-6 and C2-7 Cobb angles, and a linear regression analysis was applied to derive a predictive equation for the C2-7 Cobb angle based on the C2-6 Cobb angle. Subsequently, the 10,000 standard Chinese standing lateral radiographs were randomly assigned to the training set (80%) and the testing set (20%). An independent validation set (n = 1103) was established to assess robustness, comprising 284 implant radiographs and 287 flexion-extension radiographs from China, together with 470 from Vietnam and 62 from India.</p><p><strong>Results: </strong>Correlation analysis dem","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050583","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}
Pub Date : 2026-01-02DOI: 10.1097/corr.0000000000003822
Casey Jo Humbyrd
{"title":"Virtue Ethics in a Value-driven World: Bringing a Knife to a Gunfight.","authors":"Casey Jo Humbyrd","doi":"10.1097/corr.0000000000003822","DOIUrl":"https://doi.org/10.1097/corr.0000000000003822","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"30 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015319","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}
Pub Date : 2026-01-02DOI: 10.1097/corr.0000000000003792
Seth S Leopold
{"title":"Editor's Spotlight/Take 5: Patients With Nonanaphylactic Penicillin Allergy Are Not at Increased Risk of Allergic Events After Receiving Prophylactic Preoperative Cefazolin Prior to Closed Fracture Repair.","authors":"Seth S Leopold","doi":"10.1097/corr.0000000000003792","DOIUrl":"https://doi.org/10.1097/corr.0000000000003792","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"52 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015125","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}
Pub Date : 2026-01-02DOI: 10.1097/CORR.0000000000003820
A Lee Osterman
{"title":"CORR Insights®: Is RAGE Expression in Flexor Tendon Synovium Associated With Carpal Tunnel Syndrome in Patients With Diabetes?","authors":"A Lee Osterman","doi":"10.1097/CORR.0000000000003820","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003820","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050503","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}
Pub Date : 2026-01-01Epub Date: 2025-08-12DOI: 10.1097/CORR.0000000000003645
Christiaan H Righolt, Flavia K Borges, Jhase Sniderman, Thomas R Turgeon, P J Devereaux, Mohit Bhandari, Ernesto Guerra Farfan, Abdel-Rahman Lawendy, Ameen Patel, Vikas Tandon, Wojciech Szczeklik, Sandra Ofori, Valerie Harvey, Eric R Bohm, Gavin C A Wood
<p><strong>Background: </strong>Cemented fixation in arthroplasty to treat hip fractures is now widely recommended, but it is not universally used. Some surgeons may feel that the risk of bone cement implantation syndrome and its cardiopulmonary sequalae are too high, in part, because the evidence provides little detail on postoperative myocardial injury and other medical complications after cement use.</p><p><strong>Questions/purposes: </strong>We aimed to use data from the HIP ATTACK trial (an RCT in which patients with a hip fracture were randomized to accelerated time to surgery versus normal timing of surgery) for a secondary analysis to answer the following questions on arthroplasty for patients with hip fractures: (1) Are patients who undergo cemented hip arthroplasty for hip fractures more likely to experience cardiopulmonary events than patients who undergo uncemented hip arthroplasty? (2) Are patients who undergo cemented hip arthroplasty for hip fractures more likely to experience myocardial injury, identified by elevated troponin levels, than patients who undergo uncemented hip arthroplasty?</p><p><strong>Methods: </strong>We performed a post hoc analysis of the HIP ATTACK trial for a subset of patients who were treated with THA or hemiarthroplasty for a femoral neck fracture because the trial collected postoperative troponin levels to allow us to identify myocardial injury. The HIP ATTACK trial consisted of 2970 patients. We limited our source cohort to the 1049 patients who underwent hip arthroplasty and were not lost to follow-up (four patients who had undergone arthroplasty were lost to follow-up). We excluded two patients with unknown fixation and six patients with "other arthroplasty." We limited our analysis to femoral neck fractures, which excluded 75 more patients. Of the 966 patients who received hip arthroplasty, 61% (593) had cemented fixation. Patients with cemented fixation were older than patients with cementless fixation (median [IQR] 82 (74 to 88) versus 79 (71 to 86); p = 0.003). Race was self-reported by patients and differed between patients with cemented and cementless fixation. A higher proportion of patients who received cementless fixation had undergone THA (compared with hemiarthroplasty) than patients in the cemented fixation group (24% [91] versus 11% [66]; p < 0.001). We used logistic regression to estimate the association between cement use and a composite outcome consisting of all-cause mortality and various cardiopulmonary outcomes. We included cardiopulmonary outcomes possibly associated with bone cement implantation syndrome; there were only a small number of patients who had only nonsevere outcomes. We had 80% power to detect an OR of ≥ 1.6. We adjusted for all baseline differences between both groups except for anesthesia (as it was not associated with the outcome) and duration of surgery (as it is a function of cement use).</p><p><strong>Results: </strong>After controlling for age, sex, race, and re
背景：关节置换术中骨水泥固定治疗髋部骨折现在被广泛推荐，但并没有被普遍使用。一些外科医生可能会认为骨水泥植入综合征及其心肺后遗症的风险太高，部分原因是有关骨水泥使用后的术后心肌损伤和其他医学并发症的证据很少。问题/目的：我们的目的是使用来自髋关节攻击试验的数据（一项随机对照试验，髋部骨折患者被随机分为加速手术时间和正常手术时间）进行二次分析，以回答以下关于髋部骨折患者髋关节置换术的问题：(1)髋部骨折接受骨水泥髋关节置换术的患者是否比未接受骨水泥髋关节置换术的患者更容易发生心肺事件？(2)髋部骨折行骨水泥髋关节置换术的患者是否比未行骨水泥髋关节置换术的患者更容易发生心肌损伤（由肌钙蛋白水平升高确定）？方法：我们对一组接受髋关节置换术或半关节置换术治疗的股骨颈骨折患者进行了髋关节发作试验的事后分析，因为该试验收集了术后肌钙蛋白水平，使我们能够识别心肌损伤。髋关节发作试验包括2970名患者。我们将源队列限制在1049例接受了髋关节置换术且未丢失随访的患者（4例接受了髋关节置换术的患者丢失了随访）。我们排除了2例固定不明的患者和6例“其他关节置换术”患者。我们将分析局限于股骨颈骨折，排除了另外75例患者。在接受髋关节置换术的966例患者中，61%（593例）采用骨水泥固定。采用骨水泥固定的患者比不采用骨水泥固定的患者年龄大(中位[IQR] 82（74 ~ 88）比79 (71 ~ 86)；P = 0.003)。种族由患者自我报告，并且在骨水泥和非骨水泥固定患者之间存在差异。与半关节置换术相比，接受无骨水泥固定的患者行THA的比例高于骨水泥固定组（24%[91]对11% [66]；p < 0.001）。我们使用逻辑回归来估计水泥使用与由全因死亡率和各种心肺结局组成的复合结局之间的关系。我们纳入了可能与骨水泥植入综合征相关的心肺结局；只有少数患者只有非严重的结果。我们有80%的概率检测到OR≥1.6。我们调整了两组之间的所有基线差异，除了麻醉（因为它与结果无关）和手术持续时间（因为它是水泥使用的函数）。结果：在控制了年龄、性别、种族和相关合并症后，我们发现水泥的使用与90天复合结果的差异无关(OR 1.0[95%可信区间（CI） 0.7至1.4]；p = 0.99)或1年（or 1.0 [95% CI 0.7 ~ 1.4]; p = 0.95）或术后第1天肌钙蛋白升高（or 1.4 [95% CI 1.0 ~ 1.9]; p = 0.06）。结论：髋关节置换术内固定治疗髋部骨折患者的心肺功能无明显差异。这些发现进一步支持了对髋部骨折患者在全髋关节置换术和半关节置换术中使用骨水泥股骨固定的建议。经验有限的外科医生应熟悉这些技巧。未来的研究应该评估骨水泥固定存在哪些障碍以及如何减轻这些障碍。证据等级：III级，治疗性研究。
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Pub Date : 2026-01-01Epub Date: 2025-09-15DOI: 10.1097/CORR.0000000000003694
Nicholas J Giori
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