Pub Date : 2025-12-08DOI: 10.1097/corr.0000000000003797
Szu-An Jou,Chia-Hao Hsu
{"title":"Letter to the Editor: Factors That Increase the Risk of Prosthetic Joint Infection Within 90 Days After THA and TKA: A Nationwide Population-based Study.","authors":"Szu-An Jou,Chia-Hao Hsu","doi":"10.1097/corr.0000000000003797","DOIUrl":"https://doi.org/10.1097/corr.0000000000003797","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"50 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777471","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 : 2025-12-03DOI: 10.1097/corr.0000000000003759
Alicia R Jacobson
{"title":"CORR Insights®: Is There a Relationship Between Social Health and Musculoskeletal Discomfort and Incapability? A Systematic Review.","authors":"Alicia R Jacobson","doi":"10.1097/corr.0000000000003759","DOIUrl":"https://doi.org/10.1097/corr.0000000000003759","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"14 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847533","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 : 2025-12-02DOI: 10.1097/corr.0000000000003783
Tae Kyun Kim
{"title":"Beyond the Bone: From Healers to Enablers of Mobility.","authors":"Tae Kyun Kim","doi":"10.1097/corr.0000000000003783","DOIUrl":"https://doi.org/10.1097/corr.0000000000003783","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"4 1","pages":"20-22"},"PeriodicalIF":4.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145785829","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 : 2025-12-02DOI: 10.1097/corr.0000000000003790
Ruby Lawson,Babar Kayani,John A Skinner
{"title":"CORR Synthesis: What Is the Role of Robotic Technology in THA?","authors":"Ruby Lawson,Babar Kayani,John A Skinner","doi":"10.1097/corr.0000000000003790","DOIUrl":"https://doi.org/10.1097/corr.0000000000003790","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"28 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711021","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 : 2025-12-02DOI: 10.1097/corr.0000000000003787
Safak Ekinci
{"title":"Letter to the Editor: A Conversation With … William Berloni, Broadway and Hollywood Animal Trainer, on the Differences Between Training and Education.","authors":"Safak Ekinci","doi":"10.1097/corr.0000000000003787","DOIUrl":"https://doi.org/10.1097/corr.0000000000003787","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"29 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711020","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 : 2025-12-02DOI: 10.1097/corr.0000000000003789
Martin Aepli,Alberto Carli,Annegret Mündermann,Hannes A Rüdiger,Michael Leunig
BACKGROUNDPerforming a direct anterior approach (DAA) for THA without the use of a traction table requires precise leg manipulation and exposure. We developed a novel frame-based horizontal one-piece drape with an impermeable cover enabling repeated leg hyperextension while maintaining sterility. However, the efficiency and revision risks of this frame-based DAA for THA on a standard table remain unevaluated, which may concern surgeons who are considering the technique.QUESTIONS/PURPOSES(1) Does the frame-based DAA for THA technique require less time for setup and surgery than the traditional stockinette-based technique with its multipiece cover? (2) Is the frame-based DAA for THA technique associated with a higher infection revision rate or overall revision rate compared with other institutions as measured in the national joint registry?METHODSThis retrospective, comparative cohort study described the frame-based DAA for THA technique and evaluated its efficiency and safety. Efficiency was assessed as operative setup time and surgery duration using hospital data from consecutive unilateral DAA THAs performed by a single surgeon between January 2008 and December 2013. The control group included 387 patients (43% [167] male; mean ± SD age 73 ± 10 years; 64% [246] uncemented) using the traditional stockinette-based technique, while the intervention group comprised 385 patients (49% [188] male; age 70 ± 10 years; 89% [342] uncemented) using the frame-based technique. Safety was evaluated as 5-year revision rates and reason for revision from the mandatory Swiss National Joint Registry (SIRIS, covering 98% of all THAs in Switzerland), which also included patients who underwent revision at a different hospital than where the primary THA was performed. We compared 9973 DAA THAs performed at our institution (frame-based technique 46% [4612] male; age 67 ± 11 years; BMI 26 kg/m2 ± 5; 98% [9799] cementless) with 88,443 DAA THAs performed nationwide (any other technique 48% [42,607] male; age 69 ± 11 years; BMI 27 ± 5 kg/m2; 86% [75,649] cementless) between January 2014 and December 2024. The groups were comparable in terms of ASA classification and indication.RESULTSThe frame-based DAA for THA technique had a shorter median (IQR) setup time (37 minutes [30 to 47] versus 47 minutes [39 to 57]; p < 0.001) and a shorter median (IQR) surgery duration (63 minutes [56 to 75] versus 72 minutes [63.0 to 81.5]; p < 0.001) compared with the stockinette-based DAA for THA technique. When compared with the national benchmark for DAA THAs performed using other techniques, the frame-based technique demonstrated a lower 5-year revision rate for periprosthetic joint infection (PJI) (0.43% [16 of 3651] [95% confidence interval (CI) 0.31% to 0.60%] versus 0.94% [292 of 31,070] [95% CI 0.88% to 1.02%]) and a lower overall 5-year revision rate (1.34% [49 of 3651] [95% CI 1.10% to 1.62%] versus 3.52% [1094 of 31,070] [95% CI 3.39% to 3.67%]; p < 0.001 for both comparisons).CONC
{"title":"Frame-based Draping Technique for Standard Table Direct Anterior Approach THA: Efficient and Safe?","authors":"Martin Aepli,Alberto Carli,Annegret Mündermann,Hannes A Rüdiger,Michael Leunig","doi":"10.1097/corr.0000000000003789","DOIUrl":"https://doi.org/10.1097/corr.0000000000003789","url":null,"abstract":"BACKGROUNDPerforming a direct anterior approach (DAA) for THA without the use of a traction table requires precise leg manipulation and exposure. We developed a novel frame-based horizontal one-piece drape with an impermeable cover enabling repeated leg hyperextension while maintaining sterility. However, the efficiency and revision risks of this frame-based DAA for THA on a standard table remain unevaluated, which may concern surgeons who are considering the technique.QUESTIONS/PURPOSES(1) Does the frame-based DAA for THA technique require less time for setup and surgery than the traditional stockinette-based technique with its multipiece cover? (2) Is the frame-based DAA for THA technique associated with a higher infection revision rate or overall revision rate compared with other institutions as measured in the national joint registry?METHODSThis retrospective, comparative cohort study described the frame-based DAA for THA technique and evaluated its efficiency and safety. Efficiency was assessed as operative setup time and surgery duration using hospital data from consecutive unilateral DAA THAs performed by a single surgeon between January 2008 and December 2013. The control group included 387 patients (43% [167] male; mean ± SD age 73 ± 10 years; 64% [246] uncemented) using the traditional stockinette-based technique, while the intervention group comprised 385 patients (49% [188] male; age 70 ± 10 years; 89% [342] uncemented) using the frame-based technique. Safety was evaluated as 5-year revision rates and reason for revision from the mandatory Swiss National Joint Registry (SIRIS, covering 98% of all THAs in Switzerland), which also included patients who underwent revision at a different hospital than where the primary THA was performed. We compared 9973 DAA THAs performed at our institution (frame-based technique 46% [4612] male; age 67 ± 11 years; BMI 26 kg/m2 ± 5; 98% [9799] cementless) with 88,443 DAA THAs performed nationwide (any other technique 48% [42,607] male; age 69 ± 11 years; BMI 27 ± 5 kg/m2; 86% [75,649] cementless) between January 2014 and December 2024. The groups were comparable in terms of ASA classification and indication.RESULTSThe frame-based DAA for THA technique had a shorter median (IQR) setup time (37 minutes [30 to 47] versus 47 minutes [39 to 57]; p < 0.001) and a shorter median (IQR) surgery duration (63 minutes [56 to 75] versus 72 minutes [63.0 to 81.5]; p < 0.001) compared with the stockinette-based DAA for THA technique. When compared with the national benchmark for DAA THAs performed using other techniques, the frame-based technique demonstrated a lower 5-year revision rate for periprosthetic joint infection (PJI) (0.43% [16 of 3651] [95% confidence interval (CI) 0.31% to 0.60%] versus 0.94% [292 of 31,070] [95% CI 0.88% to 1.02%]) and a lower overall 5-year revision rate (1.34% [49 of 3651] [95% CI 1.10% to 1.62%] versus 3.52% [1094 of 31,070] [95% CI 3.39% to 3.67%]; p < 0.001 for both comparisons).CONC","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"5 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656834","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 : 2025-12-02DOI: 10.1097/corr.0000000000003773
Mark C Gebhardt
{"title":"Editorial: Remember Your Past and Open Some Doors for Those Who Follow.","authors":"Mark C Gebhardt","doi":"10.1097/corr.0000000000003773","DOIUrl":"https://doi.org/10.1097/corr.0000000000003773","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"64 1","pages":"1-2"},"PeriodicalIF":4.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145785830","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 : 2025-12-02DOI: 10.1097/CORR.0000000000003780
Nadia Azib, Michel P J van den Bekerom, Sina Ramtin, David Ring, Niels Brinkman
<p><strong>Background: </strong>Patient requests for visits, tests, and treatment may diverge from what is healthy based on evidence and experience, in part related to misconceptions and feelings of distress regarding bodily sensations. Surgeons may feel pressure to acquiesce to (that is, to reluctantly agree or comply with a patient's request despite reservations) less-healthy patient requests. Feelings of pressure to acquiesce may arise from a desire to limit legal concerns, to improve patient ratings of the care experience, to bolster referral relationships, and also via stress or emotion contagion (the transmission of emotional states from the patient to the surgeon). Identification of factors associated with specialist acquiescence can inform strategies that may limit patient exposure to unhelpful visits, tests, and treatments and their associated potential harms, including overdiagnosis and overtreatment.</p><p><strong>Questions/purposes: </strong>(1) Are there any patient factors associated with the clinician-rated likelihood to acquiesce to a patient request potentially counter to best current evidence or open to debate? (2) Are there any surgeon factors associated with the likelihood of acquiescing to such requests?</p><p><strong>Methods: </strong>In an online, survey- and scenario-based experiment, 140 upper extremity surgeons of the Science of Variation Group (SOVG)-an international collaborative of musculoskeletal surgeons that studies variation in practice-reviewed five of seven clinical vignettes of upper extremity musculoskeletal conditions with randomized elements and requests for tests or treatments that are debatable based on the available evidence. This sample represents 70% of the approximately 200 participants who complete at least one survey a year. Most participants were men (89% [125 of 140]) practicing in the United States (51% [71 of 140]) or Europe (29% [41 of 140]). Because the SOVG is not representative of the average surgeon (members are mostly White men working in academic centers; not by design, but by participation)-and perhaps no sample can be-SOVG experiments measure factors associated with variation in opinions within the sample, which should be representative of any sample with sufficient variation in opinions. The randomized elements featured patient requests that the authors considered debatable based current evidence. The randomized scenario elements included patient demographics, symptom specificity (characteristic of the disease, somewhat diffuse and less specific, or diffuse and puzzling [nonspecific]), and levels of patient distress. In two separate models, patient and surgeon factors associated with surgeon likelihood to acquiesce to debatable patient requests (measured on an 11-point ordinal scale from 0, not at all likely, to 10, definitely) were assessed using multilevel mixed-effects linear regression, accounting for surgeon-level nesting. The reported regression coefficients (RC) represent the exp
{"title":"Is There an Association of Patient Mindset and Physician Willingness to Acquiesce to Unhealthy Patient Preferences?","authors":"Nadia Azib, Michel P J van den Bekerom, Sina Ramtin, David Ring, Niels Brinkman","doi":"10.1097/CORR.0000000000003780","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003780","url":null,"abstract":"<p><strong>Background: </strong>Patient requests for visits, tests, and treatment may diverge from what is healthy based on evidence and experience, in part related to misconceptions and feelings of distress regarding bodily sensations. Surgeons may feel pressure to acquiesce to (that is, to reluctantly agree or comply with a patient's request despite reservations) less-healthy patient requests. Feelings of pressure to acquiesce may arise from a desire to limit legal concerns, to improve patient ratings of the care experience, to bolster referral relationships, and also via stress or emotion contagion (the transmission of emotional states from the patient to the surgeon). Identification of factors associated with specialist acquiescence can inform strategies that may limit patient exposure to unhelpful visits, tests, and treatments and their associated potential harms, including overdiagnosis and overtreatment.</p><p><strong>Questions/purposes: </strong>(1) Are there any patient factors associated with the clinician-rated likelihood to acquiesce to a patient request potentially counter to best current evidence or open to debate? (2) Are there any surgeon factors associated with the likelihood of acquiescing to such requests?</p><p><strong>Methods: </strong>In an online, survey- and scenario-based experiment, 140 upper extremity surgeons of the Science of Variation Group (SOVG)-an international collaborative of musculoskeletal surgeons that studies variation in practice-reviewed five of seven clinical vignettes of upper extremity musculoskeletal conditions with randomized elements and requests for tests or treatments that are debatable based on the available evidence. This sample represents 70% of the approximately 200 participants who complete at least one survey a year. Most participants were men (89% [125 of 140]) practicing in the United States (51% [71 of 140]) or Europe (29% [41 of 140]). Because the SOVG is not representative of the average surgeon (members are mostly White men working in academic centers; not by design, but by participation)-and perhaps no sample can be-SOVG experiments measure factors associated with variation in opinions within the sample, which should be representative of any sample with sufficient variation in opinions. The randomized elements featured patient requests that the authors considered debatable based current evidence. The randomized scenario elements included patient demographics, symptom specificity (characteristic of the disease, somewhat diffuse and less specific, or diffuse and puzzling [nonspecific]), and levels of patient distress. In two separate models, patient and surgeon factors associated with surgeon likelihood to acquiesce to debatable patient requests (measured on an 11-point ordinal scale from 0, not at all likely, to 10, definitely) were assessed using multilevel mixed-effects linear regression, accounting for surgeon-level nesting. The reported regression coefficients (RC) represent the exp","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849076","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 : 2025-12-01Epub Date: 2025-10-01DOI: 10.1097/CORR.0000000000003688
Patrick J Cahill
{"title":"Reply to the Letter to the Editor: How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis? A Nonrandomized Clinical Trial.","authors":"Patrick J Cahill","doi":"10.1097/CORR.0000000000003688","DOIUrl":"10.1097/CORR.0000000000003688","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2403-2405"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198612","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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