Pub Date : 2023-09-26DOI: 10.1177/15563316231200496
Varag Abed, Cale Jacobs, Matthew Skinner, Mitchell Owens, Dro Keshishi, Austin V. Stone
Background: The Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines for mesenchymal stem cell (MSC) research, published in 2017, contain a suggested checklist for reporting items in manuscripts involving MSCs. Purpose: We sought to determine how well randomized controlled trials (RCTs) on MSC intervention for knee osteoarthritis (OA) adhered to the MIBO guidelines. Methods: A comprehensive literature search was performed in the PubMed/MEDLINE and Web of Science databases. Inclusion criteria included English-only RCTs that assessed MSC intervention for knee OA published between 2018 and 2022. Metrics were extracted, including year of publication, study design, first author name, journal name, patient demographics, and MIBO checklist criteria. Results: In 27 RCTs analyzed, 1006 patients were included, with a weighted male percentage of 41.8% and weighted mean age of 60.5 ± 7.2 years. On average, 70.5% (range, 30.2%–90.6%) of the modified 53-point MIBO checklist elements were reported per article. Seven (25.9%) articles had adherence rates of 80% or more, 13 (48.1%) had rates between 60% and 79.9%, and 7 (25.9%) had rates of 59.9% or less. The MIBO “intervention” category had the greatest adherence (100%), while the other categories had more variability. Six (50.0%) categories had an adherence level of 80% or more, 3 (25.0%) had adherence levels of 60% to 79.9%, and 3 (25.0%) had an adherence level of 59.9% or less. Conclusion: The overall mean adherence to MIBO guidelines of RCTs on MSC intervention for knee OA was 70.5%. Authors should better integrate the MIBO guidelines into their methodology to improve transparency, reproducibility, and reporting.
背景:2017年发布的间充质干细胞(MSC)研究的最小信息研究评估(MIBO)指南包含了涉及间充质干细胞的手稿报告项目的建议清单。目的:我们试图确定MSC干预膝关节骨性关节炎(OA)的随机对照试验(rct)是否符合MIBO指南。方法:在PubMed/MEDLINE和Web of Science数据库中进行全面的文献检索。纳入标准包括2018年至2022年间发表的评估MSC干预膝关节OA的全英文随机对照试验。提取指标，包括发表年份、研究设计、第一作者姓名、期刊名称、患者人口统计数据和MIBO检查表标准。结果:27项随机对照试验共纳入1006例患者，加权男性比例为41.8%，加权平均年龄为60.5±7.2岁。平均每篇文章报告了修改后的53点MIBO检查表元素的70.5%(范围30.2%-90.6%)。7篇(25.9%)文章的依从率在80%或以上，13篇(48.1%)的依从率在60%至79.9%之间，7篇(25.9%)的依从率在59.9%或以下。MIBO“干预”类别的依从性最高(100%)，而其他类别的差异更大。6个(50.0%)类别的依从性水平在80%及以上，3个(25.0%)类别的依从性水平在60%至79.9%之间，3个(25.0%)类别的依从性水平在59.9%及以下。结论:mscs干预膝关节OA的随机对照试验中，总体平均遵守MIBO指南的比例为70.5%。作者应该更好地将MIBO指南整合到他们的方法中，以提高透明度、可重复性和报告。
{"title":"How Well Do Studies of Mesenchymal Stem Cell Intervention and Knee Osteoarthritis Adhere to the Minimum Information for Studies Evaluating Biologics Guidelines? A Systematic Review of Randomized Controlled Trials","authors":"Varag Abed, Cale Jacobs, Matthew Skinner, Mitchell Owens, Dro Keshishi, Austin V. Stone","doi":"10.1177/15563316231200496","DOIUrl":"https://doi.org/10.1177/15563316231200496","url":null,"abstract":"Background: The Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines for mesenchymal stem cell (MSC) research, published in 2017, contain a suggested checklist for reporting items in manuscripts involving MSCs. Purpose: We sought to determine how well randomized controlled trials (RCTs) on MSC intervention for knee osteoarthritis (OA) adhered to the MIBO guidelines. Methods: A comprehensive literature search was performed in the PubMed/MEDLINE and Web of Science databases. Inclusion criteria included English-only RCTs that assessed MSC intervention for knee OA published between 2018 and 2022. Metrics were extracted, including year of publication, study design, first author name, journal name, patient demographics, and MIBO checklist criteria. Results: In 27 RCTs analyzed, 1006 patients were included, with a weighted male percentage of 41.8% and weighted mean age of 60.5 ± 7.2 years. On average, 70.5% (range, 30.2%–90.6%) of the modified 53-point MIBO checklist elements were reported per article. Seven (25.9%) articles had adherence rates of 80% or more, 13 (48.1%) had rates between 60% and 79.9%, and 7 (25.9%) had rates of 59.9% or less. The MIBO “intervention” category had the greatest adherence (100%), while the other categories had more variability. Six (50.0%) categories had an adherence level of 80% or more, 3 (25.0%) had adherence levels of 60% to 79.9%, and 3 (25.0%) had an adherence level of 59.9% or less. Conclusion: The overall mean adherence to MIBO guidelines of RCTs on MSC intervention for knee OA was 70.5%. Authors should better integrate the MIBO guidelines into their methodology to improve transparency, reproducibility, and reporting.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-26DOI: 10.1177/15563316231201410
Erika L. Cyphert, Shannon Clare, Alexander Dash, Jacob C. Nixon, Joseph Raphael, Jonathan Harrison, Alison Heilbronner, Han Jo Kim, Matthew Cunningham, Darren Lebl, Frank Schwab, Christopher J. Hernandez, Emily M. Stein
Background: The microbiome has been identified as a contributor to bone quality. As skeletal health is critical to success of orthopedic surgery, the gut microbiome may be a modifiable factor associated with postoperative outcomes. For spine fusion surgery in particular, de novo bone formation and sufficient bone mineral density are essential for successful outcomes. Given the prevalence and complexity of these procedures, the identification of novel factors that may be related to operative success is important. Questions/purposes: We sought to investigate how the composition of the microbiota related to bone health in a focused spinal fusion surgery cohort. Methods: We investigated the composition of the microbiome in a cohort of 31 patients prior to spinal fusion surgery, as well as changes in the microbiome over 6 weeks postoperatively. Preoperative areal bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Composition of gut microbiota differed among spinal fusion patients with low bone mass ( T-score ≤ −1.0) and those with normal BMD ( P = .03). There was no significant change in composition of the gut microbiota between preoperative evaluation and 6 weeks postoperatively. Conclusions: Our findings in this small sample suggest there may be a relationship between BMD and composition of the gut microbiome in patients who undergo spinal fusion surgery. Further work is needed to investigate these relationships as well as potential interventions to foster a favorable microbial composition in spinal fusion surgery patients.
{"title":"A Pilot Study of the Gut Microbiota in Spine Fusion Surgery Patients","authors":"Erika L. Cyphert, Shannon Clare, Alexander Dash, Jacob C. Nixon, Joseph Raphael, Jonathan Harrison, Alison Heilbronner, Han Jo Kim, Matthew Cunningham, Darren Lebl, Frank Schwab, Christopher J. Hernandez, Emily M. Stein","doi":"10.1177/15563316231201410","DOIUrl":"https://doi.org/10.1177/15563316231201410","url":null,"abstract":"Background: The microbiome has been identified as a contributor to bone quality. As skeletal health is critical to success of orthopedic surgery, the gut microbiome may be a modifiable factor associated with postoperative outcomes. For spine fusion surgery in particular, de novo bone formation and sufficient bone mineral density are essential for successful outcomes. Given the prevalence and complexity of these procedures, the identification of novel factors that may be related to operative success is important. Questions/purposes: We sought to investigate how the composition of the microbiota related to bone health in a focused spinal fusion surgery cohort. Methods: We investigated the composition of the microbiome in a cohort of 31 patients prior to spinal fusion surgery, as well as changes in the microbiome over 6 weeks postoperatively. Preoperative areal bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Composition of gut microbiota differed among spinal fusion patients with low bone mass ( T-score ≤ −1.0) and those with normal BMD ( P = .03). There was no significant change in composition of the gut microbiota between preoperative evaluation and 6 weeks postoperatively. Conclusions: Our findings in this small sample suggest there may be a relationship between BMD and composition of the gut microbiome in patients who undergo spinal fusion surgery. Further work is needed to investigate these relationships as well as potential interventions to foster a favorable microbial composition in spinal fusion surgery patients.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteolytic Schwannoma in an Older Patient With Lumbar Degenerative Disk Disease: A Case Report","authors":"Changjun Chen, Qingwei Ma, Yubin Qi, Yingguang Wu, Jingkun Li, Yanjun Ren, Yun Yang","doi":"10.1177/15563316231200862","DOIUrl":"https://doi.org/10.1177/15563316231200862","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135817517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-12DOI: 10.1177/15563316231195299
Adam M. Gordon, Bhavya K. Sheth, Charles A. Conway, Andrew R. Horn, Ramin Sadeghpour, Jack Choueka
Background: Social determinants of health are prognostic indicators for patients undergoing orthopedic procedures. Purpose: Using the area deprivation index (ADI), a validated, weighted index of material deprivation and poverty (a 0%-to-100% scale, with higher percentages indicating greater disadvantage), we sought to evaluate whether there are associations in shoulder arthroplasty patients between higher ADI and rates of (1) medical complications, (2) emergency department (ED) utilizations, (3) readmissions, and (4) costs. Methods: We queried the PearlDiver nationwide database for patients who had undergone primary shoulder arthroplasty from 2010 to 2020. Patients from regions associated with high ADI (95%+) were 1:1 propensity matched to a comparison group by age, sex, and Elixhauser Comorbidity Index. This yielded 49,440 patients in total. Outcomes included 90-day complications, ED utilizations, readmissions, and costs. Logistic regression models computed odds ratios (ORs) of ADI on the dependent variables. P values of < .05 were significant. Results: Patients from high ADI regions showed higher rates and odds of complications than those in the comparison group (10.84% vs 9.45%; OR: 1.10), including acute kidney injuries (1.73% vs 1.38%; OR: 1.23), urinary tract infections (3.19% vs 2.80%; OR: 1.13), and respiratory failures (0.49% vs 0.33%; OR: 1.44), but not increased ED visits (2.66% vs 2.71%; OR: 0.99) or readmissions (3.07% vs 2.96%; OR: 1.03). Patients from high ADI regions incurred higher costs on day of surgery ($8251 vs $7337) and at 90 days ($10,999 vs $9752). Conclusions: This 10-year retrospective database study found that patients from high ADI regions undergoing primary shoulder arthroplasty had increased rates of all 90-day medical complications, suggesting that measures of social determinants of health could inform health care policy and improve post-discharge care in these patients.
背景:健康的社会决定因素是骨科手术患者的预后指标。目的:使用面积剥夺指数(ADI)，一种经过验证的物质剥夺和贫困加权指数(从0%到100%的比例，百分比越高表明劣势越大)，我们试图评估肩关节置换术患者较高的面积剥夺指数与(1)医疗并发症、(2)急诊科(ED)使用率、(3)再入院率和(4)成本之间是否存在关联。方法:我们查询了PearlDiver全国数据库中2010年至2020年间接受过原发性肩关节置换术的患者。来自高ADI相关地区(95%以上)的患者按年龄、性别和Elixhauser合并症指数与对照组进行1:1的倾向匹配。总共有49,440名患者。结果包括90天并发症、ED使用率、再入院率和费用。Logistic回归模型计算了因变量上ADI的比值比(ORs)。P值<0.05有显著性差异。结果:高ADI区患者并发症发生率和发生率均高于对照组(10.84% vs 9.45%;OR: 1.10)，包括急性肾损伤(1.73% vs 1.38%;OR: 1.23)，尿路感染(3.19% vs 2.80%;OR: 1.13)和呼吸衰竭(0.49% vs 0.33%;OR: 1.44)，但没有增加急诊科就诊(2.66% vs 2.71%;OR: 0.99)或再入院(3.07% vs 2.96%;或者:1.03)。来自高ADI地区的患者在手术当天(8251美元对7337美元)和90天(10,999美元对9752美元)的费用更高。结论:这项为期10年的回顾性数据库研究发现，来自高ADI地区接受初级肩关节置换术的患者所有90天医疗并发症的发生率增加，这表明健康的社会决定因素可以为医疗保健政策提供信息，并改善这些患者的出院后护理。
{"title":"Neighborhood Deprivation and Association With Medical Complications, Emergency Department Use, and Readmissions in Shoulder Arthroplasty Patients","authors":"Adam M. Gordon, Bhavya K. Sheth, Charles A. Conway, Andrew R. Horn, Ramin Sadeghpour, Jack Choueka","doi":"10.1177/15563316231195299","DOIUrl":"https://doi.org/10.1177/15563316231195299","url":null,"abstract":"Background: Social determinants of health are prognostic indicators for patients undergoing orthopedic procedures. Purpose: Using the area deprivation index (ADI), a validated, weighted index of material deprivation and poverty (a 0%-to-100% scale, with higher percentages indicating greater disadvantage), we sought to evaluate whether there are associations in shoulder arthroplasty patients between higher ADI and rates of (1) medical complications, (2) emergency department (ED) utilizations, (3) readmissions, and (4) costs. Methods: We queried the PearlDiver nationwide database for patients who had undergone primary shoulder arthroplasty from 2010 to 2020. Patients from regions associated with high ADI (95%+) were 1:1 propensity matched to a comparison group by age, sex, and Elixhauser Comorbidity Index. This yielded 49,440 patients in total. Outcomes included 90-day complications, ED utilizations, readmissions, and costs. Logistic regression models computed odds ratios (ORs) of ADI on the dependent variables. P values of < .05 were significant. Results: Patients from high ADI regions showed higher rates and odds of complications than those in the comparison group (10.84% vs 9.45%; OR: 1.10), including acute kidney injuries (1.73% vs 1.38%; OR: 1.23), urinary tract infections (3.19% vs 2.80%; OR: 1.13), and respiratory failures (0.49% vs 0.33%; OR: 1.44), but not increased ED visits (2.66% vs 2.71%; OR: 0.99) or readmissions (3.07% vs 2.96%; OR: 1.03). Patients from high ADI regions incurred higher costs on day of surgery ($8251 vs $7337) and at 90 days ($10,999 vs $9752). Conclusions: This 10-year retrospective database study found that patients from high ADI regions undergoing primary shoulder arthroplasty had increased rates of all 90-day medical complications, suggesting that measures of social determinants of health could inform health care policy and improve post-discharge care in these patients.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-12DOI: 10.1177/15563316231194614
Brian J. Like, Ellen M. Soffin, Sarah Ortolan, Carrie R. Guheen, Elaine Yang, Darryl B. Sneag, Vladimir N. Kramskiy, Anil S. Ranawat, James D. Beckman
Adductor canal block (ACB) is commonly included in multimodal analgesia regimens for knee surgery. Nonetheless, the incidence, etiology, and procedure-specific risk of saphenous nerve injury after knee surgery with ACB have not been established. We sought to identify the risk of saphenous nerve injury during knee surgery with ACB. We conducted a retrospective cohort study of patients at a single institution who underwent elective knee surgery with ultrasound-guided ACB between January 1, 2014, and December 31, 2018, and had subsequent saphenous nerve injury. The primary outcome was the incidence of saphenous nerve injury within 3 months of surgery, by surgical type and approach. Secondary outcomes included attribution of the most likely etiology and clinical outcome of the injury. In 28,196 cases of knee surgery with ACB, we identified 18 cases (0.06%) of saphenous nerve injury. The most common surgery associated with saphenous nerve injury was anterior cruciate ligament (ACL) reconstruction with autograft (8/18 cases); 3 cases of injury were seen after TKA, 2 after medial patellofemoral ligament reconstruction, 2 after arthroscopy/meniscal surgery, and 1 after patellar fixation. The most likely etiology of nerve injury was attributed to ACB in 5 of 18 cases (28%) and to non-ACB cause in 13 of 18 (72%). Prognosis was rated as unknown in 11 of 18, poor in 2 of 18, favorable in 3 of 18, and full recovery in 2 of 18. This 5-year retrospective, single-institution cohort study found a low overall incidence of saphenous nerve injury after knee surgery with ACB, but the injury likelihood varied based on surgery and approach. Although not statistically significant, ACL reconstruction with hamstring autograft and ACB performed for postoperative rescue analgesia were most frequently associated with nerve injury.
{"title":"Incidence and Etiology of Rare Saphenous Nerve Injury After Knee Surgery with Adductor Canal Block: A Retrospective Observational Study","authors":"Brian J. Like, Ellen M. Soffin, Sarah Ortolan, Carrie R. Guheen, Elaine Yang, Darryl B. Sneag, Vladimir N. Kramskiy, Anil S. Ranawat, James D. Beckman","doi":"10.1177/15563316231194614","DOIUrl":"https://doi.org/10.1177/15563316231194614","url":null,"abstract":"Adductor canal block (ACB) is commonly included in multimodal analgesia regimens for knee surgery. Nonetheless, the incidence, etiology, and procedure-specific risk of saphenous nerve injury after knee surgery with ACB have not been established. We sought to identify the risk of saphenous nerve injury during knee surgery with ACB. We conducted a retrospective cohort study of patients at a single institution who underwent elective knee surgery with ultrasound-guided ACB between January 1, 2014, and December 31, 2018, and had subsequent saphenous nerve injury. The primary outcome was the incidence of saphenous nerve injury within 3 months of surgery, by surgical type and approach. Secondary outcomes included attribution of the most likely etiology and clinical outcome of the injury. In 28,196 cases of knee surgery with ACB, we identified 18 cases (0.06%) of saphenous nerve injury. The most common surgery associated with saphenous nerve injury was anterior cruciate ligament (ACL) reconstruction with autograft (8/18 cases); 3 cases of injury were seen after TKA, 2 after medial patellofemoral ligament reconstruction, 2 after arthroscopy/meniscal surgery, and 1 after patellar fixation. The most likely etiology of nerve injury was attributed to ACB in 5 of 18 cases (28%) and to non-ACB cause in 13 of 18 (72%). Prognosis was rated as unknown in 11 of 18, poor in 2 of 18, favorable in 3 of 18, and full recovery in 2 of 18. This 5-year retrospective, single-institution cohort study found a low overall incidence of saphenous nerve injury after knee surgery with ACB, but the injury likelihood varied based on surgery and approach. Although not statistically significant, ACL reconstruction with hamstring autograft and ACB performed for postoperative rescue analgesia were most frequently associated with nerve injury.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-29DOI: 10.1177/15563316231192461
J. Runhaar, A. C. van Berkel, R. Agricola, J. V. van Meurs, S. Bierma-Zeinstra
Background: Despite the huge burden of hip osteoarthritis (OA) and the lack of effective treatment, research into the primary prevention of hip OA is in its infancy. Purpose: We sought to evaluate risk factors for incident clinical and incident radiographic hip OA among middle-aged and older adults, to evaluate the importance of risk factors from a preventive perspective, and to estimate the percentage of new cases attributable to these risk factors. Methods: We retrospectively reviewed data from the Rotterdam study, an open-population cohort study of individuals aged 55 years or older. Data including baseline age, sex, body mass index, smoking status, education level, diagnosis of diabetes, C-reactive protein (CRP), cam morphology, acetabular dysplasia, radiographic thumb OA, radiographic hip OA, and hip pain were assessed for their association with incident clinical hip OA and incident radiographic hip OA separately, after 11 years of follow-up. The population-attributable fractions (PAFs) of statistically significant modifiable risk factors were calculated, as well. Results: New onset of clinical hip OA was seen in 19.9% (544 of 2729) and incident radiographic hip OA in 9.9% (329 of 3309). Female sex, education level below average (PAF 21.4%), and radiographic hip OA (PAF 3.4%) were statistically significantly associated with incident clinical hip OA. Female sex, age, overweight (PAF 20.0%), cam morphology (PAF 7.9%), acetabular dysplasia (PAF 3.6%), and radiographic thumb OA (PAF 4.7%) were statistically significantly associated with radiographic hip OA. Conclusions: Our retrospective analysis suggests that, from a primary prevention perspective, the most important modifiable risk factors among middle-aged and older individuals may be low educational level for incident clinical hip OA and overweight for incident radiographic hip OA. Further study is warranted.
{"title":"Risk Factors and Population-Attributable Fractions for Incident Hip Osteoarthritis","authors":"J. Runhaar, A. C. van Berkel, R. Agricola, J. V. van Meurs, S. Bierma-Zeinstra","doi":"10.1177/15563316231192461","DOIUrl":"https://doi.org/10.1177/15563316231192461","url":null,"abstract":"Background: Despite the huge burden of hip osteoarthritis (OA) and the lack of effective treatment, research into the primary prevention of hip OA is in its infancy. Purpose: We sought to evaluate risk factors for incident clinical and incident radiographic hip OA among middle-aged and older adults, to evaluate the importance of risk factors from a preventive perspective, and to estimate the percentage of new cases attributable to these risk factors. Methods: We retrospectively reviewed data from the Rotterdam study, an open-population cohort study of individuals aged 55 years or older. Data including baseline age, sex, body mass index, smoking status, education level, diagnosis of diabetes, C-reactive protein (CRP), cam morphology, acetabular dysplasia, radiographic thumb OA, radiographic hip OA, and hip pain were assessed for their association with incident clinical hip OA and incident radiographic hip OA separately, after 11 years of follow-up. The population-attributable fractions (PAFs) of statistically significant modifiable risk factors were calculated, as well. Results: New onset of clinical hip OA was seen in 19.9% (544 of 2729) and incident radiographic hip OA in 9.9% (329 of 3309). Female sex, education level below average (PAF 21.4%), and radiographic hip OA (PAF 3.4%) were statistically significantly associated with incident clinical hip OA. Female sex, age, overweight (PAF 20.0%), cam morphology (PAF 7.9%), acetabular dysplasia (PAF 3.6%), and radiographic thumb OA (PAF 4.7%) were statistically significantly associated with radiographic hip OA. Conclusions: Our retrospective analysis suggests that, from a primary prevention perspective, the most important modifiable risk factors among middle-aged and older individuals may be low educational level for incident clinical hip OA and overweight for incident radiographic hip OA. Further study is warranted.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"85 1","pages":"407 - 412"},"PeriodicalIF":2.5,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88102528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-06DOI: 10.1177/15563316231190402
PhD Marcas M. Bamman, MD PhD S. Louis Bridges Jr., PhD Dongmei Sun, PhD Zachary A. Graham, PhD Jeremy S. McAdam, PhD Elijah D. Mayo
The progression of osteoarthritis of the hip to its end stage and ultimately to total hip arthroplasty (THA) is complex; the multifactorial pathophysiology involves myriad collaborating tissues in and around the diseased joint. We have named the heightened state of periarticular muscle inflammation at the time of surgery “muscle inflammation susceptibility” (MuIS) because it is distinct from systemic inflammation. In this review article, we discuss how MuIS and heightened atrophy-associated signaling in the periarticular skeletal muscles may contribute to reduced muscle mass, impaired muscle quality (ie, through fibrosis), and a muscle microenvironment that challenges regenerative capacity and thus functional recovery from THA. We also review directions for future research that should advance understanding of the key determinants of precision for optimized success of THA for each individual.
{"title":"Muscle Inflammation Susceptibility: A Potential Phenotype for Guiding Precision Rehabilitation After Total Hip Arthroplasty in End-Stage Osteoarthritis","authors":"PhD Marcas M. Bamman, MD PhD S. Louis Bridges Jr., PhD Dongmei Sun, PhD Zachary A. Graham, PhD Jeremy S. McAdam, PhD Elijah D. Mayo","doi":"10.1177/15563316231190402","DOIUrl":"https://doi.org/10.1177/15563316231190402","url":null,"abstract":"The progression of osteoarthritis of the hip to its end stage and ultimately to total hip arthroplasty (THA) is complex; the multifactorial pathophysiology involves myriad collaborating tissues in and around the diseased joint. We have named the heightened state of periarticular muscle inflammation at the time of surgery “muscle inflammation susceptibility” (MuIS) because it is distinct from systemic inflammation. In this review article, we discuss how MuIS and heightened atrophy-associated signaling in the periarticular skeletal muscles may contribute to reduced muscle mass, impaired muscle quality (ie, through fibrosis), and a muscle microenvironment that challenges regenerative capacity and thus functional recovery from THA. We also review directions for future research that should advance understanding of the key determinants of precision for optimized success of THA for each individual.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"42 1","pages":"453 - 458"},"PeriodicalIF":2.5,"publicationDate":"2023-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88076670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-22DOI: 10.1177/15563316221076603
Kyle W. Morse, Nicole K. Heinz, Jeremy M. Abolade, Joshua I. Wright-Chisem, Linda Alice Russell, Meng Zhang, Serene Z. Mirza, D. Pearce-Fisher, D. Orange, M. Figgie, P. Sculco, S. Goodman
Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are cost-effective procedures that decrease pain and improve health-related quality of life for patients with advanced symptomatic arthritis, including rheumatoid arthritis (RA). Patients with RA have a longer length of stay (LOS) after THA or TKA than patients with osteoarthritis, yet the factors contributing to LOS have not been investigated. Purpose: We sought to identify the factors contributing to LOS for patients with RA undergoing THA and TKA at a single tertiary care orthopedic specialty hospital. Methods: We retrospectively reviewed data from a prospectively collected cohort of 252 RA patients undergoing either THA or TKA. Demographics, RA characteristics, medications, serologies, and disease activity were collected preoperatively. Linear regression was performed to explore the relationship between LOS (log-transformed) and possible predictors. A multivariate model was constructed through backward selection using significant predictors from a univariate analysis. Results: Of the 252 patients with RA, 83% were women; they had a median disease duration of 14 years and moderate disease activity at the time of arthroplasty. We had LOS data on 240 (95%) of the cases. The mean LOS was 3.4 ± 1.5 days. The multivariate analysis revealed a longer LOS for RA patients who underwent TKA versus THA, were women versus men, required a blood transfusion, and took preoperative opioids. Conclusion: Our retrospective study found that increased postoperative LOS in RA patients undergoing THA or TKA was associated with factors both non-modifiable (type of surgery, sex) and modifiable (postoperative blood transfusion, preoperative opioid use). These findings suggest that preoperative optimization of the patient with RA might focus on improving anemia and reducing opioid use in efforts to shorten LOS. More rigorous study is warranted.
{"title":"Factors Associated With Increasing Length of Stay for Rheumatoid Arthritis Patients Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty","authors":"Kyle W. Morse, Nicole K. Heinz, Jeremy M. Abolade, Joshua I. Wright-Chisem, Linda Alice Russell, Meng Zhang, Serene Z. Mirza, D. Pearce-Fisher, D. Orange, M. Figgie, P. Sculco, S. Goodman","doi":"10.1177/15563316221076603","DOIUrl":"https://doi.org/10.1177/15563316221076603","url":null,"abstract":"Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are cost-effective procedures that decrease pain and improve health-related quality of life for patients with advanced symptomatic arthritis, including rheumatoid arthritis (RA). Patients with RA have a longer length of stay (LOS) after THA or TKA than patients with osteoarthritis, yet the factors contributing to LOS have not been investigated. Purpose: We sought to identify the factors contributing to LOS for patients with RA undergoing THA and TKA at a single tertiary care orthopedic specialty hospital. Methods: We retrospectively reviewed data from a prospectively collected cohort of 252 RA patients undergoing either THA or TKA. Demographics, RA characteristics, medications, serologies, and disease activity were collected preoperatively. Linear regression was performed to explore the relationship between LOS (log-transformed) and possible predictors. A multivariate model was constructed through backward selection using significant predictors from a univariate analysis. Results: Of the 252 patients with RA, 83% were women; they had a median disease duration of 14 years and moderate disease activity at the time of arthroplasty. We had LOS data on 240 (95%) of the cases. The mean LOS was 3.4 ± 1.5 days. The multivariate analysis revealed a longer LOS for RA patients who underwent TKA versus THA, were women versus men, required a blood transfusion, and took preoperative opioids. Conclusion: Our retrospective study found that increased postoperative LOS in RA patients undergoing THA or TKA was associated with factors both non-modifiable (type of surgery, sex) and modifiable (postoperative blood transfusion, preoperative opioid use). These findings suggest that preoperative optimization of the patient with RA might focus on improving anemia and reducing opioid use in efforts to shorten LOS. More rigorous study is warranted.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"99 1","pages":"196 - 204"},"PeriodicalIF":2.5,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73846180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-27DOI: 10.1177/15563316211051295
Hassaan Abdel Khalik, D. L. Lameire, L. Rubinger, Seper Ekhtiari, V. Khanna, O. Ayeni
Background: Distal femoral varus osteotomy (DFVO) is an effective surgical intervention for the management of symptomatic valgus malalignment of the knee. Because it preserves the native knee joint and its ligamentous stability, DFVO is preferred to total knee arthroplasty (TKA) in the young, active population. Purpose: We sought to assess return to work (RTW) and return to sport (RTS) rates following DFVO for valgus malalignment of the knee. Methods: For this systematic review, we searched EMBASE, MEDLINE, and Web of Science from inception through December 31, 2020. English language studies of all levels of evidence explicitly reporting on RTS and RTW rates following DFVO for valgus malalignment of the knee were eligible for inclusion. Results: Seven studies and 127 patients were included in our analysis. Mean age was 32.4 ± 8.8 years with men comprising 46.7% ± 22.3% of study populations. The mean RTS rate was 87.2% ± 10.7%, with a return to preoperative activity levels rate of 65.4% ± 26.8%. The mean RTW rate was 81.8% ± 23.3%, with a return to preoperative activity levels of 72.8% ± 18.1%. The mean reoperation rate was 35.6% ± 18.8% within a mean follow-up period of 5.5 ± 1.9 years. Conclusions: This systematic review of low-level studies found DFVO to be a safe and effective procedure for the management of genu valgum in young, active populations, with most patients returning to sport and/or work, although not all at their preoperative activity levels. A paucity of data surrounds RTS and RTW rates following DFVO. Future studies should explicitly report both return to activity rates and whether patients returned to their preoperative activity levels.
背景:股骨远端内翻截骨术(DFVO)是治疗有症状的膝关节外翻错位的有效手术干预。因为它保留了原有的膝关节及其韧带的稳定性，在年轻、活跃的人群中，DFVO比全膝关节置换术(TKA)更受欢迎。目的:我们试图评估DFVO治疗膝关节外翻错位后恢复工作(RTW)和恢复运动(RTS)的比率。方法:在本系统综述中，我们检索了EMBASE、MEDLINE和Web of Science，检索时间为2020年12月31日。明确报道DFVO治疗膝关节外翻错位后RTS和RTW发生率的所有级别证据的英语研究均符合纳入条件。结果:7项研究和127例患者纳入我们的分析。平均年龄为32.4±8.8岁，男性占研究人群的46.7%±22.3%。平均RTS率为87.2%±10.7%，恢复术前活动水平率为65.4%±26.8%。平均RTW率为81.8%±23.3%，恢复到术前活动水平为72.8%±18.1%。平均再手术率为35.6%±18.8%，平均随访5.5±1.9年。结论:对低水平研究的系统回顾发现，对于年轻、活跃的人群来说，DFVO是一种安全有效的治疗膝外翻的方法，大多数患者可以恢复运动和/或工作，尽管并非所有患者都能恢复术前的活动水平。关于DFVO之后的RTS和RTW速率的数据缺乏。未来的研究应明确报告恢复活动率和患者是否恢复到术前活动水平。
{"title":"Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review","authors":"Hassaan Abdel Khalik, D. L. Lameire, L. Rubinger, Seper Ekhtiari, V. Khanna, O. Ayeni","doi":"10.1177/15563316211051295","DOIUrl":"https://doi.org/10.1177/15563316211051295","url":null,"abstract":"Background: Distal femoral varus osteotomy (DFVO) is an effective surgical intervention for the management of symptomatic valgus malalignment of the knee. Because it preserves the native knee joint and its ligamentous stability, DFVO is preferred to total knee arthroplasty (TKA) in the young, active population. Purpose: We sought to assess return to work (RTW) and return to sport (RTS) rates following DFVO for valgus malalignment of the knee. Methods: For this systematic review, we searched EMBASE, MEDLINE, and Web of Science from inception through December 31, 2020. English language studies of all levels of evidence explicitly reporting on RTS and RTW rates following DFVO for valgus malalignment of the knee were eligible for inclusion. Results: Seven studies and 127 patients were included in our analysis. Mean age was 32.4 ± 8.8 years with men comprising 46.7% ± 22.3% of study populations. The mean RTS rate was 87.2% ± 10.7%, with a return to preoperative activity levels rate of 65.4% ± 26.8%. The mean RTW rate was 81.8% ± 23.3%, with a return to preoperative activity levels of 72.8% ± 18.1%. The mean reoperation rate was 35.6% ± 18.8% within a mean follow-up period of 5.5 ± 1.9 years. Conclusions: This systematic review of low-level studies found DFVO to be a safe and effective procedure for the management of genu valgum in young, active populations, with most patients returning to sport and/or work, although not all at their preoperative activity levels. A paucity of data surrounds RTS and RTW rates following DFVO. Future studies should explicitly report both return to activity rates and whether patients returned to their preoperative activity levels.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"86 1","pages":"297 - 306"},"PeriodicalIF":2.5,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83703647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-03DOI: 10.1177/15563316211040829
A. Haleem, Phelopater Sedrak, Chetan Gohal, G. Athwal, Moin Khan, B. Alolabi
Background: Hybrid glenoid components in total shoulder arthroplasty (TSA) utilize both polyethylene and metal components to provide short-term stability and long-term biologic fixation through bone ingrowth. Questions/Purpose: We sought to systematically review the literature for studies that assessed outcomes of TSA performed using hybrid glenoid components. Methods: PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase were searched systematically for articles measuring clinical and patient-reported outcomes and rates of complication and revision following TSA using a hybrid glenoid component. Results: Seven studies with 593 shoulders were included in this review. The mean age of patients was 65 ± 1 years, and 46% of the population was male. Mean follow-up was 50 months (4.2 years). The overall complication rate was 7% and rate of revision was 2.5%; glenoid radiolucency was present in 33% of shoulders at mean follow-up of 50 months. Mean improvements in forward elevation, external rotation, internal rotation score, and abduction were 49°, 28°, 2 points, and 42°, respectively. Mean improvements in Constant, American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were 36 points, 52 points, and 17 points, respectively. Conclusion: Our review found that TSA using hybrid glenoid components results in low rates of complication and revision at early follow-up. Long-term studies are warranted to understand more fully the role of hybrid glenoid components in TSA.
{"title":"Hybrid Glenoid Designs in Anatomic Total Shoulder Arthroplasty: A Systematic Review","authors":"A. Haleem, Phelopater Sedrak, Chetan Gohal, G. Athwal, Moin Khan, B. Alolabi","doi":"10.1177/15563316211040829","DOIUrl":"https://doi.org/10.1177/15563316211040829","url":null,"abstract":"Background: Hybrid glenoid components in total shoulder arthroplasty (TSA) utilize both polyethylene and metal components to provide short-term stability and long-term biologic fixation through bone ingrowth. Questions/Purpose: We sought to systematically review the literature for studies that assessed outcomes of TSA performed using hybrid glenoid components. Methods: PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase were searched systematically for articles measuring clinical and patient-reported outcomes and rates of complication and revision following TSA using a hybrid glenoid component. Results: Seven studies with 593 shoulders were included in this review. The mean age of patients was 65 ± 1 years, and 46% of the population was male. Mean follow-up was 50 months (4.2 years). The overall complication rate was 7% and rate of revision was 2.5%; glenoid radiolucency was present in 33% of shoulders at mean follow-up of 50 months. Mean improvements in forward elevation, external rotation, internal rotation score, and abduction were 49°, 28°, 2 points, and 42°, respectively. Mean improvements in Constant, American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were 36 points, 52 points, and 17 points, respectively. Conclusion: Our review found that TSA using hybrid glenoid components results in low rates of complication and revision at early follow-up. Long-term studies are warranted to understand more fully the role of hybrid glenoid components in TSA.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"29 1","pages":"219 - 228"},"PeriodicalIF":2.5,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81990445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：