Platelet rich plasma (PRP) use in orthopedics is growing. Clinical research documenting effective outcomes for various conditions is fueling interest in PRP as a safe intervention for many soft tissue and joint pathologies in orthopedics. However, clinicians do not have a consistent means to evaluate PRP as a biologic drug and as a result interpreting clinical reports can be challenging. Additionally, clinicians often do not have the necessary information to fully evaluate PRP kits and protocols when deciding on how to best integrate this therapy into their practice. This paper defines 15 different metrics that can be used to quantify PRP and to compare PRP kits and protocols. Our goal is to provide a comprehensive framework that allows for the unbiased evaluation of PRP regardless of the kit or protocol used. By using these PRP metrics routinely, we can improve characterization PRP for research and clinical purposes.
{"title":"“In My Experience…15 Data Points To Better Evaluate Platelet Rich Plasma Kits And Protocols”","authors":"Don Buford, Nathan Sherman","doi":"10.60118/001c.118697","DOIUrl":"https://doi.org/10.60118/001c.118697","url":null,"abstract":"Platelet rich plasma (PRP) use in orthopedics is growing. Clinical research documenting effective outcomes for various conditions is fueling interest in PRP as a safe intervention for many soft tissue and joint pathologies in orthopedics. However, clinicians do not have a consistent means to evaluate PRP as a biologic drug and as a result interpreting clinical reports can be challenging. Additionally, clinicians often do not have the necessary information to fully evaluate PRP kits and protocols when deciding on how to best integrate this therapy into their practice. This paper defines 15 different metrics that can be used to quantify PRP and to compare PRP kits and protocols. Our goal is to provide a comprehensive framework that allows for the unbiased evaluation of PRP regardless of the kit or protocol used. By using these PRP metrics routinely, we can improve characterization PRP for research and clinical purposes.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"56 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929207","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}
The author discusses the mentor-mentee relaationshiip as well as the many aspects that make for a great mentor.
作者讨论了指导者与被指导者之间的关系，以及成为优秀指导者的诸多方面。
{"title":"“In My Experience…Mentorship in Orthopaedic Surgery”","authors":"William Levine, MD","doi":"10.60118/001c.120359","DOIUrl":"https://doi.org/10.60118/001c.120359","url":null,"abstract":"The author discusses the mentor-mentee relaationshiip as well as the many aspects that make for a great mentor.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"132 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656294","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}
Vinod Dasa, R. Meneghini, Michael Suk, Alix Cagnin, Alex Fuentes
While knee disorders, and more specifically knee osteoarthritis, account for a significant portion of the orthopedic visits to health care providers, there are still clinical gaps that need to be addressed to achieve effective management of this disease. The absence of functional tools to objectively assess knee function in motion and weight-bearing conditions poses a challenge for clinicians to hindering their ability to design individualized conservative and surgical treatment plans aimed at achieving better patient outcomes. The Knee Kinesiography exam with the KneeKG® system provides accurate, reliable, three-dimensional, and real-time information about dynamic knee malalignment and joint dysfunction during weight-bearing activities through the assessment of kinematic biomechanical markers. This work presents a comprehensive clinical review of the materials related to this exam which have been published since its validation in 2012. The aim is to summarize literature evidence on how the Knee Kinesiography exam may enhance both non-surgical and surgical management of knee osteoarthritis and arthroplasty. The access to objective patient-source outcome measures from this exam, directly associated with both patient-reported outcomes and osteoarthritis onset and progression before and after total knee arthroplasty, can allow clinicians to identify mechanisms behind knee pain, dysfunction, and dissatisfaction. In the era of orthopedic value-based care, such patient-source data may help clinicians better understand the condition of the knee and thus assist them in their decision-making to establish the best personalized care plan possible throughout the continuum of care, from diagnosis to post-surgery management.
{"title":"A New Paradigm in the Management of Knee Osteoarthritis and Arthroplasty with Dynamic Patient-source Outcome Measures: Comprehensive Clinical Review of the Knee Kinesiography Exam with the KneeKG® System","authors":"Vinod Dasa, R. Meneghini, Michael Suk, Alix Cagnin, Alex Fuentes","doi":"10.60118/001c.94091","DOIUrl":"https://doi.org/10.60118/001c.94091","url":null,"abstract":"While knee disorders, and more specifically knee osteoarthritis, account for a significant portion of the orthopedic visits to health care providers, there are still clinical gaps that need to be addressed to achieve effective management of this disease. The absence of functional tools to objectively assess knee function in motion and weight-bearing conditions poses a challenge for clinicians to hindering their ability to design individualized conservative and surgical treatment plans aimed at achieving better patient outcomes. The Knee Kinesiography exam with the KneeKG® system provides accurate, reliable, three-dimensional, and real-time information about dynamic knee malalignment and joint dysfunction during weight-bearing activities through the assessment of kinematic biomechanical markers. This work presents a comprehensive clinical review of the materials related to this exam which have been published since its validation in 2012. The aim is to summarize literature evidence on how the Knee Kinesiography exam may enhance both non-surgical and surgical management of knee osteoarthritis and arthroplasty. The access to objective patient-source outcome measures from this exam, directly associated with both patient-reported outcomes and osteoarthritis onset and progression before and after total knee arthroplasty, can allow clinicians to identify mechanisms behind knee pain, dysfunction, and dissatisfaction. In the era of orthopedic value-based care, such patient-source data may help clinicians better understand the condition of the knee and thus assist them in their decision-making to establish the best personalized care plan possible throughout the continuum of care, from diagnosis to post-surgery management.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671184","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}
Benjamin D. Gross, Carl Cirino, A. Duey, Troy Li, Christopher White, Akshar Patel, Bradford Parsons, Dave Shukla, Paul J Cagle
Purpose: The Latarjet procedure was initially described by Michel Latarjet in 1954 as a treatment for recurrent dislocations of the shoulder. Over the last decade, an arthroscopic approach has emerged as the natural evolution of the open procedure. The purpose of this study was to identify and analyze the fifty most-cited articles related to the Latarjet, analyze the associated characteristics of each article, and to evaluate whether surgeons are currently influenced by primarily higher versus lower-level studies. Methods: Various Boolean queries were searched on the Clarivate Analytics Web of Science, which yielded final search terms of topics on “latarjet OR latarjet-bristow OR bristow-latarjet OR latarjet-patte or patte-latarjet”. Information collected included: author demographics, study type, level of evidence, journal name, number of citations, and publication year. Results: The top fifty Latarjet articles had 5,319 citations and consisted of 0 level I, 3 level II, 8 level III, 25 level IV and 14 level V studies (date range: 1983 – 2017, median 2012). The most cited article received 454 citations. Authors from France (n = 14, 27%) contributed the most to included papers, followed by the United States (n = 8, 16%). Conclusions: The most-cited articles on the Latarjet procedure tend to be case series, cohort studies, and expert opinions published primarily by French and American authors between 2000 and 2016. With the recent technical innovation surrounding the Latarjet procedure and glenoid bone-block reconstruction in general, these articles may form the foundation that future higher level-of-evidence studies will build upon in their research.
目的：1954 年，米歇尔-拉塔热（Michel Latarjet）首次将拉塔热手术描述为治疗肩关节复发性脱位的方法。在过去的十年中，关节镜方法作为开放手术的自然演变而兴起。本研究的目的是识别和分析与 Latarjet 相关的 50 篇被引用次数最多的文章，分析每篇文章的相关特征，并评估外科医生目前是否主要受到高级研究和低级研究的影响。方法：在 Clarivate Analytics Web of Science 上搜索了各种布尔查询，最终搜索出的主题词为 "latarjet OR latarjet-bristow OR bristow-latarjet OR latarjet-patte or patte-latarjet"。收集的信息包括：作者人口统计、研究类型、证据级别、期刊名称、引用次数和出版年份。结果：被引用次数最多的 50 篇 Latarjet 文章共有 5319 次引用，包括 0 篇 I 级研究、3 篇 II 级研究、8 篇 III 级研究、25 篇 IV 级研究和 14 篇 V 级研究（日期范围：1983 - 2017 年，中位数为 2012 年）。被引用次数最多的一篇文章获得了454次引用。来自法国（14 人，占 27%）的作者对收录论文的贡献最大，其次是美国（8 人，占 16%）。结论：关于Latarjet手术被引用次数最多的文章往往是病例系列、队列研究和专家意见，主要由法国和美国作者在2000年至2016年间发表。随着近期围绕Latarjet手术和盂骨块重建的技术革新，这些文章可能会成为未来更高证据水平研究的基础。
{"title":"Latarjet Classics: An Analysis of The 50 Most-Cited Articles on The Latarjet Procedure","authors":"Benjamin D. Gross, Carl Cirino, A. Duey, Troy Li, Christopher White, Akshar Patel, Bradford Parsons, Dave Shukla, Paul J Cagle","doi":"10.60118/001c.92326","DOIUrl":"https://doi.org/10.60118/001c.92326","url":null,"abstract":"Purpose: The Latarjet procedure was initially described by Michel Latarjet in 1954 as a treatment for recurrent dislocations of the shoulder. Over the last decade, an arthroscopic approach has emerged as the natural evolution of the open procedure. The purpose of this study was to identify and analyze the fifty most-cited articles related to the Latarjet, analyze the associated characteristics of each article, and to evaluate whether surgeons are currently influenced by primarily higher versus lower-level studies. Methods: Various Boolean queries were searched on the Clarivate Analytics Web of Science, which yielded final search terms of topics on “latarjet OR latarjet-bristow OR bristow-latarjet OR latarjet-patte or patte-latarjet”. Information collected included: author demographics, study type, level of evidence, journal name, number of citations, and publication year. Results: The top fifty Latarjet articles had 5,319 citations and consisted of 0 level I, 3 level II, 8 level III, 25 level IV and 14 level V studies (date range: 1983 – 2017, median 2012). The most cited article received 454 citations. Authors from France (n = 14, 27%) contributed the most to included papers, followed by the United States (n = 8, 16%). Conclusions: The most-cited articles on the Latarjet procedure tend to be case series, cohort studies, and expert opinions published primarily by French and American authors between 2000 and 2016. With the recent technical innovation surrounding the Latarjet procedure and glenoid bone-block reconstruction in general, these articles may form the foundation that future higher level-of-evidence studies will build upon in their research.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"4 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335388","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}
The author reviews his experience with a novel process of designing and bringing a medical device to market.
作者回顾了他设计医疗设备并将其推向市场的新颖过程。
{"title":"“In My Experience…Medical Device Design & Innovation in Shoulder Replacements”","authors":"Anand Murthi, MD","doi":"10.60118/001c.118463","DOIUrl":"https://doi.org/10.60118/001c.118463","url":null,"abstract":"The author reviews his experience with a novel process of designing and bringing a medical device to market.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"61 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141348279","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}
Samuel Rosas, T. D. Luo, Amy P. Trammell, Marcel G. Brown, Matthew Gwilt, Jonathan C. Levy, H. Pilson, J. Halvorson, Eben A. Carroll, Sharon N. Babcock
Clavicular fractures can be managed surgically or via a non-operative approach. In those electing for surgical fixation, post-operative CXR may be routine practice in the post-anesthesia care unit (PACU) for a rare complication of pneumothorax (PTX), thus driving up the cost for managing these fractures. The value and associated cost of this routine CXR in PACU following open reduction internal fixation (ORIF) of clavicles has not been thoroughly assessed. In this study we investigate the cost effectiveness of obtaining CXR after operative treatment of clavicle fracture. Study was designed as a healthcare two-way dichotomous model with decision trees built in where a CXR was either obtained or not. Literature review was performed to determine the cost estimates of CXR, the cost of ORIF, and associated hospital stay expenses. Annual volume of clavicle ORIF’s performed were derived from the PearlDiver database, queried for CPT-23515 (Clavicle ORIF). Estimation of CXR rates were performed from 3% to 98% of patients undergoing clavicle ORIF. Net monetary analysis with associated sensitivity analysis of 10,000 repetitions was performed. The strategy without CXR proved to be the most cost-effective strategy with a net monetary benefit (NMB) of $32,022.50. At $50,000 willingness to pay (WTP), the no CXR strategy was the preferred option. This strategy was found to be optimal 76% of the time followed by routine CXR 23% of the time and less than 1% being indifferent. The national annual costs of routine CXR after clavicle ORIFs was estimated to range from $7,100 to $349,860, which over 10 years represents anywhere from $81,540 to $2,663,640 in additional expenses. The provided study demonstrates that routine CXR after clavicle ORIF is not cost effective. Due to the exceedingly low incidence of PTX as a post-operative complication in clavicle ORIF, we recommend that hospitals and surgeons refrain from ordering radiographs in post-operative patients, with the exception of those displaying concerning clinical signs for PTX or those with known pre-operative pulmonary injury. Adopting this strategy will limit unnecessary healthcare costs accrued by patients and may be the more clinically appropriate management.
{"title":"Routine Chest X-Ray is Not Cost-Effective After Clavicle ORIF: A Cost Effectiveness Analysis with National Estimations","authors":"Samuel Rosas, T. D. Luo, Amy P. Trammell, Marcel G. Brown, Matthew Gwilt, Jonathan C. Levy, H. Pilson, J. Halvorson, Eben A. Carroll, Sharon N. Babcock","doi":"10.60118/001c.91276","DOIUrl":"https://doi.org/10.60118/001c.91276","url":null,"abstract":"Clavicular fractures can be managed surgically or via a non-operative approach. In those electing for surgical fixation, post-operative CXR may be routine practice in the post-anesthesia care unit (PACU) for a rare complication of pneumothorax (PTX), thus driving up the cost for managing these fractures. The value and associated cost of this routine CXR in PACU following open reduction internal fixation (ORIF) of clavicles has not been thoroughly assessed. In this study we investigate the cost effectiveness of obtaining CXR after operative treatment of clavicle fracture. Study was designed as a healthcare two-way dichotomous model with decision trees built in where a CXR was either obtained or not. Literature review was performed to determine the cost estimates of CXR, the cost of ORIF, and associated hospital stay expenses. Annual volume of clavicle ORIF’s performed were derived from the PearlDiver database, queried for CPT-23515 (Clavicle ORIF). Estimation of CXR rates were performed from 3% to 98% of patients undergoing clavicle ORIF. Net monetary analysis with associated sensitivity analysis of 10,000 repetitions was performed. The strategy without CXR proved to be the most cost-effective strategy with a net monetary benefit (NMB) of $32,022.50. At $50,000 willingness to pay (WTP), the no CXR strategy was the preferred option. This strategy was found to be optimal 76% of the time followed by routine CXR 23% of the time and less than 1% being indifferent. The national annual costs of routine CXR after clavicle ORIFs was estimated to range from $7,100 to $349,860, which over 10 years represents anywhere from $81,540 to $2,663,640 in additional expenses. The provided study demonstrates that routine CXR after clavicle ORIF is not cost effective. Due to the exceedingly low incidence of PTX as a post-operative complication in clavicle ORIF, we recommend that hospitals and surgeons refrain from ordering radiographs in post-operative patients, with the exception of those displaying concerning clinical signs for PTX or those with known pre-operative pulmonary injury. Adopting this strategy will limit unnecessary healthcare costs accrued by patients and may be the more clinically appropriate management.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":" 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141367858","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}
Justin A. Magnuson, Nihir Parikh, Francis Sirch, Justin R. Montgomery, Raja N. Kyriakos, Arjun Saxena, Andrew M. Star
Knee radiographs are often examined independently by both radiologists and orthopaedic surgeons when evaluating osteoarthritis (OA). While multiple systems have been described, formal classification systems are infrequently used in clinical practice and documentation. Instead, providers commonly describe knee OA on radiographs as “mild,” “moderate,” or “severe,” with loose and unclear interpretations. From a patient’s perspective, inconsistent reading and charting of knee OA severity can have financial and psychological implications, such as prior authorization denial, as well as anxiety-provoking uncertainty with their diagnosis. The purpose of this study was to investigate the agreement between orthopaedic surgeons, musculoskeletal radiologists, and general radiologists on the severity and location of knee OA. 105 deidentified radiographs of patients presenting with knee pain were obtained. Anteroposterior (AP) and lateral radiographs were reviewed independently by two high-volume arthroplasty surgeons, two musculoskeletal radiologists, and two general radiologists. Each radiograph was classified as mild, moderate, or severe OA, mirroring the language used in the providers’ documentation. Providers were also asked to comment on the location of OA, described as medial, lateral, patellofemoral, or any combination. Agreement was calculated using Fleiss’ kappa in which values less than 0.3 were considered no true agreement, 0.3 and 0.5 weak agreement, 0.5 and 0.8 moderate agreement, and greater than 0.8 strong agreement. There was inconsistent agreement for severity and location among physicians of the same specialty and between specialties. There was moderate agreement (k = 0.513) in the assessment of patellofemoral arthritis among radiologists. Orthopaedic surgeons (k = 0.503) and musculoskeletal radiologists (k = 0.568) demonstrated moderate agreement in the perceived need for TKA, and there was moderate agreement between the two specialties (k = 0.556). All other comparisons indicate weak or no agreement. A high degree of inconsistency was found in the subjective interpretation of radiographic knee OA. Although grading systems exist, providers often document knee OA based on the terms “mild,” “moderate,” and “severe,” which was shown to have poor reliability. Utilization and adherence to an existing standardized system of interpreting knee x-rays, which can be efficiently integrated into clinical practice, is necessary to improve communication for providers, patients, and insurers.
在评估骨关节炎（OA）时，放射科医生和矫形外科医生通常会独立检查膝关节X光片。虽然有多种系统被描述过，但正式的分类系统在临床实践和文件中很少使用。取而代之的是，医护人员通常将膝关节 OA 在 X 光片上描述为 "轻度"、"中度 "或 "重度"，解释松散且不明确。从患者的角度来看，对膝关节 OA 严重程度的解读和记录不一致可能会产生经济和心理影响，如拒绝预先授权，以及对诊断的不确定性产生焦虑。本研究旨在调查骨科医生、肌肉骨骼放射科医生和普通放射科医生对膝关节 OA 严重程度和位置的一致看法。研究人员采集了 105 例因膝关节疼痛就诊的患者的身份不明的 X 光片。两名工作量大的关节置换外科医生、两名肌肉骨骼放射科医生和两名普通放射科医生分别独立审查了前胸（AP）和侧位X光片。每张 X 光片都被分为轻度、中度或重度 OA，这与医疗服务提供者文件中使用的语言一致。此外，还要求医疗服务提供者对 OA 的位置进行评论，描述为内侧、外侧、髌股关节或任何组合。一致性采用弗莱斯卡帕（Fleiss' kappa）法进行计算，小于 0.3 为无真实一致性，0.3 至 0.5 为弱一致性，0.5 至 0.8 为中等一致性，大于 0.8 为强一致性。同一专业的医生之间以及不同专业的医生之间在严重程度和位置方面的一致性并不一致。放射科医生对髌股关节炎的评估存在中等程度的一致性（k = 0.513）。矫形外科医生（k = 0.503）和肌肉骨骼放射科医生（k = 0.568）在认为需要进行 TKA 方面表现出中等程度的一致性，两个专科之间也有中等程度的一致性（k = 0.556）。所有其他比较均显示一致性较弱或不一致。对膝关节 OA 影像学检查的主观解释存在高度不一致。虽然存在分级系统，但医疗服务提供者通常根据 "轻度"、"中度 "和 "重度 "来记录膝关节 OA，而这种分级系统的可靠性很差。为了改善医疗服务提供者、患者和保险公司之间的沟通，有必要利用并坚持现有的标准化膝关节X光片解读系统，并将其有效地融入临床实践中。
{"title":"Is the Interpretation of Radiographic Knee Arthritis Consistent Between Orthopaedic Surgeons and Radiologists?","authors":"Justin A. Magnuson, Nihir Parikh, Francis Sirch, Justin R. Montgomery, Raja N. Kyriakos, Arjun Saxena, Andrew M. Star","doi":"10.60118/001c.91022","DOIUrl":"https://doi.org/10.60118/001c.91022","url":null,"abstract":"Knee radiographs are often examined independently by both radiologists and orthopaedic surgeons when evaluating osteoarthritis (OA). While multiple systems have been described, formal classification systems are infrequently used in clinical practice and documentation. Instead, providers commonly describe knee OA on radiographs as “mild,” “moderate,” or “severe,” with loose and unclear interpretations. From a patient’s perspective, inconsistent reading and charting of knee OA severity can have financial and psychological implications, such as prior authorization denial, as well as anxiety-provoking uncertainty with their diagnosis. The purpose of this study was to investigate the agreement between orthopaedic surgeons, musculoskeletal radiologists, and general radiologists on the severity and location of knee OA. 105 deidentified radiographs of patients presenting with knee pain were obtained. Anteroposterior (AP) and lateral radiographs were reviewed independently by two high-volume arthroplasty surgeons, two musculoskeletal radiologists, and two general radiologists. Each radiograph was classified as mild, moderate, or severe OA, mirroring the language used in the providers’ documentation. Providers were also asked to comment on the location of OA, described as medial, lateral, patellofemoral, or any combination. Agreement was calculated using Fleiss’ kappa in which values less than 0.3 were considered no true agreement, 0.3 and 0.5 weak agreement, 0.5 and 0.8 moderate agreement, and greater than 0.8 strong agreement. There was inconsistent agreement for severity and location among physicians of the same specialty and between specialties. There was moderate agreement (k = 0.513) in the assessment of patellofemoral arthritis among radiologists. Orthopaedic surgeons (k = 0.503) and musculoskeletal radiologists (k = 0.568) demonstrated moderate agreement in the perceived need for TKA, and there was moderate agreement between the two specialties (k = 0.556). All other comparisons indicate weak or no agreement. A high degree of inconsistency was found in the subjective interpretation of radiographic knee OA. Although grading systems exist, providers often document knee OA based on the terms “mild,” “moderate,” and “severe,” which was shown to have poor reliability. Utilization and adherence to an existing standardized system of interpreting knee x-rays, which can be efficiently integrated into clinical practice, is necessary to improve communication for providers, patients, and insurers.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140684730","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}
I review here my experiences with the anterior approach to the hip in total hip arthroplasty.
我在这里回顾一下我在全髋关节置换术中采用髋关节前路的经验。
{"title":"In My Experience…Anterior Approach in to the Hip in Total Hip Replacements","authors":"Stefan Kreuzer, MD","doi":"10.60118/001c.90847","DOIUrl":"https://doi.org/10.60118/001c.90847","url":null,"abstract":"I review here my experiences with the anterior approach to the hip in total hip arthroplasty.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"145 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706803","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}
Lauren Ladehoff, Andrew B. Harris, Kevin T. Root, Jaynie Criscione, Bryan Clampitt, Alexander N. Becsey, Julius K. Oni
There has been abundant research published regarding the impact of COVID-19 on orthopaedic surgical patients which have varying degrees of impact on clinical practice. Thus, the purpose of this study was to examine the most influential articles relating to COVID-19 and patients undergoing orthopaedic surgical procedures. Though the global pandemic is over, it is beneficial to understand how the resilience of the healthcare system adapted to guide policy development and improve patient care amidst a worldwide time of crisis. The Clarivate Web of Science Core Collection was searched for ‘COVID-19 AND orthopaedic surgery’ and returned 388 articles. The most influential peer-reviewed publications were determined by citation number. Expert opinion and review articles were excluded. Article title, journal name, type of study, country of publication, and clinically relevant findings of each study were collected. The top-50 most influential manuscripts concluded these articles were collectively cited 1875 times. The total citations ranged from 13 to 111 citations per article with a mean of 38 (95% confidence interval [31, 44]). England (14), the United States (11), and Italy (10) had the top number of publications. The top affiliations were IRCCS Istituto Ortopedico Galeazzi (5) and the University of London (4). The most popular journals were Bone & Joint Open (10) and International Orthopaedics (10). Though the articles were largely heterogeneous, they described the necessity of orthopaedic surgeons during the pandemic as well as safety precautions to prevent COVID-19 transmission in orthopaedic patients. This comprehensive analysis identified the 50 most influential peer-reviewed clinical publications regarding COVID-19 and orthopaedic surgery, which is a concise resource that can be used to inform patient decision-making regarding orthopaedic care and COVID-19. The top-50 articles highlighted the importance of resource utilization, increased use of telemedicine, enhanced infection control measures, patient-centered care, and the well-being of healthcare workers during the COVID-19 pandemic.
{"title":"Analysis of the 50 Most Impactful Publications Pertaining to COVID-19 and Orthopaedic Surgery: What Have we Learned?","authors":"Lauren Ladehoff, Andrew B. Harris, Kevin T. Root, Jaynie Criscione, Bryan Clampitt, Alexander N. Becsey, Julius K. Oni","doi":"10.60118/001c.88230","DOIUrl":"https://doi.org/10.60118/001c.88230","url":null,"abstract":"There has been abundant research published regarding the impact of COVID-19 on orthopaedic surgical patients which have varying degrees of impact on clinical practice. Thus, the purpose of this study was to examine the most influential articles relating to COVID-19 and patients undergoing orthopaedic surgical procedures. Though the global pandemic is over, it is beneficial to understand how the resilience of the healthcare system adapted to guide policy development and improve patient care amidst a worldwide time of crisis. The Clarivate Web of Science Core Collection was searched for ‘COVID-19 AND orthopaedic surgery’ and returned 388 articles. The most influential peer-reviewed publications were determined by citation number. Expert opinion and review articles were excluded. Article title, journal name, type of study, country of publication, and clinically relevant findings of each study were collected. The top-50 most influential manuscripts concluded these articles were collectively cited 1875 times. The total citations ranged from 13 to 111 citations per article with a mean of 38 (95% confidence interval [31, 44]). England (14), the United States (11), and Italy (10) had the top number of publications. The top affiliations were IRCCS Istituto Ortopedico Galeazzi (5) and the University of London (4). The most popular journals were Bone & Joint Open (10) and International Orthopaedics (10). Though the articles were largely heterogeneous, they described the necessity of orthopaedic surgeons during the pandemic as well as safety precautions to prevent COVID-19 transmission in orthopaedic patients. This comprehensive analysis identified the 50 most influential peer-reviewed clinical publications regarding COVID-19 and orthopaedic surgery, which is a concise resource that can be used to inform patient decision-making regarding orthopaedic care and COVID-19. The top-50 articles highlighted the importance of resource utilization, increased use of telemedicine, enhanced infection control measures, patient-centered care, and the well-being of healthcare workers during the COVID-19 pandemic.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"101 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140709115","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}
The author reviews her experience related to sex differences in sports injuries.
作者回顾了她在运动损伤性别差异方面的经验。
{"title":"“In My Experience…Sex Differences in Common Sports Injuries: Why Are They Important?”","authors":"Elizabeth Matzkin, MD","doi":"10.60118/001c.94089","DOIUrl":"https://doi.org/10.60118/001c.94089","url":null,"abstract":"The author reviews her experience related to sex differences in sports injuries.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"261 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730478","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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