Clinical, oncological, and prognostic differences of patients with subsequent skeletal-related events in bone metastases.

Aims: Advances in treatment have extended the life expectancy of patients with metastatic bone disease (MBD). Patients could experience more skeletal-related events (SREs) as a result of this progress. Those who have already experienced a SRE could encounter another local management for a subsequent SRE, which is not part of the treatment for the initial SRE.

Long-term patient reported outcomes after revision surgery for lower extremity nonunion: A retrospective cohort study.

Introduction: Ongoing lower extremity long-bone nonunion is a devastating condition and associated with substantial patient morbidity. There is limited evidence regarding physical and mental function after surgical management of lower extremity nonunions. The purpose of this study was to assess general physical and mental health and lower extremity specific physical function of patients that underwent surgery for a lower extremity long-bone nonunion.

Comparison of Two Modern Survival Prediction Tools, SORG-MLA and METSSS, in Patients With Symptomatic Long-bone Metastases Who Underwent Local Treatment With Surgery Followed by Radiotherapy and With Radiotherapy Alone.

Background: Survival estimation for patients with symptomatic skeletal metastases ideally should be made before a type of local treatment has already been determined. Currently available survival prediction tools, however, were generated using data from patients treated either operatively or with local radiation alone, raising concerns about whether they would generalize well to all patients presenting for assessment. The Skeletal Oncology Research Group machine-learning algorithm (SORG-MLA), trained with institution-based data of surgically treated patients, and the Metastases location, Elderly, Tumor primary, Sex, Sickness/comorbidity, and Site of radiotherapy model (METSSS), trained with registry-based data of patients treated with radiotherapy alone, are two of the most recently developed survival prediction models, but they have not been tested on patients whose local treatment strategy is not yet decided.

Characteristics and Outcomes of Occult Infections in Presumed Aseptic Nonunions: A Retrospective Cohort Study.

Objectives: To determine (1) the rate of positive cultures in presumed aseptic nonunions, (2) the rate and microbial spectrum of positive cultures that represented occult infection, and (3) rates of nonunion healing.

Design: Retrospective cohort study.

Setting: Tertiary referral center.

Opportunistic CT for Prediction of Adverse Postoperative Events in Patients with Spinal Metastases.

The purpose of this study was to assess the value of body composition measures obtained from opportunistic abdominal computed tomography (CT) in order to predict hospital length of stay (LOS), 30-day postoperative complications, and reoperations in patients undergoing surgery for spinal metastases. 196 patients underwent CT of the abdomen within three months of surgery for spinal metastases. Automated body composition segmentation and quantifications of the cross-sectional areas (CSA) of abdominal visceral and subcutaneous adipose tissue and abdominal skeletal muscle was performed.

Are Current Survival Prediction Tools Useful When Treating Subsequent Skeletal-related Events From Bone Metastases?

Background: Bone metastasis in advanced cancer is challenging because of pain, functional issues, and reduced life expectancy. Treatment planning is complex, with consideration of factors such as location, symptoms, and prognosis. Prognostic models help guide treatment choices, with Skeletal Oncology Research Group machine-learning algorithms (SORG-MLAs) showing promise in predicting survival for initial spinal metastases and extremity metastases treated with surgery or radiotherapy.

Consensus on the definition and criteria for failure of surgical treatment in bacterial arthritis of a native joint: An international Delphi study.

Purpose: The literature presents a wide range of success rates for a single surgical intervention of bacterial-septic-arthritis, and there is a lack of clear criteria for identifying treatment failure and making decisions about reintervention. This Delphi study aims to establish a consensus among an international panel of experts regarding the definition of treatment failure and the criteria for reintervention in case of bacterial arthritis.

Methods: The conducting and reporting Delphi studies (CREDES) criteria were used.

Valgus stress radiographs have a minor additional value in detecting lateral cartilage wear when selecting patients for medial partial knee replacement.

Introduction: A valgus stress radiograph, in addition to the weight-bearing fixed flexion posteroanterior radiograph (e.g., Rosenberg), is deemed useful to assess lateral cartilage wear by measuring lateral joint space width (JSW) in patients with medial knee osteoarthritis.

Surprise positive culture rate in the treatment of presumed aseptic long-bone nonunion: a systematic review with meta-analysis of 2397 patients.

Introduction: In pre-operatively presumed aseptic nonunions, the definitive diagnosis of infection relies on intraoperative cultures. Our primary objective was to determine (1) the rate of surprise positive intraoperative cultures in presumed aseptic long-bone nonunion (surprise positive culture nonunion), and (2) the rate of surprise positive cultures that represent infection vs. contamination.

Radial head volume measurements using quantitative three-dimensional computed tomography images for radial head deformation following missed Monteggia lesions.

Background: In chronic radial head dislocation cases, the radial head may enlarge and become dome-shaped. To date, there is no validated tool to quantify radial head deformation and predict its influence on surgical outcomes. This study assesses the potential value of volume and surface calculations obtained by quantitative three-dimensional computed tomography scanning (Q3DCT) in the workup for a corrective surgery in pediatric patients with missed Monteggia lesions.

Fracture risk after intralesional curettage of atypical cartilaginous tumors.

Introduction: The need for curettage of atypical cartilaginous tumors (ACT) is under debate. Curretage results in defects that weaken the bone potentially leading to fractures. The purpose of this study was to retrospectively determine postoperative fracture risk after curettage of chondroid tumors, including patient-specific characteristics that could influence fracture risk.

[Non-union].

A non-union is a fracture that fails to heal within the expected time frame and occurs in approximately 3 to 5% of all fractures. Non-union has a negative impact on mental and physical functioning and quality of life. The causes, clinical presentation and treatment for non-union differ strongly on a case-by-case basis.

Failure rates in surgical treatment in adults with bacterial arthritis of a native joint: a systematic review of 8,586 native joints.

Introduction: Most adult cases of bacterial-septic-arthritis of a native joint are effectively managed with a single surgical debridement, but some cases may require more than one debridement to control the infection. Consequently, this study assessed the failure rate of a single surgical debridement in adults with bacterial arthritis of a native joint. Additionally, risk factors for failure were assessed.

Blade Plate With Autogenous Bone Grafting to Salvage Peri Ankle Nonunions.

Background: Salvage surgery for a nonunion around the ankle is challenging. Poor bone stock, stiffness, scarring, previous (or persistent) infection, and a compromised soft tissue envelope are common in these patients. We describe 15 cases that underwent blade plate fixation as salvage for a nonunion around the ankle, including patient/nonunion characteristics, Nonunion Scoring System (NUSS), surgical technique, healing rate, complications, and long-term follow-up with 2 patient-reported outcome measures.

Accuracy and Reliability of MRI Reports in Diagnosing the Symptomatic Knee in Patients Who Had Bilateral MRI.

Background: Newly symptomatic chronic musculoskeletal illness is often misinterpreted as new pathology, particularly when symptoms are first noticed after an event. In this study, we were interested in the accuracy and reliability of identifying the symptomatic knee based on bilateral MRI reports.

Methods: We selected a consecutive sample of 30 occupational injury claimants, presenting with unilateral knee symptoms who had bilateral MRI on the same date.

Needle Arthroscopy for Bacterial Arthritis of a Native Joint: Surgical Technique for the Shoulder, Elbow, Wrist, Knee, and Ankle Under Local Anesthesia.

Suspected bacterial arthritis of a native joint requires urgent management to control potential life-threatening sepsis and limit cartilage damage. Diagnosing bacterial arthritis is often challenging and relies on diagnostic tests with low accuracy. A high threshold for surgery poses a risk of undertreatment, whereas a low threshold for surgery could lead to overtreatment with unnecessary invasive and costly procedures.

Reduced 5-Year Risk for Revision of the Oxford UKA Using New Instrumentation versus Conventional Instrumentation: A Registry Study of 12,867 UKAs.

Microplasty instrumentation was introduced for a more consistent surgical implantation technique, especially component alignment and tibial resection level, of the Oxford medial unicompartmental knee arthroplasty (UKA) and thereby aims to improve UKA survival. This study aimed to assess the 5-year risk for revision and reasons for revision of the Oxford medial UKA using the new instrumentation (Microplasty) with its predecessor, that is, conventional instrumentation (Phase 3). Data of all medial UKAs from the Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Implantaten) between 2007 and 2019 were collected.

Greater tuberosity fractures are not a continuation of Hill-Sachs lesions, but do they have a similar etiology?

Background: It is unclear whether greater tuberosity fractures (GTF) in the setting of a shoulder dislocation are due to an avulsion of the rotator cuff or a result of an extensive Hill-Sachs lesion (HSL). To explore whether these lesions have similar etiology, the primary aim of this study is to compare the postinjury morphology of the proximal humerus after GTF and HSL.

Methods: Computed tomography scans of 19 patients with HSL and 18 patients with GTF after first-time shoulder dislocations were analyzed.

Body Composition Predictors of Adverse Postoperative Events in Patients Undergoing Surgery for Long Bone Metastases.

Introduction: Body composition assessed using opportunistic CT has been recently identified as a predictor of outcome in patients with cancer. The purpose of this study was to determine whether the cross-sectional area (CSA) and the attenuation of abdominal subcutaneous adipose tissue, visceral adipose tissue (VAT), and paraspinous and abdominal muscles are the predictors of length of hospital stay, 30-day postoperative complications, and revision surgery in patients treated for long bone metastases.

Methods: A retrospective database of patients who underwent surgery for long bone metastases from 1999 to 2017 was used to identify 212 patients who underwent preoperative abdominal CT.

Body composition predictors of mortality in patients undergoing surgery for long bone metastases.

Background And Objectives: Body composition measurements using computed tomography (CT) may serve as imaging biomarkers of survival in patients with and without cancer. This study assesses whether body composition measurements obtained on abdominal CTs are independently associated with 90-day and 1-year mortality in patients with long-bone metastases undergoing surgery.

Methods: This single institutional retrospective study included 212 patients who had undergone surgery for long-bone metastases and had a CT of the abdomen within 90 days before surgery.

Clinical Outcome Differences in the Treatment of Impending Versus Completed Pathological Long-Bone Fractures.

Background: The outcome differences following surgery for an impending versus a completed pathological fracture have not been clearly defined. The purpose of the present study was to assess differences in outcomes following the surgical treatment of impending versus completed pathological fractures in patients with long-bone metastases in terms of (1) 90-day and 1-year survival and (2) intraoperative blood loss, perioperative blood transfusion, anesthesia time, duration of hospitalization, 30-day postoperative systemic complications, and reoperations.

Methods: We retrospectively performed a matched cohort study utilizing a database of 1,064 patients who had undergone operative treatment for 462 impending and 602 completed metastatic long-bone fractures.