Pub Date : 2025-03-01Epub Date: 2025-02-27DOI: 10.1097/CORR.0000000000003312
Daniel C Allison
{"title":"CORR Insights®: What Functional Outcomes Can Be Expected With Osseointegrated Prostheses in Transfemoral Amputations?","authors":"Daniel C Allison","doi":"10.1097/CORR.0000000000003312","DOIUrl":"10.1097/CORR.0000000000003312","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"483 3","pages":"524-526"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522784","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 : 2025-03-01Epub Date: 2024-09-05DOI: 10.1097/CORR.0000000000003247
Mark Haft, Steve S Li, Zachary C Pearson, Uzoma Ahiarakwe, Amie F Bettencourt, Umasuthan Srikumaran
<p><strong>Background: </strong>Bovine bioinductive collagen implants (herein, "bovine collagen implant") can be used to augment rotator cuff repair. Concern exists that these bovine collagen implants may not yield clinical benefits and may actually increase postoperative stiffness and the need for reoperation.</p><p><strong>Questions/purposes: </strong>Among patients who underwent primary rotator cuff repair with or without a bovine collagen implant, we asked: (1) Did the proportion of patients undergoing reoperation for postoperative stiffness and inflammation differ between the bovine collagen implant and control groups? (2) Did short-term patient-reported outcomes differ between the two groups? (3) Did the proportion of patients receiving postoperative methylprednisolone prescriptions and corticosteroid injections differ between the two groups?</p><p><strong>Methods: </strong>We performed a retrospective, matched, comparative study of patients 18 years and older with minimum 2-year follow-up who underwent primary arthroscopic repair of partial or full-thickness rotator cuff tears diagnosed by MRI. All procedures were performed by one surgeon between February 2016 and December 2021. During the period in question, this surgeon broadly offered the bovine collagen implant to all patients who underwent rotator cuff repair and who (1) consented to xenograft use and (2) had surgery at a facility where the bovine collagen implant was available. The bovine collagen implant was used in rotator cuff tears of all sizes per the manufacturer's instructions. A total of 312 patients were considered for this study (243 control, 69 implant). Minimum 2-year clinical follow-up data were available for 83% (201 of 243) of patients in the control group and 90% (62 of 69) of patients in the bovine collagen implant group. After we applied the exclusion criteria, 163 control and 47 implant group patients remained and were eligible for matching. Propensity score matching was conducted to balance cohorts by age, gender, race (Black, White, other), ethnicity (Hispanic, non-Hispanic), health insurance status, Area Deprivation Index, BMI, American Society of Anesthesiologists physical status classification, diabetes, smoking, rotator cuff tear size, concomitant surgical procedures, preoperative American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), VAS score for pain, and shoulder ROM. We included 141 patients (47 in the implant group and 94 in the control group) after matching. Patients were categorized according to whether they received the bovine collagen implant. Before matching, the control cohort was older (mean ± SD 57 ± 10 years versus 52 ± 11 years; p = 0.004), more likely to be White (58% versus 23%; p < 0.001), with a smaller proportion of concomitant distal clavicle excisions (43% versus 21%; p = 0.003), and a smaller proportion of "other" concomitant procedures (17% versus 6%; p = 0.011) compared with the implant cohort. After matc
{"title":"No Short-term Clinical Benefit to Bovine Collagen Implant Augmentation in Primary Rotator Cuff Repair: A Matched Retrospective Study.","authors":"Mark Haft, Steve S Li, Zachary C Pearson, Uzoma Ahiarakwe, Amie F Bettencourt, Umasuthan Srikumaran","doi":"10.1097/CORR.0000000000003247","DOIUrl":"10.1097/CORR.0000000000003247","url":null,"abstract":"<p><strong>Background: </strong>Bovine bioinductive collagen implants (herein, \"bovine collagen implant\") can be used to augment rotator cuff repair. Concern exists that these bovine collagen implants may not yield clinical benefits and may actually increase postoperative stiffness and the need for reoperation.</p><p><strong>Questions/purposes: </strong>Among patients who underwent primary rotator cuff repair with or without a bovine collagen implant, we asked: (1) Did the proportion of patients undergoing reoperation for postoperative stiffness and inflammation differ between the bovine collagen implant and control groups? (2) Did short-term patient-reported outcomes differ between the two groups? (3) Did the proportion of patients receiving postoperative methylprednisolone prescriptions and corticosteroid injections differ between the two groups?</p><p><strong>Methods: </strong>We performed a retrospective, matched, comparative study of patients 18 years and older with minimum 2-year follow-up who underwent primary arthroscopic repair of partial or full-thickness rotator cuff tears diagnosed by MRI. All procedures were performed by one surgeon between February 2016 and December 2021. During the period in question, this surgeon broadly offered the bovine collagen implant to all patients who underwent rotator cuff repair and who (1) consented to xenograft use and (2) had surgery at a facility where the bovine collagen implant was available. The bovine collagen implant was used in rotator cuff tears of all sizes per the manufacturer's instructions. A total of 312 patients were considered for this study (243 control, 69 implant). Minimum 2-year clinical follow-up data were available for 83% (201 of 243) of patients in the control group and 90% (62 of 69) of patients in the bovine collagen implant group. After we applied the exclusion criteria, 163 control and 47 implant group patients remained and were eligible for matching. Propensity score matching was conducted to balance cohorts by age, gender, race (Black, White, other), ethnicity (Hispanic, non-Hispanic), health insurance status, Area Deprivation Index, BMI, American Society of Anesthesiologists physical status classification, diabetes, smoking, rotator cuff tear size, concomitant surgical procedures, preoperative American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), VAS score for pain, and shoulder ROM. We included 141 patients (47 in the implant group and 94 in the control group) after matching. Patients were categorized according to whether they received the bovine collagen implant. Before matching, the control cohort was older (mean ± SD 57 ± 10 years versus 52 ± 11 years; p = 0.004), more likely to be White (58% versus 23%; p < 0.001), with a smaller proportion of concomitant distal clavicle excisions (43% versus 21%; p = 0.003), and a smaller proportion of \"other\" concomitant procedures (17% versus 6%; p = 0.011) compared with the implant cohort. After matc","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"442-452"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139508","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 : 2025-03-01Epub Date: 2024-10-02DOI: 10.1097/CORR.0000000000003272
Matthew J Dietz, Brian M McGowan, Dylan D Thomas, Emily R Hunt, Elizabeth Stewart, Matthew W Squire
<p><strong>Background: </strong>Polymethylmethacrylate (PMMA) antibiotic-laden bone cement (ALBC) is commonly used in total joint arthroplasty to treat and potentially prevent prosthetic joint infection (PJI). Multiple properties impact the elution characteristics of antibiotics from PMMA-based ALBC, including viscosity. What is not known is how medium-viscosity cement formulations affect antibiotic elution and how different cement products from different manufacturers compare regarding reaching the minimum inhibitory concentration (MIC) of antibiotics for common PJI-causing organisms in an in vitro setting.</p><p><strong>Questions/purposes: </strong>(1) Does cement viscosity impact in vitro antibiotic elution characteristics when comparing medium-viscosity ALBC and high-viscosity ALBC formulations from the same manufacturer against four common PJI pathogens? (2) Does the manufacturer of the PMMA-based ALBC product and the type of aminoglycoside (gentamicin versus tobramycin) impact the in vitro antibiotic elution against four common PJI pathogens?</p><p><strong>Methods: </strong>Three different PMMA-based ALBC products, including Palacos® R (high viscosity) plus gentamicin (PR+G), Palacos (medium viscosity) plus gentamicin (PMV+G), and Simplex™ P (low viscosity) plus tobramycin (SP+T), and controls for each cement type, including Palacos R, Palacos medium viscosity, and Simplex P, were evaluated. These cements were tested against four common PJI pathogens: methicillin-sensitive Staphylococcus aureus , methicillin-resistant S. aureus (MRSA), methicillin-sensitive S. epidermidis (MSSE), and methicillin-resistant S. epidermidis . A 5-day elution protocol was observed using uniform cylindrical cement samples of each cement product. Each analysis was run with three separate lots of cement, with four samples created per lot and each sample run in duplicate. Standard curves with known antibiotic concentrations were created. Kirby-Bauer assays were then used to determine the zone of inhibition for each cement product against the four common PJI pathogens. The eluted antibiotic concentration was extrapolated for each product over 5 days to determine the interpolated antibiotic concentration for each of the 5 days. Area under the curve (AUC) was calculated as a surrogate for total antibiotics eluted over the 5-day period.</p><p><strong>Results: </strong>Cement viscosity does not impact antibiotic elution characteristics when comparing a medium-viscosity ALBC and a high-viscosity ALBC from the same manufacturer. The cement products from two manufacturers containing different types of aminoglycosides differ in their in vitro activity over a 5-day period against four common PJI pathogens. There was no difference in interpolated antibiotic concentration against MSSE on Day 1 between PMV+G cement and PR+G (high-viscosity) (mean ± SD medium-viscosity cement gentamicin concentration 73.6 ± 14.0 µg/mL versus high-viscosity gentamicin concentration 80.3 ± 15.5 µg/
{"title":"Does Cement Viscosity Impact Antibiotic Elution and In Vitro Efficacy Against Common Prosthetic Joint Infection Pathogens?","authors":"Matthew J Dietz, Brian M McGowan, Dylan D Thomas, Emily R Hunt, Elizabeth Stewart, Matthew W Squire","doi":"10.1097/CORR.0000000000003272","DOIUrl":"10.1097/CORR.0000000000003272","url":null,"abstract":"<p><strong>Background: </strong>Polymethylmethacrylate (PMMA) antibiotic-laden bone cement (ALBC) is commonly used in total joint arthroplasty to treat and potentially prevent prosthetic joint infection (PJI). Multiple properties impact the elution characteristics of antibiotics from PMMA-based ALBC, including viscosity. What is not known is how medium-viscosity cement formulations affect antibiotic elution and how different cement products from different manufacturers compare regarding reaching the minimum inhibitory concentration (MIC) of antibiotics for common PJI-causing organisms in an in vitro setting.</p><p><strong>Questions/purposes: </strong>(1) Does cement viscosity impact in vitro antibiotic elution characteristics when comparing medium-viscosity ALBC and high-viscosity ALBC formulations from the same manufacturer against four common PJI pathogens? (2) Does the manufacturer of the PMMA-based ALBC product and the type of aminoglycoside (gentamicin versus tobramycin) impact the in vitro antibiotic elution against four common PJI pathogens?</p><p><strong>Methods: </strong>Three different PMMA-based ALBC products, including Palacos® R (high viscosity) plus gentamicin (PR+G), Palacos (medium viscosity) plus gentamicin (PMV+G), and Simplex™ P (low viscosity) plus tobramycin (SP+T), and controls for each cement type, including Palacos R, Palacos medium viscosity, and Simplex P, were evaluated. These cements were tested against four common PJI pathogens: methicillin-sensitive Staphylococcus aureus , methicillin-resistant S. aureus (MRSA), methicillin-sensitive S. epidermidis (MSSE), and methicillin-resistant S. epidermidis . A 5-day elution protocol was observed using uniform cylindrical cement samples of each cement product. Each analysis was run with three separate lots of cement, with four samples created per lot and each sample run in duplicate. Standard curves with known antibiotic concentrations were created. Kirby-Bauer assays were then used to determine the zone of inhibition for each cement product against the four common PJI pathogens. The eluted antibiotic concentration was extrapolated for each product over 5 days to determine the interpolated antibiotic concentration for each of the 5 days. Area under the curve (AUC) was calculated as a surrogate for total antibiotics eluted over the 5-day period.</p><p><strong>Results: </strong>Cement viscosity does not impact antibiotic elution characteristics when comparing a medium-viscosity ALBC and a high-viscosity ALBC from the same manufacturer. The cement products from two manufacturers containing different types of aminoglycosides differ in their in vitro activity over a 5-day period against four common PJI pathogens. There was no difference in interpolated antibiotic concentration against MSSE on Day 1 between PMV+G cement and PR+G (high-viscosity) (mean ± SD medium-viscosity cement gentamicin concentration 73.6 ± 14.0 µg/mL versus high-viscosity gentamicin concentration 80.3 ± 15.5 µg/","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"488-497"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892125","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 : 2025-03-01Epub Date: 2024-11-08DOI: 10.1097/CORR.0000000000003313
George Grammatopoulos
{"title":"CORR Insights®: Does Cement Viscosity Impact Antibiotic Elution and In Vitro Efficacy Against Common Prosthetic Joint Infection Pathogens?","authors":"George Grammatopoulos","doi":"10.1097/CORR.0000000000003313","DOIUrl":"10.1097/CORR.0000000000003313","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"498-500"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603582","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 : 2025-03-01Epub Date: 2024-12-03DOI: 10.1097/CORR.0000000000003310
Robert Sershon
{"title":"CORR Insights®: Is 18 F-fluoride PET/CT an Accurate Tool to Diagnose Loosening After Total Joint Arthroplasty?","authors":"Robert Sershon","doi":"10.1097/CORR.0000000000003310","DOIUrl":"10.1097/CORR.0000000000003310","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"429-430"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766829","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 : 2025-03-01Epub Date: 2025-01-03DOI: 10.1097/CORR.0000000000003363
John D Kelly
{"title":"Your Best Life: Be a River With Your Blessings, Not a Reservoir.","authors":"John D Kelly","doi":"10.1097/CORR.0000000000003363","DOIUrl":"10.1097/CORR.0000000000003363","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"403-405"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920961","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 : 2025-03-01Epub Date: 2025-01-03DOI: 10.1097/CORR.0000000000003338
Seth S Leopold, Mark C Gebhardt, Terence J Gioe, Paul A Manner, Raphaël Porcher, Clare M Rimnac, Montri D Wongworawat
{"title":"Editorial: An Update on How CORR Evaluates Systematic Reviews and Meta-analyses (Which You Might Also Consider When Reading Them).","authors":"Seth S Leopold, Mark C Gebhardt, Terence J Gioe, Paul A Manner, Raphaël Porcher, Clare M Rimnac, Montri D Wongworawat","doi":"10.1097/CORR.0000000000003338","DOIUrl":"10.1097/CORR.0000000000003338","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"369-371"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945631","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 : 2025-03-01Epub Date: 2024-10-25DOI: 10.1097/CORR.0000000000003298
Augustine Mark Saiz
{"title":"CORR Insights®: What Are the Factors Associated With Revision Surgery on the Residual Limb and Functional Results in Patients With Posttraumatic Lower Limb Amputations?","authors":"Augustine Mark Saiz","doi":"10.1097/CORR.0000000000003298","DOIUrl":"10.1097/CORR.0000000000003298","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"511-512"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521200","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 : 2025-03-01Epub Date: 2024-12-03DOI: 10.1097/CORR.0000000000003324
B Sonny Bal
{"title":"Medicolegal Sidebar: Can You Lose Personal Assets in a Medical Malpractice Lawsuit?","authors":"B Sonny Bal","doi":"10.1097/CORR.0000000000003324","DOIUrl":"10.1097/CORR.0000000000003324","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"396-398"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766805","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 : 2025-03-01Epub Date: 2025-01-07DOI: 10.1097/CORR.0000000000003347
Kevin A Hao, Keegan M Hones, Daniel S O'Keefe, Josie Elwell, Ryan W Simovitch, Thomas W Wright, Joseph J King, Bradley S Schoch
<p><strong>Background: </strong>A variety of clinically important benchmarks of success (CIBS) have been defined for total shoulder arthroplasty (TSA) to quantify success. However, it is unclear how the preoperative status of the patient influences their likelihood of achieving each CIBS.</p><p><strong>Questions/purposes: </strong>(1) What proportion of patients achieve commonly used CIBS after TSA? (2) Is there a relationship between a patients' preoperative function and their probability of achieving different CIBS? (3) Does there exist preoperative ranges for each outcome measure that are associated with greater achievement of CIBS?</p><p><strong>Methods: </strong>We retrospectively queried a multicenter shoulder arthroplasty database for primary anatomic TSA (aTSA) and reverse TSA (rTSA). A total of 2041 aTSAs and 3205 rTSAs were included. The mean ± SD age at time of surgery was 66 ± 9 years for aTSAs and 72 ± 8 years for rTSAs. In all, 51% (1049 of 2041) of aTSAs and 61% (1955 of 3205) of rTSAs were in patients who were women. For aTSAs, osteoarthritis with an intact rotator cuff was the most common preoperative diagnosis (92% [1869 of 2041]). For rTSAs, the most common preoperative diagnoses included rotator cuff tear arthropathy (40% [1280 of 3205]), osteoarthritis with an intact rotator cuff (24% [780 of 3205]), osteoarthritis with a torn rotator cuff (20% [632 of 3205]), and massive rotator cuff tear (10% [309 of 3205]). Outcomes were evaluated at latest follow-up (aTSA 61 ± 36 months, rTSA 47 ± 26 months) and consisted of ROM (abduction, forward elevation, external and internal rotation) as well as the most commonly used outcome scores: the Simple Shoulder Test (SST), Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Shoulder Pain and Disability Index (SPADI), and the Shoulder Arthroplasty Smart (SAS) score. The CIBS that we evaluated included the minimum clinically important difference (MCID), substantial clinical benefit (SCB), patient acceptable symptom state (PASS), minimum clinically important percentage of maximal possible improvement (MCI-%MPI), and substantial clinically important percentage of maximal possible improvement (SCI-%MPI). Prosthesis-specific anchor-based CIBS were adopted from prior publications on patients from this database. Multivariable regression was performed to identify the relationship between preoperative outcome measures and achievement of CIBS. Additionally, receiver operating characteristic (ROC) curve analyses were performed to determine whether thresholds in preoperative outcome measures were associated with achieving CIBS.</p><p><strong>Results: </strong>For all ROM measures and outcome scores, poorer preoperative ROM was associated with greater odds of achieving the MCID and SCB but lower odds of achieving the PASS. For the SST and the two scores without ceiling effects (the Constant and SAS scores), poorer preoperative outcome sco
{"title":"Does the Relationship Between Preoperative Function and Achievement of Clinically Important Benchmarks of Success After Total Shoulder Arthroplasty Depend on Outcome Assessment Design?","authors":"Kevin A Hao, Keegan M Hones, Daniel S O'Keefe, Josie Elwell, Ryan W Simovitch, Thomas W Wright, Joseph J King, Bradley S Schoch","doi":"10.1097/CORR.0000000000003347","DOIUrl":"10.1097/CORR.0000000000003347","url":null,"abstract":"<p><strong>Background: </strong>A variety of clinically important benchmarks of success (CIBS) have been defined for total shoulder arthroplasty (TSA) to quantify success. However, it is unclear how the preoperative status of the patient influences their likelihood of achieving each CIBS.</p><p><strong>Questions/purposes: </strong>(1) What proportion of patients achieve commonly used CIBS after TSA? (2) Is there a relationship between a patients' preoperative function and their probability of achieving different CIBS? (3) Does there exist preoperative ranges for each outcome measure that are associated with greater achievement of CIBS?</p><p><strong>Methods: </strong>We retrospectively queried a multicenter shoulder arthroplasty database for primary anatomic TSA (aTSA) and reverse TSA (rTSA). A total of 2041 aTSAs and 3205 rTSAs were included. The mean ± SD age at time of surgery was 66 ± 9 years for aTSAs and 72 ± 8 years for rTSAs. In all, 51% (1049 of 2041) of aTSAs and 61% (1955 of 3205) of rTSAs were in patients who were women. For aTSAs, osteoarthritis with an intact rotator cuff was the most common preoperative diagnosis (92% [1869 of 2041]). For rTSAs, the most common preoperative diagnoses included rotator cuff tear arthropathy (40% [1280 of 3205]), osteoarthritis with an intact rotator cuff (24% [780 of 3205]), osteoarthritis with a torn rotator cuff (20% [632 of 3205]), and massive rotator cuff tear (10% [309 of 3205]). Outcomes were evaluated at latest follow-up (aTSA 61 ± 36 months, rTSA 47 ± 26 months) and consisted of ROM (abduction, forward elevation, external and internal rotation) as well as the most commonly used outcome scores: the Simple Shoulder Test (SST), Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Shoulder Pain and Disability Index (SPADI), and the Shoulder Arthroplasty Smart (SAS) score. The CIBS that we evaluated included the minimum clinically important difference (MCID), substantial clinical benefit (SCB), patient acceptable symptom state (PASS), minimum clinically important percentage of maximal possible improvement (MCI-%MPI), and substantial clinically important percentage of maximal possible improvement (SCI-%MPI). Prosthesis-specific anchor-based CIBS were adopted from prior publications on patients from this database. Multivariable regression was performed to identify the relationship between preoperative outcome measures and achievement of CIBS. Additionally, receiver operating characteristic (ROC) curve analyses were performed to determine whether thresholds in preoperative outcome measures were associated with achieving CIBS.</p><p><strong>Results: </strong>For all ROM measures and outcome scores, poorer preoperative ROM was associated with greater odds of achieving the MCID and SCB but lower odds of achieving the PASS. For the SST and the two scores without ceiling effects (the Constant and SAS scores), poorer preoperative outcome sco","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"377-395"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945164","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：