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Patients With Moderate to Severe Dementia Who Undergo Elective TKA Face Elevated Risks of Death, Delirium, and Intensive Interventions: A Large, Propensity-weighted Database Study. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-13 Taylor D Ottesen,Lingwei Xiang,Rachel R Adler,Kaitlyn E Holly,Clancy J Clark,Karen Sepucha,Samir K Shah,Dae Hyun Kim,John Hsu,Antonia F Chen,Joel S Weissman,Andrew J Schoenfeld
BACKGROUND Although TKA is one of the most commonly performed and successful orthopaedic interventions, its efficacy may be reduced in individuals living with dementia. Prior studies have not effectively accounted for confounding by indication or the use of intensive interventions, or considered the fact that cognitive impairment exists on a continuum and that patients with mild dementia may have different
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Is Proximal Tibial Hemiarthroplasty Reconstruction Effective in Minimizing Limb Length Discrepancy Among Skeletally Immature Patients With Primary Bone Sarcomas? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-08 Zhuoyu Li,Daoyang Fan,Jilong Zhao,Zhiping Deng,Yongkun Yang,Tao Jin,Qing Zhang,Xiaohui Niu,Weifeng Liu
BACKGROUND Proximal tibial resection and reconstruction with a hinged knee megaprostheses may result in severe limb length discrepancy (LLD) in very young children because of the removal of the distal femoral and proximal physis. An alternative reconstruction using a proximal tibial hemiarthroplasty reconstruction has been proposed and reduces the degree of LLD because the distal femoral physis is
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What Is the Anatomic Footprint of the Anterolateral Ligament of the Knee? A Race- and Sex-based MRI Analysis. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-07 Tianwen Huang,Xiaopeng He,Lihang Zhang,Changzhao Li,Yiming Yang,Jiaying Zhang,Dimitris Dimitriou,Tsung-Yuan Tsai,Pingyue Li
BACKGROUND The anatomic location of the anterolateral ligament (ALL) of the knee is critical to ALL reconstruction, but there is not a clear consensus about the location of its footprint. Knowledge of the anatomic footprint is necessary to assess intraoperative positioning and postoperative functional outcomes of ALL reconstruction. Furthermore, while racial and sex-related variations in the ACL have
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Not the Last Word: Direct-to-consumer Advertising Sends the Wrong Message. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-06 Joseph Bernstein
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CORR Insights®: Frailty Is Associated With Increased 30-day Readmissions and Costs After Total Shoulder Arthroplasty. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-06 Jashvant Poeran
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CORR Insights®: No Difference in Outcome Scores or Persistent Instability After Latarjet Procedure for Anterior Instability in Patients With Shoulder Hyperlaxity Versus Those Without Hyperlaxity. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-06 Betsy McAllister Nolan
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No Difference in Outcome Scores or Persistent Instability After Latarjet Procedure for Anterior Instability in Patients With Shoulder Hyperlaxity Versus Those Without Hyperlaxity. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-06 Dipit Sahu,Darshil Shah
BACKGROUND The prevalence of hyperlaxity in patients with shoulder instability is high, and its management is challenging. Shoulder hyperlaxity denotes a redundant anterior capsule with an elongated or weak glenohumeral ligament that may be associated with worse functional outcomes after procedures for instability. The functional outcomes and postoperative recurrence after a Latarjet procedure for
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Your Best Life: Humility-A Key Virtue for Inner Peace. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-05 John D Kelly
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Efficacy of Educational Presentations in the Pediatric Orthopaedics Clinic. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-02 Vivek Mathew Abraham,Eric D Shirley
BACKGROUND The patient education process is an important part of healthcare, and tools including handouts, videos, and webpage suggestions have been used to aid this process. Although educational slide presentations are commonly used for teaching in academic settings and have been used in certain specialty clinics, their use for educating families and improving the shared decision-making process has
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CORR Insights®: How Often Does Bacteremia Occur in Patients With Chronic Periprosthetic Joint Infection? A Prospective, Observational Study. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-02 Charalampos G Zalavras
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CORR Insights®: Should We Stop Assessing Intraoperative Frozen Section Marrow Margins During Ewing Sarcoma Resection? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-02 Megan E Anderson
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Value-based Healthcare: Making PROMs Work for Musculoskeletal Care. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-01 Juan Pablo Flanagan,Paul Bonilla,Kevin J Bozic
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CORR Insights®: Does Periacetabular Osteotomy Affect the Load Distribution on the Knee? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-05-01 Harinderjit S Gill
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On Patient Safety: Managing the Risks of Telehealth Prescribing. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-30 James Rickert
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Letter to the Editor: Is Ocular Safety in Orthopaedics Overlooked? A Systematic Review of Annual Ocular Radiation Exposure and Protective Measures. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-29 Isaac Mordukhovich,Bahar Bassiri Gharb,Antonio Rampazzo
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Is 2-week Cast Wearing Followed by 4-week Functional Bracing Superior to 6-week Cast Immobilization After Surgery for Ankle Fractures? A 2-year Follow-up of a Randomized Controlled Trial. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-25 Hannu Lehtonen,Thomas Ibounig,Ville Ponkilainen,Lasse Rämö,Heikki Mäenpää,Teppo L N Järvinen
BACKGROUND Functional orthoses offer comparable outcomes to traditional casting in function and symptom relief after ankle fracture surgery, with the potential benefit of improved patient comfort and mobility. Even though early functional treatment after ankle fracture surgery shows promise, uncertainties about functional outcomes, symptom relief, and wound complications remain. QUESTIONS/PURPOSES
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Does the Degree of Liner Constraint Increase Risk of Complications in Articulating Spacers in Two-stage Revision After THA? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-24 Anzar Sarfraz,Ittai Shichman,Zachary L LaPorte,Joshua C Rozell,Ran Schwarzkopf,Vinay K Aggarwal
BACKGROUND Two-stage revisions for chronic periprosthetic joint infections (PJIs) often include antibiotic-loaded cement spacers to control for infection and preserve function. While studies have reported on complications (dislocations, readmissions, and reoperations) after static versus articulating spacer types, there is a paucity of evidence about whether the degree of spacer constraint in articulating
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CORR Insights®: Highly Elevated Metal Ion Levels After Tumor Resections and Reconstruction With Megaprostheses Around the Knee. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-24 Ryan McLemore
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Highly Elevated Metal Ion Levels After Tumor Resections and Reconstruction With Megaprostheses Around the Knee. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-23 Hans Roland Dürr,Maria Hett,Alexander Klein,Stefan Rakete,Boris Michael Holzapfel,Christoph Lahr
BACKGROUND Tumor resections around the knee leave defects that are often reconstructed with megaprostheses. Because megaprostheses have a large surface area, modular design, and constrained coupling mechanism, they are prone to metal wear, which can result in elevated levels of metal ions, particularly cobalt (Co) and chromium (Cr). Currently, there are limited published data on elevated ion levels
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Letter to the Editor: Leptin Enhances M1 Macrophage Polarization and Impairs Tendon-Bone Healing in Rotator Cuff Repair: A Rat Model. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-22 Xu Cai,Bolun Wang,Lin Cheng,Qifeng Ou
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CORR Insights®: Is Civilian Hospital Treatment of Lumbar Spinal Disorders Associated With Greater Odds of Fusion Procedures? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-22 Jiayong Liu
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CORR Insights®: Are Gabapentinoids Effective at Reducing Pain and Improving Sleep After Nerve Injury? A Systematic Review and Meta-analysis. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-22 Robert J Barth
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Editor's Spotlight/Take 5: Is Platelet-rich Plasma Effective in Treating Achilles Tendinopathy? A Meta-analysis of Randomized Clinical Trials. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-18 Seth S Leopold
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Virtue Ethics in a Value-driven World: Political Flair in Healthcare. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-18 Casey Jo Humbyrd
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Association of Payment Model Changes With the Rate of Total Joint Arthroplasty in Patients Undergoing Kidney Replacement Therapy. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-18 Jennifer D Motter,Sunjae Bae,Amanda Paredes-Barbeito,Antonia F Chen,Mara McAdams-DeMarco,Dorry L Segev,Allan B Massie,Casey Jo Humbyrd
BACKGROUND To encourage high-quality, reduced-cost care for total joint arthroplasty (TJA), the Centers of Medicare & Medicaid Services mandated a pay-for-performance model, the Comprehensive Care for Joint Replacement (CJR), as part of the Patient Protection and Affordable Care Act (PPACA). The CJR incentivizes cost containment, and it was anticipated that its implementation would reduce access to
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Medicolegal Sidebar: Is Hospital CQI and Peer Review Information Always Protected? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-17 B Sonny Bal
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Is Rotationplasty Still a Reasonable Reconstruction Option for Patients With a Femoral Bone Sarcoma? A Comparative Study of Patients With a Minimum of 20 Years of Follow-up After Rotationplasty and Lower Extremity Amputation. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-17 Gerhard Martin Hobusch,Christoph Hofer,Kevin Döring,Florian Ellersdorfer,Tryphon Kelaridis,Reinhard Windhager
BACKGROUND Rotationplasty was first introduced as an alternative to above-the-knee amputation after resection of bone sarcomas of the distal femur by Salzer in 1974. Although the procedure involves a substantial body image issue, it has many advantages such as durability of the reconstruction (compared with limb salvage procedures) and avoidance of phantom pain (compared with amputation). Although
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Standardized Intraoperative Robotic Laxity Assessment in TKA Leads to No Clinically Important Improvements at 2 Years Postoperatively: A Randomized Controlled Trial. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-16 Hannes Vermue,Nele Arnout,Thomas Tampere,Lenka Stroobant,Alexander Dereu,Jan Victor
BACKGROUND Joint stability is a major factor associated with success after TKA. However, most assistive technologies, such as robotic-assisted TKA, do not incorporate a standardized laxity assessment. To address this gap, we opted to perform a randomized controlled trial comparing the results of a manual versus a robot-assisted TKA system with standardized laxity assessment. QUESTIONS/PURPOSES (1)
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How Do Gunshot and Explosive Injuries to the Lower Extremities Differ in Severity and Treatment? A Comparative Study From the Israel-Gaza Conflict. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-15 Dan Prat,Maya Braun,Adi Givon,Sharon Goldman,Eldad Katorza,Shachar Shapira
BACKGROUND Lower extremity injuries are common in conflict-related trauma, with gunshot wounds (GSWs) causing localized damage and explosive trauma leading to extensive tissue injuries. Existing research lacks direct comparisons of injury severity and treatment outcomes between GSWs and explosive trauma in modern conflicts. This study clarifies these differences to improve triage strategies, surgical
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Should We Stop Assessing Intraoperative Frozen Section Marrow Margins During Ewing Sarcoma Resection? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-15 Stephen W Chenard,Akhil Rekulapelli,Rachel B Mersfelder,Hakmook Kang,Jennifer L Halpern,Herbert S Schwartz,Ginger E Holt,Reena Singh,Scott C Borinstein,Joshua M Lawrenz
BACKGROUND Ewing sarcoma is a rare and highly aggressive pediatric bone cancer that is histologically composed of small, round blue cells. These histologic findings can make it difficult to assess intraoperative frozen section bone marrow margins because the bone marrow that regenerates after preoperative chemotherapy has a similar appearance, especially on frozen section analysis. Prior studies have
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CORR Insights®: Releasing Forces in Adhesive Capsulitis Are Important Indicators of Shoulder Stiffness and Postoperative Function. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-11 Betsy McAllister Nolan
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Letter to the Editor: "Dr. AI Will See You Now": How Do ChatGPT-4 Treatment Recommendations Align With Orthopaedic Clinical Practice Guidelines? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-10 Lin Po-Chun,Zhi-Hong Zheng
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Reply to the Letter to the Editor: "Dr. AI Will See You Now": How Do ChatGPT-4 Treatment Recommendations Align With Orthopaedic Clinical Practice Guidelines? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-10 Tanios Dagher,Jason Strelzow
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Editorial: Coming Back to Work After a Wrong-site Surgical Procedure. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-10 M Daniel Wongworawat
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Frailty Is Associated With Increased 30-day Readmissions and Costs After Total Shoulder Arthroplasty. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-10 Akshay Lakra,Nyi-Rein Kyaw,James M Puleo,Michael C Kuna,Michael Tram,Joseph P Zimmerman
BACKGROUND Frailty has been associated with a greater risk of complications and higher treatment costs for various medical conditions and surgical procedures. The Modified Frailty Index, which analyzes five or six medical comorbidities, helps grade the severity of a patient's frailty. Patients with frailty, as recognized by this index, are more likely to face adverse medical and surgical events after
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Reply to the Letter to the Editor: On Patient Safety: It Is Time to Rethink Gabapentin. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-09 James Rickert
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Letter to the Editor: On Patient Safety: It Is Time to Rethink Gabapentin. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-09 Ethan Lichtblau
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Letter to the Editor: On Patient Safety: It Is Time to Rethink Gabapentin. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-09 T Desmond Brown
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CORR Insights®: Leptin Enhances M1 Macrophage Polarization and Impairs Tendon-Bone Healing in Rotator Cuff Repair: A Rat Model. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-09 Xudong Joshua Li
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CORR Insights®: Can Surgeons or Patients Predict the Likelihood of Improvement With Nonoperative Treatment of Chronic Tennis Elbow? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-09 Pedro K Beredjiklian
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What Characteristics of Orthopaedic Surgery Residency Programs Are Associated With Increased Percentage of Matched Women Residents? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-04-08 Megan N Baughman,Tessa C Griffin,Reagan S H Beyer,Samuel J Mosiman,Elizabeth H G Turner,Tamara A Scerpella,Andrea M Spiker
BACKGROUND Women are underrepresented in the field of orthopaedics, and growth of the proportion of women is lagging behind all other medical specialties. Improvement begins with recruiting more women residents; however, few data exist regarding the factors that may attract women applicants to orthopaedic training programs. QUESTIONS/PURPOSES In the 2020 to 2023 match cycles: (1) Was there a relationship
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Pearls: Anchorless Fixation of Iliotibial Band Lateral Extra-articular Tenodesis Using ACL Femoral Graft Sutures. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-28 Peter D Fabricant,Tyler R Mange
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What Is the Functional Spinopelvic Relationship in Three Dimensions? A CT and EOS Study. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-28 Angelika Ramesh,Johann Henckel,Xing Lim,Patrick Tompsett,Alister Hart,Anna Di Laura
BACKGROUND Understanding the spinopelvic relationship is essential in THA planning, especially given the elevated hip dislocation risk in patients exhibiting abnormal spinopelvic movements. Rotations of the spinopelvic unit affect the functional orientation of the acetabulum and, in turn, the placement of the acetabular cup. Currently, however, the kinematic behavior of the pelvis is not considered
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Is Private Sector Treatment of Lumbar Spinal Disorders Associated With Greater Odds of Fusion Procedures? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-26 Mark C Lawlor,Madison N Cirillo,Kaitlyn E Holly,Patawut Bovonratwet,Brendan M Striano,Christian Coles,Tracey P Koehlmoos,Andrew J Schoenfeld
BACKGROUND Technological advancements in spine surgical care are disproportionately slanted toward fusion-based procedures, which may influence surgeons to prefer these over other less expensive techniques. These issues may be particularly magnified within the context of integrated care delivery systems such as the Military Health System, where patients can be treated at centers with different philosophies
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Cochrane in CORR®: Exercise for Osteoarthritis of the Knee. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-25 Kim Madden
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Letter to the Editor: Artificial Intelligence Shows Limited Success in Improving Readability Levels of Spanish-language Orthopaedic Patient Education Materials. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-25 Hinpetch Daungsupawong,Viroj Wiwanitkit
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How Accurate Are Fulcrum Bending Radiographs in Estimating Postoperative Outcomes in Adolescent Idiopathic Scoliosis? A Systematic Review and Meta-analysis. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-25 Victoria Yuk Ting Hui,Samuel Tin Yan Cheung,Jason Pui Yin Cheung,Prudence Wing Hang Cheung
BACKGROUND Fulcrum bending radiographs can be used to assess coronal flexibility in patients with adolescent idiopathic scoliosis (AIS) to estimate postoperative correction. To obtain fulcrum bending radiographs, patients are passively bent over a radiolucent fulcrum at the apex of the curve. Available studies have disagreed about the accuracy in estimating postoperative correction, although these
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What Are the Medium-term Reciprocal Changes in Cervical Sagittal Alignment After Posterior Correction for Lenke 5C Adolescent Idiopathic Scoliosis? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-21 Yiwei Zhao,You Du,Yang Yang,Haoran Zhang,Chenkai Li,Dihan Sun,Ziquan Li,Jianguo Zhang,Shengru Wang
BACKGROUND Abnormal cervical sagittal alignment (CSA), typically cervical kyphosis, is more common in patients with adolescent idiopathic scoliosis (AIS) than in teenagers without AIS. Changes in CSA after posterior spinal fusion for AIS have been observed and may be associated with patient-reported clinical outcomes and age-related cervical disc degeneration. Previous studies have shown inconsistent
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What Is the Clinical Efficacy of Combined Semitendinosus Autograft Reconstruction and Scar Tissue Repair for Chronic Irreparable Patellar Tendon Rupture? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-18 Kunhao Chen,Min Zhu,Chenghao Zhang,Jiayao Zhang,Yuyan Zhang,Shuang Li,Jian Li,Tingwu Qin,Qi Li
BACKGROUND Chronic patellar tendon rupture is a rare but serious injury that can lead to significant functional impairment if not treated effectively. Traditional repair methods often result in rerupture because of tendon defects, adhesions, and poor tissue quality. Although tendon graft reconstruction is the first-line treatment, the role of combining the remaining scar tissue with tendon grafting
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Can Oritavancin Be Used for Treatment and/or Suppressive Antimicrobial Therapy of Bone and Joint Infections Caused by Vancomycin-resistant Enterococcus faecium? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-14 Martin Krsak,Taylor Morrisette,Laura Damioli,Brandon Flues,Eugene W Liu,Anna Y Zhou,Abdulwhab Shremo Msdi,Caleb McLeod,Saagar Akundi,Mark Redell,Kyle C Molina
BACKGROUND Vancomycin-resistant enterococcus (VRE) infections pose substantial challenges for the treatment and suppression of bone and joint infections. Oritavancin, a long-acting lipoglycopeptide antibiotic, has shown promising in vitro activity against VRE. Limited data are available on using oritavancin for bone and joint infections caused by VRE, both for treatment (therapy to eliminate active
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CORR Insights®: Does Transhumeral Osseointegration After Amputation Improve Patient-reported Outcomes and Prosthesis Use? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-13 Nathaniel Elliot Schaffer
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CORR Insights®: Can We Accurately Predict Adult Height in Pediatric Patients Who Undergo Treatment for Sarcoma? Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-12 Joel L Mayerson
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Letter to the Editor: Editorial: The Goal is Health, Not Surgery. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-12 James Amis
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Letter to the Editor: Discrepancies in Periprosthetic Joint Infection Diagnostic Criteria Reporting and Use: A Scoping Review and Call for a Standard Reporting Framework. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-12 Andy O Miller,Ricardo Sousa
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Letter to the Editor: Value-based Healthcare: The Impact of Consolidation in Healthcare on the Field of Orthopaedic Surgery. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-12 Alison Klika,David J Jacofsky,Wael K Barsoum
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Discrepancies in Periprosthetic Joint Infection Diagnostic Criteria Reporting and Use: A Scoping Review and Call for a Standard Reporting Framework. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-12 Alexandra L Hohmann,Cristian A DeSimone,Natalie A Lowenstein,Carl Deirmengian,Yale A Fillingham
BACKGROUND Numerous criterion-based definitions of periprosthetic joint infection (PJI) with differing criteria and point systems have been published, but the frequency of their use or application to study methods in publications on PJI has not been evaluated. Assessing the use of these definitions in studies is an important step to ensuring the validity and reproducibility of PJI research and to determining
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Behind the Mask: My New Best Friend. Clin. Orthop. Relat. Res. (IF 4.2) Pub Date : 2025-03-12 Steven E Zhang