JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME

Outcomes Following Transtibial Amputation with and without a Tibiofibular Synostosis Procedure: A Multicenter Randomized Clinical Trial (TAOS Study)
This study compared outcomes at 18 months between patients who underwent transtibial amputation with and without a tibiofibular synostosis procedure. We hypothesized that complication rates would be lower in patients who did not receive a synostosis procedure compared with those who did receive a synostosis procedure, but the synostosis group would report better function.
The 2024 American Orthopaedic Association-Japanese Orthopaedic Association Traveling Fellowship
McDonald LS, Hynes KK, Parry JA, Stephens BF and Schwab JH
In 1992, the American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship was created to develop and enhance collaboration between the Japanese and American orthopaedic communities. The fellowship is geared to early-career surgeons and fosters clinical and cultural exchange between members of the 2 countries. In 2024, the fellows hailed from around the United States: Kelly K. Hynes, Lucas S. McDonald, Joshua A. Parry, Joseph H. Schwab, and Byron F. Stephens all participated in the program. During the 3-week fellowship, the fellows visited 8 academic centers across Japan and attended the JOA Annual Meeting in Fukuoka. This experience was incredibly rewarding, both clinically and professionally, and all the fellows returned home with novel ideas for their clinical practices.
Achieving Better Clinical Outcomes After Total Knee Arthroplasty in Knees with Valgus Deformity: The Role of Alignment Strategies
Batailler C, Lording T, Libert T, Servien E and Lustig S
Personalized alignment in total knee arthroplasty (TKA) has demonstrated good functional outcomes for knees with varus alignment. However, limited research has explicitly addressed optimal alignment strategies for valgus knees. The aims of the current study were to assess the impact of the postoperative knee alignment and of the degree of correction of knee alignment on functional outcomes and satisfaction in a population with preoperative valgus and to evaluate the complication and revision rates based on postoperative alignment.
Radiographic Outcome Following Treatment of Residual Hip Dysplasia with Pemberton Versus Salter Osteotomy: Comparison of Results in Patients Followed to Skeletal Maturity
Sucato DJ, Brabham CE, De La Rocha A, Podeszwa DA and Karol LA
Salter osteotomy (SO) and Pemberton acetabuloplasty (PA) are procedures to treat skeletally immature patients with developmental dysplasia of the hip (DDH). The purpose of this study was to compare the radiographic results and rate of residual dysplasia (RD) after treatment with SO and with PA.
The CR Versus PS Debate: A Throwback Throw-Down in Total Knee Arthroplasty: Commentary on an article by Young-Hoo Kim, MD, et al: "No Discernible Difference in Revision Rate or Survivorship Between Posterior Cruciate-Retaining and Posterior Cruciate-Substituting TKA"
Abdeen A
Our Impact on Global Warming: A Carbon Footprint Analysis of Orthopaedic Operations
Eidmann A, Geiger F, Heinz T, Jakuscheit A, Docheva D, Horas K, Stratos I and Rudert M
The health-care sector and particularly the surgical sector are major contributors to the exacerbation of the global climate crisis. Little is known about the carbon emissions caused by surgical procedures. Therefore, the aim of this study was to estimate the carbon footprint associated with common orthopaedic surgical procedures.
Determining Maximal Outcome Improvement Thresholds for Patient-Reported Outcome Measures After Primary ACL Reconstruction: A Mid-Term Follow-up Study Using the Anchor Method
Zhang ZY, Shi WL, Bai WB, Hong LJ, Dai WL, Pan XY, Fu XY, Wang JQ and Wang C
The clinical interpretation of patient-reported outcome measures (PROMs) after anterior cruciate ligament (ACL) reconstruction (ACLR) can be challenging. This study aimed to establish the clinical relevance of PROMs by determining maximal outcome improvement (MOI) thresholds at mid-term follow-up after primary ACLR.
What Is the Best Way to Treat Focal Articular Cartilage Lesions of the Knee? Perhaps No Treatment at All: Commentary on an article by Thomas Birkenes, MD, et al.: "Long-Term Outcomes of Arthroscopically Verified Focal Cartilage Lesions in the Knee. A 19-Year Multicenter Follow-up with Patient-Reported Outcomes"
Matava MJ
Development and Validation of Objective and Subjective Osteoporosis Knowledge Instruments Among Chinese Orthopaedic Surgeons
Mo J, Mo Y, He J, Yang B, Jiang X, He L, Lu S, Wu W, Pang M, Feng F, Xie P, Fan S and Rong L
Clinicians must be knowledgeable about osteoporosis so that they can convey information regarding the prevention of fragility fractures to their patients. The purposes of this study were to develop objective and subjective knowledge instruments for osteoporosis and fragility fractures and then test their reliability and validity among Chinese orthopaedic surgeons.
What's Important (Arts & Humanities): Temple of Healing
Fareed H
This literary investigation dives into the complex combination of scientific knowledge, creative expertise, surgical skills, and fundamental humanistic qualities that constitute the orthopaedic profession. This poetic perspective conveys the essence of orthopaedic surgery techniques by figuratively describing the processes involved in bone and joint operations and commenting on the meticulous labor that doctors undertake with sinews, sockets, tendons, and bones. It emphasizes the human body's resilience and the restorative power of orthopaedic interventions, depicting how surgeons navigate the complexities of human anatomy to repair injuries and alleviate degenerative conditions, not only restoring physical strength but also giving patients a renewed sense of life and mobility. "Temple of Healing" is a dedication to orthopaedic surgeons, stressing the combination of art and science in their work and highlighting the enormous influence of orthopaedic surgery on patient quality of life.
Trends in Medicare Payments for Facility Fees and Surgeon Professional Fees for Spine Surgeries
Federico VP, Acuna AJ, Salazar LM, Vucicevic R, Nguyen AQ, Reed L, Harkin WE, Serino J, Butler AJ, Colman MW and Phillips FM
What's Important: Osteoempathy: Bridging Surgeon and Bone
Saggar R
What's Important: Let's Learn to Talk About Our Patients as if They Are Sitting Right in Front of Us
Harrison RK
Blood and Bone-Derived DNA Methylation Ages Predict Mortality After Geriatric Hip Fracture: A Pilot Study
Tarpada SP, Heid J, Sun S, Lee M, Maslov A, Vijg J and Sen M
The purpose of this study was to (1) perform the first analysis of bone-derived DNA methylation, (2) compare DNA methylation clocks derived from bone with those derived from whole blood, and (3) establish a relationship between DNA methylation age and 1-year mortality within the geriatric hip fracture population.
Multicenter Randomized Clinical Trial of Highly Cross-Linked Polyethylene Versus Conventional Polyethylene in 518 Primary TKAs at 10 Years
Salmons HI, Larson DR, Ortiguera CJ, Clarke HD, Spangehl MJ, Pagnano MW, Stuart MJ and Abdel MP
Second-generation highly cross-linked polyethylene (HXLPE) has revolutionized total hip arthroplasty. However, the long-term risks and benefits of HXLPE in primary total knee arthroplasty (TKA) remain unknown. This randomized clinical trial evaluated implant survivorship, complications, radiographic results, and clinical outcomes of HXLPE and conventional ultra-high molecular weight polyethylene (UHMWPE) inserts in primary TKAs.
Spondylolisthesis in Young Patients in a Large National Cohort: Reoperation Rate Depends on Surgical Approach
Nilssen PK, Narendran N, Finkel RA, Illingworth KD and Skaggs DL
The current literature investigating surgical treatments for lumbar spondylolisthesis in adolescent patients is limited by small sample sizes. There are high reoperation rates, and posterior interbody fusion has not been reported to help. The current study aimed to utilize a nationwide database to investigate outcomes of spinal fusion for spondylolisthesis in young patients.
What's Important (Patient Perspective): Never Too Old to Gain Empathy
Herzenberg JE
The Microbial Road Trip: Are We Nearing the Golden Era of Orthopaedics?: Commentary on an article by Sunqi Nian, MM, et al.: "Landscape of the Lumbar Cartilaginous End Plate Microbiota and Metabolites in Patients with Modic Changes"
Dahmen J and Kerkhoffs GMMJ
Shoulder Periprosthetic Joint Infection: Principles of Prevention, Diagnosis, and Treatment
Nazzal EM, Herman ZJ, Como M, Kaarre J, Reddy RP, Wagner ER, Klatt BA and Lin A
➢ Shoulder periprosthetic joint infection (PJI) is a potentially devastating complication after arthroplasty and is projected to rise with increasing numbers of performed arthroplasties, particularly reverse shoulder arthroplasties.➢ Important considerations for the diagnosis and treatment of shoulder PJI include age, sex, implant type, primary compared with revision shoulder surgery, comorbidities, and medications (i.e., corticosteroids and disease-modifying antirheumatic drugs).➢ Diagnosis and management are unique compared with lower-extremity PJI due to the role of lower-virulence organisms in shoulder PJI, specifically Cutibacterium acnes.➢ Treatment pathways depend on chronicity of infection, culture data, and implant type, and exist on a spectrum from irrigation and debridement to multistage revision with temporary antibiotic spacer placement followed by definitive revision arthroplasty.
Early-Stage Femoral Head Hypoperfusion Correlates with Femoral Head Deformity at Intermediate Follow-up in Legg-Calvé-Perthes Disease
Kang MS, Zimmerhanzel D, Haider S and Kwang-Woo Kim H
Perfusion MRI (pMRI) can quantify femoral head hypoperfusion in early-stage Legg-Calvé-Perthes disease. We investigated whether the severity of hypoperfusion measured at the early stage correlates with femoral head deformity at intermediate-term follow-up.
The Consequences of Surgical Timing in Multiligament Knee Injury: Commentary on an article by Graeme Hoit, MD, et al.: "Early Compared with Delayed Reconstruction in Multiligament Knee Injury. A Retrospective Propensity Analysis"
Dekker TJ