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

The SCARE Score: A Simplified Risk Score for Predicting Intraoperative Neuromonitoring Signal Loss in Pediatric Spinal Deformity Surgery

Aug 7, 2026

This study aims to identify preoperative parameters associated with intraoperative neuromonitoring (IONM) signal loss during pediatric spinal deformity surgery, ultimately developing a simplified risk score called the SCARE score. The SCARE score incorporates factors such as spinal cord morphology and deformity angular ratio, allowing surgeons to predict the likelihood of IONM signal loss, which occurred in 24% of cases analyzed. The score is designed to enhance surgical planning and improve patient safety, pending further external validation.

The Impact of Lesser Tuberosity Osteotomy Repair After Reverse Total Shoulder Arthroplasty: A Randomized Controlled Trial

Aug 4, 2026

This study aimed to evaluate the outcomes of reverse total shoulder arthroplasty (rTSA) with and without the repair of the lesser tuberosity osteotomy (LTO) for managing the subscapularis tendon. The results indicated that patients who underwent LTO repair had significantly better American Shoulder and Elbow Surgeons (ASES) scores and improved internal rotation range of motion compared to those without repair, suggesting that subscapularis reattachment enhances functional outcomes without compromising shoulder motion in other planes.

Frailty and Surgical Invasiveness Are Independently Associated with Complications in Pediatric Spinal Deformity Surgery

Aug 4, 2026

The authors aimed to investigate the independent associations of frailty and surgical invasiveness with perioperative outcomes in pediatric patients undergoing spinal fusion for deformity. Their findings revealed that both higher levels of frailty and increased surgical invasiveness significantly correlated with higher rates of adverse events, suggesting that these factors should be considered in preoperative assessments to enhance patient counseling and planning.

An International Expert Consensus Statement Defining the Best Practices and Areas of Uncertainty Concerning the Use of Orthobiologics

Jul 28, 2026

The authors aimed to establish an international expert consensus on best practices and uncertainties regarding the use of orthobiologics in musculoskeletal medicine. Through a Delphi study involving 24 experts, they developed and refined 77 statements, ultimately achieving high consensus on many applications of orthobiologics, particularly regarding platelet-rich plasma (PRP) therapies. However, the study highlighted ongoing uncertainties in preparation, dosing, and efficacy, indicating a need for standardization in these areas.

Harnessing the Biologic Power of Bacteriophages to Improve the Treatment of Periprosthetic Joint Infection: Barriers and Future Directions

Jul 28, 2026

The authors investigate the potential of bacteriophage therapy as an adjunct treatment for periprosthetic joint infection (PJI), which has high failure rates with current therapies. They aim to address the barriers to integrating phage therapy into clinical practice, particularly the knowledge gap between preclinical research and its application in standard care. The review outlines the therapeutic advantages of phages while identifying ongoing challenges that hinder their adoption in treating PJI.

Transforming Orthopaedic Trauma Care: Forecasting Operating Room Demand by Harnessing Time-Series Analysis and Machine Learning

Jul 28, 2026

The authors aim to improve the efficiency of operating room (OR) scheduling in trauma centers by developing time-series and machine learning models to accurately forecast daily orthopaedic trauma caseloads. By integrating historical data with external factors, their model significantly outperforms traditional forecasting methods, achieving a mean absolute error of 1.80 hours compared to higher errors from rolling averages and intuitive models. This predictive framework is designed to enhance resource allocation and minimize surgical delays in trauma care settings.

Who Owns Arthroplasty Data?: Governance in the Era of Robotics, Registries, and Industry Partnerships

Jul 28, 2026

The authors investigate the governance challenges surrounding data ownership and access in total joint arthroplasty, particularly in the context of robotic platforms and proprietary registries. They highlight the need for clear governance structures to ensure transparency, data portability, and independent oversight, aiming to protect the interests of surgeons and patients while fostering innovation in the field. The article proposes a framework to address these issues and promote ethical data stewardship in arthroplasty.

Lexicon on the Pathomechanics of the Native Hip Joint at Risk for Arthritis

Jul 27, 2026

The authors aim to develop a structured lexicon that defines the morphological features and pathomechanical mechanisms associated with symptomatic, pre-arthritic hip conditions, addressing the inconsistencies in existing terminology that hinder scientific communication and treatment standardization. By synthesizing biomechanical, radiographic, and clinical evidence, they propose a framework that categorizes wear modes and mechanisms, linking them to specific pathological loading environments and tissue damage. This lexicon is intended to enhance diagnostic and therapeutic approaches in hip preservation by providing a coherent framework for understanding pre-arthritic hip disease.

Impact of T4-L1-Hip Axis Normalization on Outcomes and Complications in Adult Spinal Deformity

Jul 21, 2026

The authors aimed to investigate the relationship between T4-pelvic angle (T4PA) and L1-pelvic angle (L1PA) mismatch and its impact on mechanical complications (MCs) and patient-reported outcomes (PROs) following long-segment surgery for adult spinal deformity. Their findings indicate that both under- and overcorrection of the T4PA-L1PA alignment increases the risk of MCs, while normalization of this axis is linked to fewer complications but does not improve PROs. The study highlights the importance of construct-related and patient-related factors, particularly pelvic fixation, in predicting MCs.

Peptide Therapeutics in Orthopaedics: Current Evidence and Future Directions

Jul 21, 2026

The authors explore the current landscape and future potential of peptide therapeutics in orthopaedics, focusing on their design principles and clinical applications. They highlight the evolution from naturally occurring peptides to engineered synthetics, such as teriparatide and PLG0206, while addressing the challenges in achieving clinical validation for disease-modifying osteoarthritis drugs. The article also discusses the role of artificial intelligence in peptide design and the ongoing efforts to translate computational findings into effective clinical therapies.