المؤلفون: Musbahi, Omar, Collins, Jamie E., Yang, Heidi, Selzer, Faith, Chen, Antonia F., Lange, Jeffrey, Losina, Elena, Katz, Jeffrey N.

المصدر: JBJS Open Access ; volume 8, issue 4 ; ISSN 2472-7245

الوصف: Background: Residual pain after total knee arthroplasty (TKA) refers to knee pain after 3 to 6 months postoperatively. The estimates of the proportion of patients who experience residual pain after TKA vary widely. We hypothesized that the variation may stem from the range of methods used to assess residual pain. We analyzed data from 2 prospective studies to assess the proportion of subjects with residual pain as defined by several commonly used metrics and to examine the association of residual pain defined by each metric with participant dissatisfaction. Methods: We combined participant data from 2 prospective studies of TKA outcomes from subjects recruited between 2011 and 2014. Residual pain was defined using a range of metrics based on the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain score (0 to 100, in which 100 indicates worst), including the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). We also examined combinations of MCID and PASS cutoffs. Subjects self-reported dissatisfaction following TKA, and we defined dissatisfied as somewhat or very dissatisfied at 12 months. We calculated the proportion of participants with residual pain, as defined by each metric, who reported dissatisfaction. We examined the association of each metric with dissatisfaction by calculating the sensitivity, specificity, positive predictive value, and Youden index. Results: We analyzed data from 417 subjects with a mean age (and standard deviation) of 66.3 ± 8.3 years. Twenty-six participants (6.2%) were dissatisfied. The proportion of participants defined as having residual pain according to the various metrics ranged from 5.5% to >50%. The composite metric Improvement in WOMAC pain score ≥20 points or final WOMAC pain score ≤25 had the highest positive predictive value for identifying dissatisfied subjects (0.54 [95% confidence interval, 0.35 to 0.71]). No metric had a Youden index of ≥50%. Conclusions: Different metrics provided a wide range of ...

الإتاحة: https://doi.org/10.2106/jbjs.oa.23.00077Test

المؤلفون: Katz, Jeffrey N., Betensky, Daniel

المصدر: Journal of Bone and Joint Surgery ; volume 106, issue 3, page 177-179 ; ISSN 0021-9355 1535-1386

الإتاحة: https://doi.org/10.2106/jbjs.23.01388Test

المؤلفون: Acosta Julbe, José I., Gottreich, Julia R., Ermann, Joerg, Isaac, Zacharia, DeFilipp, Miriam, Andrew, Michael N., Chang, Yuchiao, Zampini, Jay M., Katz, Jeffrey N., Mandell, Jacob C.

المصدر: Spine ; volume 49, issue 10, page 733-740 ; ISSN 0362-2436

الوصف: Study design. Retrospective. Objective. We aimed to assess the frequency of facet joint inflammatory features noted in routine radiology reports of lumbar spine magnetic resonance imaging (MRI) studies among patients with chronic low back pain. Summary of Background Data. Facet joint arthropathy is one of the most common causes of chronic low back pain. It may encompass various inflammatory imaging characteristics, such as facet joint effusion, bone marrow edema, and soft tissue edema. The extent to which radiology reports mention inflammatory features of the lumbar facet joints and the accuracy of these reports have not been investigated. Materials and Methods. The authors performed a chart review on 49 subjects with previous facet-related interventions ( i.e . medial branch blocks or intra-articular facet joint injection) and MRI available in the medical record. One senior musculoskeletal radiologist and a musculoskeletal radiology fellow graded the inflammatory features using a published facet joint inflammation grading system [Gold Standard (GS)]. The authors identified the inflammatory markers mentioned in the radiology reports and calculated the sensitivity and positive predictive value of the radiology reports compared with GS readings. Results. Compared with the GS, the sensitivity of radiology reports for facet joint effusion, bone marrow, and soft tissue edema ranged from 6% to 22%, and the positive predictive value ranged from 25% to 100%. L4/5 had the highest number of cases with inflammatory features noted on the reports. Conclusion. Inflammatory findings, such as facet joint effusion, bone marrow edema, and soft tissue edema, are not commonly identified in radiology reports. Further investigations are needed to determine the clinical importance of MRI-detected lumbar facet joint inflammatory features as a potential mechanism of nociception and as a predictor of outcomes following injections or other therapies.

الإتاحة: https://doi.org/10.1097/brs.0000000000004923Test

المؤلفون: Ellrodt, Jack, Pincus, Theodore, Shadick, Nancy A., Stratton, Jacklyn, Santacroce, Leah, Katz, Jeffrey N., Smolen, Josef, Solomon, Daniel H.

المصدر: JCR: Journal of Clinical Rheumatology ; volume 28, issue 5, page 265-269 ; ISSN 1536-7355 1076-1608

الوصف: Objective Limited information is available concerning experiences of participants in a virtual learning collaborative (LC), and little qualitative data or participant feedback on how this format can be improved. One prior in-person LC in rheumatology successfully improved adherence with treat-to-target (TTT) for RA. We conducted a virtual LC on TTT and herein report on participant satisfaction. Methods We conducted a virtual LC with 18 rheumatology practices from across the United States during 2020 to 2021. The LC included a virtual kickoff meeting and monthly videoconferences, accompanied by data submission and feedback. At the conclusion of the LC, we surveyed the 45 LC participants concerning individual experience and satisfaction. Results All sites and 78% of participants responded to the surveys. The LC included small and large practices, 14 academic and 4 nonacademic, and respondents ranged in their roles: 24 physicians, 5 nurses or nurse practitioners, 3 administrators, and 3 other roles. Overall, 94% of respondents indicated they were either somewhat or very satisfied with the LC, and 94% said they would recommend a similar LC to a colleague. Aspects of the LC described as “very useful” included a kickoff meeting, intersite discussion, and monthly speakers; however, digital tools such as the Web site and meeting recordings were not found useful. Conclusions Virtual LCs are feasible, and participants reported strong satisfaction. Virtual LCs were highly valued by rheumatologists, trainees, and their practice staffs. Potential topics were identified for future LCs that could improve the quality of care delivered to rheumatology patients.

الإتاحة: https://doi.org/10.1097/rhu.0000000000001851Test

المؤلفون: Katz, Jeffrey N., Williams, Emma E.

المصدر: Journal of Bone and Joint Surgery ; volume 102, issue Suppl 1, page 15-20 ; ISSN 0021-9355 1535-1386

الوصف: ➢ The United States is struggling with an epidemic of opioid use both within and outside of the medical field. ➢ Pain management is a critical focus for orthopaedic practice. ➢ Recent orthopaedic research literature has focused on international perspectives on opioid use, patterns of opioid use, chronic opioid use, preoperative opioid use, and educational interventions to reduce opioid prescribing. ➢ Studies at the intersection of opioid use and orthopaedics pose methodological challenges, including quantifying opioid use, confounding by indication, and interpreting the results of nonrandomized intervention studies given secular changes in practice.

الإتاحة: https://doi.org/10.2106/jbjs.20.00142Test

المؤلفون: Stenquist, Derek S., Ready, Lauren V., Ghazinouri, Roya, Beagan, Carolyn, Wisdom, Aliesha, Katz, Jeffrey N.

المصدر: JAAOS: Global Research and Reviews ; volume 4, issue 10 ; ISSN 2474-7661

الإتاحة: https://doi.org/10.5435/jaaosglobal-d-20-00074Test

المؤلفون: Heckman, James D., Swiontkowski, Marc, Katz, Jeffrey N., Losina, Elena, Schoenfeld, Andrew J., Bedard, Nicholas A., Bono, Christopher M., Carey, James L., Graham, Brent, Hensinger, Robert N., Gebhardt, Mark C., Mallon, William J., Rossi, Michael J., Matzkin, Elizabeth, Pinzur, Michael S.

المصدر: Journal of Bone and Joint Surgery ; volume 102, issue 10, page 855-855 ; ISSN 0021-9355 1535-1386

الإتاحة: https://doi.org/10.2106/jbjs.20.00289Test

المؤلفون: Breslow, Rebecca G., Chen, Angela T., Shrestha, Swastina, Katz, Jeffrey N., Collins, Jamie E.

المصدر: Medicine & Science in Sports & Exercise ; volume 52, issue 7S, page 795-795 ; ISSN 1530-0315 0195-9131

الإتاحة: https://doi.org/10.1249/01.mss.0000683896.88817.b9Test

المؤلفون: Lange, Jeffrey K., Yang, Heidi Y., Collins, Jamie E., Losina, Elena, Katz, Jeffrey N.

المصدر: JBJS Open Access ; volume 5, issue 3, page e19.00073-e19.00073 ; ISSN 2472-7245

الوصف: Background: The goal of this study was to investigate the association between preoperative radiographic severity of knee osteoarthritis (OA) and patient-reported outcomes following total knee replacement. Methods: We used data from a prospective cohort study of individuals who underwent total knee replacement at a high-volume medical center. Patient-reported outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score and the Knee injury and Osteoarthritis Outcome Score (KOOS) activities of daily living (ADL) subscore, assessed preoperatively and 2 years postoperatively. We measured preoperative radiographic OA severity using the Osteoarthritis Research Society International (OARSI) Atlas score, dichotomized at the median. We assessed the association between radiographic OA severity and postoperative patient-reported outcomes in bivariate analyses and in multivariable linear regression, with adjustment for age, sex, body mass index, and comorbidity score. Results: The analytic cohort included 240 patients with a mean age at surgery of 66.6 years (standard deviation, 8 years); 61% were female. The median total OARSI radiographic severity score was 10 (range, 3 to 17). The cohort improved substantially at 2 years following total knee replacement, with WOMAC pain and KOOS ADL score improvements on the order of 30 points. We did not observe significant or clinically important differences in pain relief or functional improvement between patients with milder and more severe radiographic OA. Sensitivity analyses using other radiographic assessment measures yielded similar findings. Conclusions: Total knee replacement offers substantial symptomatic relief and functional improvement regardless of preoperative radiographic OA severity. Level of Evidence: Prognostic Level IV . See Instructions for Authors for a complete description of levels of evidence.

الإتاحة: https://doi.org/10.2106/jbjs.oa.19.00073Test

المؤلفون: Katz, Jeffrey N.

المصدر: Journal of Bone and Joint Surgery ; volume 102, issue 24, page e137 ; ISSN 0021-9355 1535-1386

الإتاحة: https://doi.org/10.2106/jbjs.20.01764Test