Comparison and Validation of Methods for Restoring Neck Length in Hip Arthroplasty That Can Be Applied for Femoral Neck Fracture.

Restoring leg length during total hip arthroplasty (THA) for femoral neck fracture is challenging due to the lack of an intact femoral neck on the fractured side. Thus, templating methods typically use size of the intact contralateral hip to estimate length. Common reference points include the distance from the lesser trochanter to the center of the femoral head (LTC) and femoral head diameter (FHD).

Individuals with Heterogenous Trabecular Bone Texture by Clinical MRI have Lower Bone Strength and Stiffness by QCT Based Finite Element Analysis.

Opportunistic screening is essential to improve the identification of individuals with osteoporosis. Our group has utilized image texture features to assess bone quality using clinical MRIs. We have previously demonstrated that greater heterogeneity of MRI texture related to history of fragility fractures, lower bone density, and worse microarchitecture.

Focal Fibrocartilaginous Dysplasia and Growth Arrest: Case Report.

Case: A pediatric patient with focal fibrocartilaginous dysplasia (FFCD) developed angular deformity and growth arrest despite standard guided growth management. The patient underwent implant-mediated guided growth for proximal tibia varus deformity which recurred; subsequently, a physeal bar of the medial proximal tibia was diagnosed, which progressed to physeal arrest.

Conclusion: Treatment options for FFCD-associated angular deformity include observation and guided growth.

Sex and Gender Considerations in Orthopaedic Research: Existing Barriers, What's Needed by Institutions and Research Departments, and How to Guide Junior Investigators and Faculty.

JBJS convened a symposium to discuss the reporting of sex and gender in research studies as an imperative to improve research methods and results to benefit all patients. Barriers to improved reporting include a lack of societal and cultural acceptance of its need; a lack of education regarding appropriate terminology and appropriate statistical methods and efficient study designs; a need for increased research funding to support larger group sizes; unknown concordance of cell and animal models with humans to reflect biologic variables such as sex; and a lack of understanding of key considerations of gender, race, and other social determinants of health and how these factors intersect. Attention to developing and disseminating best-practice statistical methods and to educating investigators (at all career levels), reviewers, funders, editors, and staff in their proper implementation will aid reporting.

Latissimus Dorsi Tendon Transfer and Reverse Shoulder Arthroplasty: Restoring Mechanical Advantage by Transfer Posterior to the Long Head of the Triceps Tendon.

Background: Patients undergoing reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy may present with an external rotation (ER) lag due to posterior rotator cuff insufficiency. As a result, the addition of a latissimus dorsi (LD) tendon transfer in combination with RSA has become increasingly utilized. Initial descriptions of LD tendon transfer involved rerouting of the LD tendon posterior to the long head of the triceps tendon.

Temporal Changes in PROMs Improvement and Recovery Kinetics Following Transforaminal Endoscopic Lumbar Discectomy.

Study Design: Retrospective cohort study.

Objective: to analyze trends in PROMs improvement and recovery kinetics following transforaminal endoscopic lumbar discectomy and foraminotomy (TELD).

Summary Of Background Data: As TELDs become an increasingly common alternative to fusions for lateral disc herniations, it is important to understand patients' postoperative recovery timelines to manage patient expectations.

Glucagon-Like Peptide-1 Receptor Agonists Decrease Medical and Surgical Complications in Morbidly Obese Patients Undergoing Primary TKA.

Background: Weight optimization methods in morbidly obese patients with a body mass index (BMI) of ≥40 kg/m2 undergoing total knee arthroplasty (TKA) have shown mixed results. The purpose of this study was to evaluate the effect of perioperative use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with a BMI of ≥40 kg/m2 undergoing primary TKA.

Methods: Using an administrative claims database, patients with morbid obesity undergoing primary TKA were stratified into GLP-1 RA use for 3 months before and after the surgical procedure (treatment group) and GLP-1 RA non-use (control group), and were matched on the basis of patient age, gender, diagnosis of type-2 diabetes mellitus, and Charlson Comorbidity Index (CCI).

Allogeneic haematopoietic stem-cell transplantation for children with refractory systemic juvenile idiopathic arthritis and associated lung disease: outcomes from an international, retrospective cohort study.

Background: Systemic juvenile idiopathic arthritis-related lung disease (sJIA-LD) is a severe complication in patients with treatment-refractory systemic juvenile idiopathic arthritis (sJIA). The objective of this study was to evaluate the effect of allogeneic haematopoietic stem-cell transplantation (HSCT) in a cohort of children with sJIA-LD.

Methods: This international, retrospective cohort study was performed in nine hospitals across the USA and Europe in children with sJIA-LD who had received allogeneic HSCT.

Osteomyelitis and Septic Arthritis of the Upper Extremity in Pediatric Patients.

Purpose Of Review: For pediatric osteomyelitis and septic arthritis, 10-24% of cases occur in the upper extremity (UE). Due to delays in presentation and diagnosis, UE infections are often more complex and severe than infections of the lower extremity (LE). This review evaluates the literature from the past 6 years related to pediatric osteomyelitis and septic arthritis of the UE and provides a guide for professionals managing these conditions in children.

Perioperative Geriatrician Assessment Is Associated with a Lower Risk of Emergency Department Visits After Total Joint Arthroplasty.

Background: Previous research has underscored the benefits of geriatrician consultation in improving outcomes for older patients undergoing hip fracture repair, highlighting enhanced functional outcomes and reduced morbidity. However, the impact of geriatrician care in outcomes for patients undergoing elective total joint arthroplasty (TJA) has yet to be described. We aimed to determine whether preoperative or postoperative geriatrician involvement was associated with differences in the length of hospital stay and emergency department (ED) visits after TJA.

Long non-coding RNA fine-tunes bone homeostasis and repair by orchestrating cellular crosstalk and β-catenin-OPG/Jagged1 pathway.

The IncRNA was initially believed to be dispensable for physiology due to the lack of observable phenotypes in knockout (KO) mice. However, our study challenges this conclusion. We found that both KO and conditional KO mice in the osteoblast lineage exhibit significant osteoporosis.

Injury Patterns, Imaging Findings, and Prognosis for Muscle Strength Recovery in Surgical Infraclavicular Brachial Plexus Injuries.

Purpose: Historically, infraclavicular brachial plexus injuries (IBPIs) were considered neuropraxic injuries that would improve with nonsurgical intervention. However, more recent studies suggest that these injuries may benefit from surgical intervention. The aims of this retrospective study were to (1) describe injury patterns and associated injuries of isolated, traumatic IBPIs, (2) evaluate the concordance of preoperative ultrasound and magnetic resonance neurography with surgical findings of patients who underwent surgical intervention for IBPIs, and (3) describe outcomes of surgical intervention for these injuries.

What's up with patella alta?

Purpose Of Review: Patella alta, which describes an abnormally proximally positioned patella, has become of particular interest as it has been identified as a potential factor in patellofemoral instability (PFI) and other common pediatric orthopedic conditions. The purpose of this review is to describe the condition, measuring techniques, and its association with pediatric orthopedic conditions, and to evaluate methods of correction of patella alta.

Recent Findings: Recent literature has explored the etiology of patella alta by investigating patellar height as age increases, with inconclusive findings as to whether the condition is congenital or acquired over time.

Association between modifiable and nonmodifiable risk factors with paralumbar muscle health in patients with lower back pain.

Background: Prior studies have linked sarcopenia and fat infiltration in paraspinal muscles with lumbar pain, spinal pathology, and adverse postoperative outcomes in lumbar spine surgery. A recent magnetic resonance imaging (MRI)-based method for assessing muscle health, incorporating parameters such as Goutallier Classification (GC) and the Paralumbar Muscle Cross-Sectional Area to Body Mass Index ratio (PL-CSA/BMI), has shown that higher muscle grades correlate with significant improvements in patient-reported outcomes. Despite these advancements, there is limited research on the associations between paralumbar muscle health and factors such as age, BMI, walking tolerability, and spondylolisthesis.

Which Osteochondritis Dissecans Lesions Will Heal Nonoperatively? An Application of Machine Learning to the ROCK Prospective Cohort.

Background: There are limited evidence-based guidelines to predict which osteochondritis dissecans (OCD) lesions will heal with nonoperative treatment.

Purpose: To train a set of classification algorithms to predict nonoperative OCD healing while identifying new clinically meaningful predictors.

Study Design: Case-control study; Level of evidence, 3.

Mid-term Results Following Surgical Hip Dislocation for Residual Pediatric Deformities.

Background: Mid-term results following surgical hip dislocation (SHD) for healed slipped capital femoral epiphysis (SCFE) and Perthes-related deformities are limited. This study aimed to characterize patient-reported outcome measures [including rates of achieving the minimal clinically important difference (MCID) and patient-acceptable symptomatic state (PASS)], report survivorship free from conversion to arthroplasty, and identify risk factors associated with composite failure.

Methods: Twenty-seven patients (n=13 SCFE, n=14 Perthes) with minimum 2-year follow-up (mean 5.

Large Language Models Applied to Health Care Tasks May Improve Clinical Efficiency, Value of Care Rendered, Research, and Medical Education.

Large language models (LLMs) are generative artificial intelligence models that create content on the basis of the data on which it was trained. Processing capabilities have evolved from text only to being multimodal including text, images, audio, and video features. In health care settings, LLMs are being applied to several clinically important areas, including patient care and workflow efficiency, communications, hospital operations and data management, medical education, practice management, and health care research.

A Comparison of Throwing Arm Kinetics and Ball Velocity in Professional Baseball Pitchers with the Fastest Maximum Joint and Segment Velocities.

Background: Significant associations have been established among individual maximum joint and segment velocities with throwing arm kinetics and ball velocity in baseball.

Purpose: Investigate how pitches with the fastest maximum joint and segment velocities, in both ideal and non-ideal sequence order, may impact ball velocity and throwing arm kinetics in professional baseball pitchers.

Methods: Professional(n=338) pitchers threw 8-12 fastball pitches while evaluated with 3D-motion capture (480 Hz).

Skeletal Stem Cells: A Basis for Orthopaedic Pathology and Tissue Repair.

➢ Skeletal stem cells (SSCs) continually replenish mature cell populations to support skeletal homeostasis.➢ SSCs repopulate by self-renewal, have multilineage potential, and are long-lived in vivo.➢ SSCs express specific combinations of cell surface markers that reflect their lineage identity.

Effectiveness of a large language model for clinical information retrieval regarding shoulder arthroplasty.

Purpose: To determine the scope and accuracy of medical information provided by ChatGPT-4 in response to clinical queries concerning total shoulder arthroplasty (TSA), and to compare these results to those of the Google search engine.

Methods: A patient-replicated query for 'total shoulder replacement' was performed using both Google Web Search (the most frequently used search engine worldwide) and ChatGPT-4. The top 10 frequently asked questions (FAQs), answers, and associated sources were extracted.

Understanding rare genetic variants within the terminal pathway of complement system in preeclampsia.

Preeclampsia is a common multifactorial disease of pregnancy. Dysregulation of complement activation is among emerging candidates responsible for disease pathogenesis. In a targeted exomic sequencing study of 609 women with preeclampsia and 2092 non-preeclamptic controls, we identified 14 variants within nine genes coding for components of the membrane attack complex (MAC, C5b-9) that are associated with preeclampsia.

Ethical Application of Generative Artificial Intelligence in Medicine.

Generative artificial intelligence (AI) may revolutionize health care, providing solutions that range from enhancing diagnostic accuracy to personalizing treatment plans. However, its rapid and largely unregulated integration into medicine raises ethical concerns related to data integrity, patient safety, and appropriate oversight. One of the primary ethical challenges lies in generative AI's potential to produce misleading or fabricated information, posing risks of misdiagnosis or inappropriate treatment recommendations, which underscore the necessity for robust physician oversight.