Pub Date : 2025-01-01Epub Date: 2024-07-23DOI: 10.1097/CORR.0000000000003198
Nancy B Muir, Margo Orlin, Patricia Rubertone, Glenn Williams
<p><strong>Background: </strong>Periacetabular osteotomy (PAO) surgery presents an opportunity for shared decision-making (SDM) and may be facilitated by decision-making tools. Currently, no diagnosis or treatment-specific decision-making tools exist for this patient population. Understanding patient PAO surgery decision-making experiences and processes would enable development of a treatment-specific decision-making tool and would help hip preservation surgeons with SDM practices.</p><p><strong>Questions/purposes: </strong>Qualitative methodology was used to address the following questions: (1) What were the information support needs of adult patients with hip dysplasia who decided to have PAO? (2) What was important to adult patients with hip dysplasia who decided to have PAO? (3) How did adult patients with hip dysplasia who have undergone PAO experience the surgical decision-making process? (4) What elements of SDM did adult patients with hip dysplasia experience with their surgeons when deciding to have PAO?</p><p><strong>Methods: </strong>Fifteen volunteer, English-speaking patients in the United States who had been diagnosed with hip dysplasia and who had undergone PAO surgery 6 to 12 months prior to the study were recruited through five PAO surgery Facebook support groups. Individuals were excluded if they had an underlying neuromuscular condition or other diagnosis related to nondevelopmental dysplasia of the hip or if they had a previous PAO surgery > 12 months before data collection. We used purposive sampling strategies to promote sample heterogeneity based on age and preoperative activity level, as these are characteristics that may impact decision-making. Participants were categorized into three age groups: 20 to 29 years, 30 to 39 years, and ≥ 40 years. Participants were also categorized as having "low activity," "moderate activity," or "high activity" preoperatively based on self-reported University of California Los Angeles (UCLA) Activity Scale scores. Participants were enrolled consecutively if they met the inclusion criteria and fulfilled one of our sampling categories; we had plans to enroll more participants if thematic saturation was not achieved through the first 15 interviews. Participants included 14 women and one man ranging in age from 23 to 48 years, and all had undergone PAO surgery for hip dysplasia 6 to 12 months prior to the interview. One-on-one semistructured interviews were conducted with each participant by a single interviewer through Zoom video conferencing using video and audio recording. Participants answered semistructured interview questions and provided verbal responses to survey questions so researchers could gain demographic information and details about their symptoms, diagnosis, and PAO surgery between June 2021 and August 2021. Quantitative survey data were analyzed using descriptive statistics. Qualitative data were analyzed by three researchers using principles of reflexive thematic analysis. Can
背景：髋臼周围截骨术（PAO）手术为共同决策（SDM）提供了机会，决策工具可为其提供便利。目前，还没有针对这一患者群体的诊断或治疗决策工具。了解患者的 PAO 手术决策经验和过程将有助于开发针对特定治疗的决策工具，并帮助保髋外科医生开展 SDM 实践：采用定性方法解决以下问题：（1）决定进行 PAO 手术的髋关节发育不良成年患者的信息支持需求是什么？(2) 对决定接受 PAO 的髋关节发育不良成年患者而言，什么是重要的？(3) 接受 PAO 手术的髋关节发育不良成年患者是如何经历手术决策过程的？(4) 髋关节发育不良的成年患者在决定接受 PAO 时，与外科医生一起经历了哪些 SDM 要素？通过五个 PAO 手术 Facebook 支持小组招募了 15 名美国的英语志愿者，他们被诊断为髋关节发育不良，并在研究前 6 至 12 个月接受了 PAO 手术。如果患者患有潜在的神经肌肉疾病或与非发育性髋关节发育不良相关的其他诊断，或者在数据收集前 12 个月内曾接受过 PAO 手术，则排除在外。我们采用了目的性抽样策略，以促进基于年龄和术前活动水平的样本异质性，因为这些特征可能会影响决策。参与者被分为三个年龄组：20 至 29 岁、30 至 39 岁和≥ 40 岁。根据自我报告的加州大学洛杉矶分校（UCLA）活动量表评分，参试者在术前也被分为 "低活动量"、"中等活动量 "或 "高活动量"。如果参与者符合纳入标准并符合我们的抽样类别之一，我们就会连续招募他们；如果前 15 次访谈的主题未达到饱和，我们还计划招募更多参与者。参与者包括 14 名女性和 1 名男性，年龄在 23 岁至 48 岁之间，均在访谈前 6 至 12 个月因髋关节发育不良接受过 PAO 手术。每位受试者均由一名访谈者通过 Zoom 视频会议进行一对一的半结构化访谈，并进行视频和音频录制。受试者回答了半结构化访谈问题，并对调查问题做出了口头回答，这样研究人员就可以获得人口统计学信息以及他们在 2021 年 6 月至 2021 年 8 月期间的症状、诊断和 PAO 手术的详细信息。定量调查数据采用描述性统计进行分析。定性数据由三位研究人员使用反思性主题分析原则进行分析。对候选主题进行反复定义和重新定义，直到形成明显不同但又集中相关并能回答研究问题的中心主题为止。所有为类别和主题发展提供信息的代码都是在分析的前六份记录誊本中产生的。研究小组认为，15 个访谈已经达到了主题饱和：髋关节发育不良成年患者的主要信息需求包括诊断和治疗相关信息，以及与手术和康复相关的后勤信息。许多患者表示，他们的外科医生只能满足他们的部分信息需求；大多数患者会从科学研究和网络资源中寻求更多信息，并依靠患者同伴来满足有关手术和康复的生活经验和后勤保障方面的信息需求。对患者来说，PAO 手术可以保留他们的原位髋关节或推迟 THA 的时间，并且 PAO 手术有可能减轻他们的疼痛并改善功能，这一点非常重要；当患者能够确定 PAO 手术的适应症和目标如何与他们自身的情况和手术目标相一致时，决策就会变得更加容易。当信息需求得到满足、PAO 手术的适应症和目标与患者的个人价值观和目标相一致、患者希望和实际的决策角色相一致时，患者的决策体验会更加积极。髋关节发育不良的成年患者描述，在邀请患者分享有关 PAO 手术的个人偏好、价值观和目标的程度以及评估患者首选决策角色的程度方面存在很大差异：我们发现，髋关节保存实践中并没有始终如一地融入 SDM 要素。 通过这项工作获得的关于患者 PAO 手术信息需求、患者在决定手术时关心的问题以及他们在 PAO 手术决策方面的经验等知识，可以为未来 PAO 手术决策工具的开发提供参考。今后还需要开展研究来验证本研究的结果，并确定这些结果是否适用于具有不同人口统计学特征的成年髋关节发育不良患者或不参加社交媒体支持小组的患者：外科医生应认识到，患者很可能在信息需求未得到满足的情况下离开诊室。SDM 策略可以促进临床中更有效的信息交流，这样外科医生就可以帮助患者确定他们的信息需求，提供教育和指导，使其获得准确、可靠的资源以满足这些需求，并帮助患者评估他们收集到的信息并将其应用到个人情况中。髋关节保留外科医生可以使用这里提供的 SDM 脚本和清单样本，为正在做出 PAO 手术决定的髋关节发育不良成年患者提供支持，直到将来有了专门的诊断和治疗决策工具。
{"title":"Can We Enhance Shared Decision-making for Periacetabular Osteotomy Surgery? A Qualitative Study of Patient Experiences.","authors":"Nancy B Muir, Margo Orlin, Patricia Rubertone, Glenn Williams","doi":"10.1097/CORR.0000000000003198","DOIUrl":"10.1097/CORR.0000000000003198","url":null,"abstract":"<p><strong>Background: </strong>Periacetabular osteotomy (PAO) surgery presents an opportunity for shared decision-making (SDM) and may be facilitated by decision-making tools. Currently, no diagnosis or treatment-specific decision-making tools exist for this patient population. Understanding patient PAO surgery decision-making experiences and processes would enable development of a treatment-specific decision-making tool and would help hip preservation surgeons with SDM practices.</p><p><strong>Questions/purposes: </strong>Qualitative methodology was used to address the following questions: (1) What were the information support needs of adult patients with hip dysplasia who decided to have PAO? (2) What was important to adult patients with hip dysplasia who decided to have PAO? (3) How did adult patients with hip dysplasia who have undergone PAO experience the surgical decision-making process? (4) What elements of SDM did adult patients with hip dysplasia experience with their surgeons when deciding to have PAO?</p><p><strong>Methods: </strong>Fifteen volunteer, English-speaking patients in the United States who had been diagnosed with hip dysplasia and who had undergone PAO surgery 6 to 12 months prior to the study were recruited through five PAO surgery Facebook support groups. Individuals were excluded if they had an underlying neuromuscular condition or other diagnosis related to nondevelopmental dysplasia of the hip or if they had a previous PAO surgery > 12 months before data collection. We used purposive sampling strategies to promote sample heterogeneity based on age and preoperative activity level, as these are characteristics that may impact decision-making. Participants were categorized into three age groups: 20 to 29 years, 30 to 39 years, and ≥ 40 years. Participants were also categorized as having \"low activity,\" \"moderate activity,\" or \"high activity\" preoperatively based on self-reported University of California Los Angeles (UCLA) Activity Scale scores. Participants were enrolled consecutively if they met the inclusion criteria and fulfilled one of our sampling categories; we had plans to enroll more participants if thematic saturation was not achieved through the first 15 interviews. Participants included 14 women and one man ranging in age from 23 to 48 years, and all had undergone PAO surgery for hip dysplasia 6 to 12 months prior to the interview. One-on-one semistructured interviews were conducted with each participant by a single interviewer through Zoom video conferencing using video and audio recording. Participants answered semistructured interview questions and provided verbal responses to survey questions so researchers could gain demographic information and details about their symptoms, diagnosis, and PAO surgery between June 2021 and August 2021. Quantitative survey data were analyzed using descriptive statistics. Qualitative data were analyzed by three researchers using principles of reflexive thematic analysis. Can","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"120-136"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757545","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 : 2025-01-01Epub Date: 2024-11-22DOI: 10.1097/CORR.0000000000003320
Ryan D Muchow, Maureen O'Shaughnessy, Alicia R Jacobson
{"title":"Clinical Faceoff: The Pros and Cons of Pass/Fail Scoring for the USMLE Step 1 Examination.","authors":"Ryan D Muchow, Maureen O'Shaughnessy, Alicia R Jacobson","doi":"10.1097/CORR.0000000000003320","DOIUrl":"10.1097/CORR.0000000000003320","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"32-36"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715133","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 : 2025-01-01Epub Date: 2024-12-19DOI: 10.1097/CORR.0000000000003199
Reme Arhewoh, J Ryan Hill, Julianne Sefko, Alexander Aleem, Aaron Chamberlain, Jay Keener, Benjamin Zmistowski
<p><strong>Background: </strong>Deficient internal rotation after shoulder arthroplasty can inhibit specific essential activities of daily living that require behind-the-back arm positioning. Although postoperative internal rotation deficits occur, their impact on outcomes of total shoulder arthroplasty (TSA) is not well established. Previous authors have validated the Single Assessment Numeric Evaluation (SANE) as a patient-reported assessment of acceptable outcomes of TSA.</p><p><strong>Questions/purposes: </strong>(1) Is there an association between postoperative internal rotation and acceptable outcomes following TSA as assessed by SANE? (2) Is there a threshold for internal rotation after TSA beyond which increasing internal rotation no longer improves odds of acceptable outcomes?</p><p><strong>Methods: </strong>A single institution's longitudinally maintained shoulder arthroplasty registry was used to identify patients undergoing primary anatomic or reverse TSA (RTSA). The registry provides postoperative patient-reported outcomes, including SANE scores. Postoperatively, patients complete a previously validated ROM self-assessment to quantify their current abduction, forward elevation, external rotation in adduction and abduction, and internal rotation in adduction. Data on patient age, preoperative Patient-Reported Outcomes Measurement Information System mental health scores, gender, surgery performed, and hand dominance were also obtained. In all, 784 patient-reported surveys were available. Thirty-four percent (268 of 784) of the surveys were collected at 1 year, 52% (410 of 784) at 2 years, 11% (87 of 784) at 5 years, and 2% (19 of 784) at 10 years. More than 50% percent (446 of 784) of patients underwent RTSA, 48% were men, and the mean ± SD age was 68 ± 8 years at the time of surgery. A logistic multivariate analysis was used to assess the association of internal rotation with an acceptable outcome (defined as a SANE score of > 75%). A receiver operating characteristic curve was used to assess an internal rotation threshold associated with an acceptable SANE score.</p><p><strong>Results: </strong>After accounting for age, gender, hand dominance, pain level, and surgical procedure, patients with internal rotation below the upper back had lower odds of achieving a SANE score of > 75% (p < 0.05). The threshold for SANE scores > 75% was identified to be internal rotation to the midback and higher, resulting in an area under the curve of 0.71 (95% CI 0.67 to 0.75; p < 0.001) with sensitivity of 57% (95% CI 0.56 to 0.58) and specificity of 75% (95% CI 0.73 to 0.77).</p><p><strong>Conclusion: </strong>After shoulder arthroplasty, shoulder normalcy was associated with postoperative internal rotation. Although our study has not proven a causal relationship between limited internal rotation and poorer SANE scores, our clinical experience combined with these findings suggests that limited internal rotation indeed is likely clinically important in
{"title":"Is There an Association Between Postoperative Internal Rotation and Patient-reported Outcomes After Total Shoulder Arthroplasty?","authors":"Reme Arhewoh, J Ryan Hill, Julianne Sefko, Alexander Aleem, Aaron Chamberlain, Jay Keener, Benjamin Zmistowski","doi":"10.1097/CORR.0000000000003199","DOIUrl":"10.1097/CORR.0000000000003199","url":null,"abstract":"<p><strong>Background: </strong>Deficient internal rotation after shoulder arthroplasty can inhibit specific essential activities of daily living that require behind-the-back arm positioning. Although postoperative internal rotation deficits occur, their impact on outcomes of total shoulder arthroplasty (TSA) is not well established. Previous authors have validated the Single Assessment Numeric Evaluation (SANE) as a patient-reported assessment of acceptable outcomes of TSA.</p><p><strong>Questions/purposes: </strong>(1) Is there an association between postoperative internal rotation and acceptable outcomes following TSA as assessed by SANE? (2) Is there a threshold for internal rotation after TSA beyond which increasing internal rotation no longer improves odds of acceptable outcomes?</p><p><strong>Methods: </strong>A single institution's longitudinally maintained shoulder arthroplasty registry was used to identify patients undergoing primary anatomic or reverse TSA (RTSA). The registry provides postoperative patient-reported outcomes, including SANE scores. Postoperatively, patients complete a previously validated ROM self-assessment to quantify their current abduction, forward elevation, external rotation in adduction and abduction, and internal rotation in adduction. Data on patient age, preoperative Patient-Reported Outcomes Measurement Information System mental health scores, gender, surgery performed, and hand dominance were also obtained. In all, 784 patient-reported surveys were available. Thirty-four percent (268 of 784) of the surveys were collected at 1 year, 52% (410 of 784) at 2 years, 11% (87 of 784) at 5 years, and 2% (19 of 784) at 10 years. More than 50% percent (446 of 784) of patients underwent RTSA, 48% were men, and the mean ± SD age was 68 ± 8 years at the time of surgery. A logistic multivariate analysis was used to assess the association of internal rotation with an acceptable outcome (defined as a SANE score of > 75%). A receiver operating characteristic curve was used to assess an internal rotation threshold associated with an acceptable SANE score.</p><p><strong>Results: </strong>After accounting for age, gender, hand dominance, pain level, and surgical procedure, patients with internal rotation below the upper back had lower odds of achieving a SANE score of > 75% (p < 0.05). The threshold for SANE scores > 75% was identified to be internal rotation to the midback and higher, resulting in an area under the curve of 0.71 (95% CI 0.67 to 0.75; p < 0.001) with sensitivity of 57% (95% CI 0.56 to 0.58) and specificity of 75% (95% CI 0.73 to 0.77).</p><p><strong>Conclusion: </strong>After shoulder arthroplasty, shoulder normalcy was associated with postoperative internal rotation. Although our study has not proven a causal relationship between limited internal rotation and poorer SANE scores, our clinical experience combined with these findings suggests that limited internal rotation indeed is likely clinically important in","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"483 1","pages":"152-159"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920965","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 : 2025-01-01Epub Date: 2024-08-19DOI: 10.1097/CORR.0000000000003229
Yoshinobu Watanabe
{"title":"CORR Insights®: No Difference in 10-year Clinical or Radiographic Outcomes Between Kinematic and Mechanical Alignment in TKA: A Randomized Trial.","authors":"Yoshinobu Watanabe","doi":"10.1097/CORR.0000000000003229","DOIUrl":"10.1097/CORR.0000000000003229","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"150-151"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003768","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 : 2025-01-01Epub Date: 2024-10-23DOI: 10.1097/CORR.0000000000003295
Olivier Quinten Groot
{"title":"CORR Insights®: De Novo Natural Language Processing Algorithm Accurately Identifies Myxofibrosarcoma From Pathology Reports.","authors":"Olivier Quinten Groot","doi":"10.1097/CORR.0000000000003295","DOIUrl":"10.1097/CORR.0000000000003295","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"88-90"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562686","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 : 2025-01-01Epub Date: 2024-10-24DOI: 10.1097/CORR.0000000000003271
Benjamin F Ricciardi
{"title":"CORR Insights®: How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life?","authors":"Benjamin F Ricciardi","doi":"10.1097/CORR.0000000000003271","DOIUrl":"10.1097/CORR.0000000000003271","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"171-173"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562689","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 : 2025-01-01Epub Date: 2024-11-08DOI: 10.1097/CORR.0000000000003306
James Rickert
{"title":"On Patient Safety: When Whistleblowing Is the Last Chance to Protect Patients.","authors":"James Rickert","doi":"10.1097/CORR.0000000000003306","DOIUrl":"10.1097/CORR.0000000000003306","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"27-28"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603585","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 : 2025-01-01Epub Date: 2024-06-21DOI: 10.1097/CORR.0000000000003161
Colin J Anderson, HsihTe Yang, Judy Parsons, Will A Ahrens, Megan H Jagosky, Johann H Hsu, Joshua C Patt, Jeffrey S Kneisl, Nury M Steuerwald
<p><strong>Background: </strong>A liquid biopsy is a test that evaluates the status of a disease by analyzing a sample of bodily fluid, most commonly blood. In recent years, there has been progress in the development and clinical application of liquid biopsy methods to identify blood-based, tumor-specific biomarkers for many cancer types. However, the implementation of these technologies to aid in the treatment of patients who have a sarcoma remains behind other fields of cancer medicine. For this study, we chose to evaluate a sarcoma liquid biopsy based on circulating tumor DNA (ctDNA). All human beings have normal cell-free DNA (cfDNA) circulating in the blood. In contrast with cfDNA, ctDNA is genetic material present in the blood stream that is derived from a tumor. ctDNA carries the unique genomic fingerprint of the tumor with changes that are not present in normal circulating cfDNA. A successful ctDNA liquid biopsy must be able to target these tumor-specific genetic alterations. For instance, epidermal growth factor receptor (EGFR) mutations are common in lung cancers, and ctDNA liquid biopsies are currently in clinical use to evaluate the status of disease in patients who have a lung cancer by detecting EGFR mutations in the blood. As opposed to many carcinomas, sarcomas do not have common recurrent mutations that could serve as the foundation to a ctDNA liquid biopsy. However, many sarcomas have structural changes to their chromosomes, including gains and losses of portions or entire chromosomes, known as copy number alterations (CNAs), that could serve as a target for a ctDNA liquid biopsy. Murine double minute 2 (MDM2) amplification in select lipomatous tumors or parosteal osteosarcoma is an example of a CNA due to the presence of extra copies of a segment of the long arm of chromosome 12. Since a majority of sarcomas demonstrate a complex karyotype with numerous CNAs, a blood-based liquid biopsy strategy that searches for these CNAs may be able to detect the presence of sarcoma ctDNA. Whole-genome sequencing (WGS) is a next-generation sequencing technique that evaluates the entire genome. The depth of coverage of WGS refers to how detailed the sequencing is, like higher versus lower power on a microscope. WGS can be performed with high-depth sequencing (that is, > 60×), which can detect individual point mutations, or low-depth sequencing (that is, 0.1× to 5×), referred to as low-passage whole-genome sequencing (LP-WGS), which may not detect individual mutations but can detect structural chromosomal changes including gains and losses (that is, CNAs). While similar strategies have shown favorable early results for specific sarcoma subtypes, LP-WGS has not been evaluated for applicability to the broader population of patients who have a sarcoma.</p><p><strong>Questions/purposes: </strong>Does an LP-WGS liquid biopsy evaluating for CNAs detect ctDNA in plasma samples from patients who have sarcomas representing a variety of histologic subty
{"title":"Can a Liquid Biopsy Detect Circulating Tumor DNA With Low-passage Whole-genome Sequencing in Patients With a Sarcoma? A Pilot Evaluation.","authors":"Colin J Anderson, HsihTe Yang, Judy Parsons, Will A Ahrens, Megan H Jagosky, Johann H Hsu, Joshua C Patt, Jeffrey S Kneisl, Nury M Steuerwald","doi":"10.1097/CORR.0000000000003161","DOIUrl":"10.1097/CORR.0000000000003161","url":null,"abstract":"<p><strong>Background: </strong>A liquid biopsy is a test that evaluates the status of a disease by analyzing a sample of bodily fluid, most commonly blood. In recent years, there has been progress in the development and clinical application of liquid biopsy methods to identify blood-based, tumor-specific biomarkers for many cancer types. However, the implementation of these technologies to aid in the treatment of patients who have a sarcoma remains behind other fields of cancer medicine. For this study, we chose to evaluate a sarcoma liquid biopsy based on circulating tumor DNA (ctDNA). All human beings have normal cell-free DNA (cfDNA) circulating in the blood. In contrast with cfDNA, ctDNA is genetic material present in the blood stream that is derived from a tumor. ctDNA carries the unique genomic fingerprint of the tumor with changes that are not present in normal circulating cfDNA. A successful ctDNA liquid biopsy must be able to target these tumor-specific genetic alterations. For instance, epidermal growth factor receptor (EGFR) mutations are common in lung cancers, and ctDNA liquid biopsies are currently in clinical use to evaluate the status of disease in patients who have a lung cancer by detecting EGFR mutations in the blood. As opposed to many carcinomas, sarcomas do not have common recurrent mutations that could serve as the foundation to a ctDNA liquid biopsy. However, many sarcomas have structural changes to their chromosomes, including gains and losses of portions or entire chromosomes, known as copy number alterations (CNAs), that could serve as a target for a ctDNA liquid biopsy. Murine double minute 2 (MDM2) amplification in select lipomatous tumors or parosteal osteosarcoma is an example of a CNA due to the presence of extra copies of a segment of the long arm of chromosome 12. Since a majority of sarcomas demonstrate a complex karyotype with numerous CNAs, a blood-based liquid biopsy strategy that searches for these CNAs may be able to detect the presence of sarcoma ctDNA. Whole-genome sequencing (WGS) is a next-generation sequencing technique that evaluates the entire genome. The depth of coverage of WGS refers to how detailed the sequencing is, like higher versus lower power on a microscope. WGS can be performed with high-depth sequencing (that is, > 60×), which can detect individual point mutations, or low-depth sequencing (that is, 0.1× to 5×), referred to as low-passage whole-genome sequencing (LP-WGS), which may not detect individual mutations but can detect structural chromosomal changes including gains and losses (that is, CNAs). While similar strategies have shown favorable early results for specific sarcoma subtypes, LP-WGS has not been evaluated for applicability to the broader population of patients who have a sarcoma.</p><p><strong>Questions/purposes: </strong>Does an LP-WGS liquid biopsy evaluating for CNAs detect ctDNA in plasma samples from patients who have sarcomas representing a variety of histologic subty","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"39-48"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436334","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 : 2025-01-01Epub Date: 2024-11-12DOI: 10.1097/CORR.0000000000003318
Seth S Leopold
{"title":"Editorial: Work-life Balance Tips From a Man Who Seems to Have Cracked the Code.","authors":"Seth S Leopold","doi":"10.1097/CORR.0000000000003318","DOIUrl":"10.1097/CORR.0000000000003318","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1-2"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681007","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 : 2025-01-01Epub Date: 2024-11-12DOI: 10.1097/CORR.0000000000003317
Paul J Dougherty
{"title":"CORR® Curriculum-Orthopaedic Education: Thinking the Unthinkable: How Should We Train for Future Combat Casualty Care?","authors":"Paul J Dougherty","doi":"10.1097/CORR.0000000000003317","DOIUrl":"10.1097/CORR.0000000000003317","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"483 1","pages":"22-24"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920962","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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