Beyond the Usual Significance: Fragility Indices of Randomized Controlled Trials in Top General Orthopaedic Journals.

Introduction: Understanding the reliability of outcomes in randomized controlled trials (RCTs) is crucial, as standard metrics, such as P-value do not fully capture result fragility. This led to the adoption of specific indices: the fragility index (FI), which measures the strength of trial through significant results by calculating the minimum number of patient status changes from nonevent to event required to make the results statistically insignificant; reverse fragility index (RFI), used for insignificant results; and continuous fragility index (CFI), which acts similar to FI for significant continuous outcomes. The objective is to assess the robustness of orthopaedics RCTs using these indices across leading orthopaedic journals.

Does the duration of antibiotic treatment following one-stage treatment of infected total knee arthroplasty influence the eradication rate? A systematic review.

Purpose: The aim of this study was to perform a systematic review of the current literature to elucidate the optimal duration of systemic antibiotic therapy following one-stage revision TKA in the setting of PJI.

Methods: We conducted an electronic search in four databases including Medline (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials without any publication date, language or study design filter on October 1, 2022. The search strategy adhered to PRISMA guidelines and consisted of four main keywords categories which were knee arthroplasty or knee prosthesis, infection and one-stage/single-stage revision.

Clinical challenges in bone tissue engineering - A narrative review.

Bone tissue engineering (BTE) has emerged as a promising approach to address large bone defects caused by trauma, infections, congenital malformations, and tumors. This review focuses on scaffold design, cell sources, growth factors, and vascularization strategies, highlighting their roles in developing effective treatments. We explore the complexities of balancing mechanical properties, porosity, and biocompatibility in scaffold materials, alongside optimizing mesenchymal stem cell delivery methods.

Using a Popular Video Platform to Assess Patient Perceptions of Clubfoot Deformity.

Background: In today's world, individuals receive much of their medical information from the Internet, including social media platforms such as the increasingly popular TikTok, a video-sharing site. This study's purpose was to better understand the content popular online regarding clubfoot deformity.

Methods: The 50 most viewed, English language videos on TikTok with the tags #clubfootjourney, #talipes, #clubfootcast, #clubfoottreatment, and #clubfoot were identified and independently evaluated by 2 separate reviewers for creator demographics, video type, and prominent themes.

The Efficacy of Calcium Sulfate/Hydroxyapatite (CaS/HA) Gentamicin in Osteomyelitis Treatment: A Case Series.

Background: Osteomyelitis is a challenging condition caused by infection and inflammation of the bone, presenting a significant economic burden to healthcare systems. Calcium sulfate/hydroxyapatite (CaS/HA) is a bone void filler composed of 60% calcium sulfate and 40% hydroxyapatite. This case series aimed to report the efficacy and infection-related outcomes of CaS/HA combined with Gentamicin (CaS/HA-G) in treating osteomyelitis.

The role of cannabis on total hip and knee surgeries outcomes: a systematic review and meta-analysis.

Purpose: Cannabis refers to medications derived from the Cannabis plant. Cannabis has long been used to treat a wide range of conditions. The widespread legalization of cannabis has increased its use.

Comparative Efficacy and Safety of Intramedullary Lengthening Nails vs. Alternative Techniques for Femoral Limb Lengthening: A Systematic Review and Meta-Analysis.

Background: Limb lengthening procedures are performed for various indications, including limb length discrepancies (LLDs) and short stature. This systematic review and meta-analysis compares the efficacy and safety of the newer motorized intramedullary lengthening nails (MILNs) with the traditional alternative techniques (ATs) for femoral limb lengthening.

Methods: We conducted a comprehensive literature search in the Medline, Embase, Cochrane, Web of Science, and Scopus databases, inclusive of all dates through July 1, 2023, and without language restrictions.

Impact of Program Characteristics on Diversity Representation in Orthopaedic Surgery Residency Websites.

Objectives: To examine how residency program characteristics, including program type, city population, region, program director/chair sex and ethnicity, and program size, influence the representation of diversity elements on orthopaedic surgery residency program websites.

Design: Cross-sectional study.

Setting: Orthopaedic surgery residency programs in the United States.

Mechanical complications and revision following total joint arthroplasty in acromegalic patients: A nationwide US-based study.

Background: Acromegaly is associated with significant osteoarthritis (OA) and increased risk of vertebral and hip fractures. There is limited data on total joint arthroplasty (TJA) outcomes in patients with acromegaly.

Methods: In this retrospective study, we identified patients with acromegaly who underwent total hip arthroplasty (THA), total knee arthroplasty (TKA), and total shoulder arthroplasty (TSA) between 2010 and 2022 using the PearlDiver national database.

Impacts of radiation therapy on quality of life and pain relief in patients with bone metastases.

Bone metastases (BM) are a common complication in advanced cancer patients, significantly contributing to morbidity and mortality due to their ability to cause pain, fractures, and spinal cord compression. Radiation therapy (RT) is vital in managing these complications by targeting metastatic lesions to ease pain, improve mobility, and reduce the risk of skeletal-related events such as fractures. Evidence supports the effectiveness of RT in pain relief, showing its ability to provide significant palliation and lessen the need for opioid painkillers, thereby enhancing the overall quality of life (QoL) for patients with BM.

International medical graduates (IMGs) matching into US orthopaedic surgery residency: a fifteen year analysis of trends in applications and geographical distribution.

Purpose: International Medical Graduates (IMGs) face challenges in securing orthopaedic surgery residencies in the U.S. This study examines residency matching trends and geographic distribution for U.

Poor Outcomes of Girdlestone Resection Arthroplasty in Injection Drug Users: A Retrospective Study.

This retrospective cohort study aims to investigate the clinical outcomes of Girdlestone resection arthroplasty (GRA) in injection drug users with septic hip arthritis. Patients who underwent primary GRA for septic hip arthritis secondary to injection drug use at two academic trauma centers from 2015 to 2023 were retrospectively reviewed. Patient demographics, surgical details, and follow-up outcomes, including patient-reported outcome measures, were collected and analyzed.

Preoperative SSRI use increases perioperative transfusion need in patients undergoing surgical procedures on the hip joint.

Purpose: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for psychiatric conditions. Previous studies have shown that SSRIs can increase bleeding risk by affecting platelet aggregation. However, their impact on perioperative outcomes in hip surgery remains uncertain.

Efficacy and safety of asfotase alfa in patients with hypophosphatasia: A systematic review.

Background: Hypophosphatasia (HPP) is a rare genetic disorder characterized by defective bone mineralization, leading to skeletal abnormalities and systemic complications. Asfotase alfa, a recombinant human tissue-nonspecific alkaline phosphatase (TNSALP) enzyme replacement therapy, has emerged as a promising treatment for HPP. However, a comprehensive evaluation of its efficacy and safety is warranted to guide clinical practice effectively.

Knee fusion versus above knee amputation as two options to deal with knee periprosthetic joint infection.

Background: Periprosthetic joint infection (PJI) poses a significant challenge in total knee arthroplasty (TKA), with recurrence rates as high as 14-28%, leading to substantial morbidity and treatment costs. When conventional treatments fail, knee fusion and above-the-knee amputation (AKA) emerge as alternative options. Existing literature offers conflicting views on the efficacy and impact of knee fusion versus AKA with varied outcomes and limitations.

Risk factors of postoperative urinary retention following total hip and knee arthroplasty.

Aims: The aim of this meta-analysis was to determine the pooled incidence of postoperative urinary retention (POUR) following total hip and knee arthroplasty (total joint replacement (TJR)) and to evaluate the risk factors and complications associated with POUR.

Methods: Two authors conducted searches in PubMed, Embase, Web of Science, and Scopus on TJR and urinary retention. Eligible studies that reported the rate of POUR and associated risk factors for patients undergoing TJR were included in the analysis.

Effectiveness of synthetic versus autologous bone grafts in foot and ankle surgery: a systematic review and meta-analysis.

Background: All orthopaedic procedures, comprising foot and ankle surgeries, seemed to show a positive trend, recently. Bone grafts are commonly employed to fix bone abnormalities resulting from trauma, disease, or other medical conditions. This study specifically focuses on reviewing the safety and efficacy of various bone substitutes used exclusively in foot and ankle surgeries, comparing them to autologous bone grafts.