Journal of Bone and Joint Surgery - Series A




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Revision Risk After Unipolar or Bipolar Hemiarthroplasty for Femoral Neck Fractures: An Instrumental Variable Analysis of 62,875 Procedures from the Australian Orthopaedic Association National Joint Replacement Registry

Farey, John E.; Cuthbert, Alana R.; Adie, Sam; Harris, Ian A

doi : 10.2106/JBJS.20.00486

The Journal of Bone and Joint Surgery. 103(3):195-204, February 3, 2021.

Background: There remains much international practice variation regarding the choice of a unipolar or bipolar prosthesis design for displaced femoral neck fractures that are treated with hemiarthroplasty. The purpose of the present study was to compare revision rates following primary hemiarthroplasty for femoral neck fracture to determine if the unipolar hemiarthroplasty design increases the risk of revision arthroplasty for all causes.

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Moderators and Mediators of Activity Intolerance Related to Pain

Cremers, Teun; Zoulfi Khatiri, Michael; van Maren, Koen; Ring, David; Teunis, Teun; Fatehi, Amirreza 

doi : 10.2106/JBJS.20.00241

The Journal of Bone and Joint Surgery. 103(3):205-212, February 3, 2021.

There is wide variation in activity intolerance for a given musculoskeletal pathophysiology. In other words, people often experience illness beyond what one would expect given their level of pathophysiology. Mental health (i.e., cognitive bias regarding pain [e.g., worst-case thinking] and psychological distress [symptoms of anxiety and depression]) is an important and treatable correlate of pain intensity and activity intolerance that accounts for much of this variation. This study tested the degree to which psychological distress accentuates the role of cognitive bias in the relationship between pain intensity and activity intolerance.

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Pelvic Fragility Fractures: An Opportunity to Improve the Undertreatment of Osteoporosis

Smith, Christian T.; Barton, David W.; Piple, Amit S.; Carmouche, Jonathan J

doi : 10.2106/JBJS.20.00738

The Journal of Bone and Joint Surgery. 103(3):213-218, February 3, 2021.

Osteoporosis is often undiagnosed until patients experience fragility fractures. Pelvic fractures are common but underappreciated sentinel fractures. Screening patients with a pelvic fracture for osteoporosis may provide an opportunity to initiate appropriate treatments such as anti-osteoporosis therapy to prevent additional fractures.

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Postoperative Prophylactic Antibiotics in Spine Surgery: A Propensity-Matched Analysis

The Journal of Bone and Joint Surgery. 103(3):219-226, February 3, 2021.

doi : 10.2106/JBJS.20.00934

The Journal of Bone and Joint Surgery. 103(3):219-226, February 3, 2021.

Surgical site infections are common and costly complications after spine surgery. Prophylactic antibiotics are the standard of care; however, the appropriate duration of antibiotics has yet to be adequately addressed. We sought to determine whether the duration of antibiotic administration (preoperatively only versus preoperatively and for 24 hours postoperatively) impacts postoperative infection rates.

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Demographic, Comorbidity, and Episode-of-Care Differences in Primary Total Knee Arthroplasty

Siddiqi, Ahmed; Warren, Jared A.; McLaughlin, John; Kamath, Atul F.; Krebs, Viktor E.; Molloy, Robert M.; Piuzzi, Nicolas S

doi : 10.2106/JBJS.20.00597

The Journal of Bone and Joint Surgery. 103(3):227-234, February 3, 2021.

Understanding time trends in age, demographic characteristics, and comorbidities is especially critical to highlight the effects on clinical practice change, outcomes, and the value of total knee arthroplasty (TKA). Therefore, the purpose of this study was to identify trends in the demographic characteristics, comorbidities, and episode-of-care outcomes for patients who underwent TKA from 2008 to 2018.

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Secondary Surgery and Residual Dysplasia Following Late Closed or Open Reduction of Developmental Dysplasia of the Hip

Morris, William Z.; Hinds, Sean; Worrall, Hannah; Jo, Chan-Hee; Kim, Harry K.W. Less

doi : 10.2106/JBJS.20.00562

The Journal of Bone and Joint Surgery. 103(3):235-242, February 3, 2021.

Outcomes studies following successful closed reduction of late-detected developmental dysplasia of the hip (DDH) reveal high rates of secondary reconstructive surgery with limited comparative data demonstrating lower rates of residual dysplasia with open reduction. The purpose of this study was to compare long-term outcomes, with regard to radiographic evidence of residual dysplasia and secondary reconstructive procedures, between late closed and late open reduction for DDH in patients 6 to 24 months of age at reduction.

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Day-of-Surgery Video Calls and Phone Calls Increase Patient Satisfaction with Outpatient Surgery Experience: A Randomized Controlled Trial of Postoperative Communication Modalities

Kingery, Matthew T.; Hoberman, Alexander; Baron, Samuel L.; Gonzalez-Lomas, Guillem; Jazrawi, Laith M.; Alaia, Michael J.; Strauss, Eric J

doi : 10.2106/JBJS.20.00426

The Journal of Bone and Joint Surgery. 103(3):243-250, February 3, 2021.

With the increasing utilization of patient satisfaction as a metric for clinical care, there is growing interest in techniques that can be used to improve satisfaction in patients undergoing surgery. The purpose of this trial was to assess the impact of day-of-surgery video and phone calls on patient satisfaction.

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Medium-Term Clinical and Radiographic Results of an All-Polyethylene, Pegged, Bone-Ingrowth Glenoid Component: A Concise Follow-up of a Previous Report*

Borbas, Paul; Taylor, David McD.; Lee, Steven; Wijeratna, Malin; Hoy, Gregory; Evans, Matthew C

doi : 10.2106/JBJS.20.00084

The Journal of Bone and Joint Surgery. 103(3):251-256, February 3, 2021.

We previously reported the mean 4-year outcomes of anatomic total shoulder replacement using an all-polyethylene, pegged, hybrid-fixation (bone ingrowth and cement) glenoid component. In the present study, we report on that patient cohort after another 4 years of follow-up (mean, 101 months; range, 77 to 146 months). At that time, the median American Shoulder and Elbow Surgeons (ASES) score was 92 points (interquartile range [IQR], 81.7 to 98.3) and the median Oxford Shoulder Score was 47 points (IQR, 41 to 48). Osseointegration, demonstrated by bone ingrowth between the flanges on the central peg as seen on coronal computed tomography (CT), was complete in 75% of the shoulders, partial in 21%, and absent in 4%. There were radiolucent lines at the bone-prosthesis interface on CT, with a median Yian score of 1 (IQR, 0 to 2; range, 0 to 18). The conclusion in the present study was that shoulder arthroplasty with an all-polyethylene, hybrid-fixation (bone ingrowth and cement) pegged glenoid component has durable clinical and radiographic outcomes at medium-term follow-up.

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Reverse Dynamization Accelerates Bone-Healing in a Large-Animal Osteotomy Model

Glatt, Vaida; Samchukov, Mikhail; Cherkashin, Alexander; Iobst, Christopher

doi : 10.2106/JBJS.20.00380

The Journal of Bone and Joint Surgery. 103(3):257-263, February 3, 2021.

Reverse dynamization is a mechanical manipulation regimen designed to accelerate bone-healing and remodeling. It is based on the hypothesis that a fracture that is initially stabilized less rigidly allows micromotion to encourage initial cartilaginous callus formation. Once substantial callus has formed, the stabilization should then be converted to a rigid configuration to prevent the disruption of neovascularization. The aim of the present study was to investigate whether bone-healing can be accelerated using a regimen of reverse dynamization in a large-animal osteotomy model.

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Activation of Bone Remodeling Compartments in BMP-2-Injected Knees Supports a Local Vascular Mechanism for Arthritis-Related Bone Changes

Seeherman, Howard J.; Li, X. Jian; Wozney, John M.

doi : 10.2106/JBJS.20.00883

The Journal of Bone and Joint Surgery. 103(3):e8, February 3, 2021.

Synovial membrane-derived factors are implicated in arthritis-related bone changes. The route that synovial factors use to access subchondral bone and the mechanisms responsible for these bone changes remain unclear. A safety study involving intra-articular injection of bone morphogenetic protein-2 (BMP-2)/calcium phosphate matrix (CPM) or CPM addresses these issues.

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A Reevaluation of the Risk of Infection Based on Time to Debridement in Open Fractures: Results of the GOLIATH Meta-Analysis of Observational Studies and Limited Trial Data

Foote, Clary J.; Tornetta, Paul III; Reito, Aleksi; Al-Hourani, Khalid; Schenker, Mara; Bosse, Michael; Coles, Chad P.; Bozzo, Anthony; Furey, Andrew; Leighton, Ross; the GOLIATH Investigators

doi : 10.2106/JBJS.20.01103

The Journal of Bone and Joint Surgery. 103(3):265-273, February 3, 2021.

Open fractures are one of the leading causes of disability worldwide. The threshold time to debridement that reduces the infection rate is unclear.

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Orthopaedic Care of the Transgender Patient

Ramsey, Duncan C.; Lawson, Michelle M.; Stuart, Ariana; Sodders, Emelia; Working, Zachary M. Less

doi : 10.2106/JBJS.20.00628

The Journal of Bone and Joint Surgery. 103(3):274-281, February 3, 2021.

A transgender person is defined as one whose gender identity is incongruent with their biological sex assigned at birth. This highly marginalized population numbers over 1.4 million individuals in the U.S.; this prevalence skews more heavily toward younger generations and is expected to increase considerably in the future.

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What’s Important: Self-Belief, Serenity, and Self-Awareness in Orthopaedic Surgery Residency

Danford, Nicholas C.

doi : 10.2106/JBJS.20.01116

The Journal of Bone and Joint Surgery. 103(3):282-283, February 3, 2021.

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Achieving a Diverse, Equitable, and Inclusive Environment for the Black Orthopaedic Surgeon: Part 1: Barriers to Successful Recruitment of Black Applicants

Ode, Gabriella E.; Bradford, Letitia; Ross, William A. Jr.; Carson, Eric W.; Brooks, Jaysson T

doi : 10.2106/JBJS.20.01768

The Journal of Bone and Joint Surgery. 103(3):e9, February 3, 2021.

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Psychological and Social Nature of Pain in Orthopaedics: Commentary on an article by Teun Cremers, BSc, et al.: “Moderators and Mediators of Activity Intolerance Related to Pain”

Barth, Robert J.

doi : 10.2106/JBJS.20.01954

The Journal of Bone and Joint Surgery. 103(3):e10, February 3, 2021.

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Undertreatment After Pelvic Fragility Fractures: Commentary on an article by Christian T. Smith, MS, et al.: “Pelvic Fragility Fractures. An Opportunity to Improve the Undertreatment of Osteoporosis”

Anderson, Paul A.

doi : 10.2106/JBJS.20.01913

The Journal of Bone and Joint Surgery. 103(3):e11, February 3, 2021.

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The Pendulum Swings On: Earlier Open Fracture Debridement May Be Best: Commentary on an article by Clary J. Foote, MD, MSc, et al.: “A Reevaluation of the Risk of Infection Based on Time to Debridement in Open Fractures. Results of the GOLIATH Meta-Analysis of Observational Studies and Limited Trial Data”

Schottel, Patrick C.

doi : 10.2106/JBJS.20.01604

The Journal of Bone and Joint Surgery. 103(3):e12, February 3, 2021.

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Erratum: Back Pain and Quality of Life After Surgical Treatment for Adolescent Idiopathic Scoliosis at 5-Year Follow-up

doi : 10.2106/JBJS.ER.18.01370

The Journal of Bone and Joint Surgery. 103(3):e13, February 3, 2021.

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Erratum: Anterior Cruciate Ligament Repair: The Current Status

doi : 10.2106/JBJS.ER.20.00509

The Journal of Bone and Joint Surgery. 103(3):e14, February 3, 2021.

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