JBJS 100: Juvenile Rheumatoid Arthritis, Tibial Fracture Healing
Under one name or another, The Journal of Bone & Joint Surgery has published quality orthopaedic content spanning three centuries. In 1919, our publication was called the Journal of Orthopaedic Surgery, and the first volume of that journal was Volume 1 of what we know today as JBJS.
Thus, the 24 issues we turn out in 2018 will constitute our 100th volume. To help celebrate this milestone, throughout the year we will be spotlighting 100 of the most influential JBJS articles on OrthoBuzz, making the original content openly accessible for a limited time.
Unlike the scientific rigor of Journal content, the selection of this list was not entirely scientific. About half we picked from “JBJS Classics,” which were chosen previously by current and past JBJS Editors-in-Chief and Deputy Editors. We also selected JBJS articles that have been cited more than 1,000 times in other publications, according to Google Scholar search results. Finally, we considered “activity” on the Web of Science and The Journal’s websites.
We hope you enjoy and benefit from reading these groundbreaking articles from JBJS, as we mark our 100th volume. Here are two more:
Changes in the Cervical Spine in Juvenile Rheumatoid Arthritis
R N Hensinger, P D DeVito, C G Ragsdale: JBJS, 1986 January; 68 (2): 189
This study of 121 patients with juvenile rheumatoid arthritis (RA) found that severe neck pain was not common, although neck stiffness and radiographic changes were commonly seen in the subset of patients with polyarticular-onset disease. The authors concluded that patients with juvenile RA who present with evidence of disease in the cervical spine should be examined carefully for involvement of multiple joints.
A Functional Below-the-Knee Cast for Tibial Fractures
A Sarmiento: JBJS, 1967 July; 49 (5): 855
In this report of 100 consecutive tibial shaft fractures, Gus Sarmiento encouraged early weight bearing in a skin-tight plaster cast that was molded proximally to contain the muscles of the leg. All 100 fractures healed, and healing occurred with minimal deformity or shortening. While most tibial shaft fractures are now treated with intramedullary nails, the principles developed by Dr. Sarmiento still apply, as the nail acts much like the fracture brace to maintain alignment during the weight-bearing healing process.
RA Progression Rate Predicts Need for Future Surgery
UK epidemiologists presenting at the annual meeting of the British Society for Rheumatology recently reported that X-ray evidence of rapid rheumatoid arthritis (RA) progression during the first 12 months of the disease can help predict the need for later surgery of hand, foot, hip, and knee joints. Lewis Carpenter and colleagues analyzed data from the Early Rheumatoid Arthritis Study and found that a change in the Larsen radiographic score of four units during the first 12 months of RA was associated with an 80% increased risk of subsequent surgery on joints of the hand and foot, and a 50% increase in the risk of later hip or knee surgery. (The 0 to 5 Larsen score includes both joint-erosion and joint-space narrowing components.) Carpenter told MedPage Today that these findings help “build the case for early treatment in rheumatoid arthritis” and support the argument that a “therapeutic window of opportunity” exists with RA.
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