Return to Play After Hook of Hamate Fracture: A Systematic Review and Meta-Analysis

In athletes, a hook of hamate fracture is concerning in terms of time to return to sport and effect on performance upon return. This study aims to analyze the treatment of hook of hamate fractures in athletes to determine their rates of return to play, timelines of recovery, and performance level upon return to play. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform this analysis. The PubMed database was queried to perform the literature search. Data were pooled and analyzed. P values <.05 were considered significant. Data were analyzed using the Comprehensive Meta-Analysis software to determine heterogeneity. Twenty studies with 823 patients sustaining hook of hamate fractures that reported any competitive level of play were included in the analysis. Of the 823 patients, 778 (94.5%) were able to return to play with 91.2% (506/555) of patients demonstrating similar or improved performance. The mean time to return to play was 45 days (range: 21-168 days). Treatment included surgical excision for 787 patients (95.6%), open reduction and internal fixation for 18 patients (2.2%), stress reduction/casting for 13 patients (1.6%), and loss to follow-up or surgery refusal for 5 patients (0.6%). A very high number of athletes return to play following a hook of hamate fracture at the same or improved level of performance. In our study, the majority of injuries were treated with surgical excision of the fractured hook of hamate fragment. Most athletes returned to their sport at an average of 45 days.

The Impact of the City of Miami's Decision to Revoke Electric Scooter Company Permits on Orthopedic Trauma at a Level I Trauma Center

BACKGROUND

Since the introduction of electric-scooter (e-scooter) mobile applications, there has been a marked increase in e-scooter-related injury. On January 19, 2022, the City of Miami revoked permits to five major mobile applications for violation of safety protocols.

OBJECTIVES

The purpose of our study was to assess the effects of this notice on the orthopedic patients seen at our corresponding Level I trauma center.

METHODS

Institutional Review Board approval was obtained for this study. A retrospective chart review was performed including all patients with orthopedic injuries at our Level I trauma center between July 19, 2021 and July 19, 2022. These dates include 6 months prior to and after the major e-scooter operators ceased use in Miami. SPSS statistical software version 28.0.0 (SPSS, IBM, Armonk, NY) was utilized for all statistical analysis.

RESULTS

There were 2558 patients in the prenotice cohort, and 2492 patients in the postnotice cohort. After the notice, there was a significant decrease in the number of patients that presented to our institution due to injuries caused by e-scooters (2.8% vs. 1.8% patients; p = 0.021). Patients with injuries caused by e-scooters had a significantly lower age (38 vs. 42, respectively; p = 0.034) and were more likely to be male (79.3% vs. 67.4% male, respectively; p = 0.007) than patients with other orthopedic injuries.

CONCLUSION

This study demonstrates that the 2022 notice revoking the major mobile application operators from the City of Miami resulted in a significant decrease in the number of orthopedic cases due to e-scooter-related injury at the corresponding Level I trauma center.

The impacts of anxiety and depression on outcomes in orthopaedic trauma surgery: a narrative review

Introduction

The impact of anxiety and depression on outcomes in orthopaedic trauma surgery is a topic of growing research interest.

Patients and methods

Orthopaedic trauma patients often experience high rates of psychiatric disorders, with anxiety and depression being the most prevalent. Mental health disorders have been shown to increase the risk of negative surgical outcomes and morbidity. This narrative review seeks to summarize the current literature surrounding the impacts of anxiety and depression on orthopaedic trauma surgery outcomes.

Discussion

There is a bidirectional relationship between chronic pain and mental health disorders, involving overlapping brain regions and neurotransmitter pathways. Anxiety and depression have been identified as predictors of negative surgical outcomes in orthopaedic trauma patients. Screening tools like the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-7 (GAD-7), and Medical Outcomes Study 36-item Short Form (SF-36) can assess mental health status and help tailor interventions. Psychological distress, chronic pain, and traumatic limb amputation are factors that contribute to adverse mental health outcomes in orthopaedic trauma patients. Opioid use for pain management is common in orthopaedic surgery, but it can worsen symptoms of depression and lead to dependency. Non-opioid pain management strategies may improve postoperative outcomes by reducing the impact of opioid-exacerbated depression.

Conclusion

Mental health interventions, both preoperative and postoperative, are crucial in optimizing surgical outcomes and improving patient quality of life. Multidisciplinary approaches that address both physical and mental health are recommended for orthopaedic trauma patients. Further research is needed to develop effective interventions for improving mental health outcomes in this patient population.

Characteristics and trends of the most cited papers in robotic assisted arthroplasty

Purpose

To compile and analyze the top 50 most frequently cited articles published on robotic-assisted arthroplasty, allowing clinicians to effectively identify the most influential literature pertaining to this topic.

Methods

Guidelines set by the Preferred Reporting Items for Systematic Reviews were used as the foundation for data collection and analysis. All papers pertaining to robotic-assisted arthroplasty were retrieved using the Scopus database. Data including: manuscript title, authors, total citation count, level of evidence, journal, publication year, and country of publication was extracted from a final list of articles.

Results

The top 50 publications regarding robotic assisted arthroplasty were cited a total of 4530 times (including self-citations), with an average total of 91. The years with the most publications in the top 50 were: 2017, 2018, and 2019, producing 7, 6, and 5 papers, respectively. Only 4 papers in the top 50 were published prior to the year 2003. The most common level of evidence was level V, and the most common category was Clinical Outcomes (74%). The United States contributed half of the 50 articles, and Princess Grace Hospital and University of London were the most contributory institutions, each with 6 of the top 50 articles.

Conclusion

This analysis provides a comprehensive review of the most cited and influential papers in robotic-assisted arthroplasty. Understanding these trends in the literature will ultimately pave the way for physicians and researchers to continue to innovate and research in a targeted manner as they gain an understanding of what has been studied and what remains inadequately explored.

Level of evidence

3.

The 50 Most-Cited Articles Regarding Hip Resurfacing

Background

Hip resurfacing arthroplasty is an accepted treatment option for young patients presenting with osteoarthritis of the hip. The purpose of this review was to evaluate and identify the top 50 most-cited articles pertaining to hip resurfacing, to help clinicians identify influential articles and navigate the literature more effectively.

Material and methods

Clarivate Analytics Web of Science was used to identify all articles related to hip resurfacing. The screening was based on the number of citations for each article. The final list of articles was further reviewed, and further data including manuscript title, authors, total citation count, year of publication, journal, country of origin, and level of evidence were extracted.

Results

The most-cited publication was “Pseudotumors associated with metal-on-metal hip resurfacings”, which was cited 704 times. The average total number of citations per publication was 203. The most prolific publication year was 2008 with 8 publications, and the most recent article was published in 2012. The journals with the most attributable publications were Journal of Bone and Joint Surgery and Clinical and Orthopedic Related Research.

Conclusions

This review provides a comprehensive analysis of the most-cited articles pertaining to hip resurfacing.

Level of evidence

III.

Characteristics and Trends of the Most Cited Arthroplasty Articles in the Journal of Bone and Joint Surgery

Introduction

The Journal of Bone and Joint Surgery (JBJS) is one of most influential orthopaedic journals, with Total Joint Replacements (TJR) being a frequent topic. The importance of TJR research parallels it’s high prevalence in American society.

Objective

To compile and analyze the top 50 most frequently cited articles published in the Journal of Bone and Joint Surgery regarding total joint reconstruction or arthroplasty.

Methods

Guidelines set by the Preferred Reporting Items for Systematic Reviews were used as the foundation for data collection and analysis. Scopus database was used to acquire the metric analyzed in the study. Data was then exported to an excel sheet for analysis.

Results

The top 50 TJR publications analyzed for this study were cited a total of 35,850 times (including self-citations), with an average number of citations per article of 717. Kurtz and Neer II were the only authors contributing more than one. 38 of 50 articles analyzed met the criteria for Level II or III in terms of Level of Evidence (LOE). The United States contributed the most publications with a total of 34. Harvard University and Massachusetts General Hospital, with eight publications each, were the highest contributing institutions.

Conclusion

The Journal of Bone and Joint Surgery has published very influential research papers as noted by the number of citations amassed by its most popular articles. JBJS’s top cited publications hail largely from major institutions in the United States and are composed of high-quality reports of mostly Level 2 and Level 3 evidence classifications.

Level of Evidence

3

Characteristics and Trends of the Most Cited Knee Surgery, Sports Traumatology, Arthroscopy Articles

Purpose

To compile and analyze the top 50 most frequently cited articles published in the Knee Surgery, Sports Traumatology, Arthroscopy journal.

Methods

Guidelines set by the Preferred Reporting Items for Systematic Reviews were used as the foundation for data collection and analysis. Scopus database was used to acquire the metric analyzed in the study. Once collected, the data was exported to an excel sheet in order to be organized, sorted, and analyzed in accordance with the metrics of interest.

Results

The United States was the most contributory nation with 14 publications, followed by Sweden with13 publications and Germany with eight publications. The most contributory institution was Umeå University in Vasterbottens, Sweden (8) followed by National Institute for Working Life in Stockholm, Sweden (7) and The University of Pittsburgh (5). Most publications were either Level II (19) or Level III (19) in terms of Level of Evidence. There was only one publication that was classified as a Level I paper.

Conclusion

The Journal of Knee Surgery, Sports Traumatology, and Arthroscopy has published very influential research papers as noted by the number of citations amassed by its most popular articles. KSSTA's top cited publications hail largely from major European and United States institutions and are composed of high-quality reports of mostly Level 2 and Level 3 evidence classifications.

Level of Evidence

3.

Contrast induced-acute kidney injury following peripheral angiography with carbon dioxide versus iodinated contrast media: A meta-analysis and systematic review of current literature

OBJECTIVE

We conducted a meta-analysis to compare the incidence of acute kidney injury (AKI) with carbon dioxide (CO₂ ) versus iodinated contrast media (ICM).

BACKGROUND

Contrast induced-acute kidney injury (CI-AKI) is a known complication following endovascular procedures with ICM. CO₂ has been employed as an alternative imaging medium as it is nontoxic to the kidneys.

METHODS

Search of indexed databases was performed and 1,732 references were retrieved. Eight studies (7 observational, 1 Randomized Controlled Trial) formed the meta-analysis. Primary outcome was AKI. Fixed effect model was used when possible in addition to analysis of publication bias.

RESULTS

In this meta-analysis, 677 patients underwent 754 peripheral angiographic procedures. Compared with ICM, CO₂ was associated with a decreased incidence of AKI (4.3% vs. 11.1%; OR 0.465, 95% CI: 0.218-0.992; P = 0.048). Subgroup analysis of four studies that included granular data for patients with chronic kidney disease (CKD) did not demonstrate a decreased incidence of AKI with CO₂ (4.1% vs. 10.0%; OR 0.449, 95% CI: 0.165-1.221, P = 0.117). Patients undergoing CO₂ angiography experienced a higher number of nonrenal events including limb/abdominal pain (11 vs. 0; P = 0.001) and nausea/vomiting (9 vs. 1; P = 0.006).

CONCLUSIONS

In comparison to ICM, CO₂ use is associated with a modestly reduced rate of AKI with more frequent adverse nonrenal events. In studies that use CO₂ as the primary imaging agent, the average incidence of AKI remained high at 6.2%-supporting the concept that factors other than renal toxicity from ICM may contribute to renal impairment following peripheral angiography. © 2017 Wiley Periodicals, Inc.