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Posterior Cruciate Ligament (PCL) Versus Combined PCL and Posterolateral Corner Reconstruction in Isolated PCL Grade-III Injuries. 后十字韧带(PCL)与联合后十字韧带和后外侧角重建在孤立的PCL iii级损伤中的应用。
Pub Date : 2025-11-03 DOI: 10.2106/jbjs.24.01051
Kyoung Ho Yoon,Bo Seung Bae,Dae Keun Suh
BACKGROUNDIsolated grade-III posterior cruciate ligament (PCL) injuries are defined as PCL injuries without any other ligamentous pathology that have a posterior translation of ≥12 mm compared with the contralateral knee. The aims of this study were to investigate isolated grade-III PCL injuries and to compare the clinical outcomes of 2 surgical methods.METHODSPatients with a PCL injury between 2008 and 2020 were retrospectively reviewed. Patients with an isolated grade-III PCL injury underwent either PCL reconstruction or combined PCL and posterolateral corner (PLC) reconstruction. Stress radiographs (Telos) and International Knee Documentation Committee (IKDC) subjective score, Lysholm knee score, and Tegner activity scale values were obtained preoperatively and at each follow-up.RESULTSOf 448 patients with a PCL injury, 254 patients with an isolated PCL injury were identified. Sixty of the 254 patients had a grade-III posterior translation. Thirty patients were excluded due to a lack of follow-up or medical information, leaving a cohort of 30 patients. The 17 patients who underwent isolated PCL reconstruction (Group I) and the 13 patients who underwent combined PCL and PLC reconstruction (Group II) had a mean age of 36.2 years (range, 16 to 59 years) and 31.8 years (range, 16 to 58 years) (p = 0.438), respectively, with a mean follow-up of 4.9 years (range, 2 to 11.8 years) and 4.3 years (range, 2 to 10 years) (p = 0.623), respectively. In Groups I and II, posterior translation, compared with the contralateral knee, improved from 13.7 ± 1.7 mm to 7.2 ± 3.2 mm (p < 0.0001) and from 14.6 ± 2.0 to 7.1 ± 2.4 mm (p = 0.001), respectively. In Group I, the mean IKDC, Lysholm, and Tegner scores improved from 54.8 to 71.8 (p = 0.001), from 56.7 to 77.9 (p = 0.004), and from 3.8 to 5.5 (p = 0.021), respectively. In Group II, the mean IKDC, Lysholm, and Tegner scores improved from 47.1 to 69.5 (p = 0.003), from 54.2 to 77.8 (p = 0.003), and from 4.0 to 5.2 (p = 0.042), respectively. No differences were observed between the groups.CONCLUSIONSPatients with an isolated grade-III PCL injury who underwent isolated PCL reconstruction showed significant improvements in subjective and objective outcomes. No significant difference was observed between patients who underwent isolated PCL reconstruction and those who underwent combined PCL and PLC reconstruction.LEVEL OF EVIDENCETherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
背景:离体iii级后交叉韧带(PCL)损伤定义为无其他韧带病理的PCL损伤,与对侧膝关节相比后侧移位≥12 mm。本研究的目的是研究孤立的iii级PCL损伤,并比较两种手术方法的临床结果。方法回顾性分析2008年至2020年发生PCL损伤的患者。孤立的iii级PCL损伤患者接受PCL重建或PCL联合后外侧角(PLC)重建。术前和每次随访时获得应力x线片(Telos)和国际膝关节文献委员会(IKDC)主观评分、Lysholm膝关节评分和Tegner活动量表值。结果448例PCL损伤患者中有254例为孤立性PCL损伤。254例患者中有60例为iii级后平移。由于缺乏随访或医疗信息,30名患者被排除在外,留下30名患者。单独行PCL重建的17例患者(I组)和PCL联合PLC重建的13例患者(II组)的平均年龄分别为36.2岁(16 ~ 59岁)和31.8岁(16 ~ 58岁)(p = 0.438),平均随访时间分别为4.9年(2 ~ 11.8年)和4.3年(2 ~ 10年)(p = 0.623)。在I组和II组中,与对侧膝关节相比,后侧移位分别从13.7±1.7 mm改善到7.2±3.2 mm (p < 0.0001)和从14.6±2.0改善到7.1±2.4 mm (p = 0.001)。在第一组中,平均IKDC、Lysholm和Tegner评分分别从54.8提高到71.8 (p = 0.001),从56.7提高到77.9 (p = 0.004),从3.8提高到5.5 (p = 0.021)。在第二组中,平均IKDC、Lysholm和Tegner评分分别从47.1提高到69.5 (p = 0.003),从54.2提高到77.8 (p = 0.003),从4.0提高到5.2 (p = 0.042)。各组之间没有观察到差异。结论孤立性iii级PCL损伤患者接受孤立性PCL重建后主客观预后均有显著改善。单独行PCL重建的患者与联合行PCL和PLC重建的患者之间无显著差异。证据水平:治疗性三级。有关证据水平的完整描述,请参见作者说明。
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引用次数: 0
A Medical Student's Reflections on Autism, Movement, and Orthopaedic Collaboration: Beyond the Clinic. 一个医科学生对自闭症、运动和骨科合作的反思:超越诊所。
Pub Date : 2025-11-03 DOI: 10.2106/jbjs.25.00448
Camila Vicioso,Noy Alon,Michelle J Adler,Bonnie Schlachte,Alexander Kolevzon,Sheena C Ranade
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引用次数: 0
Revisiting Surgery for Proximal Humeral Fractures: How Much High-Quality Evidence Is Needed to De-Implement Surgery Introduced without High-Quality Evidence? 肱骨近端骨折的重访手术:在没有高质量证据的情况下实施手术需要多少高质量证据?
Pub Date : 2025-11-03 DOI: 10.2106/jbjs.25.00543
Stig Brorson
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引用次数: 0
The Latarjet Procedure May Induce Pathokinematics with Posterior Humeral Head Subluxation: An Experimental Dynamic Radiostereometric Study. Latarjet手术可能诱发肱骨后头半脱位的病理运动:一项实验性动态放射立体研究。
Pub Date : 2025-11-03 DOI: 10.2106/jbjs.25.00120
Josephine Olsen Kipp,Emil Toft Petersen,Theis Muncholm Thillemann,Sepp de Raedt,Lærke Borgen,Lars Lindgren,Annemarie Brüel,Thomas Falstie-Jensen,Maiken Stilling
BACKGROUNDThe effectiveness of the Latarjet procedure in stabilizing the glenohumeral joint (GHJ) in the abducted and externally rotated position is well documented. However, evidence of its ability to restore the GHJ kinematics in other positions and without anterior-directed load is sparse. The purpose of this study was to evaluate the GHJ kinematics, throughout external rotation, following the Latarjet procedure in shoulders with 15% anterior glenoid bone loss.METHODSEight human donor arms were examined using dynamic radiostereometry during GHJ external rotation with anterior-directed loads of 0 to 30 N. Kinematics, measured on the basis of the humeral head center and the contact point relative to the glenoid, were assessed at 30° and 60° of GHJ abduction for 3 conditions: the native GHJ, 15% glenoid bone loss, and following the Latarjet procedure.RESULTSFollowing the Latarjet procedure, the humeral head center and contact point were up to 9.7 mm (95% confidence interval [CI], 0.5 to 18.8 mm) more posterior and 7.4 mm (95% CI, 0.3 to 14.4 mm) more superior compared with 15% glenoid bone loss. With a 30 N anterior-directed load, the contact point was up to 4.4 mm (95% CI, 2.4 to 6.4 mm) more anterior compared with 15% glenoid bone loss. No significant differences in kinematics between the native GHJ and following the Latarjet procedure were observed with anterior-directed load application. However, without an anterior-directed load, the humeral head center and contact point were up to 7.9 mm (95% CI, 2.3 to 13.5 mm) more posterior and 6.1 mm (95% CI, 0.0 to 12.2 mm) more inferior following the Latarjet procedure compared with the native GHJ.CONCLUSIONSWith anterior-directed loading, the Latarjet procedure to treat 15% glenoid bone loss restored the native GHJ kinematics, with the largest stabilizing effect at the end-range external rotation. However, without anterior-directed loading, the humeral head center and contact point were more posterior and inferior following the Latarjet procedure than in the native GHJ, suggesting potential excessive posterior humeral head translation.CLINICAL RELEVANCEPosterior subluxation of the humeral head during resting and non-loaded activities following the Latarjet procedure may be a concern in terms of future posterior glenoid cartilage wear and GHJ osteoarthritis. However, these results need to be confirmed in a clinical setting.
背景:Latarjet手术在外展和外旋位置稳定盂肱关节(GHJ)方面的有效性已得到充分证明。然而,在没有前向载荷的情况下,其在其他位置恢复GHJ运动学的能力的证据很少。本研究的目的是评估肩关节前盂骨丢失15%的Latarjet手术后整个外旋过程中GHJ的运动学。方法在GHJ外旋过程中,采用动态放射立体测量技术检测8只供体手臂,前向载荷为0 - 30 n。运动学测量基于肱骨头中心和相对于肩胛盂的接触点,在GHJ外展30°和60°时评估3种情况:天然GHJ、15%肩胛盂骨丢失和Latarjet手术。结果采用Latarjet手术后,肱骨头中心和接触点后侧增加9.7 mm(95%可信区间[CI], 0.5至18.8 mm),与15%盂骨丢失相比,后侧增加7.4 mm (95% CI, 0.3至14.4 mm)。在30 N的前向载荷下,与15%的盂骨丢失相比,接触点前移4.4 mm (95% CI, 2.4 - 6.4 mm)。在前向载荷作用下,观察到原位GHJ和Latarjet手术后的GHJ在运动学上没有显著差异。然而,在没有前向载荷的情况下,与原生GHJ相比,Latarjet手术后肱骨头中心和接触点后侧多7.9 mm (95% CI, 2.3 - 13.5 mm),下侧多6.1 mm (95% CI, 0.0 - 12.2 mm)。结论:采用前路定向负荷,Latarjet手术治疗15%的盂骨丢失恢复了GHJ的运动学,在踝关节末端外旋时稳定效果最大。然而,在没有前向载荷的情况下,与天然GHJ相比,Latarjet手术后肱骨头中心和接触点更后侧和下方,这表明可能存在肱骨头后侧移位过度的情况。临床意义:Latarjet手术后休息和无负荷活动期间肱骨头后路半脱位可能是未来后盂软骨磨损和GHJ骨关节炎的一个问题。然而,这些结果需要在临床环境中得到证实。
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引用次数: 0
Demystifying Traditional Bonesetting: Lessons from Mbarara Regional Hospital. 揭开传统正骨的神秘面纱:来自姆巴拉拉地区医院的经验教训。
Pub Date : 2025-11-03 DOI: 10.2106/jbjs.24.00387
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.
在全球范围内,传统的接骨师(tbs)通常为患者提供矫形方面的护理,从肌肉骨骼损伤到肿瘤病理,通常使用的技术可能不同于西方的方法。本研究的目的是调查寻求TBS治疗的动机、接受的治疗类型以及对传统植骨的态度,并确定创伤性和非创伤性肌肉骨骼病变患者之间的差异。方法:我们调查了乌干达姆巴拉拉地区转诊医院(MRRH)骨科门诊就诊的患者,这些患者之前因其骨科问题曾见过TBS,以确定他们寻求TBS治疗的原因以及他们的护理印象。结果本研究纳入168例患者:109例表现为外伤性损伤,59例表现为其他骨科问题。创伤组的家庭月收入(p < 0.001)和受教育程度(p = 0.006)均高于非创伤组。TBS提供的治疗方法包括切割或穿刺皮肤,局部使用草药,铸造和其他传统方法。创伤患者寻求传统接骨的最大动机是相信其疗效;非创伤组的患者相信TBS可以逆转导致他们疾病的巫术或诅咒。管理失败是创伤组和非创伤组终止TBS治疗的最主要原因。结论骨科病理学影响个体寻求传统正骨的方式和动机。对于非创伤性病理,迷信信仰和对其功效的信念在传统接骨的选择中发挥了作用。对个体的额外调查可能会进一步阐明寻求TBS治疗的结果。证据级别:治疗性v级。参见《作者说明》获得证据级别的完整描述。
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引用次数: 0
How Being a Patient Led to Surgical Insights. 作为一个病人是如何获得手术洞察力的。
Pub Date : 2025-11-03 DOI: 10.2106/jbjs.25.00055
Zhi-Hong Zheng
{"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}
引用次数: 0
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". 除了缓解疼痛:体育活动作为全膝关节置换术后的预防策略:对Hyung Jun Park, MD, PhD等人的一篇文章的评论:“保持或增加体育活动对于全膝关节置换术后心血管和脑血管风险的管理至关重要。”一项全国性队列研究”。
Pub Date : 2025-10-15 DOI: 10.2106/jbjs.25.00977
Hiromasa Tanino,Ryo Mitsutake,Hiroshi Ito
{"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}
引用次数: 0
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". 使用AEFIX系统的外固定:扩展全球标准护理骨科:对Kaveh Momenzadeh博士等人的一篇文章的评论:“为资源有限的环境设计的负担得起的外固定器(AEFIX)的机械性能评估”。
Pub Date : 2025-10-15 DOI: 10.2106/jbjs.25.00901
Patrick Morgan
{"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}
引用次数: 0
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". 超越意识:从知识到手术室可持续发展的行动:对Laura L. Bellaire医学博士和Isabelle Freiling博士的一篇文章的评论:“有效的沟通策略来解决矫形外科手术室的过度浪费和过度消费”。
Pub Date : 2025-10-01 DOI: 10.2106/jbjs.25.00711
David S Jevsevar
{"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}
引用次数: 0
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". 减少TKA术后贫血,促进术后恢复:探索氨甲环酸和可吸收止血药的协同作用:对张庆义等人的文章《氨甲环酸联合可吸收止血药减少全膝关节置换术围手术期出血量的疗效和安全性》的评论。前瞻性、盲法、随机对照试验”。
Pub Date : 2025-10-01 DOI: 10.2106/jbjs.25.00395
Yukihide Minoda,Yohei Ohyama,Sho Masuda,Hideki Ueyama,Ryo Sugama,Hidetomi Terai
{"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}
引用次数: 0
期刊
The Journal of Bone & Joint Surgery
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