JBJS/JOSPT Webinar: Basilar Thumb Arthritis—October 13, 1:30 PM EDT

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Thumbs account for approximately 40% of human hand function, playing a critical role during work, play, and activities of daily living.  Arthritis at the base of the thumb (basilar or trapeziometacarpal joint) is one of the most common forms of hand osteoarthritis, affecting as many as 40 percent of the female population older than 55.

This complimentary webinar, hosted jointly by The Journal of Bone & Joint Surgery (JBJS) and the Journal of Orthopaedic & Sports Physical Therapy (JOSPT), will look at the efficacy of both nonoperative and surgical approaches to basilar thumb arthritis.

  • Co-authors Jorge Villafañe, PT, PhD, and Joshua Cleland, PT, PhD, will discuss results from a randomized trial in JOSPTthat compared a multimodal program of exercise and mobilization to a placebo in the management of basilar thumb arthritis.
  • E.R. Hovius, MD, co-author of a randomized trial in JBJS comparing trapeziometacarpal fusion with trapeziectomy plus ligament reconstruction, will delineate the findings from this Level I study.

Moderated by Sanjeev Kakar, MD, a hand surgeon at the Mayo Clinic in Rochester, Minnesota, the webinar will include additional perspectives from two expert commentators—Krysia Dziedzic, PhD, and Peter Stern, MD.

 

Click here to register.

JBJS JOPA Image Quiz: 74-Year-Old Woman with Knee Pain

jopa-image-quiz_9_26_16This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) presents the case of a 74-year-old woman with a 2-month history of left knee pain. She was given an intra-articular knee injection for presumed osteoarthritis, which failed to provide any relief. At a follow-up visit, clinicians obtained the MRI shown here.

Pick among five possible diagnoses: secondary osteonecrosis, transient osteoporosis, spontaneous osteonecrosis, osteochondritis dissecans, or bone marrow edema lesion.

JBJS Editor’s Choice: HTO Remains Relevant

marc-swiontkowski-2Sport activity continues to increase in priority in modern society. And with a concomitant increase in single-sport focus early in life and near year-round training, the incidence of knee injuries will also continue to increase.  Among surgeons and patients, there has been some waning of interest in high tibial osteotomy (HTO) for the most common form of unicompartmental arthritis because results from   unicompartmental arthroplasty keep improving, but HTO remains an appropriate choice for patients with very high functional demand.

In the September 21, 2016 issue of The Journal, Ekhtiari et al. report on the findings of a well-conducted systematic review on return-to-work and -sport outcomes of HTO. The authors found that more than four-fifths of patients returned to work or sport, usually within a year after surgery. Approximately four-fifths of patients returned to sport at a level equal to or greater than their preoperative level, and among non-military patients included in the review, 97.8% returned to work at an equal or greater level.

As with most systematic reviews in orthopaedic surgery, the basic concern here is with the quality of the literature that forms the basis of the analysis. The vast majority of studies included in the review were Level IV case series, which leads to concerns about selection and detection bias. Those concerns notwithstanding, a return to sport activity of 87% at a mean follow-up of longer than 5 years is remarkable.

We must recognize that patients who wish to return to sport are the most highly motivated population we serve. HTO should not fall off our radar screen of options for patients with high functional demand and medial compartment arthritis, for they can be some of the most satisfied patients we treat.

Marc Swiontkowski, MD
JBJS Editor-in-Chief

Peer Review Week, Day 5: JBJS Elite Reviewers

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JBJS Reviewers are key to The Journal’s ability to publish the highest quality of evidence-based information, to advance research, and to enhance the quality of care for orthopaedic patients. The JBJS Elite Reviewers Program publicly recognizes our best reviewers for their outstanding efforts. We hope that the Program and its reviewer benefits will encourage all reviewers to aspire to meet the program requirements.

Reviewers who review 4 or more manuscripts per year, rarely decline an invitation to review a manuscript (responding within 48 hours), and complete highly graded reviews within 1 week are eligible for the program. Elite Reviewers receive the following benefits in recognition of their exemplary performance:

  • No submission fees for papers of which the reviewer is the first author (for 12 months)
  • Free CME credits for all reviews
  • Free online access to all JBJS publications
  • A letter to the reviewer’s department head from JBJS Editor-in-Chief, Marc Swiontkowski, MD, recognizing and commending his/her good work
  • Name recognition on the JBJS Elite Reviewers Program Web page and on the masthead of The Journal

Here is the current list of JBJS Elite Reviewers:

Steven P. Arnoczky

George Babis

Ryan Calfee

Antonia F. Chen

Charles Cornell

Charles Cox

John M. Cuckler

Thomas A. DeCoster

Lawrence Dorr

Freddie H. Fu

H. Kerr Graham

Greg Guyton

Edward Joseph Harvey

James A. Keeney

Mark C. Lee

Stephen Li

Leisel D. Masson

Michael D. McKee

Robert Pilliar

Dino Samartzis

Andrew Jason Schoenfeld

Edward M. Schwarz

Howard Joel Seeherman

J. Michael Wiater

Andre van Wijnen

David Wong

Adolph J. Yates

 

Peer Review Week: Day 4

JBJS is helping celebrate Peer Review Week 2016 by formally recognizing some of its top reviewers for their contributions. Each day during Peer Review Week 2016, JBJS will profile three different top reviewers on OrthoBuzz. The week will culminate with a listing of our current Elite Reviewers.

Today, let’s meet Harry McKellop, Gordon Groh, and Philipp Moroder:

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Harry McKellop, PhD
UCLA

What do you like best about reviewing for JBJS?
It helps to keep me informed of the latest accomplishments in research; I usually
am able to suggest ways for the authors to improve their manuscripts; in the end,
it is a benefit to the orthopaedic community and the patients.
How do you find time to review for JBJS?
I am a “retired” emeritus professor; but I always considered reviewing
for JBJS as an enjoyable way for giving  back to the profession.
What do you see as JBJS’ role in shaping the future of orthopaedics?
The research and clinical papers provide valuable information and guidelines
for improving the quality of care to the patients.

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Gordon Groh, MD
Mission Health

What do you like best about reviewing for JBJS?
Reviewing offers me the opportunity to “make a bigger impact.” Changing the paradigms for patient care affects entire populations of individuals and improves outcomes for everyone.  JBJS leads the effort to study, report, understand and improve musculoskeletal disease processes, and I am delighted to play a role.
How do you find time to review for JBJS?
Giving back is an inherent part of the contract which each of us is bound to as part of our training process.  Doing the right thing is never easy or convenient, but the rewards always outweigh the inconvenience.
What do you see as JBJS’ role in shaping the future of orthopaedics?
JBJS creates a landscape which is both permanent and evolving.  The Journal creates a permanent electronic record of our current thoughts regarding musculoskeletal disease and produces a template for understanding that which is ever-changing.

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Philipp Moroder, MD
Charitè Universitaetsmedizin, Berlin

What do you like best about reviewing for JBJS?
The JBJS is a top-notch Journal which features high-quality manuscripts. Additionally, the editorial staff is great and puts
a lot of effort into even further improving the content quality.
How do you find time to review for JBJS?
Even though my schedule is pretty busy, I try my best to “fit-in” the JBJS reviews since to me it is a great honour to serve as a reviewer for
the JBJS.
What do you see as JBJS’ role in shaping the future of orthopaedics?
JBJS is probably one of the orthopaedic journals with  the most “clinical
impact.”Due to its high publication standards and excellent content,
it is a great source for information on what is new in the field of orthopedics
and offers ideas and solutions for the improvement of our daily patient care.

Peer Review Week: Day 3

JBJS is helping celebrate Peer Review Week 2016 by formally recognizing some of its top reviewers for their contributions. Each day during Peer Review Week 2016, JBJS will profile three different top reviewers on OrthoBuzz. The week will culminate with a listing of our Elite Reviewers for the first half of 2016.

Today, let’s meet Chad Mather, Carola van Eck, and David Kovacevic:

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Chad Mather, MD
Duke Health

What do you like best about reviewing for JBJS?
I always look forward to reviewing articles for JBJS as they are always interesting
and related to my area of expertise.The articles are typically well written so I
am able to focus on the quality of the methods and direction of the discussion.
This makes it an enjoyable and stimulating experience.
How do you find time to review for JBJS?
It is a challenge but I usually read them while riding my indoor cycle.
The two work together to keep me fit and not too far behind in my reviews!
What do you see as JBJS’ role in shaping the future of orthopaedics?
Impact factor aside, JBJS is the most credible and prestigious orthopaedic
journal.  Articles published in JBJS will always be highly read, cited and respected.
JBJS has a role in not only ensuring the scientific methods are correct
but also to choose articles that lead our field into the future.

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Carola van Eck, MD
Kerlan Jobe Orthopaedic Clinic

What do you like best about reviewing for JBJS?
I love that I could be the first person reading about the latest and greatest
breakthroughs in orthopaedic surgery.
How do you find time to review for JBJS?
Peer reviewing is fun, but can take a substantial amount of time. Luckily,
you get faster at it as you gain more experience. Usually I find time
between my cases to work on peer reviews.
What do you see as JBJS’ role in shaping the future of orthopaedics?
I believe JBJS continues to be a top journal in the field of orthopaedics. Its
Impact Factor has consistently been amongst the highest in the field,
proving the journal will have a huge role in shaping the future or orthopaedics.

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David Kovacevic, MD
Yale University

What do you like best about reviewing for JBJS?
Opportunity to review manuscripts that have the potential to change the way we practice orthopaedics.
How do you find time to review for JBJS?
It is a privilege to be a reviewer for the leading orthopaedic journal in the world so finding time to help the section editors is a top priority.
What do you see as JBJS’ role in shaping the future of orthopaedics?
Providing orthopaedic surgeons and musculoskeletal providers with the best evidence-based medicine by integrating basic science research with clinical expertise to enhance patient outcomes.

Soccer Players Benefit from Ankle-Injury Prevention Programs

6580f_sports-medicine-devices-marketA Level-I meta-analysis by Grimm et al. in the September 7, 2016 issue of The Journal of Bone & Joint Surgery found a significant reduction in the risk of ankle injury among soccer athletes who participated in ankle-injury prevention programs. Researchers reviewed data from 10 randomized controlled trials of such prevention programs involving more than 4,000 female and male soccer players, applying random-effects statistical models to determine pooled risk differences. Not surprisingly, the authors found substantial heterogeneity among the included studies, but there was no evidence of publication bias.

Despite the overall finding of a protective effect from prevention programs, the authors were “unable to comment on the role of individual elements of injury prevention programs,” saying that further research is needed to evaluate the effectiveness of specific exercises and the optimal timing and age for implementing these programs.

Peer Review Week: Day 2

JBJS is helping celebrate Peer Review Week 2016 by formally recognizing some of its top reviewers for their contributions. Each day during Peer Review Week 2016, JBJS will profile three different top reviewers on OrthoBuzz. Today, let’s meet Gwo-Chin Lee, Michelle Ghert, and Michael McKee:

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Gwo-Chin Lee, MD
University of Pennsylvania

What do you like best about reviewing for JBJS?
It gives me a pulse of all of the interesting and hot topics of research occurring in our field and helps me focus my own research initiatives and clinical practice.
How do you find time to review for JBJS?
I make it a priority as best as I can to review for the journal.  I see it as not only a service and a way to give back, but also an educational opportunity for me.
What do you see as JBJS’ role in shaping the future of orthopaedics?
The journal is the premier orthopaedic publication and forum for orthopaedic research.  As it moves onto other educational ventures, it will continue to be a vehicle for the orthopaedic community to communicate, disseminate, and innovate

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Michelle Ghert, MD
McMaster University

What do you like best about reviewing for JBJS?
The work is interesting and helps me keep up with knowledge in my field. I also feel that reviewing is an important service to the academic community.
How do you find time to review for JBJS?
I set aside some time on my research days.
What do you see as JBJS’ role in shaping the future of orthopaedics?
JBJS is an important source of knowledge dissemination in orthopaedics and a forum for advanced research methodology.

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Michael McKee, MD
University of Toronto

What do you like best about reviewing for JBJS?
Reviewing keeps me abreast of the latest clinical and research developments.
How do you find time to review for JBJS?
I dedicate a set time each week for reviews.
What do you see as JBJS’ role in shaping the future of orthopaedics?
JBJS is the premier journal for orthopaedics, adaptable and flexible, and it will continue to flourish in this.

JBJS Editor’s Choice: Short (or No) Hospital Stays for TJAs

swiontkowski marc color.jpgIn the September 7, 2016 issue of The Journal, Sutton III et al. report results from a sophisticated analysis of the National Surgical Quality Improvement Program (NSQIP) database confirming that hospital discharge 0 to 2 days after total joint arthroplasty (TJA) is safe in select patients in terms of 30-day major-complication and readmission rates. Large dataset analyses like this represent the next step in confirming what has been going on at the grass-roots level across the world—a movement toward outpatient TJAs and/or very early discharges following those procedures. (See related “Global Forum” article in the July 6, 2016 JBJS.)

This trend has been associated with very high patient satisfaction and low morbidity. The movement away from multiple-day hospital admission and toward rapid discharge to home or alternative postoperative care environments such as hotels or rehabilitation centers has far surpassed the novelty stage and is under way in every major metropolitan area around the world. The trend is a welcome motivation for us to address patient expectations for the postoperative period, which are specifically linked to more judicious use of narcotic medication accompanied by regional and local anesthetic efforts and liberal use of nonsteroidal anti-inflammatory medication. Total joint replacement is the ideal surgical intervention to lead this no- or short-hospitalization movement because of the standardized surgical approaches and requirements for implants, blood-loss management, and thromboprophylaxis.

I envision a time in the not-too-distant future where 80% to 90% of musculoskeletal post-intervention care takes place outside of the hospital environment, a shift that will require efficient use of remote-monitoring technology and continued improvement in post-intervention pain management. Hospitals will then become the setting for very complex events like organ transplantation, appropriate intensive care, and high-level trauma care. This will result in lowering the overall cost of care, improving patient satisfaction (who among us would not rather sleep in our own bed?), and minimizing nosocomial complications.

Marc Swiontkowski, MD
JBJS Editor-in-Chief

Peer Review Week: Day 1

JBJS is helping celebrate Peer Review Week 2016 by formally recognizing some of its top reviewers for their contributions. Each day during Peer Review Week 2016, JBJS will profile three different top reviewers on OrthoBuzz. Today, let’s meet Kim Templeton, John Birch, and Kanu Okike:

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Kimberly Templeton, MD
University of Kansas Medical Center

What do you like best about reviewing for JBJS?
Reviewing for JBJS is another way for me to give back to a profession that has meant so much to me. It also allows me to keep up to date on current trends in research, which helps in formatting education programming for our residents.
How do you find time to review for JBJS?
I review for JBJS between cases, while sitting at airports waiting for planes, or any other downtime that I can find. Because of the importance of the work of JBJS to me, I find a way to fit reviewing into my schedule.
What do you see as JBJS’ role in shaping the future of orthopaedics?
As JBJS is a go-to journal in residency education, the research that is published is informing the education of the next generations of orthopaedic surgeons. Discussing articles within JBJS not only provides opportunities for discussion of current trends in the field but also important areas such as appropriate research design, interpretation of results, and other areas such as applicability of results based on the sex of the patient and other social determinants of health.

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John G. Birch, MD
Texas Scottish Rite Hospital for Children

What do you like best about reviewing for JBJS?
I have a “passive” opportunity to learn what is new and developing in my
specialty.
How do you find time to review for JBJS?
It’s surprisingly easy, since a review doesn’t leave me messages or demand an
immediate response. I can read the manuscript quickly, think about it, read it again, simultaneously creating a list of questions/suggestions.
Any of these tasks are “pigeon-holed” into larger responsibilities.
What do you see as JBJS’ role in shaping the future of orthopaedics?
The demanding, earnest, blinded peer-review process effectively guarantees quality research publication that the readers may rely on for veracity and timeliness.

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Kanu Okike, MD
Kaiser Moanalua Medical Center

What do you like best about reviewing for JBJS?
In reviewing for JBJS, I have the opportunity to help shape the future of our field.  The articles published in JBJS are often quite influential, and I enjoy contributing to the process by which these articles are selected and improved via the peer-review process.
How do you find time to review for JBJS?
Like many academically-oriented surgeons, I try to set aside time each week for research.  For me, this time includes not only doing my own research, but also contributing to the peer-review process as a reviewer for JBJS.
What do you see as JBJS’ role in shaping the future of orthopaedics?
High-quality research is paramount for the continued advancement of orthopaedic surgery.  Given that JBJS is currently the highest-impact journal in the field, the articles printed on its pages have the potential to greatly influence orthopaedic practice.