{"title":"In Patients with Bilateral Knee Osteoarthritis, Cementless and Cemented Total Knee Arthroplasties Did Not Differ for Functional Outcomes at 2 Years","authors":"Jason A. Bryman, Douglas A. Dennis","doi":"10.2106/jbjs.24.00567","DOIUrl":"https://doi.org/10.2106/jbjs.24.00567","url":null,"abstract":"","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"63 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141347059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael A. Moverman, Richard N. Puzzitiello, Evan A. Glass, Daniel P. Swanson, Kristian Efremov, Ryan Lohre, Adam R. Bowler, Kuhan A. Mahendraraj, Kiet Le, Warren R. Dunn, Dylan J. Cannon, Lisa G. M. Friedman, Jaina A. Gaudette, John Green, Lauren Grobaty, Michael J. Gutman, Jaquelyn Kakalecik, Michael A. Kloby, Elliot N. Konrade, Margaret C. Knack, A. Loveland, Joshua I. Mathew, Luke A. Myhre, Jacob Nyfeler, Doug E. Parsell, Marissa Pazik, Teja S. Polisetty, P. Ponnuru, Karch M. Smith, Katherine A. Sprengel, Ocean Thakar, Lacie M. Turnbull, Alayna Vaughan, J. Wheelwright, Joseph A. Abboud, April D Armstrong, Luke S. Austin, Tyler J. Brolin, V. Entezari, Grant E. Garrigues, Brian M. Grawe, L. Gulotta, Rhett Hobgood, J. Gabe Horneff, Jason E. Hsu, J. Iannotti, Michael Khazzam, Joseph J. King, Jacob M. Kirsch, Jonathan C. Levy, A. Murthi, S. Namdari, Gregory P. Nicholson, Randall J. Otto, E. Ricchetti, R. Tashjian, T. Throckmorton, Thomas W. Wright, Andrew Jawa
This study aimed to identify implant positioning parameters and patient factors contributing to acromial stress fractures (ASFs) and scapular spine stress fractures (SSFs) following reverse shoulder arthroplasty (RSA). In a multicenter retrospective study, the cases of patients who underwent RSA from June 2013 to May 2019 and had a minimum 3-month follow-up were reviewed. The study involved 24 surgeons, from 15 U.S. institutions, who were members of the American Shoulder and Elbow Surgeons (ASES). Study parameters were defined through the Delphi method, requiring 75% agreement among surgeons for consensus. Multivariable logistic regression identified factors linked to ASFs and SSFs. Radiographic data, including the lateralization shoulder angle (LSA), distalization shoulder angle (DSA), and lateral humeral offset (LHO), were collected in a 2:1 control-to-fracture ratio and analyzed to evaluate their association with ASFs/SSFs. Among 6,320 patients, the overall stress fracture rate was 3.8% (180 ASFs [2.8%] and 59 SSFs [0.9%]). ASF risk factors included inflammatory arthritis (odds ratio [OR] = 2.29, p < 0.001), a massive rotator cuff tear (OR = 2.05, p = 0.010), osteoporosis (OR = 2.00, p < 0.001), prior shoulder surgery (OR = 1.82, p < 0.001), cuff tear arthropathy (OR = 1.76, p = 0.002), female sex (OR = 1.74, p = 0.003), older age (OR = 1.02, p = 0.018), and greater total glenoid lateral offset (OR = 1.06, p = 0.025). Revision surgery (versus primary surgery) was associated with a reduced ASF risk (OR = 0.38, p = 0.019). SSF risk factors included female sex (OR = 2.45, p = 0.009), rotator cuff disease (OR = 2.36, p = 0.003), osteoporosis (OR = 2.18, p = 0.009), and inflammatory arthritis (OR = 2.04, p = 0.024). Radiographic analysis of propensity score-matched patients showed that a greater increase in the LSA (ΔLSA) from preoperatively to postoperatively (OR = 1.42, p = 0.005) and a greater postoperative LSA (OR = 1.76, p = 0.009) increased stress fracture risk, while increased LHO (OR = 0.74, p = 0.031) reduced it. Distalization (ΔDSA and postoperative DSA) showed no significant association with stress fracture prevalence. Patient factors associated with poor bone density and rotator cuff deficiency appear to be the strongest predictors of ASFs and SSFs after RSA. Final implant positioning, to a lesser degree, may also affect ASF and SSF prevalence in at-risk patients, as increased humeral lateralization was found to be associated with lower fracture rates whereas excessive glenoid-sided and global lateralization were associated with higher fracture rates. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
{"title":"Implant-Positioning and Patient Factors Associated with Acromial and Scapular Spine Fractures After Reverse Shoulder Arthroplasty","authors":"Michael A. Moverman, Richard N. Puzzitiello, Evan A. Glass, Daniel P. Swanson, Kristian Efremov, Ryan Lohre, Adam R. Bowler, Kuhan A. Mahendraraj, Kiet Le, Warren R. Dunn, Dylan J. Cannon, Lisa G. M. Friedman, Jaina A. Gaudette, John Green, Lauren Grobaty, Michael J. Gutman, Jaquelyn Kakalecik, Michael A. Kloby, Elliot N. Konrade, Margaret C. Knack, A. Loveland, Joshua I. Mathew, Luke A. Myhre, Jacob Nyfeler, Doug E. Parsell, Marissa Pazik, Teja S. Polisetty, P. Ponnuru, Karch M. Smith, Katherine A. Sprengel, Ocean Thakar, Lacie M. Turnbull, Alayna Vaughan, J. Wheelwright, Joseph A. Abboud, April D Armstrong, Luke S. Austin, Tyler J. Brolin, V. Entezari, Grant E. Garrigues, Brian M. Grawe, L. Gulotta, Rhett Hobgood, J. Gabe Horneff, Jason E. Hsu, J. Iannotti, Michael Khazzam, Joseph J. King, Jacob M. Kirsch, Jonathan C. Levy, A. Murthi, S. Namdari, Gregory P. Nicholson, Randall J. Otto, E. Ricchetti, R. Tashjian, T. Throckmorton, Thomas W. Wright, Andrew Jawa","doi":"10.2106/jbjs.23.01203","DOIUrl":"https://doi.org/10.2106/jbjs.23.01203","url":null,"abstract":"\u0000 \u0000 This study aimed to identify implant positioning parameters and patient factors contributing to acromial stress fractures (ASFs) and scapular spine stress fractures (SSFs) following reverse shoulder arthroplasty (RSA).\u0000 \u0000 \u0000 \u0000 In a multicenter retrospective study, the cases of patients who underwent RSA from June 2013 to May 2019 and had a minimum 3-month follow-up were reviewed. The study involved 24 surgeons, from 15 U.S. institutions, who were members of the American Shoulder and Elbow Surgeons (ASES). Study parameters were defined through the Delphi method, requiring 75% agreement among surgeons for consensus. Multivariable logistic regression identified factors linked to ASFs and SSFs. Radiographic data, including the lateralization shoulder angle (LSA), distalization shoulder angle (DSA), and lateral humeral offset (LHO), were collected in a 2:1 control-to-fracture ratio and analyzed to evaluate their association with ASFs/SSFs.\u0000 \u0000 \u0000 \u0000 Among 6,320 patients, the overall stress fracture rate was 3.8% (180 ASFs [2.8%] and 59 SSFs [0.9%]). ASF risk factors included inflammatory arthritis (odds ratio [OR] = 2.29, p < 0.001), a massive rotator cuff tear (OR = 2.05, p = 0.010), osteoporosis (OR = 2.00, p < 0.001), prior shoulder surgery (OR = 1.82, p < 0.001), cuff tear arthropathy (OR = 1.76, p = 0.002), female sex (OR = 1.74, p = 0.003), older age (OR = 1.02, p = 0.018), and greater total glenoid lateral offset (OR = 1.06, p = 0.025). Revision surgery (versus primary surgery) was associated with a reduced ASF risk (OR = 0.38, p = 0.019). SSF risk factors included female sex (OR = 2.45, p = 0.009), rotator cuff disease (OR = 2.36, p = 0.003), osteoporosis (OR = 2.18, p = 0.009), and inflammatory arthritis (OR = 2.04, p = 0.024). Radiographic analysis of propensity score-matched patients showed that a greater increase in the LSA (ΔLSA) from preoperatively to postoperatively (OR = 1.42, p = 0.005) and a greater postoperative LSA (OR = 1.76, p = 0.009) increased stress fracture risk, while increased LHO (OR = 0.74, p = 0.031) reduced it. Distalization (ΔDSA and postoperative DSA) showed no significant association with stress fracture prevalence.\u0000 \u0000 \u0000 \u0000 Patient factors associated with poor bone density and rotator cuff deficiency appear to be the strongest predictors of ASFs and SSFs after RSA. Final implant positioning, to a lesser degree, may also affect ASF and SSF prevalence in at-risk patients, as increased humeral lateralization was found to be associated with lower fracture rates whereas excessive glenoid-sided and global lateralization were associated with higher fracture rates.\u0000 \u0000 \u0000 \u0000 Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.\u0000","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"30 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141382870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In Older Patients with an Unreconstructible Distal Humeral Fracture, Elbow Hemiarthroplasty and Total Elbow Arthroplasty Did Not Differ for Function at ≥2 Years","authors":"J. Sanchez-Sotelo","doi":"10.2106/jbjs.24.00566","DOIUrl":"https://doi.org/10.2106/jbjs.24.00566","url":null,"abstract":"","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"17 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141271072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Newton C. McCollough III","authors":"Peter Armstrong","doi":"10.2106/jbjs.24.00532","DOIUrl":"https://doi.org/10.2106/jbjs.24.00532","url":null,"abstract":"","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"52 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141103201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Robert G. (Bob) Volz 1932-2023","authors":"","doi":"10.2106/jbjs.24.00348","DOIUrl":"https://doi.org/10.2106/jbjs.24.00348","url":null,"abstract":"","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"6 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141004491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What’s Important: Get Out of the Chair","authors":"Sean Pirkle","doi":"10.2106/jbjs.24.00234","DOIUrl":"https://doi.org/10.2106/jbjs.24.00234","url":null,"abstract":"","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Pellisé, Maria Capdevila Bayo, Aleix Ruiz de Villa, S. Núñez-Pereira, S. Haddad, M. Barcheni, J. Pizones, Manuel Ramírez Valencia, I. Obeid, A. Alanay, Frank Kleinstück, A. Mannion
The long-term impact of reoperations following adult spinal deformity (ASD) surgery is still poorly understood. Our aim was to identify the relationship between unplanned reoperation and health-related quality of life (HRQoL) gain at 2 and 5 years of follow-up. We included patients enrolled in a prospective ASD database who underwent surgery ≥5 years prior to the start of the study and who had 2 years of follow-up data. Adverse events (AEs) leading to an unplanned reoperation, the time of reoperation occurrence, invasiveness (blood loss, surgical time, hospital stay), and AE resolution were assessed. HRQoL was measured with use of the Oswestry Disability Index, Scoliosis Research Society-22, and Short Form-36. Linear models controlling for baseline data and index surgery characteristics were utilized to assess the relationships between HRQoL gain at 2 and 5-year follow-up and the number and invasiveness of reoperations. The association between 5-year HRQoL gain and the time of occurrence of the unplanned reoperation and that between 5-year HRQoL gain and AE resolution were also investigated. Of 361 eligible patients, 316 (87.5%) with 2-year follow-up data met the inclusion criteria and 258 (71.5%) had 5-year follow-up data. At the 2-year follow-up, 96 patients (30.4%) had a total of 165 unplanned reoperations (1.72 per patient). At the 5-year follow-up, 73 patients (28.3%) had a total of 117 unplanned reoperations (1.60 per patient). The most common cause of reoperations was mechanical complications (64.9%), followed by surgical site infections (15.7%). At the 5-year follow-up, the AE that led to reoperation was resolved in 67 patients (91.8%). Reoperation invasiveness was not associated with 5-year HRQoL scores. The number of reoperations was associated with lesser HRQoL gain at 5 years for all HRQoL measures. The mean associated reduction in HRQoL gain per unplanned reoperation was 41% (range, 19% to 66%). Reoperations resulting in no resolution of the AE or resolution with sequelae had a greater impact on 5-year follow-up HRQoL scores than reoperations resulting in resolution of the AE. A postoperative, unplanned reoperation following ASD surgery was associated with lesser gain in HRQoL at 5 years of follow-up. The association did not diminish over time and was affected by the number, but not the magnitude, of reoperations. Resolution of the associated AE reduced the impact of the unplanned reoperation. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
{"title":"The Impact of Unplanned Reoperation Following Adult Spinal Deformity Surgery","authors":"F. Pellisé, Maria Capdevila Bayo, Aleix Ruiz de Villa, S. Núñez-Pereira, S. Haddad, M. Barcheni, J. Pizones, Manuel Ramírez Valencia, I. Obeid, A. Alanay, Frank Kleinstück, A. Mannion","doi":"10.2106/jbjs.23.00242","DOIUrl":"https://doi.org/10.2106/jbjs.23.00242","url":null,"abstract":"\u0000 \u0000 The long-term impact of reoperations following adult spinal deformity (ASD) surgery is still poorly understood. Our aim was to identify the relationship between unplanned reoperation and health-related quality of life (HRQoL) gain at 2 and 5 years of follow-up.\u0000 \u0000 \u0000 \u0000 We included patients enrolled in a prospective ASD database who underwent surgery ≥5 years prior to the start of the study and who had 2 years of follow-up data. Adverse events (AEs) leading to an unplanned reoperation, the time of reoperation occurrence, invasiveness (blood loss, surgical time, hospital stay), and AE resolution were assessed. HRQoL was measured with use of the Oswestry Disability Index, Scoliosis Research Society-22, and Short Form-36. Linear models controlling for baseline data and index surgery characteristics were utilized to assess the relationships between HRQoL gain at 2 and 5-year follow-up and the number and invasiveness of reoperations. The association between 5-year HRQoL gain and the time of occurrence of the unplanned reoperation and that between 5-year HRQoL gain and AE resolution were also investigated.\u0000 \u0000 \u0000 \u0000 Of 361 eligible patients, 316 (87.5%) with 2-year follow-up data met the inclusion criteria and 258 (71.5%) had 5-year follow-up data. At the 2-year follow-up, 96 patients (30.4%) had a total of 165 unplanned reoperations (1.72 per patient). At the 5-year follow-up, 73 patients (28.3%) had a total of 117 unplanned reoperations (1.60 per patient). The most common cause of reoperations was mechanical complications (64.9%), followed by surgical site infections (15.7%). At the 5-year follow-up, the AE that led to reoperation was resolved in 67 patients (91.8%). Reoperation invasiveness was not associated with 5-year HRQoL scores. The number of reoperations was associated with lesser HRQoL gain at 5 years for all HRQoL measures. The mean associated reduction in HRQoL gain per unplanned reoperation was 41% (range, 19% to 66%). Reoperations resulting in no resolution of the AE or resolution with sequelae had a greater impact on 5-year follow-up HRQoL scores than reoperations resulting in resolution of the AE.\u0000 \u0000 \u0000 \u0000 A postoperative, unplanned reoperation following ASD surgery was associated with lesser gain in HRQoL at 5 years of follow-up. The association did not diminish over time and was affected by the number, but not the magnitude, of reoperations. Resolution of the associated AE reduced the impact of the unplanned reoperation.\u0000 \u0000 \u0000 \u0000 Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.\u0000","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"47 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140460215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Limitations of Minimal Clinically Important Difference Estimates and Potential Alternatives","authors":"Daniel L. Riddle, L. Dumenci","doi":"10.2106/jbjs.23.00467","DOIUrl":"https://doi.org/10.2106/jbjs.23.00467","url":null,"abstract":"","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"40 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138593632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"It’s Time to Rein in the Opioids","authors":"R. D. Blasier","doi":"10.2106/jbjs.23.00993","DOIUrl":"https://doi.org/10.2106/jbjs.23.00993","url":null,"abstract":"","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138595799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Austrian-Swiss-German Fellowship was set up in 1978 to facilitate a program through which surgeons from the German-speaking countries of Austria, Switzerland, and Germany could visit the United Kingdom, Canada, and the United States of America. In 2023, surgeons Brian Mullis and Satish Kutty, representing the American Orthopaedic Association and the British Orthopaedic Association, respectively, visited centers in Austria, Switzerland, and Germany over the course of 4 weeks. This article describes their journey and experiences.
{"title":"The 2023 Austrian-Swiss-German Fellowship","authors":"S. Kutty, B.H. Mullis","doi":"10.2106/jbjs.23.01065","DOIUrl":"https://doi.org/10.2106/jbjs.23.01065","url":null,"abstract":"The Austrian-Swiss-German Fellowship was set up in 1978 to facilitate a program through which surgeons from the German-speaking countries of Austria, Switzerland, and Germany could visit the United Kingdom, Canada, and the United States of America. In 2023, surgeons Brian Mullis and Satish Kutty, representing the American Orthopaedic Association and the British Orthopaedic Association, respectively, visited centers in Austria, Switzerland, and Germany over the course of 4 weeks. This article describes their journey and experiences.","PeriodicalId":50250,"journal":{"name":"Journal of Bone and Joint Surgery","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139224917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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