General Orthopaedics Archive

SUMMARY: Autograft remains the most effective bone grafting material, but substitutes (allograft, ceramics, demineralized bone matrix, marrow, composites) each supply only part of the needed osteoconductive, osteoinductive, and osteogenic properties, so choice depends on the clinical indication.

SUMMARY: Nontobacco nicotine products may impair healing biologically, but database studies suffer from exposure misclassification, so nicotine-specific surgical risk is unproven; perioperative cessation of all nicotine remains a reasonable precaution.

SUMMARY: This overview of orthopaedic care in Brazil describes its universal public system and mixed public-private trauma delivery, highlighting unequal access between urban centers and underserved regions and the need for better registries and outcome data.

SUMMARY: This expert-opinion review explains how generative AI methods such as autoencoders, GANs, and diffusion models enable medical image reconstruction, with potential benefits for image quality and surgical planning, and stresses the need for governance.

SUMMARY: In a large NSQIP database study, 22% of orthopaedic patients with preoperative HbA1c had undiagnosed prediabetes and 4% undiagnosed diabetes; complication risk rose with HbA1c, though readmission and reoperation were not independently increased.

SUMMARY: Review explaining why early-career orthopaedic surgeons should join professional societies, with guidance on getting involved and a list of leadership, mentorship, fellowship, and research opportunities for surgeons in their first 10 years of practice.

SUMMARY: This review introduces radiomics, the extraction of quantitative imaging features invisible to the human eye, and explains its basics and potential diagnostic and prognostic uses for orthopaedic surgeons.

SUMMARY: Calculates the risk of transplanting a bone allograft from an HIV-infected donor as extremely low (about one in a million) with rigorous donor screening, but far higher (about one in 161) with antibody testing alone.

SUMMARY: In 30,003 prior authorization requests at a large orthopaedic practice, 97% were approved on the first try and only 1% ultimately denied, yet the process still consumed substantial staff time and delayed care.

SUMMARY: In 3,020 aircraft employees followed over 4 years, low job enjoyment and high MMPI Hy scores predicted reported back injury, underscoring psychosocial factors beyond purely physical risks.

SUMMARY: This review introduces Bayesian statistics for orthopaedic surgeons, contrasting it with P value testing using prosthetic joint infection and the VANCO trial as examples, and outlines how to critically appraise Bayesian studies.

SUMMARY: Overview of the ethical and policy challenges of implementing artificial intelligence in surgery, including surgical ethics basics and current health AI policy, emphasizing core ethical principles for safe adoption.

SUMMARY: This review explains how local mechanical stress and strain guide mesenchymal tissue toward bone, cartilage, or fibrous tissue during fracture healing and distraction osteogenesis, with finite element models predicting observed patterns.

SUMMARY: Cartilage from osteoarthritic hips showed reduced safranin-O staining and markedly increased DNA, protein, and polysaccharide synthesis versus fracture controls, suggesting chondrocytes revert to a more proliferative, matrix-producing state under chronic stress.

SUMMARY: This review explains how the FDA regulates commonly injected orthobiologics, including PRP, bone marrow, adipose, and birth-tissue products, and how processing and marketing determine the applicable regulatory pathway.

SUMMARY: Overview of how increasingly affordable 3-D printing is reshaping orthopaedics through anatomic models, custom guides and instruments, patient-specific devices, preoperative planning, and education.

SUMMARY: This essay argues that orthopaedic surgeons' responsibilities can extend beyond the operating room into advocacy, education, and policy work, provided such roles multiply patient benefit without eroding needed surgical capacity.

SUMMARY: Practical guide explaining propensity score matching and target trial emulation for observational orthopaedic research, with a checklist for appraising studies and a reminder that neither fixes unmeasured confounding.

SUMMARY: Technical note describing a cheap, hands-free method to suspend the lower limb during surgical prep using a bandage loop, two cotton swabs, and an IV pole, reducing staff strain.

SUMMARY: A scoping review of 15 laboratory studies found dose-dependent TXA toxicity to cartilage, tendon, and synovium above about 20 mg/ml, with no clinical toxicity reported; concentrations at or below 20 mg/ml appear safe, but human trials are needed.

SUMMARY: In rabbits, multiple subchondral perforations let cartilage-like tissue fully resurface the joint by 12 months, but it lost its hyaline appearance after 8 months and resembled dense collagenous tissue.

SUMMARY: Review of hereditary sensory and autonomic neuropathies, outlining their orthopaedic manifestations (Charcot arthropathy, spinal deformity, fractures, osteomyelitis) and a treatment focus on infection control, fracture stabilization, and joint stability.

SUMMARY: Proposes OSCAR, a conceptual 6-stage framework tracking orthopaedic AI tools from model development through monitored clinical deployment, stressing that accuracy alone doesn't establish clinical readiness; it remains unvalidated.

SUMMARY: Reviews CMS value-based care models (VBEs, TEAM, mandatory PROMs) for musculoskeletal care, arguing that realigned incentives and surgeon participation are needed to improve outcomes and cost efficiency.

SUMMARY: Reviews how economic evaluations of short-term surgical trips to developing countries are done and proposes a conceptual model to guide cost analyses, helping policymakers reduce cost and improve access to specialty surgery.

SUMMARY: This narrative review explores how AI tools such as augmented vision, ambient clinical documentation, and personalized patient education could streamline orthopaedic workflows and improve counseling, while noting adoption limitations.

SUMMARY: Reviews how low-resource innovations, such as the Ilizarov fixator, Jaipur Foot and local negative-pressure wound systems, could be adapted to high-income settings to cut costs and improve access, using pilot programs and careful monitoring.

SUMMARY: In 192 adults, iliac crest grafting had a 2.4% major complication rate, and about 19% still reported donor-site pain beyond two years, so morbidity remains substantial.

SUMMARY: This primer explains how Medicare works and its shift from fee-for-service toward value-based payment, aimed at helping orthopaedic surgeons and other stakeholders understand and improve the program.

SUMMARY: This pediatric orthopaedic review summarizes neuroscience showing empathy and compassion are innate, teachable, and modifiable, and suggests this understanding can inform programs to reduce clinician burnout and improve compassionate care.