JBJS Reviews

»: The opioid epidemic represents a serious health burden on patients across the United States. »: This epidemic is particularly pertinent to the field of orthopaedics because it is one of the fields providing the highest volume of opioid prescriptions. »: The use of opioids before orthopaedic surgery has been associated with decreased patient-reported outcomes, increased surgery-related complications, and chronic opioid use...

»: The rapid increase in the use of electronic medical records (EMRs) has led to some unintended consequences that negatively affect physicians and their patients. »: The use of medical scribes may serve as a possible solution to some of the EMR-related concerns. »: Research has demonstrated an overall positive impact of having scribes on both physician and patient well-being, safety, and satisfaction. »: Adaptation of advances in technology, including remote and asynchronous scribing, use of face-mounted devices, voice recognition software, and applications of artificial intelligence may address some of the barriers to more traditional in-person scribes...

OBJECTIVE: Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to address certain shortcomings of traditional, or legacy patient-reported outcome measures (PROMs). Because the use of PROMIS across orthopedic populations continues to increase, the purpose of this study was to provide a comprehensive overview of the use and validation of PROMIS in spine surgery. METHODS: PubMed and Google Scholar were searched for relevant articles reporting on the use and validation of PROMIS in spine surgery...

INTRODUCTION: Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty (TJA), with treatment failure occurring in 12% to 28% after 2-stage revision. It is vital to identify diagnostic tools indicative of persistent infection or treatment failure after 2-stage revision for PJI. METHODS: The Cochrane Library, PubMed (MEDLINE), and EMBASE were searched for randomized controlled trials and comparative observational studies published before October 3, 2021, which evaluated the utility of serum/plasma biomarkers (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], interleukin-6 [IL-6], fibrinogen, D-dimer), synovial biomarkers (white blood cell [WBC] count, neutrophil percentage [PMN %], alpha-defensin [AD], leukocyte esterase [LE]), tissue frozen section, tissue culture, synovial fluid culture, or sonicated spacer fluid culture indicative of persistent infection before the second stage of 2-stage revision for PJI or treatment failure after 2-stage revision for PJI...

»: Both unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) allow for compartment-specific intervention on an arthritic knee joint that preserves bone stock and native soft tissue compared to a total knee arthroplasty (TKA). Both operations give a more natural feeling with native proprioception compared with a TKA. »: HTO is better suited in patients who are younger (<55 years-of-age), have a body mass index (BMI) <30 kg/m2, high activity requirements, mechanical malalignment, asymmetric varus, isolated anterior cruciate ligament insufficiency, need for multiplanar correction, and a preference for joint preserving interventions...

»: Patients with diabetes are at higher risk for complications after surgical fixation of unstable fractures due to impaired neurovascular functioning and wound-healing capabilities. »: Patients with uncontrolled diabetes have higher rates of complications when compared with patients with controlled diabetes. »: Despite higher rates of complications, operative fixation of unstable ankle fractures in diabetic patients reliably leads to a functional lower extremity with an overall lower rate of complications than nonoperative management...

»: Tibial pilon fractures are devastating injuries requiring complexsurgical management resulting in a challenging postoperativecourse. »: A multidisciplinary approach is required to manage these injuries in addition to patients' medical comorbidities and concomitant injuries to achieve optimal outcomes. »: The case presented here demonstrates the importance of communication and teamwork between specialties in the management of a patient with a tibial pilon fracture that was medically optimized for surgery using a team-based approach...

»: Halo-gravity traction (HGT) is a well-established technique for correcting severe spinal deformity in pediatric patients. »: HGT induces soft-tissue relaxation and gradually lengthens the spine, and it can be used preoperatively and intraoperatively. »: It is typically indicated for spinal deformity over 90° in any plane and medical optimization. »: There are several complications associated with the use of HGT, and it is critical to follow a protocol and perform serial examinations to minimize this risk...

»: Foot deformities make up a large percentage of all orthopaedic complaints in patients with Down syndrome, Marfan syndrome, Ehlers-Danlos syndrome, Larsen syndrome, and osteogenesis imperfecta. »: Some common causes of foot deformities in these conditions include increased ligament laxity, hypotonia, and hypermobility of the joints. »: Treatment options for syndromic foot deformities include the use of foot orthoses, physical therapy, bracing, and various surgical procedures...

»: Lateral epicondylitis (LE) or tennis elbow is a common cause of elbow pain in the general population, especially women in the fourth and fifth decades of life who participate in repetitive forceful movements involving the wrist and forearm. »: The pathogenesis of this overuse injury is believed to start from an overload event leading to a microtear in or near the origin of the extensor carpi radialis brevis that is subsequently prone to additional injury and structural weakness over time...

BACKGROUND: Cast room procedures can be a source of considerable distress for pediatric patients. High levels of anxiety can make it difficult to perform procedures effectively and may negatively affect the doctor-patient relationship. We sought to evaluate available interventions to reduce anxiety in pediatric patients undergoing orthopaedic cast room procedures. METHODS: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines, we performed a systematic review to answer our study question (PROSPERO registration of the study protocol: CRD42022333001, May 28, 2022)...

»: Inadvertent activation of electrosurgical device was more likely to result in patient burns and harm. »: There are significant knowledge gaps in the orthopaedic surgery community relating to fire prevention, fire safety, and fire management. »: Arthroplasty was the most common procedure with reported fire events. »: It is the responsibility of the orthopaedic surgeon to understand the risks of surgical fire in the operating room and implement actions to reduce those risks...

»: All-suture anchors or so-called "soft" anchors, initially adapted for labral repairs, have increased in popularity for use in rotator cuff repair because of their smaller size, decreased occupation of the footprint, improved points of fixation, ease of use, and ease of revision. »: In limited series, soft anchors have demonstrated equivalent biomechanical and clinical performance compared with hard body anchors for rotator cuff repair. »: Perianchor cyst formation can occur with both hard body and soft anchors...

No abstract text is available yet for this article.

»: Mental health evaluation should be considered an essential part of the routine preoperative assessment and should be managed by a multidisciplinary team composed of the primary care physician, orthopaedic provider, and behavioral health specialist. »: The scientific literature indicates that patients without comorbid psychiatric symptoms and adaptive coping strategies, resilience, and well-managed expectations have improved functional outcomes and satisfaction after orthopaedic procedures...

»: Scapular dyskinesis is an alteration of normal scapular kinematics. It is essential that each patient be evaluated holistically and that sport-related factors be taken into account. »: The presentation of scapular dyskinesis may be highly variable depending on the underlying etiology or associated pathology, but the onset of symptoms is often gradual. »: Sport-specific literature on scapular dyskinesis is most commonly reported in the context of baseball, swimming, and tennis...

INTRODUCTION: Resorption after lumbar disk herniation is a common yet unpredictable finding. It is hypothesized that nearly 70% of lumbar herniated nucleus pulposus (HNP) undergo the resorption to a significant degree after acute herniation, which has led to nonoperative management before surgical planning. METHODS: This narrative review on the literature from 4 databases (MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Cochrane) examines historical and recent advancements related to disk resorption...

BACKGROUND: Surgical repair of clavicle fractures is being employed more frequently, although most fractures are still treated conservatively. Both can result in nonunion. Current treatments for clavicle nonunion include open reduction with internal fixation (ORIF) plating without bone graft, ORIF plating with bone graft, and intramedullary pin fixation. METHODS: We performed a systematic review and meta-analysis of studies reporting outcome, complication, and reoperation rates following surgical treatment for clavicle nonunion...

»: As total joint arthroplasty volume continues to grow nationwide, more uncommon complications such as metal implant hypersensitivity are reported with greater frequency in the literature. »: Metal hypersensitivity is a challenging diagnosis given the potentially vague symptomology. It should be considered a diagnosis of exclusion, necessitating careful consideration of other potential etiologies of a failing implant before arriving at the final diagnosis of metal hypersensitivity...

BACKGROUND: Persistent shoulder pain and dysfunction after vaccination are relatively rare but well-known complications after inoculations into the deltoid muscle. The term SIRVA (shoulder injury related to vaccine administration) is frequently used to encompass many of these occurrences; however, multiple distinct pathologies with similar presentations have been reported after vaccination. We performed a systematic review of the literature on vaccine-related shoulder injuries to help guide practitioners in appropriate workup and treatment based on specific diagnoses...