Tag Archive | Medicine

Publisher’s Note from Kent Anderson, CEO and Publisher of JBJS

The Internet has fundamentally changed how orthopaedic surgeons discover and share information, but it has also put greater emphasis on the need for quality information. The editorial teams at JBJS work exceptionally hard to ensure that the information we publish is reliable, evidence-based, and trustworthy. Our peer review process is one of the tools we use.

Peer review has been under pressure lately. Some publishers have decreased the steps involved. Others have eliminated roles such Editor-in-Chief from journals they publish. Still others have even started journals with professional editors and then, once they began to receive enough submissions, simply fired the professional editor and replaced him or her with a staff person. Standards for acceptance vary more than ever, with some publications publishing works if they are “methodologically sound” or even if “they are science.” These definitions are clearly inadequate, especially when patient care is involved.

We don’t want our readers to be confused about what “peer review” means for the core articles in The Journal of Bone & Joint Surgery, so we’re introducing a new feature on each article starting this month – the peer review statement.

This statement lays out in just a few sentences who reviewed the article, from the Editor-in-Chief to the Deputy Editors to the outside reviewers and experts in methodology and biostatistics. We also mention the talented and experienced staff editors who help authors fine-tune the language and keep the numbers straight. It’s all part of achieving “Excellence Through Peer Review.” You can read more about this new feature in editorial published this month in The Journal.

In an age where everyone’s a publisher, quality matters more than ever. We remain committed to ensuring that you can trust what we publish, and we are proud to describe the process we use to get the best and most reliable information to you. Thank you for translating this information into superior outcomes for the patients you treat every day.

How to Prevent Surgical “No-Shows”

When patients don’t show up for their scheduled surgery, many costs are incurred that cannot be recouped, including the OR staff, the anesthesiology team, and equipment and medication that have been ordered. Reducing potential “no-shows” is imperative to maximize efficiencies. In addition to “no-shows,” reasons for cancelled surgeries to include scheduling errors, equipment problems, cancellations due to patient medical status, and emergency surgeries bumping medical procedures.
Key predictors of no-shows include prior missed appointments, history of alcoholism or other substance abuse and/or psychiatric issues. Measures can be taken to deter no-shows among patients from low-income background, such as scheduling appointments around public transportation times, educating patients on the benefits of the surgery, and eliminating the fear of uncomfortable procedures that seems to be higher in low-income patients.

Editor’s Choice

The article, “Guiding Femoral Rotational Growth in an Animal Model” by Arami, et al. is an intriguing variation on the common applications of guided growth in pediatric patients.  Implants that bridge the physis to inhibit growth in a given anatomic location are widely used to correct angular deformity or leg-length differences in the growing child and to decrease the need for a more invasive corrective osteotomy.

At present, correction of rotational deformity in the pediatric femur or tibia requires a derotational osteotomy and commonly six weeks of casting postoperatively. This study in rabbits demonstrates the ability of implants to alter the rotational profile in the growing femur by bridging the physis in an oblique orientation, rather than in a vertical orientation used for angular deformity correction.

The authors have elegantly demonstrated histologically the swirling or bending appearance of the physeal columns in treated femora, while controls maintained the normal linear columnar appearance of the physis.  This interesting and unique animal study lays the foundation for consideration of using oblique placement of physeal-bridging implants to guide rotational growth in skeletally immature patients, without the need for osteotomy.