The Journal of bone and joint surgery. American volume
Audio Summaries

Diagnostic Performance and Clinical Outcomes of Intraoperative Neuromonitoring in Adolescent Idiopathic Scoliosis: A Comprehensive Analysis of 5,206 Patients

Sep 23, 2026

The authors aimed to identify curve-specific risk factors for intraoperative neuromonitoring (IONM) alerts during spinal fusion surgery for adolescent idiopathic scoliosis (AIS) in a cohort of 5,206 patients. They found that IONM alerts occurred in 5% of patients, with a significant association to larger preoperative major Cobb angles and specific Lenke classifications, but noted that alerts did not adversely affect 2-year surgical correction outcomes. Overall, the study highlights the importance of monitoring and understanding risk factors associated with IONM alerts in AIS surgeries.

Spine Surgery Missions in Low-Resource Settings: Practical Considerations and Lessons Learned

Sep 23, 2026

The authors investigate the critical factors that contribute to the success of spine surgery missions in low-resource settings, specifically through their experiences in Jamaica. They emphasize the importance of logistical planning, ethical patient selection, and sustainable partnerships with local institutions to enhance the impact of these missions. The paper offers practical recommendations for surgeons and organizations aiming to conduct similar initiatives.

Orthopaedic Oncology in India and Asia: A Report on Disease Burden, Access, Current Status, and Improving Care Delivery

Sep 23, 2026

The authors investigate the challenges and current status of orthopaedic oncology in Asia, particularly focusing on the significant burden of sarcoma and the socioeconomic factors affecting care delivery. They highlight the need for improved training for specialists, government initiatives, and regional collaboration to address disparities in sarcoma treatment. The study emphasizes that insights gained from Asia's experience can inform global strategies for sustainable healthcare in oncology.

Extra-Articular Malunions and Nonunions of the Scapular Body and Neck: A Comparison of Functional Outcomes Before and After Reconstruction

Sep 23, 2026

This study investigates the functional outcomes of patients with extra-articular malunions and nonunions of the scapular body and neck following surgical reconstruction. The authors found significant improvements in range of motion, strength, and disability scores postoperatively, indicating that corrective surgery effectively addresses the complications associated with these fractures. Overall, the results suggest that timely and principled reconstruction can lead to favorable outcomes in patients suffering from these conditions.

Ability of Deep Learning to Predict Surgical Recommendations for Distal Radial Fractures: A Feasibility Study

Sep 22, 2026

This study investigates the feasibility of using artificial intelligence to predict whether a fellowship-trained hand surgeon would recommend operative or nonoperative management for distal radial fractures based on pre-reduction radiographs and clinical data. The developed model achieved high accuracy and sensitivity, indicating its potential utility in clinical decision-making. Future research will aim to validate the model externally and enhance its performance by incorporating more imaging features.

Prevention of Periprosthetic Fractures: What Should We Be Doing to Address This Impending Epidemic?

Sep 22, 2026

The authors investigate the rising incidence of periprosthetic fractures following total hip arthroplasties, emphasizing the urgent need for preventive strategies due to the high morbidity and mortality associated with these fractures. They highlight the importance of a multidisciplinary approach in arthroplasty care to mitigate the risks and improve outcomes for patients as the population ages and the number of joint replacements increases.

The CPT 22-Modifier at a Single Private-Practice Orthopaedic Institution: Success, Reimbursement, and Financial Burden

Sep 21, 2026

This study investigates the effectiveness and financial implications of using the CPT 22-modifier in surgical billing at a private orthopaedic practice, focusing on its success rates, reimbursement amounts, and associated delays across various subspecialties. The findings reveal that while the modifier is more frequently approved by government payers and results in a modest increase in reimbursement, it also leads to significant delays and higher rebilling rates, suggesting that the administrative burden may outweigh the financial benefits in certain cases.

The Management of Pelvic and Vertebral Fragility Fractures: An Unmet Care Need

Sep 18, 2026

The authors investigate the challenges in diagnosing and managing pelvic and vertebral fragility fractures, which are prevalent and associated with significant morbidity and mortality. They emphasize the importance of nonoperative treatment for most patients while highlighting the need for surgical intervention in cases of severe pain or functional impairment. Additionally, the paper underscores the necessity of secondary fracture prevention to enhance recovery and reduce the risk of further fractures.

A Novel Mini-Prosthesis with a Nano-Multilayer Film-Coated Surface and 3D-Printed Porous Stem for Focal Cartilage Lesions: In Vivo Performance in a Porcine Model

Sep 16, 2026

This study investigates the in vivo performance of a novel mini-prosthesis designed for treating focal cartilage lesions (FCLs) in a porcine model, comparing it to existing options. The results indicate that the Ti6Al4V mini-prosthesis with a nano-multilayer film-coated surface and a 3D-printed porous stem (NMF@3D-Ti) demonstrated superior biocompatibility, osseointegration, and cartilage protection compared to traditional prostheses and microfracture techniques. These findings suggest that the NMF@3D-Ti mini-prosthesis could be a promising joint-preserving alternative in the management of osteoarthritis.

Reimplantation in 2-Stage Exchange: Breaking the Dogma of the 2-Week Antibiotic Holiday

Sep 16, 2026

The authors investigate the optimal timing for reimplantation in patients undergoing 2-stage exchange revision for periprosthetic joint infection, questioning the necessity of a 2-week antibiotic holiday prior to reimplantation. They suggest that a combination of clinical signs and declining serological markers may be more effective in guiding reimplantation timing than traditional metrics, and highlight the potential benefits of continuous antibiotic therapy in improving outcomes. The study calls for the development of a reliable tool to aid in determining the best timing for reimplantation.