Camila Vicioso,Noy Alon,Michelle J Adler,Bonnie Schlachte,Alexander Kolevzon,Sheena C Ranade
{"title":"A Medical Student's Reflections on Autism, Movement, and Orthopaedic Collaboration: Beyond the Clinic.","authors":"Camila Vicioso,Noy Alon,Michelle J Adler,Bonnie Schlachte,Alexander Kolevzon,Sheena C Ranade","doi":"10.2106/jbjs.25.00448","DOIUrl":"https://doi.org/10.2106/jbjs.25.00448","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"228 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433687","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":"Revisiting Surgery for Proximal Humeral Fractures: How Much High-Quality Evidence Is Needed to De-Implement Surgery Introduced without High-Quality Evidence?","authors":"Stig Brorson","doi":"10.2106/jbjs.25.00543","DOIUrl":"https://doi.org/10.2106/jbjs.25.00543","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145434029","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}
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。
{"title":"The Latarjet Procedure May Induce Pathokinematics with Posterior Humeral Head Subluxation: An Experimental Dynamic Radiostereometric Study.","authors":"Josephine Olsen Kipp,Emil Toft Petersen,Theis Muncholm Thillemann,Sepp de Raedt,Lærke Borgen,Lars Lindgren,Annemarie Brüel,Thomas Falstie-Jensen,Maiken Stilling","doi":"10.2106/jbjs.25.00120","DOIUrl":"https://doi.org/10.2106/jbjs.25.00120","url":null,"abstract":"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.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145434031","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}
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}
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