Sumaiya Sayeed,Kristin Yu,Cosmas Sibindi,Michael Flores,Devin Conway,Adrienne Socci,Daniel K Kisitu
BACKGROUNDGlobally, traditional bonesetters (TBSs) often provide patients with care for their orthopaedic concerns, from musculoskeletal injuries to oncological pathologies, often using techniques that may differ from Western methods. The aim of this study was to investigate the motivations for seeking care from a TBS, the types of treatments received, and the attitudes toward traditional bonesetting, and to determine any differences between patients with traumatic versus nontraumatic musculoskeletal pathologies.METHODSWe surveyed patients who presented to the Orthopaedic Outpatient Clinic at Mbarara Regional Referral Hospital (MRRH) in Mbarara, Uganda, who had previously seen a TBS for their orthopaedic concern, in order to determine their reasons for seeking care from a TBS and the impressions of their care.RESULTSThis study included 168 patients: 109 presented with traumatic injury, and 59 presented with another orthopaedic concern. The trauma group had a higher monthly family income (p < 0.001) and a higher level of education (p = 0.006) than the nontrauma cohort. Treatments provided by the TBS included cutting or puncturing of the skin, locally applied herbs, casting, and other traditional methods. The greatest motivation for seeking traditional bonesetting among trauma patients was belief in its efficacy; the patients in the nontrauma cohort believed that a TBS could reverse the witchcraft or curse that had caused their ailment. Failure of management was the reason that was cited most by both the trauma and nontrauma groups for discontinuing treatment with a TBS.CONCLUSIONSOrthopaedic pathology influences the way that individuals seek traditional bonesetting and their motivations for doing so. For nontraumatic pathologies, superstitious beliefs and a belief in its efficacy play a role in the selection of traditional bonesetting. Additional surveys of individuals may further elucidate the outcomes of seeking care from a TBS.LEVEL OF EVIDENCETherapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
{"title":"Demystifying Traditional Bonesetting: Lessons from Mbarara Regional Hospital.","authors":"Sumaiya Sayeed,Kristin Yu,Cosmas Sibindi,Michael Flores,Devin Conway,Adrienne Socci,Daniel K Kisitu","doi":"10.2106/jbjs.24.00387","DOIUrl":"https://doi.org/10.2106/jbjs.24.00387","url":null,"abstract":"BACKGROUNDGlobally, traditional bonesetters (TBSs) often provide patients with care for their orthopaedic concerns, from musculoskeletal injuries to oncological pathologies, often using techniques that may differ from Western methods. The aim of this study was to investigate the motivations for seeking care from a TBS, the types of treatments received, and the attitudes toward traditional bonesetting, and to determine any differences between patients with traumatic versus nontraumatic musculoskeletal pathologies.METHODSWe surveyed patients who presented to the Orthopaedic Outpatient Clinic at Mbarara Regional Referral Hospital (MRRH) in Mbarara, Uganda, who had previously seen a TBS for their orthopaedic concern, in order to determine their reasons for seeking care from a TBS and the impressions of their care.RESULTSThis study included 168 patients: 109 presented with traumatic injury, and 59 presented with another orthopaedic concern. The trauma group had a higher monthly family income (p < 0.001) and a higher level of education (p = 0.006) than the nontrauma cohort. Treatments provided by the TBS included cutting or puncturing of the skin, locally applied herbs, casting, and other traditional methods. The greatest motivation for seeking traditional bonesetting among trauma patients was belief in its efficacy; the patients in the nontrauma cohort believed that a TBS could reverse the witchcraft or curse that had caused their ailment. Failure of management was the reason that was cited most by both the trauma and nontrauma groups for discontinuing treatment with a TBS.CONCLUSIONSOrthopaedic pathology influences the way that individuals seek traditional bonesetting and their motivations for doing so. For nontraumatic pathologies, superstitious beliefs and a belief in its efficacy play a role in the selection of traditional bonesetting. Additional surveys of individuals may further elucidate the outcomes of seeking care from a TBS.LEVEL OF EVIDENCETherapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Being a Patient Led to Surgical Insights.","authors":"Zhi-Hong Zheng","doi":"10.2106/jbjs.25.00055","DOIUrl":"https://doi.org/10.2106/jbjs.25.00055","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145434030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beyond Pain Relief: Physical Activity as a Preventive Strategy After Total Knee Arthroplasty: Commentary on an article by Hyung Jun Park, MD, PhD, et al.: \"Maintaining or Increasing Physical Activity Is Essential for Managing Cardiovascular and Cerebrovascular Risks After Total Knee Arthroplasty. A Nationwide Cohort Study\".","authors":"Hiromasa Tanino,Ryo Mitsutake,Hiroshi Ito","doi":"10.2106/jbjs.25.00977","DOIUrl":"https://doi.org/10.2106/jbjs.25.00977","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"95 1","pages":"e97"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"External Fixation with the AEFIX System: Extending the Global Reach of Standard-of-Care Orthopaedics: Commentary on an article by Kaveh Momenzadeh, MD, et al.: \"Assessment of the Mechanical Performance of an Affordable External Fixator (AEFIX) Designed for Resource-Limited Settings\".","authors":"Patrick Morgan","doi":"10.2106/jbjs.25.00901","DOIUrl":"https://doi.org/10.2106/jbjs.25.00901","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"42 1","pages":"e98"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beyond Awareness: Moving from Knowledge to Action in Operating Room Sustainability: Commentary on an article by Laura L. Bellaire, MD, and Isabelle Freiling, PhD: \"Effective Communication Strategies to Address Excessive Waste and Overconsumption in the Orthopaedic Operating Room\".","authors":"David S Jevsevar","doi":"10.2106/jbjs.25.00711","DOIUrl":"https://doi.org/10.2106/jbjs.25.00711","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"103 1","pages":"e96"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reducing Postoperative Anemia and Enhancing Postoperative Recovery in TKA: Exploring the Synergistic Effects of Tranexamic Acid and Absorbable Hemostat: Commentary on an article by Qing-Yi Zhang, MD, et al.: \"Efficacy and Safety of Tranexamic Acid Combined with Absorbable Hemostat in Reducing Perioperative Blood Loss in Total Knee Arthroplasty. A Prospective, Blinded, Randomized Controlled Trial\".","authors":"Yukihide Minoda,Yohei Ohyama,Sho Masuda,Hideki Ueyama,Ryo Sugama,Hidetomi Terai","doi":"10.2106/jbjs.25.00395","DOIUrl":"https://doi.org/10.2106/jbjs.25.00395","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"215 1","pages":"e94"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current ACL Machine-Learning Models Are Nice Proofs of Concept but Are Far from Being the \"Holy Grail\" Prediction Tools That They Strive to Be: Commentary on an article by Jon A. Anderson, MBBS, et al.: \"Predicting Anterior Cruciate Ligament Reconstruction Revision Risk. An Enhanced Machine Learning Analysis of the Danish Knee Ligament Reconstruction Registry\".","authors":"Dean Wang","doi":"10.2106/jbjs.25.00703","DOIUrl":"https://doi.org/10.2106/jbjs.25.00703","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"91 1","pages":"e95"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leslie Bisson,Kyle Flikkema,Paul Myers,Jacob E Geiger,Nomi S Weiss-Laxer,Zehua Zhou,Karim Belal,William Wind
BACKGROUNDArthroscopic partial meniscectomy (APM) for degenerative meniscal tears is one of the most common orthopaedic procedures. Surgeons often encounter chondral lesions during APM, and often debride them. The Chondral Lesions And Meniscus Procedures (ChAMP) trial found no benefit to debriding chondral lesions during APM at 1 and 5-year follow-up intervals. To gauge longer-term patient outcomes, we evaluated the original ChAMP trial patients 9 years after surgery.METHODSWe collected patient-reported outcome measures (PROMs) with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale for pain (VAS-Pain), and Short Form-36 (SF-36); performed a physical examination including evaluation of the range of motion, quadriceps circumference, and effusion; measured radiographic joint space narrowing; and recorded any subsequent surgery. We compared treatment groups (observation versus debridement) with t tests, multiple linear regression analysis, chi-square tests, and adjusted logistic regression. P values of <0.05 were considered significant. All analyses were completed using R statistical software.RESULTSOf the 190 patients in the original ChAMP trial, 140 (64 [69.6%] of those in the observation group and 76 [77.6%] of those in the debridement group; p = 0.278) were available for outcome collection at the 9-year follow-up. The majority of patients were male (62.6%), and the average age was 63.9 ± 7.2 years at the 9-year follow-up. Of those 140 patients, 25 (17.9%) had had subsequent surgery on the index knee. Of the remaining patients, 115 completed PROMs, 106 underwent the physical assessment, and 109 underwent radiographic examination. There were no differences between the treatment groups with regard to demographics, except for preoperative weight, which was adjusted for in the modeling. There were no significant differences between the groups with respect to the WOMAC pain score (p = 0.15), other PROMs, physical assessment measurements, radiographic measurements of joint-space narrowing in the surgically treated knees, or rates of subsequent surgery.CONCLUSIONSData collected at 9 years, including PROMs, findings on physical examination, joint space narrowing, and rates of subsequent surgery, indicated that there was no benefit to debriding unstable chondral lesions at the time of APM.LEVEL OF EVIDENCETherapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
{"title":"Debridement of Unstable Chondral Lesions During Arthroscopic Partial Meniscectomy Provides No Long-Term Benefit: Patient Outcomes 9 Years After the Original ChAMP Trial.","authors":"Leslie Bisson,Kyle Flikkema,Paul Myers,Jacob E Geiger,Nomi S Weiss-Laxer,Zehua Zhou,Karim Belal,William Wind","doi":"10.2106/jbjs.24.01196","DOIUrl":"https://doi.org/10.2106/jbjs.24.01196","url":null,"abstract":"BACKGROUNDArthroscopic partial meniscectomy (APM) for degenerative meniscal tears is one of the most common orthopaedic procedures. Surgeons often encounter chondral lesions during APM, and often debride them. The Chondral Lesions And Meniscus Procedures (ChAMP) trial found no benefit to debriding chondral lesions during APM at 1 and 5-year follow-up intervals. To gauge longer-term patient outcomes, we evaluated the original ChAMP trial patients 9 years after surgery.METHODSWe collected patient-reported outcome measures (PROMs) with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale for pain (VAS-Pain), and Short Form-36 (SF-36); performed a physical examination including evaluation of the range of motion, quadriceps circumference, and effusion; measured radiographic joint space narrowing; and recorded any subsequent surgery. We compared treatment groups (observation versus debridement) with t tests, multiple linear regression analysis, chi-square tests, and adjusted logistic regression. P values of <0.05 were considered significant. All analyses were completed using R statistical software.RESULTSOf the 190 patients in the original ChAMP trial, 140 (64 [69.6%] of those in the observation group and 76 [77.6%] of those in the debridement group; p = 0.278) were available for outcome collection at the 9-year follow-up. The majority of patients were male (62.6%), and the average age was 63.9 ± 7.2 years at the 9-year follow-up. Of those 140 patients, 25 (17.9%) had had subsequent surgery on the index knee. Of the remaining patients, 115 completed PROMs, 106 underwent the physical assessment, and 109 underwent radiographic examination. There were no differences between the treatment groups with regard to demographics, except for preoperative weight, which was adjusted for in the modeling. There were no significant differences between the groups with respect to the WOMAC pain score (p = 0.15), other PROMs, physical assessment measurements, radiographic measurements of joint-space narrowing in the surgically treated knees, or rates of subsequent surgery.CONCLUSIONSData collected at 9 years, including PROMs, findings on physical examination, joint space narrowing, and rates of subsequent surgery, indicated that there was no benefit to debriding unstable chondral lesions at the time of APM.LEVEL OF EVIDENCETherapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Working to Mitigate Bias in ABOS Board Certification and Recertification.","authors":"Charles L Nelson,April D Armstrong","doi":"10.2106/jbjs.24.00636","DOIUrl":"https://doi.org/10.2106/jbjs.24.00636","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"50 1","pages":"30-32"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of Network Meta-Analysis to Compare the Efficacy of Osteobiologics in Spinal Fusion: Commentary on an article by Luca Ambrosio, MD, et al.: \"Efficacy and Safety of Osteobiologics for Lumbar Spinal Fusion. A Systematic Review and Network Meta-Analysis\".","authors":"Thomas W Bauer","doi":"10.2106/jbjs.25.00440","DOIUrl":"https://doi.org/10.2106/jbjs.25.00440","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"37 1","pages":"e90"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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