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Self-Regulation as an Element of Professionalism in Orthopaedic Surgery: Whose Perspective?
Swiontkowski, Marc MD; Editor-in-Chief
doi : 10.2106/JBJS.21.00775
August 4, 2021 - Volume 103 - Issue 15 - p 1367
ACL Reconstruction Delay in Pediatric and Adolescent Patients Is Associated with a Progressive Increased Risk of Medial Meniscal Tears
Kolin, David A. BA, MSc1,a; Dawkins, Brody BA1; Park, Joshua BA2; Fabricant, Peter D. MD, MPH1; Gilmore, Allison MD2; Seeley, Mark MD3; Mistovich, R. Justin MD, MBA2
doi : 10.2106/JBJS.20.01459
August 4, 2021 - Volume 103 - Issue 15 - p 1368-1373
We sought to investigate the relationship between the time from an anterior cruciate ligament (ACL) tear to the surgical procedure and meniscal tears in the pediatric and adolescent population.
Minimal Clinically Important Differences for Patient-Reported Outcomes After TKA Depend on Central Sensitization
Kim, Man Soo MD, PhD1; Koh, In Jun MD, PhD2; Choi, Keun Young MD1; Seo, Jeong Yong MD1; In, Yong MD, PhD1,a
doi : 10.2106/JBJS.20.02138
August 4, 2021 - Volume 103 - Issue 15 - p 1374-1382
To our knowledge, it is still unknown if central sensitization (CS) influences the magnitude of the minimal clinically important difference (MCID) for patient-reported outcome measures after total knee arthroplasty (TKA). The purpose of this study was to determine the influence of CS on the MCID for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score in patients who underwent TKA for knee osteoarthritis.
Recent Trends in Medicare Utilization and Reimbursement for Orthopaedic Procedures Performed at Ambulatory Surgery Centers
Lopez, Cesar D. BS1; Boddapati, Venkat MD1,a; Schweppe, Eric A. BS1; Levine, William N. MD1; Lehman, Ronald A. MD1; Lenke, Lawrence G. MD1
doi : 10.2106/JBJS.20.01105
August 4, 2021 - Volume 103 - Issue 15 - p 1383-1391
As part of a market-driven response to the increasing costs of hospital-based surgical care, an increasing volume of orthopaedic procedures are being performed in ambulatory surgery centers (ASCs). The purpose of the present study was to identify recent trends in orthopaedic ASC procedure volume, utilization, and reimbursements in the Medicare system between 2012 and 2017.
Prevalence and Outcomes of Unexpected Positive Intraoperative Cultures in Presumed Aseptic Revision Hip Arthroplasty
Neufeld, Michael E. MD, MSc, FRCSC1,a; Lanting, Brent A. MD, MSc, FRCSC1,2; Shehata, Michael MD, BCh, BAO1; Howard, James L. MD, MSc, FRCSC1,2; MacDonald, Steven J. MD, FRCSC1,2; Teeter, Matthew G. PhD1,2,3; Vasarhelyi, Edward M. MD, MSc, FRCSC1,2
doi : 10.2106/JBJS.20.01559
August 4, 2021 - Volume 103 - Issue 15 - p 1392-1401
The prevalence and outcomes of unexpected positive cultures (UPCs) of specimens taken during presumed aseptic revision total hip arthroplasty (THA) are unclear. The purpose of this study was to determine the prevalence of UPC and infection-free implant survival in this patient population. Secondary aims included identifying factors associated with subsequent infection-related failure in patients with UPC.
Do Nonsteroidal Anti-Inflammatory or COX-2 Inhibitor Drugs Increase the Nonunion or Delayed Union Rates After Fracture Surgery?
Kim, Hyojune MD1,2,*; Kim, Do-Hoon MD3,*; Kim, Dong Min MD1; Kholinne, Erica MD, PhD1,4; Lee, Eui-Sup MD1; Alzahrani, Wael Mohammed MD1; Kim, Ji Wan MD, PhD1; Jeon, In-Ho MD, PhD1; Koh, Kyoung Hwan MD, PhD1,a
doi : 10.2106/JBJS.20.01663
August 4, 2021 - Volume 103 - Issue 15 - p 1402-1410
The effects of nonsteroidal anti-inflammatory drugs (NSAIDs)/cyclooxygenase (COX)-2 inhibitors on postoperative fracture-healing are controversial. Thus, we investigated the association between NSAID/COX-2 inhibitor administration and postoperative nonunion or delayed union of fractures. We aimed to determine the effects of NSAID/COX-2 inhibitor administration on postoperative fracture-healing with use of a common data model.
Mental-Health Phenotypes and Patient-Reported Outcomes in Upper-Extremity Illness
Miner, Harrison BA1; Rijk, Léon MD1; Thomas, Jacob MA1; Ring, David MD, PhD1,a; Reichel, Lee M. MD1; Fatehi, Amirreza MD1
doi : 10.2106/JBJS.20.01945
August 4, 2021 - Volume 103 - Issue 15 - p 1411-1416
Prior studies have suggested that misconceptions (i.e., unhelpful thoughts or cognitive errors resulting from cognitive bias) and distress (symptoms of anxiety or depression) are key factors associated with variation in health, as quantified with use of patient-reported outcome measures. The primary purpose of the present study was to identify mental-health phenotypes (i.e., combinations of various types of misconceptions and distress) that might help direct care and to test for differences in magnitude of activity tolerance, pain intensity, and self-efficacy in response to pain between phenotypes. We also studied demographic factors and diagnostic categories associated with mental-health phenotypes.
Relationship Between Glenoid Component Shift and Osteolysis After Anatomic Total Shoulder Arthroplasty
Ricchetti, Eric T. MD1,a; Jun, Bong-Jae PhD1; Jin, Yuxuan MS1; Ho, Jason C. MD1; Patterson, Thomas E. PhD1; Dalton, Jarrod E. PhD1; Derwin, Kathleen A. PhD1; Iannotti, Joseph P. MD, PhD1
doi : 10.2106/JBJS.20.00833
August 4, 2021 - Volume 103 - Issue 15 - p 1417-1430
The purpose of this study was to evaluate glenoid component position and radiolucency following anatomic total shoulder arthroplasty (TSA) using sequential 3-dimensional computed tomography (3D CT) analysis.
Prevention of Unplanned Surgery Due to Delayed Diagnosis of Occult Ipsilateral Femoral Neck Fractures Associated with Femoral Shaft Fractures
Park, Young-Chang MD1,2; Song, Hyung-Keun MD3; Yang, Kyu-Hyun MD, PhD1,a
doi : 10.2106/JBJS.20.02033
August 4, 2021 - Volume 103 - Issue 15 - p 1431-1437
The purpose of the present study was to investigate the effectiveness of using the computed tomography (CT) capsular sign with lipohemarthrosis of the hip joint as a selective indicator for preoperative magnetic resonance imaging (MRI) of the hip or prophylactic fixation of the ipsilateral femoral neck for the prevention of unplanned surgery due to delayed diagnosis of occult ipsilateral femoral neck fractures in patients with high-energy femoral shaft fractures.
Demographic, Surgical, and Radiographic Risk Factors for Symptomatic Adjacent Segment Disease After Lumbar Fusion
Lau, Kenney K.L. BA, MSc1,2; Samartzis, Dino BSc, MSc, DSc3,4; To, Nicholas S.C. BSc1; Harada, Garrett K. MD3,4; An, Howard S. MD3,4; Wong, Arnold Y.L. PT, MPhil, PhD1,3,4,a
doi : 10.2106/JBJS.20.00408
August 4, 2021 - Volume 103 - Issue 15 - p 1438-1450
Although multiple studies have investigated risk factors for symptomatic adjacent segment disease (ASD) after lumbar fusion, their findings were diverse and inconsistent. This review aimed to summarize risk factors for ASD in order to guide the management of ASD and future research.
Oxidative Stress and Osteoporosis
Kimball, Jeff S. MD1; Johnson, Joey P. MD1; Carlson, DuWayne A. MD1
doi : 10.2106/JBJS.20.00989
August 4, 2021 - Volume 103 - Issue 15 - p 1451-1461
Oxidative stress has been implicated as a causative factor in many disease states, possibly including the diminished bone mineral density in osteoporosis.
What’s Important: Addressing Racism in Patient Encounters
Bonsu, Janice M. MPH1,a
doi : 10.2106/JBJS.21.00170
August 4, 2021 - Volume 103 - Issue 15 - p 1462-1463
Facilitating the Approval Process of Anti-Infective Technologies and Advancing Them to the Market
Goh, Graham S. MD1; Tornetta, Paul III MD2; Parvizi, Javad MD, FRCS1,a
doi : 10.2106/JBJS.21.00007
August 4, 2021 - Volume 103 - Issue 15 - p e57
Orthopaedic device-related infection is one of the most devastating complications in orthopaedic and trauma surgery. With increasing life expectancies as well as the lifelong risk of bacterial seeding on an implant, the prevention and treatment of device-related infection remains an important area for research and development. To facilitate information exchange and enhance collaboration among various stakeholders in the orthopaedic community, the U.S. Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) organized an inaugural workshop on orthopaedic device-related infections, exploring the regulatory challenges that are faced when proceeding from the bench level to marketing and clinical implementation of new infection-control devices and products. This article summarizes the perspectives of scientists, clinicians, and industry partners on the current regulatory approval process for orthopaedic anti-infective technologies as well as the proposed strategies to overcome these regulatory challenges.
The Estimated Cost of Maintenance of Certification
LaVigne, Caleb BS1; Foulkes, Guy MD, FAOA2,3,a; Kane, Steve MD4
doi : 10.2106/JBJS.20.00632
August 4, 2021 - Volume 103 - Issue 15 - p e58
Maintenance of Certification (MOC) is a controversial topic in medicine for many different reasons. Studies have suggested that there may be associations between fewer negative outcomes and participation in MOC. However, MOC still remains controversial because of its cost. We sought to determine the estimated cost of MOC to the average orthopaedic surgeon, including fees and time cost, defined as the market value of the physician’s time.
Pediatric and Adolescent ACL Reconstruction: Is Delaying Surgery Doing More Harm Than Good?
Mascarenhas, Randy MD, FRCSC1
doi : 10.2106/JBJS.21.00508
August 4, 2021 - Volume 103 - Issue 15 - p e59
Central Sensitization Is an Important Factor in the Outcome of Patients Undergoing Total Knee Arthroplasty
Bedard, Nicholas A. MD1,a
doi : 10.2106/JBJS.21.00497
August 4, 2021 - Volume 103 - Issue 15 - p e60
The Value of Maintenance of Certification
The American Board of Orthopaedic Surgery’s Board of Directors*
doi : 10.2106/JBJS.21.00704
August 4, 2021 - Volume 103 - Issue 15 - p e61
Erratum: Providing an Evidence Base for Tissue Sampling and Culture Interpretation in Suspected Fracture-Related Infection
doi : 10.2106/JBJS.ER.20.00409
August 4, 2021 - Volume 103 - Issue 15 - p e62
Erratum: Larger Initial Opioid Prescriptions Following Total Joint Arthroplasty Are Associated with Greater Risk of Prolonged Use
doi : 10.2106/JBJS.ER.20.00732
August 4, 2021 - Volume 103 - Issue 15 - p e63
