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A Deep Learning-Based Clinical Classification System for the Differential Diagnosis of Hip Prosthesis Failures Using Radiographs: A Multicenter Study. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Limin Wu,Biao Wang,Bin Lin,Mingyang Li,Yuangang Wu,Haibo Si,Yi Zeng,Liangji Lu,Lulu Gao,Zheting Chen,Risheng Yu,Liang Zhao,Yong Nie,Kang Li,Bin Shen
BACKGROUND Accurate and timely differential diagnosis of hip prosthesis failures remains a major clinical challenge. Radiographic examination remains the most cost-effective and common first-line imaging modality for hip prostheses, and integrating deep learning has the potential to improve its diagnostic accuracy and efficiency. METHODS A deep learning-based clinical classification system (Hip-Net)
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Higher Reoperation Rates in Planned, Staged Treatment of Open Fractures Compared with Fix-and-Close: A Propensity Score-Matched Analysis. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Yohan Jang,Roman M Natoli,Gregory J Della Rocca,Robert D Zura,Kevin D Phelps,G David Potter,John A Scolaro,Mark J Gage,Augustine M Saiz,Nathan N O'Hara,Christina A Stennett,Sheila Sprague,Gerard P Slobogean,
BACKGROUND Initial surgical management of Gustilo-Anderson type-I to IIIA open fractures varies from surgical fixation of the fracture with immediate closure of the traumatic wound to various combinations of staged fracture and wound management. The decision to choose staged management has historically been based on wound contamination and the severity of the open fracture. The purpose of this study
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Impact of Living in a Food Desert on Complications After Fracture Surgery. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 I Leah Gitajn,Joseph D Phillips,Yinzhou Wang,Christina A Stennett,Gerard Chang,Nathan N O'Hara,Devon T Brameier,Arvind G von Keudell,Michael J Weaver,Gregory J Della Rocca,Holly T Pilson,Patrick F Bergin,Sheila Sprague,Gerard P Slobogean,
BACKGROUND Food deserts-communities with limited access to healthy food-have been linked with poor surgical outcomes; however, their impact on orthopaedic trauma outcomes remains unknown. The aims of this study were to determine the prevalence of food desert residency among orthopaedic trauma patients and to investigate the impact of food desert residency on the rate of unplanned reoperation with use
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Differences in Practice Patterns in the Use of Temporary External Fixation for the Management of Open Lower-Extremity Fractures. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Augustine M Saiz,Christina A Stennett,Nicholas M Romeo,Kevin D Phelps,Joshua L Gary,Christopher M Domes,Mark J Gage,Nathan N O'Hara,Sheila Sprague,Gerard P Slobogean,Stephen J Warner,
BACKGROUND External fixation is often used in the management of open lower-extremity fractures. The objectives of this study were to identify hospital characteristics that are associated with greater use of temporary external fixation and to determine if external fixation reduces the odds of surgical site infection (SSI) and unplanned reoperation among patients with open lower-extremity fractures.
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Deep Infections After Open and Closed Fractures. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Michael Polmear,Jennifer E Hagen,Gregory M Schrank,Marilyn Heng,Francesc A Marcano-Fernández,Kyle J Jeray,Mark J Gage,Gerard P Slobogean,Sheila Sprague,Terrie Vasilopoulos,
BACKGROUND The purpose of this study was to describe the culture and speciation results of patients with surgical site infection (SSI) from the PREPARE and Aqueous-PREP studies from the PREP-IT Investigators. METHODS Patients with suspected SSI underwent collection of deep or organ tissue samples for culture. The culture positivity rate was estimated as a percentage along with the exact binomial 95%
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Chlorhexidine Gluconate Bathing Has Limited Ability to Prevent Surgical Site Infection Following Operative Fixation of Extremity and Pelvic Fractures. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Michael C Willey,Joan N Hebden,Loreen A Herwaldt,Greg E Gaski,Sara Kheiri,Lyndsay M O'Hara,Nathan N O'Hara,Sheila Sprague,Sofia Bzovsky,Mark J Gage,Gerard P Slobogean,
BACKGROUND A preoperative chlorhexidine gluconate (CHG) bath is used to reduce the risk of surgical site infection (SSI) in elective surgery, but its efficacy in the trauma setting is unknown. We compared the incidence of SSI between patients who did versus did not receive a CHG bath before operative fixation of extremity and/or pelvic fractures. METHODS We conducted a secondary analysis of the PREP-IT
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Skin Antisepsis in the Surgical Treatment of Extremity Fractures: Should We Reject the Null Hypothesis? J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Iberê Pereira Datti
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Local Antibiotics and the Risk of Antimicrobial Resistance in Extremity Fractures Complicated by Fracture-Related Infection. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Gregory M Schrank,Nicolas Jozefowski,Robert D Zura,Kyle J Jeray,Joshua L Gary,Greg E Gaski,Steven F Shannon,Sofia Bzovsky,Sheila Sprague,Gerard P Slobogean,Ashley E Levack,
BACKGROUND We evaluated antimicrobial resistance (AMR) patterns following local antibiotic use in a large cohort of patients with fractures from the PREP-IT (A Program of Randomized Trials to Evaluate Preoperative Antiseptic Skin Solutions in Orthopaedic Trauma) study. We hypothesized that, among patients with extremity fractures who developed fracture-related infection (FRI), there would be no difference
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Outcomes Associated with Choice of Prophylactic Antibiotics in Open Fractures. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Carol A Lin,Tim Kobes,Eric Kholodovsky,Giselle Hernandez,Nathan N O'Hara,Gregory M Schrank,Robert V O'Toole,Gerard P Slobogean,Sheila Sprague,Marilyn Heng,
BACKGROUND The ideal antibiotic prophylaxis for open fractures is unknown. We evaluated outcomes following different antibiotic prophylaxis regimens for open fractures. METHODS This is a secondary analysis of data from PREP-IT. Prophylactic antibiotics were defined as any intravenous antibiotic given on the day of admission. The outcomes were surgical site infection (SSI) within 90 days and reoperation
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Performance of the OTA-OFC3 Classification System for Open Fractures. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Vivian Li,Alice C Bell,David Okhuereigbe,Sara Kheiri,Christina A Stennett,Robert V O'Toole,Nathan N O'Hara,Christopher M Domes,Samir Mehta,Sheila Sprague,Meir T Marmor,Gerard P Slobogean,
BACKGROUND The purpose of this study was to compare the simplified modification of the Orthopaedic Trauma Association-Open Fracture Classification (OTA-OFC3) with the original OTA-OFC and Gustilo-Anderson classification systems in predicting surgical site infection and unplanned reoperation. METHODS This was a retrospective cohort study conducted using the PREP-IT (A Program of Randomized Trials to
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Alcohol-Based Versus Aqueous Skin Antisepsis Before Surgical Fixation of Open Fractures: A Combined Analysis of 2 Cluster-Randomized Crossover Trials. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Kyle Gouveia,Sofia Bzovsky,Nathan N O'Hara,Mark Phillips,Lehana Thabane,Kyle J Jeray,Rachel M Reilly,Mohit Bhandari,Gerard P Slobogean,Sheila Sprague,
BACKGROUND Skin antisepsis remains a vital component in prophylaxis against surgical site infection (SSI); however, for open fractures, it is unclear whether alcohol-based or aqueous solutions should be preferred. The purpose of this study was to compare the use of alcohol-based and aqueous skin antisepsis solutions, using data from the 2 PREP-IT trials, with respect to the risks of SSI and unplanned
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A Portfolio of Secondary Analyses from the PREP-IT Trial. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Jennifer E Hagen,Mark J Gage,
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Skin Antisepsis: When New Evidence Emerges, Reevaluate Your Practice: Commentary on an article by Iberê Pereira Datti, MD: "Skin Antisepsis in the Surgical Treatment of Extremity Fractures. Should We Reject the Null Hypothesis?" J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Gerard Slobogean,Nathan N O'Hara,Sheila Sprague,
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Secondary Analyses from the PREP-IT Trial. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Jennifer E Hagen,Mark J Gage,Mohit Bhandari
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Milking the Benefits: Can Bovine Milk Accelerate Bone Healing?: Commentary on an article by Faezeh Gouhari, MSc, et al.: "Therapeutic Effects of Bovine Colostrum on Bone Healing, Rehabilitation, and Postoperative Complications. A Prospective, Randomized, Double-Blinded Comparative Trial". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Jari Dahmen,Gino M M J Kerkhoffs
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Addressing the Inadequacy of BMI: Superior Prediction of Aseptic Loosening Risk in TKA Using Weight-to-Implant Surface Area Ratio: Commentary on an article by Nathan A. Huebschmann, BA, et al.: "Ratio of Weight-to-Tibial Baseplate Surface Area in Predicting Aseptic Tibial Loosening in TKA and the Protective Effect of Tibial Stem Extensions". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Morad Karimpour,Arash Sharafatvaziri
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When More Is Worse: Multiple Cultures Predict PJI Treatment Failure: Commentary on an article by Saad Tarabichi, MD, et al.: "Isolation of Multiple Positive Cultures at Resection Arthroplasty Is a Predictor of Failure Following Reimplantation". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 David S Jevsevar
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The Patient's View of Success: Commentary on an article by Bahar Entezari, MD, et al.: "Successful Management of Periprosthetic Joint Infection Following Total Joint Arthroplasty, as Defined by the Patient. A Qualitative Study". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-18 Nicholas Michael Hernandez,JaeWon Yang
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AI Will Not Save Us: Technological Authoritarianism, the Electronic Medical Record, and the Erosion of the Practice of Medicine. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-10 Melinda S Sharkey
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Intraneural Ganglion Cysts Arising from the Hip Joint as Rare Causes of Sciatic Neuropathy: A Case Series of 13 Patients Treated with Hip Arthroscopy. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-09 Chan-Woo Park,Sang Jin Jeong,Jae Soon Kim,Seung-Jae Lim,Youn-Soo Park
BACKGROUND Sciatic neuropathy can result from pressure, injury, or inflammation around the sciatic nerve. In rare instances, sciatic neuropathy is caused by an intraneural ganglion cyst (IGC) originating from the hip joint. However, an effective treatment modality for this condition has not yet been established. The purpose of the present study was to evaluate the clinical and radiographic outcomes
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PGE2 Ameliorates Aging-Aggravated Rotator Cuff Muscle Atrophy. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-06 Longqiang Shu,Xin Wang,Haoyuan Wang,Yang Tang,Chongyang Wang,Yao Zhang
BACKGROUND The aging-related escalation of muscle degeneration impacts the structure and function of rotator cuff muscles, contributing to spontaneous and tear-induced muscle atrophy. This study investigated how prostaglandin E2 (PGE2), a regulator of muscle regeneration, influences muscular structure and mitochondrial function in aged mice by using SW033291 to inhibit PGE2 degradation, revealing potential
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Immobilization Time for Conservative Treatment of Distal Radial Fractures in Elderly Patients: A Randomized Controlled Trial. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-05 A Sala-Pujals,A Portes Chiva,J Chillon Soria,D Valverde Vilamala,E Dominguez Font,A Pardo Pol
BACKGROUND The management of distal radial fractures (DRFs) in elderly patients remains controversial. Although conservative treatment with cast immobilization is widely accepted, the optimal duration for immobilization is unclear. This study aimed to compare pain control, functional outcomes, and complication rates between 4-week and 6-week immobilization periods in elderly patients treated nonoperatively
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The Future Is Mobile: Pilot Validation Study of Apple Health Metrics in Orthopaedic Trauma. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-04 Dane J Brodke,Brian M Shear,Haley Demyanovich,Vivian Li,Alice Bell,David Okhuereigbe,Nelson F SooHoo,Gerard P Slobogean,Robert V O'Toole,Nathan N O'Hara
BACKGROUND Surgeons often lack objective data on patient functional outcomes, particularly as compared with the patient's baseline. The present study aimed to determine whether gait parameters recorded on Apple iPhones provided longitudinal mobility data following lower-extremity fracture surgery that matched clinical expectations. We hypothesized that iPhones would detect the mobility changes of injury
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What's Important (Arts & Humanities): In the Stillness of the Spine. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-04 Kefu Chen
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The Risk of Venous Thromboembolism in Children After Trauma Is Greater Than We Think: Commentary on an article by Mehul M. Mittal, BBA, et al.: "Risk of Venous Thromboembolism in Pediatric Patients with Surgically Treated Lower-Extremity Fractures. A Propensity-Matched Cohort Study". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-04 R Dale Blasier
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Long-Term Mortality Associated with Periprosthetic Infection in Total Hip Arthroplasty: A Registry Study of 4,651 Revisions for Infection. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-03 David G Campbell,Joshua S Davis,Richard N de Steiger,Michelle F Lorimer,Dylan Harries,Ian A Harris,Laurens Manning,Peter L Lewis
BACKGROUND While the morbidity associated with revision total hip arthroplasty (THA) or periprosthetic infection (PJI) has been well characterized, less is known about the risk of mortality. With this study, we aimed to determine the long-term mortality associated with revision THA for PJI and associated risk factors. METHODS Data from the Australian Orthopaedic Association National Joint Replacement
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Myocardial Infarction Prior to TKA Is Associated with Increased Risk of Medical and Surgical Complications in a Time-Dependent Manner. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-06-02 Alejandro M Holle,Sayi P Boddu,Jens T Verhey,Paul Van Schuyver,David G Deckey,Joshua S Bingham,Zachary K Christopher
BACKGROUND There has been minimal literature evaluating how a prior myocardial infraction (MI) influences outcomes after total knee arthroplasty (TKA). Thus, the purpose of this study was to evaluate how the timing, type, and treatment of MI prior to TKA affect postoperative cardiac complications, general medical complications, and surgical complications. METHODS A retrospective comparative study was
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Evaluating Artificial Intelligence-Based Writing Assistance Among Published Orthopaedic Studies: Detection and Trends for Future Interpretation. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-30 Tucker Callanan,Josue Marquez,Claire Pisani,Phillip Schmitt,John Pietro,Miaoyan Chen,John Milner,Mohammad Daher,Luka Katz,Jonathan Liu,Alan H Daniels
BACKGROUND The integration of artificial intelligence (AI), particularly large language models (LLMs), into scientific writing has led to questions about its ethics, prevalence, and impact in orthopaedic literature. While tools have been developed to detect AI-generated content, the interpretation of AI detection percentages and their clinical relevance remain unclear. The aim of this study was to
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Completely Displaced Midshaft Clavicular Fractures with Skin Tenting in Adolescents: Results from the FACTS Multicenter Prospective Cohort Study. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-30 S Clifton Willimon,Philip L Wilson,Michael Quinn,Joshua H Pang,Crystal A Perkins,Henry B Ellis,Ying Li,Jeffrey J Nepple,Nirav K Pandya,Andrew T Pennock,David D Spence,Donald S Bae,Michael T Busch,Eric W Edmonds,Mininder S Kocher,Coleen S Sabatini,Benton E Heyworth
BACKGROUND Skin tenting is a commonly utilized surgical indication for clavicular fractures. The impact of skin tenting on fracture outcomes has not been investigated in adolescents. The present study compared the clinical and patient-reported outcome measures (PROMs) of nonoperatively and operatively treated adolescent clavicular fractures with skin tenting at presentation. METHODS Patients 10 to
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Five-Year Functional Outcomes After Acetabular Labral Repair with and without Bone Marrow Aspirate Concentrate. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-30 Scott D Martin,Kieran S Dowley,Bilal S Siddiq,Stephen M Gillinov,Jonathan S Lee,Nathan J Cherian,Christopher T Eberlin,Michael P Kucharik,Michael C Dean
BACKGROUND Bone marrow aspirate concentrate (BMAC) augmentation at the time of hip arthroscopy is a potential solution to improve functional outcomes in patients with cartilage damage concomitant with acetabular labral tearing; however, follow-up functional scores to date have not exceeded 24 months. Therefore, the present study compares minimum 5-year outcomes in patients treated with or without BMAC
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An Ultra-Short Stemless Femoral Hip Prosthesis: A Concise Follow-up, at 10 Years, of a Previous Report. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-30 Martin Peter Nielsen,Janus Duus Christensen,Thomas Jakobsen,Poul Torben Nielsen
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Perioperative Opioid Counseling for Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-29 Jonathan D Packer,Ali Aneizi,Evan L Honig,Samir Kaveeshwar,Matheus Schneider,Natalie L Leong,Sean J Meredith,Nathan N O'Hara,R Frank Henn
BACKGROUND The use of opioids to manage pain after anterior cruciate ligament (ACL) reconstruction remains problematic. This study evaluated the impact of opioid-limiting perioperative pain management education and counseling on postoperative opioid consumption. METHODS A parallel-arm, randomized controlled trial was conducted at a single academic institution. We included patients ≥14 years old who
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Functional and Radiographic Outcomes of Bone Grafting for Severe Glenoid Defects in Reverse Shoulder Arthroplasty: A Minimum 5-Year Follow-up. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-28 Adrik Da Silva,Michael A Moverman,Chance McCutcheon,Peter N Chalmers,Christopher D Joyce,Robert Z Tashjian
BACKGROUND The outcomes of bone grafting for severe glenoid defects in reverse shoulder arthroplasty (RSA) are unpredictable. The purpose of this study was to describe the intermediate-term outcomes of glenoid bone grafting in RSA for severe glenoid defects utilizing a baseplate with a long central post. METHODS All patients who underwent glenoid bone grafting for severe glenoid defects during RSA
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Enabling Technology in Fracture Surgery: State of the Art. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-27 Alexander R Farid,Simon Comtesse,H Claude Sagi,Karl-Heinz Frosch,Michael J Weaver,Richard S Yoon,Arvind von Keudell
➢ Three-dimensional (3D) printing and virtual modeling, using computed tomographic (CT) scans as a base for the 3D-printed model, help surgeons to visualize relevant anatomy, may provide a better understanding of fracture planes, may help to plan surgical approaches, and can possibly simulate surgical fixation options.➢ Navigation systems create real-time 3D maps of patient anatomy intraoperatively
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Antibiotic Holiday in 2-Stage Exchange for Periprosthetic Joint Infection: A Scoping Review. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-26 Andrew Fraval,Daniel Gould,Mehmet Kursat Yilmaz,Alex Soriano,Javad Parvizi
BACKGROUND The use of a 2-stage exchange remains a common management strategy for periprosthetic joint infection (PJI). The use of an "antibiotic holiday" before the second stage to confirm the clearance of infection is often employed, but there is little evidence to guide this practice. The aim of this review was to systematically map the literature reporting on the use of an antibiotic holiday as
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The Effect of Implant Constraint and Ligament Repair on Compartment Balancing After Medial Collateral Ligament Injury in TKA. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-23 Alirio J deMeireles,Mouhanad M El-Othmani,Thomas R Gardner,Hui Zhang,Nana O Sarpong,Carl L Herndon,Roshan P Shah,H John Cooper,Jeffrey A Geller,Alexander L Neuwirth
BACKGROUND An intraoperative midsubstance injury to the medial collateral ligament (MCL) is a devastating complication of total knee arthroplasty (TKA). No single treatment method has been shown to yield optimal stability. This cadaveric study compared primary MCL repair, increasing prosthetic constraint, and a combination of both techniques on tibiofemoral compartment gapping after an iatrogenic MCL
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The Effect of Traction and Spinal Cord Morphology on Intraoperative Neuromonitoring Alerts in Adolescent Idiopathic Scoliosis. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-23 William J Hadden,Evan Fene,Lydia Klinkerman,Yuhan Ma,Chanhee Jo,Michelle R Christie,Jaysson T Brooks,Charles Johnston,Megan Johnson
BACKGROUND Patients with apical spinal cord deformity have been shown to be at a greater risk for intraoperative neuromonitoring (IONM) alerts when undergoing posterior spinal instrumented fusion (PSF) for adolescent idiopathic scoliosis (AIS). The use of intraoperative traction during deformity correction has also been associated with an increased risk of IONM alerts. With use of the Spinal Cord Shape
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Immediate Weight-Bearing Compared with Non-Weight-Bearing After Operative Ankle Fracture Fixation: Results of the INWN Pragmatic, Randomized, Multicenter Trial. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-23 Ramy Khojaly,Fiachra E Rowan,Vinay Shah,Matthew Nagle,Muhammad Shahab,Amir Sohaib Ahmad,Darren Dahly,Colm Taylor,Ruairí Mac Niocaill,May Cleary
BACKGROUND There has been weak consensus and a paucity of robust literature with regard to the best postoperative weight-bearing and immobilization regime for operatively treated ankle fractures. This trial compared immediate protected weight-bearing (IWB) with non-weight-bearing (NWB) with cast immobilization following ankle fracture fixation (open reduction and internal fixation [ORIF]), with a particular
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Surgical Correction of Severe Scoliosis Leads to Changes in Central Airway Resistance Evaluated with CT-Based 3D Reconstruction and Impulse Oscillometry. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-23 Hanwen Zhang,Yong Hai
BACKGROUND Previous studies have not compared airway resistance and morphological parameters before and after the treatment of severe scoliosis. In the present study, 3-dimensional (3D) computed tomographic (CT) reconstruction and impulse oscillometry (IOS) were used to evaluate the changes in airway dilation and airway resistance caused by posterior spinal fusion for the treatment of severe kyphoscoliosis
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Primary Total Knee Arthroplasty in Patients with BMI of ≥50 kg/m2: A Cohort Study with Long-Term Follow-up. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-23 Christiaan H Righolt,Maxwell Luke Armstrong,Thomas R Turgeon,Eric R Bohm,Jhase Sniderman
BACKGROUND The obesity epidemic has given rise to an orthopaedic patient subgroup with a body mass index (BMI) of ≥50 kg/m2. Without sound evidential guidance, arthroplasty surgeons and anesthesiologists do not know whether they can push the limits of the surgical feasibility of total knee arthroplasty (TKA) without risks of harm. METHODS In a retrospective cohort study of patients who had undergone
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Three Hundred Periprosthetic Tibial Fractures Around a Total Knee Replacement: Classification and Outcomes from a Single Institution. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-23 Evan M Dugdale,Thomas D Alter,Michael J Stuart,Stephen A Sems,Brandon J Yuan,Mark J Spangehl,Bryan D Springer,Daniel J Berry,Matthew P Abdel
BACKGROUND Periprosthetic tibial fractures around a total knee replacement (TKR) remain challenging to manage, with little published information for guidance. The purpose of this study was to review the types, management techniques, and outcomes of periprosthetic tibial fractures in the largest series to date. METHODS We identified 300 periprosthetic tibial fractures (285 patients) around a TKR (43%
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Acute Interpositional Fat Autograft Does Not Protect Against Bar Formation in Physeal Fractures. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-22 Mikhail S Tretiakov,Christine L Farnsworth,Garrett E Rupp,Kelly E Gordon,Kortney A Ponce,David B Berry,Suzanne M Tucker,Eric W Edmonds
BACKGROUND Long-bone fractures in children can lead to premature physeal bar formation and growth disturbance. Bar excision has been studied, but data on prophylactic tissue interposition into physeal fractures are limited. This study used an established animal model to evaluate acute placement of fat autograft. The number of animals was selected to give 80% power on the basis of pilot data on induction
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A Review of Medical Ethics in Orthopaedic Surgery: Current Foci and Future Considerations. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-22 Ryan X Lam,Zhi Mei Sonia He,Ruhi Thapar,Maggie Wang,Dion G Birhiray,Matthew Milad,Lara Ouellette,Umar Ghilzai,Tucker J Cushing,M Brent Price,Brenden B Ronna,Omar H Atassi,Christopher H Perkins,John R Dawson,William M Granberry,Melvyn A Harrington,Douglas R Dirschl,Lorenzo R Deveza
➢ Medical ethics education is a required component of orthopaedic surgery resident training per the Accreditation Council for Graduate Medical Education (ACGME) guidelines, although no standardized curriculum currently exists.➢ Beyond the 4 principles of bioethics (autonomy, beneficence, nonmaleficence, justice), additional ethical concepts relevant to orthopaedic care include utilitarianism, deontology
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Litigation Patterns of Acute Compartment Syndrome: Distinctions Between Orthopaedic and Non-Orthopaedic Cases and Factors Predicting Successful Defense. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-22 Haad A Arif,Jose A Morales,Emmanuel Brito,Simon T Moore,Carol A Lin
BACKGROUND Acute compartment syndrome (ACS) is a medical emergency and a cause of medical litigation across multiple specialties. We sought to compare the characteristics and outcomes of ACS-related litigation levied against surgeons in orthopaedics compared with other specialties. METHODS The Westlaw database was queried for ACS-related cases filed within the United States between 1980 and 2023 using
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A Photovoice Study on Life After Traumatic Brachial Plexus Injury: "There Is Somebody Out There Who Knows What You're Going Through". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-22 Amanda M Faust,Katherine M Gerull,Jean Hunleth,David M Brogan,Christopher J Dy
BACKGROUND Brachial plexus injury (BPI) leads to a variety of life-altering changes, both physically and mentally. While tremendous effort has been dedicated to improving patients' upper-extremity function through surgical and rehabilitation advances, patients' life experiences after BPI are largely understudied and poorly understood. Our study aims were to qualitatively assess the patient experience
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Effects of Depression and/or Anxiety on the Outcomes of Hip Arthroscopy for Femoroacetabular Impingement and Labral Tears: A Minimum 5-Year Follow-up Study. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-21 Roger Quesada-Jimenez,Elizabeth G Walsh,Jessica C Keane,Ady H Kahana-Rojkind,Elijah S Domb,Benjamin G Domb
BACKGROUND Depression and anxiety are recognized as adverse prognostic factors in various orthopaedic surgical interventions. The aim of this study is to report the intermediate-term outcomes of hip arthroscopy for the treatment of femoroacetabular impingement (FAI) and labral tears in patients with depression and/or anxiety. METHODS Data were retrospectively analyzed for patients with a self-reported
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Balancing Risks and Benefits: Arthroscopic Lysis of Adhesions After Total Knee Arthroplasty: Commentary on an article by Kian Niknam, BS, et al.: "Rates of Periprosthetic Joint Infection and Revision Increase After Arthroscopic Lysis of Adhesions Subsequent to Primary TKA". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-21 Mona Badawy
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Workplace Culture-A Different Look at the Perspective of Orthopaedic Women Faculty Members: Commentary on an article by Katherine M. Gerull, MD, et al.: "Addressing Issues of Inclusive Workplace Culture for Women Orthopaedic Surgeons in Academia. A Qualitative Investigation". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-21 J L Marsh
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Worth the Hype(rglycemia)? Dexamethasone in Diabetic Patients Undergoing Total Knee Arthroplasty: Commentary on an article by Hyung Jun Park, MD, PhD, et al.: "Intravenous Dexamethasone Transiently Elevates Blood Glucose Levels and Reduces Pain After TKA in Patients with Type-2 Diabetes Mellitus. A Randomized Controlled Study". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-21 Elizabeth G Lieberman
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Traditional Bonesetters: Risks, Complications, and the Way Forward. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-21 B A Petrisor
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Rigorous Control in Clinical Research: Evaluating the EmeTerm Bracelet for PONV Prevention: Commentary on an article by Yidan Yang, MMSc, et al.: "Risk of Postoperative Nausea and Vomiting After Total Hip or Knee Arthroplasty Under Spinal Anesthesia: Randomized Trial Comparing Conventional Antiemetics with or without the EmeTerm Bracelet". J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-21 William L Bargar
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A Too-Long Anterior Process of the Calcaneus: Defining Normative Values for the Calcaneonavicular Distance Using MRI in a Pediatric Population. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-16 Nastassia Pralong-Guanziroli,Blaise Cochard,Elvin Gurbanov,Anne Tabard-Fougère,Nathaly Gavira,Silvia Valisena,Romain Dayer,Dimitri Ceroni
BACKGROUND The calcaneonavicular distance has yet to be definitively defined on the basis of morphological studies and thus remains a somewhat elusive value for orthopaedists. The purposes of the present study were to measure the calcaneonavicular distance with use of magnetic resonance imaging (MRI) in a control pediatric population and to assess whether sex and age affected this distance. METHODS
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What's Important (Arts & Humanities): Scars of Courage. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-13 Harjot Uppal
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Colorado Limb Donning-Timed Up and Go (COLD-TUG) Test in Lower-Extremity Amputation: Less Donning Time with Osseointegrated Bone-Anchored Prosthetic Limb. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-13 Mohamed E Awad,Guy Lev,Danielle H Melton,Kylie G Shaw,Peter B Thomsen-Freitas,Brecca M M Gaffney,Cory L Christiansen,Jason W Stoneback
BACKGROUND Osseointegration of a bone-anchored limb (BAL) establishes a direct skeletal interface for prosthesis attachment, simplifying the donning/doffing process. The Timed Up and Go (TUG) test reliably assesses mobility in individuals with lower-extremity amputation who use socket prostheses, but it does not account for the time required to don a prosthetic limb. The aim of this study was to develop
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Intraoperative Direct Sonication Versus Conventional Sonication in the Diagnosis of Periprosthetic Joint Infection: Comparison of Diagnostic Accuracy and Time to Positivity of Fluid Culture. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-13 Yicheng Li,Fei Wang,Tuerhongjiang Wahafu,Wenbo Mu,Baochao Ji,Abudousaimi Aimaiti,Xiaobin Guo,Haoyang Tian,Xiaogang Zhang,Li Cao
BACKGROUND Conventional sonication is a recommended method in the diagnosis of periprosthetic joint infection (PJI), but the accuracy of diagnosis is still not ideal. We have applied the use of a handheld ultrasonic device and the intraoperative direct sonication of prostheses and soft tissues retrieved during surgery to improve the efficacy of the microbiological diagnosis of PJI and the incubation
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The Future of Private Equity in Orthopaedics. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-09 Sudheer C Reddy,Gary Herschman
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Kienböck Disease: Recent Advances in Understanding and Management. J. Bone Joint. Surg. (IF 4.4) Pub Date : 2025-05-08 David M Lichtman,William F Pientka
➢ An at-risk lunate (due to anatomic factors) subjected to a trigger event (axial load, embolism, hypercoagulability) leads to the development of lunate osteonecrosis.➢ Children, adolescents, and elderly patients with Kienböck disease respond well to nonoperative treatments, and this should be considered before any surgical intervention.➢ For disease limited to the lunate, treatment decisions should