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Knee Pain Is Not Always the Knee.

JBJS Rev

January 2025

Adult Reconstruction, Orthopedic Surgery Department, Lenox Hill Hospital Northwell Health, New York, New York.

» Lumbar spine pathology is a known cause of referred pain to the lower extremities and should be investigated as a possible source of knee pain, especially with patients in their sixth decade.» While primary knee pathology is common, spinal pathology should always be considered in older patients presenting with knee pain, especially in atraumatic cases where knee imaging does not correlate with complaints or examination findings.» Lumbar (L) 3-4 pathology is most commonly affected in referred knee pain, with the 2 most common pathologies being spinal stenosis and disc herniation.

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Background: Reverse shoulder arthroplasty (RSA) is increasingly used in the treatment of proximal humerus fractures (PHFs) with reliable clinical improvement. Lateralized RSA implants have conferred superior outcomes compared with the original Grammont design in patients with nontraumatic indications. However, in the setting of a PHF, lateralized components can place increased tension across the tuberosity fracture site and potentially compromise tuberosity healing and outcomes.

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» Anemia is a common comorbidity in orthopaedic trauma patients with important clinical consequences, significantly negatively affecting a patient's course following orthopaedic trauma.» Anemia remains relatively understudied in the orthopaedic trauma population with a large amount of current literature focused solely on geriatric hip fracture patients.» Greater investigation into alternatives to blood transfusions such as iron therapy or cell salvaging for treatment of anemia in the orthopaedic trauma population is needed.

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Review of Outcomes After Peripheral Nerve Transfers for Motor Nerve Injury in the Upper Extremity.

JBJS Rev

November 2024

Division of Plastic and Reconstructive Surgery, University of Colorado School of Medicine, Anschutz Medical Center, Aurora, Colorado.

Background: Modern nerve-to-nerve transfers are a significant advancement in peripheral nerve surgery. Nerve transfers involve transferring donor nerves or branches to recipient nerves close to the motor end unit, leading to earlier reinnervation and preservation of the musculotendinous units in proximal nerve injuries. After nerve reinnervation, function may be superior to traditional tendon transfer techniques in terms of strength and independent motion.

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» Increased professional, personal, and emotional stress can have compounding negative effects on physicians, which can be detrimental to teamwork dynamics, workplace environment, productivity, and personal well-being. Orthopaedic surgery, in particular, is a medical specialty that demonstrates high workplace demands, elevated rates of burnout, and low workplace diversity.» Professional coaching can help combat these challenges and facilitate professional success by providing an outlet for discussion and planning toward one's career development and goals.

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