Clinical Orthopaedics and Related Research®最新文献

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CORR Insights®: What Are the Complications, Reconstruction Survival, and Functional Outcomes of Modular Prosthesis and Allograft-prosthesis Composite for Proximal Femur Reconstruction in Children With Primary Bone Tumors? CORR Insights®：原发性骨肿瘤患儿股骨近端重建的模块化假体和同种异体假体复合材料的并发症、重建存活率和功能疗效如何？

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-03-01 Epub Date: 2024-11-08 DOI: 10.1097/CORR.0000000000003311

Albert J Aboulafia

引用次数: 0

Reply to the Letter to the Editor: Is Information About Musculoskeletal Malignancies From Large Language Models or Web Resources at a Suitable Reading Level for Patients? 回复给编辑的信：来自大型语言模型或网络资源的关于肌肉骨骼恶性肿瘤的信息是否适合患者阅读？

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-03-01 Epub Date: 2024-12-03 DOI: 10.1097/CORR.0000000000003331

Paul G Guirguis, Mark P Youssef, Ankit Punreddy, Mina Botros, Susan McDowell

引用次数: 0

Letter to the Editor: How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life? 致编辑的信：假体关节感染及其成功治疗对患者报告的生活质量有多大影响？

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-03-01 Epub Date: 2024-11-26 DOI: 10.1097/CORR.0000000000003334

Tien-Ching Lee

引用次数: 0

CORR Insights®: What Factors Are Associated With Implant Revision in the Treatment of Pathologic Subtrochanteric Femur Fractures? CORR Insights®：在病理性股骨粗隆下骨折的治疗中，与植入物翻修相关的因素是什么？

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-03-01 Epub Date: 2024-12-31 DOI: 10.1097/CORR.0000000000003370

Stein Jasper Janssen

引用次数: 0

CORR Insights®: Outpatient Revision TKA Does Not Increase Incidence of Repeat Revision or Medical and Surgical Complications Compared With Inpatient Revision TKA.

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-02-27 DOI: 10.1097/CORR.0000000000003437

Matthew L Webb

引用次数: 0

Readmission Within 90 Days After Primary THA Is Associated With Decreased Improvement in 1-Year Patient-reported Outcome Measures and Increased Reoperation Rates.

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-02-27 DOI: 10.1097/CORR.0000000000003429

Shujaa T Khan, Ignacio Pasqualini, Yuxuan Jin, Alison K Klika, Nicolas S Piuzzi

Background: Readmissions after THA can negatively impact patients, increase healthcare utilization, and subsequently increase costs. However, there is little to demonstrate whether readmission after THA is associated with poorer results in outcomes that matter to patients, such as pain relief, restoration of function, or activities of daily living. Moreover, the impact of medical-related readmissions compared with orthopaedic-related readmissions on postoperative outcomes is currently unknown.Questions/purpose: Are patients readmitted within 90 days of an index THA less likely to achieve a minimum clinically important difference (MCID) or patient acceptable symptom state (PASS) threshold in postoperative patient-reported outcome measures (PROMs) compared with those who are not readmitted? (2) Is the cause of readmission within 90 days (medical or orthopaedic) associated with a lower likelihood of achieving either MCID or PASS thresholds 1 year after THA? (3) How does 90-day readmission compare with other patient-specific factors associated with a lower likelihood of attaining either MCID or PASS? (4) Are patients readmitted within 90 days more likely to undergo further surgery?Methods: Between January 2016 and December 2020, we treated 11,026 patients with primary THA at a large tertiary academic center. Patients undergoing nonelective (n = 551) and bilateral THAs (n = 1582) were excluded, leaving 8893 for final analysis here. Of these, 2476 patients were lost to follow-up and thus not included in the 1-year PROMs analysis, but they remained included in the study overall. Data for each patient were extracted from a validated longitudinally maintained institutional database. The mean ± SD age of patients was 65 ± 11.5 years, 57% were women, and 86% self-reported as White. Readmissions were individually reviewed and grouped into medical-related or orthopaedic-related causes based on the primary cause. Multivariable logistic regression models were used to investigate the association of 90-day readmission with 1-year PROMs. Overall, 6% (502 of 8893) were readmitted within 90 days, with 75% (377 of 502) being medically related and 25% (125 of 502) being orthopaedically related readmissions. PROM scores were obtained preoperatively and at 1 year after each of the THAs and included Hip Disability and Osteoarthritis Outcome Score (HOOS) pain, physical function, and joint replacement scores, as well as the Veterans Rand 12-Item Health Survey mental component summary score. Each was scored from 0 to 100, with higher scores representing better patient-perceived outcomes. Anchor-based MCID (HOOS pain 33, HOOS physical function 34, and HOOS joint replacement 18) and PASS thresholds (HOOS pain 80.6, HOOS physical function 83.6, and HOOS joint replacement 76.8) were utilized.Results: Patients readmitted within 90 days of an index THA were less likely to achieve the MCID

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引用次数: 0

CORR Insights®: What Is the Survivorship of TKA With a Twin-peg or Spikes-and-keel Cementless Implant Compared With Cemented? A Registry-based Cohort Study.

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-02-27 DOI: 10.1097/CORR.0000000000003438

W P Yau

引用次数: 0

CORR Insights®: A New Measure of Quantified Social Health Is Associated With Levels of Discomfort, Capability, and Mental and General Health Among Patients Seeking Musculoskeletal Specialty Care.

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-02-27 DOI: 10.1097/CORR.0000000000003426

Tanmaya D Sambare

引用次数: 0

Can Surgeons or Patients Predict the Likelihood of Improvement With Nonoperative Treatment of Chronic Tennis Elbow?

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-02-27 DOI: 10.1097/CORR.0000000000003425

Teemu Karjalainen, Toni Luokkala, Tuomas Lähdeoja, Mikko Salmela, Clare Ardern, Venla-Linnea Karjalainen, Simo Taimela, Teppo Lassi Nestori Järvinen

Background: Persisting symptoms after an attempt of nonoperative treatment represents one of the most common indications for surgery in many musculoskeletal conditions, such as tennis elbow. The rationale behind the practice of resorting to surgery in individuals with long-standing symptoms is that resolution of symptoms is believed to be unlikely without surgery after a certain period, and surgeons can identify a subgroup to benefit from surgery. For this approach to be sound, surgeons must be able to reliably distinguish between patients unlikely to improve without surgery and those who are likely to benefit from it.Questions/purposes: (1) Do patients with persistent tennis elbow symptoms (lasting > 10 months) who are referred to a surgeon improve without surgery over a 24-month follow-up period? (2) Are surgeons' or patients' predictions about improvement associated with actual improvement? (3) What patient characteristics, if any, are associated with predictions of improvement made by either surgeons or patients?Methods: Between 2016 and 2018, we prospectively recruited 97 patients with persistent tennis elbow symptoms (> 10 months) who were dissatisfied with nonsurgical treatment and referred for surgical consultation at five secondary or tertiary public hospitals. Of these, 89% (86 of 97) agreed to continued nonoperative treatment and were included in this observational cohort study. To evaluate the outcomes of continued nonoperative treatment, we measured the Oxford Elbow Score (OES) and global improvement at 6 weeks and at 3, 6, 12, and 24 months. To assess whether either the surgeons or the patients could predict the likelihood of symptom improvement, we asked both parties at baseline to predict whether each patient would be satisfied with their symptom state without surgery within the next 6 months. We then evaluated the prognostic value of these predictions by comparing the OES and global improvement scores between (1) patients who believed that they would improve versus patients who did not and (2) patients whom the surgeons predicted would improve versus those whom the surgeons predicted would not. To explore factors that might explain the predictions, we assessed the correlation between the predictions and baseline characteristics, including age, sex, affected side, smoking status, duration of symptoms, disability (OES score), Pain Catastrophizing Scale score, prior corticosteroid injections, and any planned injection treatments. Data from patients who underwent surgery during the follow-up period were included only up to the time of surgery. The mean ± SD age of the patients was 49 ± 5.4 years, and prior to the initial consultation, they had had symptoms for a mean ± SD of 20 ± 12 months. One-half of the patients were female.Results: Nine percent (8 of 86) of patients eventually underwent operation during the 2-year follow-up period. The mea

{"title":"Can Surgeons or Patients Predict the Likelihood of Improvement With Nonoperative Treatment of Chronic Tennis Elbow?","authors":"Teemu Karjalainen, Toni Luokkala, Tuomas Lähdeoja, Mikko Salmela, Clare Ardern, Venla-Linnea Karjalainen, Simo Taimela, Teppo Lassi Nestori Järvinen","doi":"10.1097/CORR.0000000000003425","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003425","url":null,"abstract":"Background: Persisting symptoms after an attempt of nonoperative treatment represents one of the most common indications for surgery in many musculoskeletal conditions, such as tennis elbow. The rationale behind the practice of resorting to surgery in individuals with long-standing symptoms is that resolution of symptoms is believed to be unlikely without surgery after a certain period, and surgeons can identify a subgroup to benefit from surgery. For this approach to be sound, surgeons must be able to reliably distinguish between patients unlikely to improve without surgery and those who are likely to benefit from it.Questions/purposes: (1) Do patients with persistent tennis elbow symptoms (lasting > 10 months) who are referred to a surgeon improve without surgery over a 24-month follow-up period? (2) Are surgeons' or patients' predictions about improvement associated with actual improvement? (3) What patient characteristics, if any, are associated with predictions of improvement made by either surgeons or patients?Methods: Between 2016 and 2018, we prospectively recruited 97 patients with persistent tennis elbow symptoms (> 10 months) who were dissatisfied with nonsurgical treatment and referred for surgical consultation at five secondary or tertiary public hospitals. Of these, 89% (86 of 97) agreed to continued nonoperative treatment and were included in this observational cohort study. To evaluate the outcomes of continued nonoperative treatment, we measured the Oxford Elbow Score (OES) and global improvement at 6 weeks and at 3, 6, 12, and 24 months. To assess whether either the surgeons or the patients could predict the likelihood of symptom improvement, we asked both parties at baseline to predict whether each patient would be satisfied with their symptom state without surgery within the next 6 months. We then evaluated the prognostic value of these predictions by comparing the OES and global improvement scores between (1) patients who believed that they would improve versus patients who did not and (2) patients whom the surgeons predicted would improve versus those whom the surgeons predicted would not. To explore factors that might explain the predictions, we assessed the correlation between the predictions and baseline characteristics, including age, sex, affected side, smoking status, duration of symptoms, disability (OES score), Pain Catastrophizing Scale score, prior corticosteroid injections, and any planned injection treatments. Data from patients who underwent surgery during the follow-up period were included only up to the time of surgery. The mean ± SD age of the patients was 49 ± 5.4 years, and prior to the initial consultation, they had had symptoms for a mean ± SD of 20 ± 12 months. One-half of the patients were female.Results: Nine percent (8 of 86) of patients eventually underwent operation during the 2-year follow-up period. The mea","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540416","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}

引用次数: 0

What Risk Factors Are Associated With Recurrent Osteoporotic Vertebral Compression Fractures After Percutaneous Vertebral Augmentation? A Meta-analysis.

IF 4.2 2区医学 Q1 ORTHOPEDICS

Clinical Orthopaedics and Related Research®

Pub Date : 2025-02-26 DOI: 10.1097/CORR.0000000000003430

Yan-Hong Lin, Jin Lin, Jia-Yun Xu, Bing-Xin Lai, Min-Hao He, Ying-Ru Zhu, Ya-Li Pang, Li Dong, Jun-Hao Li, Sheng-Sheng Zhao, Yu-Zhi Lin, Rui-Zhong Li, Hai-Yan Yao, Dao-Chen Liang

Background: Osteoporotic vertebral compression fracture (OVCF) has been extensively treated clinically using percutaneous vertebral augmentation (PVA), which includes percutaneous kyphoplasty and percutaneous vertebroplasty. Postoperative refracture is a common complication after PVA, but the associated factors and specific mechanisms behind these fractures are not entirely clear.Questions/purposes: In a systematic review and meta-analysis, we asked: What factors were associated with increased or decreased odds of refracture after PVA for OVCF?Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines, we conducted a comprehensive search of the Cochrane Library, PubMed, Web of Science, and Embase for the time period from database inception to August 31, 2024 (which also was when we last searched). We included case-control studies in which participants were patients with OVCF and were treated with PVA, grouped into refracture versus non-refracture groups based on the presence or absence of refracture. We excluded studies published on preprint servers, conference reports, case reports, and systematic reviews or meta-analyses. We collected 2398 records in the database. After excluding studies that were duplicates and did not meet the inclusion criteria, we included 22 studies involving 7132 participants, 75% (5368) of whom were women, with a mean age of 76 years for patients in the refracture group and 74 years for patients in the non-refracture group. Quality assessment was performed using the Newcastle-Ottawa Scale, with which we assessed three aspects of the study; the mean ± SD score for the included studies was 7.3 ± 0.7 of 9 total (on this scale, higher scores are better), representing generally high study quality. The determination of heterogeneity relied on I2 and chi-square test, and we used a random-effects model when the I2 was > 50% and p ≤ 0.05; otherwise, a fixed-effects model was chosen. According to the Egger test and trim and fill method, publication bias did not significantly affect most of our results.Results: The combined results showed that older age (mean difference 2.24 [95% confidence interval (CI) 1.25 to 3.23]; p < 0.001), lower bone mineral density (BMD) (standardized mean difference [SMD] -0.72 [95% CI -0.99 to -0.45]; p < 0.001), greater preoperative AP vertebral height ratio (SMD 0.26 [95% CI 0.07 to 0.45]; p = 0.01), greater preoperative kyphotic angle (KA) (SMD 0.47 [95% CI 0.10 to 0.83]; p = 0.01), bone cement leakage (OR 1.39 [95% CI 1.05 to 1.84]; p = 0.02), multivertebral fractures (OR 3.58 [95% CI 2.53 to 5.07]; p < 0.001), smoking (OR 1.53 [95% CI 1.16 to 2.02]; p = 0.003), use of glucocorticoids (OR 3.18 [95% CI 2.09 to 4.84]; p < 0.001), and previous osteoporotic vertebral fracture (OR 2.55 [95% CI 1.58 to 4.13]; p < 0.001) were associated with increased odds

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