Pub Date : 2026-02-04DOI: 10.2106/JBJS.ER.24.01169
Michael P Murphy, Kaden M Kunz, Patrick Mark, Jacob Tadje, Madeline Tiee, Bailey Johnson, Hobie Summers, Joseph Cohen, William D Lack
{"title":"Erratum: A Multicenter Study of Intertrochanteric and Pertrochanteric Fragility Fractures: Spanning Fixation Mitigates the Risk of Peri-Implant Fractures.","authors":"Michael P Murphy, Kaden M Kunz, Patrick Mark, Jacob Tadje, Madeline Tiee, Bailey Johnson, Hobie Summers, Joseph Cohen, William D Lack","doi":"10.2106/JBJS.ER.24.01169","DOIUrl":"https://doi.org/10.2106/JBJS.ER.24.01169","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"e5"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.2106/JBJS.ER.24.01060
Christiaan H Righolt, Maxwell Luke Armstrong, Thomas R Turgeon, Eric R Bohm, Jhase Sniderman
{"title":"Erratum: Primary Total Knee Arthroplasty in Patients with BMI of ≥50 kg/m2.","authors":"Christiaan H Righolt, Maxwell Luke Armstrong, Thomas R Turgeon, Eric R Bohm, Jhase Sniderman","doi":"10.2106/JBJS.ER.24.01060","DOIUrl":"https://doi.org/10.2106/JBJS.ER.24.01060","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"e2"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Studies of Posttraumatic Knee Osteoarthritis Following ACL Reconstruction Requires Longer Than 5-Year Minimum Follow-up: Commentary on an article by Nifon K. Gkekas, MD, MSc, PhD, et al.: \"Combining ACL Reconstruction with Lateral Extra-Articular Tenodesis Reduces Long-Term Osteoarthritis Risk Versus Isolated ACL Reconstruction. A Systematic Review and Meta-Analysis\".","authors":"Dustin J Schuett","doi":"10.2106/JBJS.25.01432","DOIUrl":"https://doi.org/10.2106/JBJS.25.01432","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"153"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Orthopaedic Surgeons Need to Ask About Intimate Partner Violence: Commentary on an article by Natalie Fleming, MSW, et al.: \"Intimate Partner Violence in a Patient Population with Orthopaedic Trauma. Gender Disparities, Delayed Disclosures, and Poor Clinical Outcomes\".","authors":"Joshua L Gary","doi":"10.2106/JBJS.25.01087","DOIUrl":"https://doi.org/10.2106/JBJS.25.01087","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"156-157"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04Epub Date: 2025-11-18DOI: 10.2106/JBJS.25.00498
Robert K Wagner, Stein J Janssen, Mark Cote, Jacob S Borgida, Wei Shao Tung, Peter Kloen, Michael J Weaver, Mitchel B Harris, Arun Aneja, Thuan V Ly
Background: Lateral locked plating remains an important treatment strategy for distal femoral fractures but has been associated with nonunion rates ranging from 6% to 20%. The objective of this study was to identify factors associated with nonunion following lateral locked plating of distal femoral fractures with use of a Bayesian analysis.
Methods: All consecutive patients ≥18 years of age who were treated with lateral locked plating for a distal femoral fracture at 2 Level-I trauma centers between 2006 and 2024 and who had ≥3 months of follow-up were included. Multivariable Bayesian logistic regression analysis was performed to identify factors associated with nonunion, which was defined as a reoperation to promote healing, and the results are reported as odds ratios (ORs) with 95% credible intervals (CrIs). Probabilities of >95% were considered very strong evidence of an association with nonunion, and probabilities of 90% to 95% were considered strong evidence.
Results: A total of 560 patients (median age, 68 years; 29% male; 90% White; 97% non-Hispanic; 41% with distal periprosthetic fractures) were included. Fifty-four patients (9.6%) underwent reoperation to promote healing. There was very strong evidence that multifragmentary comminution of the metaphysis (versus simple fracture: OR, 2.60; 95% CrI, 0.91 to 8.06), medial cortical comminution of >0 to 25 mm (versus 0 mm: OR, 3.11; 95% CrI, 1.35 to 7.48), and varus (lateral distal femoral angle [LDFA] of ≥84°: OR, 3.04; 95% CrI, 1.46 to 6.51) or valgus (LDFA of ≤78°: OR, 2.42; 95% CrI, 0.96 to 5.99) malalignment increased the odds of nonunion. A screw density of ≤0.60 proximal to the working length reduced the odds of nonunion (versus ≥0.81: OR, 0.40; 95% CrI, 0.16 to 0.95), although the size and certainty of this effect varied in the sensitivity analysis that utilized alternative thresholds. There was strong evidence that obesity increased the odds of nonunion (OR, 1.64; 95% CrI, 0.86 to 3.13) and that intact wedge fractures reduced the odds of nonunion (versus simple fracture: OR, 0.35; 95% CrI, 0.05 to 1.74).
Conclusions: One in 10 patients developed nonunion and underwent reoperation to promote healing. Surgeons should restore coronal plane alignment and may consider augmenting fixation in the presence of multifragmentary comminution. Constructs in which all screw holes proximal to the working length are filled should be avoided, although the optimal configuration remains unclear and depends on other construct characteristics influencing biomechanics. Overall, the small to moderate effect sizes highlight the multifactorial etiology of nonunion following lateral locked plating of distal femoral fractures.
Level of evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
{"title":"Risk Factors for Nonunion Following Lateral Locked Plating of Distal Femoral Fractures: A Bayesian Analysis of 560 Patients.","authors":"Robert K Wagner, Stein J Janssen, Mark Cote, Jacob S Borgida, Wei Shao Tung, Peter Kloen, Michael J Weaver, Mitchel B Harris, Arun Aneja, Thuan V Ly","doi":"10.2106/JBJS.25.00498","DOIUrl":"10.2106/JBJS.25.00498","url":null,"abstract":"<p><strong>Background: </strong>Lateral locked plating remains an important treatment strategy for distal femoral fractures but has been associated with nonunion rates ranging from 6% to 20%. The objective of this study was to identify factors associated with nonunion following lateral locked plating of distal femoral fractures with use of a Bayesian analysis.</p><p><strong>Methods: </strong>All consecutive patients ≥18 years of age who were treated with lateral locked plating for a distal femoral fracture at 2 Level-I trauma centers between 2006 and 2024 and who had ≥3 months of follow-up were included. Multivariable Bayesian logistic regression analysis was performed to identify factors associated with nonunion, which was defined as a reoperation to promote healing, and the results are reported as odds ratios (ORs) with 95% credible intervals (CrIs). Probabilities of >95% were considered very strong evidence of an association with nonunion, and probabilities of 90% to 95% were considered strong evidence.</p><p><strong>Results: </strong>A total of 560 patients (median age, 68 years; 29% male; 90% White; 97% non-Hispanic; 41% with distal periprosthetic fractures) were included. Fifty-four patients (9.6%) underwent reoperation to promote healing. There was very strong evidence that multifragmentary comminution of the metaphysis (versus simple fracture: OR, 2.60; 95% CrI, 0.91 to 8.06), medial cortical comminution of >0 to 25 mm (versus 0 mm: OR, 3.11; 95% CrI, 1.35 to 7.48), and varus (lateral distal femoral angle [LDFA] of ≥84°: OR, 3.04; 95% CrI, 1.46 to 6.51) or valgus (LDFA of ≤78°: OR, 2.42; 95% CrI, 0.96 to 5.99) malalignment increased the odds of nonunion. A screw density of ≤0.60 proximal to the working length reduced the odds of nonunion (versus ≥0.81: OR, 0.40; 95% CrI, 0.16 to 0.95), although the size and certainty of this effect varied in the sensitivity analysis that utilized alternative thresholds. There was strong evidence that obesity increased the odds of nonunion (OR, 1.64; 95% CrI, 0.86 to 3.13) and that intact wedge fractures reduced the odds of nonunion (versus simple fracture: OR, 0.35; 95% CrI, 0.05 to 1.74).</p><p><strong>Conclusions: </strong>One in 10 patients developed nonunion and underwent reoperation to promote healing. Surgeons should restore coronal plane alignment and may consider augmenting fixation in the presence of multifragmentary comminution. Constructs in which all screw holes proximal to the working length are filled should be avoided, although the optimal configuration remains unclear and depends on other construct characteristics influencing biomechanics. Overall, the small to moderate effect sizes highlight the multifactorial etiology of nonunion following lateral locked plating of distal femoral fractures.</p><p><strong>Level of evidence: </strong>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"235-243"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04Epub Date: 2025-11-20DOI: 10.2106/JBJS.25.00688
Pietro Regazzoni, Jesse B Jupiter, Wen-Chih Liu, Alberto Fernandez Dell'Oca
{"title":"Managing Expertise Bias in Randomized Trials: Do We Need a Better Approach?","authors":"Pietro Regazzoni, Jesse B Jupiter, Wen-Chih Liu, Alberto Fernandez Dell'Oca","doi":"10.2106/JBJS.25.00688","DOIUrl":"https://doi.org/10.2106/JBJS.25.00688","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"176-178"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04Epub Date: 2025-11-17DOI: 10.2106/JBJS.25.00260
Harjot Uppal
{"title":"The Cartilage Conundrum.","authors":"Harjot Uppal","doi":"10.2106/JBJS.25.00260","DOIUrl":"10.2106/JBJS.25.00260","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"179"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thigh Muscle Changes at Long-Term Evaluation Following ACL Injury Differ from Early Changes Associated with ACL Injury and Reconstruction: Commentary on an article by Osama Alzobi, MD, et al.: \"Thigh Muscle Changes in the ACL-Deficient Knee. A 4-Year Longitudinal MRI Study of 1,207 Patients\".","authors":"John J Elias","doi":"10.2106/JBJS.25.01271","DOIUrl":"https://doi.org/10.2106/JBJS.25.01271","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"158-159"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.2106/JBJS.ER.25.00036
Tessa Balach, Stuart Trent Guthrie, Nicole Schroeder, Adrienne Socci
{"title":"Erratum: Are We Choosing and Training the Best Surgeons?","authors":"Tessa Balach, Stuart Trent Guthrie, Nicole Schroeder, Adrienne Socci","doi":"10.2106/JBJS.ER.25.00036","DOIUrl":"https://doi.org/10.2106/JBJS.ER.25.00036","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"e4"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nonunion of Distal Femoral Fractures: Commentary on an article by Robert K. Wagner, MD, et al.: \"Risk Factors for Nonunion Following Lateral Locked Plating of Distal Femoral Fractures. A Bayesian Analysis of 560 Patients\".","authors":"Carl Haasper","doi":"10.2106/JBJS.25.01111","DOIUrl":"https://doi.org/10.2106/JBJS.25.01111","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"162-163"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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