The Journal of Bone & Joint Surgery最新文献

{"title":"Orthopaedic Sports Medicine Subspecialty Certification: Past, Present, and Future.","authors":"Christopher D Harner,Terry L Thompson","doi":"10.2106/jbjs.24.00782","DOIUrl":"https://doi.org/10.2106/jbjs.24.00782","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"17 1","pages":"27-29"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071692","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":"A Physis Set Up to Fail: Commentary on an article by Eduardo N. Novais, MD, et al.: \"Impact of Childhood Obesity on Capital Femoral Epiphysis Morphology. A Large-Scale, Automated 3D-CT Study and Potential Implications for SCFE Pathogenesis\".","authors":"Douglas G Armstrong","doi":"10.2106/jbjs.25.00730","DOIUrl":"https://doi.org/10.2106/jbjs.25.00730","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"22 1","pages":"e89"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071695","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":"Oral Examination Is a Requirement for Certification by the American Board of Orthopaedic Surgery.","authors":"James R Kasser,Kyle J Jeray,Frederick M Azar","doi":"10.2106/jbjs.24.00799","DOIUrl":"https://doi.org/10.2106/jbjs.24.00799","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"21 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071693","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":"Erratum: What's New in Hand and Wrist Surgery.","authors":"Eric R Wagner,Nina Suh","doi":"10.2106/jbjs.er.24.01427","DOIUrl":"https://doi.org/10.2106/jbjs.er.24.01427","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"50 1","pages":"e91"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071690","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":"The American Board of Orthopaedic Surgery and Orthopaedic Residency Education: Dynamic Leadership and Effective Partnerships.","authors":"Ann Van Heest,J L Marsh","doi":"10.2106/jbjs.24.00635","DOIUrl":"https://doi.org/10.2106/jbjs.24.00635","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"83 1","pages":"4-8"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071698","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":"Psychometric Properties and Feasibility of PROMIS Computerized Adaptive Tests Compared with Disease-Specific Measures in Knee Arthroplasty.","authors":"Olivier Dhollander,Leo D Roorda,Seydou Diarra,Ignace Ghijselings,Alex Demurie,Caroline B Terwee,Olivier Cornu,Hans Van den Wyngaert","doi":"10.2106/jbjs.24.01348","DOIUrl":"https://doi.org/10.2106/jbjs.24.01348","url":null,"abstract":"BACKGROUNDThe efficient assessment of health outcomes in knee arthroplasty may benefit from universally applicable Patient-Reported Outcomes Measurement Information System computerized adaptive tests (PROMIS CATs), rather than disease-specific measures. This study aimed to evaluate and compare some psychometric properties and the feasibility of various PROMIS CATs (Pain Interference [PROMIS-PI-CAT, v1.1], Physical Function [PROMIS-PF-CAT, v2.0], Mobility [PROMIS-Mob-CAT, v2.0], Ability to Participate in Social Roles and Activities [PROMIS-AS-CAT, v2.0], and Satisfaction with Social Roles and Activities [PROMIS-SS-CAT, v2.0]), with the Knee Injury and Osteoarthritis Outcome Score (KOOS) scales, including the KOOS Physical Function Shortform [KOOS-PS] and KOOS for Joint Replacement [KOOS-JR], and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scales.METHODSPatients (n = 193; mean age [and standard deviation], 64.4 ± 10.1 years; 56% female; mean body mass index, 29.6 ± 5.2 kg/m2) undergoing unilateral or bilateral primary or revision knee arthroplasty at AZ Alma (Eeklo, Belgium) completed the measures 6 weeks before and 6 weeks and 3, 6, and 12 months after surgery. The study evaluated precision (standard error as a percentage of scale range [SE%]), responsiveness (hypothesized correlations and standardized response mean [SRM]), floor and ceiling effects (percentage with the worst and the best scores), and feasibility (completion time and number of items).RESULTSThe PROMIS-PI-CAT and PROMIS-PF-CAT showed better precision at baseline compared with corresponding KOOS/WOMAC scales (SE%, 4.6 versus 7.1/9.3 and 3.6 versus 4.4/4.4), but less precision at 12 months of follow-up (SE%, 6.8 versus 4.8/5.5 and 3.6 versus 3.0/3.0). All PROMIS CATs had good responsiveness (75% to 100% of hypotheses not rejected; SRMs at 12 months: PROMIS-PI-CAT = -1.35 versus KOOS Pain = 1.78 and WOMAC Pain = -1.59; PROMIS-PF-CAT = 1.14 versus KOOS-ADL/WOMAC-PF = 1.43/-1.44; PROMIS-AS-CAT = 0.93 and PROMIS-SS-CAT = 0.93). The PROMIS-PF-CAT did not show ceiling effects at 12 months, unlike the KOOS-ADL/WOMAC-PF (17.5%). PROMIS CATs were more feasible at baseline and follow-ups compared with KOOS and WOMAC scales.CONCLUSIONSPROMIS-CATs effectively assess health outcomes in knee arthroplasty patients, showing strong psychometric properties and favorable feasibility, supporting their role in value-based health care.LEVEL OF EVIDENCEPrognostic Level II. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071700","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":"Spinal Fusion in Patients with GMFCS IV or V Cerebral Palsy: Durable Correction and Lasting Quality of Life Improvements: Five-Year Multicenter Outcomes.","authors":"Arun R Hariharan,Michael W Brown,Tracey Bryan,Craig R Louer,John S Vorhies,Robert H Cho,Paul Sponseller,Stefan Parent,Suken A Shah,Patrick Cahill,Joshua M Pahys,Vidyadhar V Upasani,Baron S Lonner,Peter O Newton,Amer F Samdani,Firoz Miyanji, ","doi":"10.2106/jbjs.25.00186","DOIUrl":"https://doi.org/10.2106/jbjs.25.00186","url":null,"abstract":"BACKGROUNDUnderstanding outcomes of spinal fusion (SF) in children with cerebral palsy (CP) beyond the short term is important to determine efficacy and durability. This study examined complications, unplanned returns to the operating room (UPROR), and radiographic and clinical outcomes after SF in children with CP.METHODSPatients with GMFCS IV or V CP who had been followed for a minimum of 5 years after SF were identified in a prospective multicenter database and analyzed. The major Cobb angle and pelvic obliquity (PO) were recorded. Data regarding complications and any UPROR were collected prospectively. The Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire was completed preoperatively and at 2 and 5 years postoperatively. Data were analyzed using a generalized estimating equation (GEE), repeated-measures analysis of variance (RM-ANOVA), and the Kaplan-Meier method.RESULTSOne hundred and eighty-nine patients (mean age, 13.4 ± 2.7 years; 94 male and 95 female; 45% White, 24% Hispanic, 16% Black, and 4% Asian as self-reported) were included in the study. The preoperative Cobb angle (82.8° ± 23.0°) was improved at 2 years (29.9° ± 16.2°; p < 0.001), and the improvement was maintained at 5 years (30.2° ± 17.0°; p = 0.284). The preoperative PO (27.4° ± 15.6°) was improved at 2 years (9.7° ± 9.1°; p < 0.001), and the improvement was maintained at 5 years (9.9° ± 9.8°; p = 0.997). There were 46 patients (24.3%) with major complications and 25 patients (13.2%) who required UPROR, mostly within the first year. The probability of remaining free of major complications and of having no UPROR at 5 years was >75% and >87%, respectively. Improvements in CPCHILD scores were observed at 2 years and remained improved at 5 years compared with baseline. RM-ANOVA demonstrated no significant differences in the change in scores over time in patients with complications or UPROR compared with those who did not. Those with complications or UPROR showed no evidence of a major decline in CPCHILD scores.CONCLUSIONSSF resulted in durable radiographic correction and sustained improvements in caregiver-reported quality of life over a minimum of 5 years. Patients with major complications or UPROR showed no deterioration in CPCHILD scores. These findings support SF as an effective treatment option for appropriately selected patients with GMFCSIV or V CP.LEVEL OF EVIDENCETherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071704","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":"Hamstring Tendon Versus Bone-Patellar Tendon-Bone Autograft for ACL Reconstruction with Concurrent Lateral Extra-Articular Procedure: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.","authors":"Kwangho Chung,Joo Hyung Han,Se-Han Jung,Hyun-Soo Moon,Min Jung,Sung-Hwan Kim","doi":"10.2106/jbjs.25.00068","DOIUrl":"https://doi.org/10.2106/jbjs.25.00068","url":null,"abstract":"BACKGROUNDNo studies have yet evaluated the clinical outcomes of different anterior cruciate ligament (ACL) autografts in combination with a lateral extra-articular procedure (LEP). Thus, we systematically reviewed randomized controlled trials (RCTs) and conducted a network meta-analysis (NMA) to compare graft options for ACL reconstruction (ACLR) with concurrent LEP.METHODSA systematic search in the PubMed, Embase, Cochrane Library, and Google Scholar databases identified RCTs on primary ACLR plus LEP. Data on ACLR failure, residual knee instability, patient-reported outcome measures, and complications were analyzed using NMA.RESULTSOn the basis of 13 studies (1,690 patients), ACLR with a hamstring tendon (HT) autograft plus LEP was associated with significantly lower odds of graft rupture (odds ratio [OR]: 0.28; 95% confidence interval [CI]: 0.16 to 0.50), graft failure (OR: 0.27; 95% CI: 0.15 to 0.47), clinical failure (OR: 0.48; 95% CI: 0.36 to 0.65), and residual pivot shift (OR: 0.43; 95% CI: 0.22 to 0.84) compared with isolated ACLR. Bone-patellar tendon-bone (BPTB) autograft plus LEP was associated with a significantly lower clinical failure rate (OR: 0.30; 95% CI: 0.12 to 0.80) compared with isolated ACLR. Both HT (mean difference [MD]: 2.40; 95% CI: 1.25 to 3.55) and BPTB (MD: 3.70; 95% CI: 0.85 to 6.55) autograft plus LEP were associated with higher Lysholm scores compared with isolated ACLR. The outcomes did not differ between the graft types when combined with LEP.CONCLUSIONSThe odds of graft rupture, graft failure, and clinical failure after ACLR with HT autograft plus LEP were lower by 72%, 73%, and 52%, respectively, than the odds after isolated ACLR. ACLR with BPTB autograft plus LEP significantly lowered only the odds of clinical failure, by approximately 70%, potentially due to the smaller sample size. Both grafts remain viable options for ACLR plus LEP, with the benefit of LEP requiring further validation.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":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068240","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":"Injection-Based Therapies for the Management of Hip and Knee Osteoarthritis.","authors":"K T Matthew Seah,Michael E Neufeld,Lisa C Howard,Donald S Garbuz,Bassam A Masri","doi":"10.2106/jbjs.25.00239","DOIUrl":"https://doi.org/10.2106/jbjs.25.00239","url":null,"abstract":"➢ Corticosteroid injections are largely safe, but patients and practitioners should be aware of the small risk of adverse side effects, and their limited duration of efficacy. The timing of injection should be coordinated with potential surgical dates.➢ The routine use of hyaluronic acid injections for osteoarthritis is not recommended, but there are certain subsets of patients, such as those who have undergone other therapies that failed, who may benefit from it.➢ Local anesthetics are frequently used in conjunction with corticosteroids for enhanced pain control; however, caution is needed because of concerns regarding chondrotoxicity. Proper patient selection is crucial, and their overuse for diagnostic purposes is not recommended.➢ There is currently insufficient evidence to support the routine use of prolotherapy, bone marrow aspirate concentrate, stromal vascular fraction, and mesenchymal stromal cell injections.➢ Intra-articular saline solution has been associated with improvements in both patient-reported pain and function scores, and this should be considered in future study designs.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068241","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":"Hip and Knee Arthroplasty in Patients with Obesity.","authors":"Chuan Kong Koh,Simon Garceau,George Grammatopoulos,Paul E Beaulé","doi":"10.2106/jbjs.25.00131","DOIUrl":"https://doi.org/10.2106/jbjs.25.00131","url":null,"abstract":"➢ Obesity is associated with increased postoperative complications and reoperation following total joint arthroplasty.➢ Meaningful functional improvement can be achieved with appropriate measures.➢ Preoperative measures include medical optimization, weight management, and consideration of bariatric surgery and glucagon-like peptide-1 receptor agonists.➢ Perioperative optimization requires an experienced multidisciplinary team and awareness of technical considerations for patients with obesity undergoing total joint arthroplasty.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043747","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}