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  1. Article ; Online: Republication of "Evidence Versus Practice: Operative Treatment Preferences in Hallux Valgus".

    Noback, Peter C / Trofa, David P / Vosseller, J Turner

    Foot & ankle orthopaedics

    2023  Volume 8, Issue 3, Page(s) 24730114231195359

    Abstract: Background: There is substantial variability in the operative treatment of hallux valgus despite the existence of high quality evidence to guide treatment decisions. The purpose of this study was to determine the current trends in the treatment of mild, ...

    Abstract Background: There is substantial variability in the operative treatment of hallux valgus despite the existence of high quality evidence to guide treatment decisions. The purpose of this study was to determine the current trends in the treatment of mild, moderate, and severe hallux valgus and if greater degrees of consensus correlate with the presence of higher-level evidence.
    Methods: Members of the American Orthopaedic Foot & Ankle Society completed a 14-item survey. A total of 131 (14%) of 922 members completed the survey. Three cases representing 3 stages of HV were presented, and respondents selected their preferred treatment. Preferred forms of proximal and distal metatarsal osteotomies, as well as mode of fixation for each, were inquired.
    Results: In the treatment of mild hallux valgus without second metatarsalgia, 80% of those surveyed chose a distal metatarsal osteotomy, while, if second metatarsalgia was present, 56% chose a distal metatarsal osteotomy with a second metatarsal-shortening osteotomy. In the treatment of moderate hallux valgus, there was generally less consensus, while, in the treatment of severe hallux valgus, a majority of those surveyed chose a Lapidus procedure, with the addition of a second metatarsal-shortening osteotomy in the presence of second metatarsalgia. The most popular distal and proximal metatarsal osteotomies, respectively, were chevron osteotomy (80%) and opening wedge osteotomy (33%). The presence of Level I evidence did not significantly correlate with higher degrees of consensus.
    Conclusion: Despite the existence of high-quality evidence supporting the use of certain procedures in the treatment of HV, there exists an apparent lack of consensus among surgeons about the choice of surgical procedures. Moreover, higher-level evidence was not correlated with greater consensus in hallux valgus.
    Level of evidence: Level II.
    Language English
    Publishing date 2023-08-14
    Publishing country United States
    Document type Journal Article
    ISSN 2473-0114
    ISSN (online) 2473-0114
    DOI 10.1177/24730114231195359
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  2. Article ; Online: Contemporary Review: An Overview of the Utility of Patient-Reported Outcome Measurement Information System (PROMIS) in Foot and Ankle Surgery.

    Czerwonka, Natalia / Desai, Sohil S / Arciero, Emily / Greisberg, Justin / Trofa, David P / Chien, Bonnie Y

    Foot & ankle international

    2023  Volume 44, Issue 6, Page(s) 554–564

    Abstract: Patient-Reported Outcome Measurement Information System (PROMIS) has favorable psychometric and administrative properties in orthopaedic clinical research. It facilitates clinically meaningful data collection while minimizing administration time and ... ...

    Abstract Patient-Reported Outcome Measurement Information System (PROMIS) has favorable psychometric and administrative properties in orthopaedic clinical research. It facilitates clinically meaningful data collection while minimizing administration time and survey fatigue and improving compliance. PROMIS is a critical component of patient-centered care and shared decision making, as it provides enhanced communication and engagement between patients and providers. As a validated instrument, it may also aid in measuring value-based health care quality. The goal of the current work is to provide an overview of PROMIS metrics used in orthopaedic foot and ankle, including advantages and disadvantages compared to legacy scales and PROMIS's applicability in specific foot and ankle conditions based on psychometric properties. We provide a review of the literature regarding the utilization of PROMIS as an outcome measure for specific foot and ankle procedures and conditions.
    MeSH term(s) Humans ; Ankle/surgery ; Ankle Joint/surgery ; Patient Reported Outcome Measures ; Surveys and Questionnaires ; Information Systems
    Language English
    Publishing date 2023-04-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1183283-6
    ISSN 1944-7876 ; 1071-1007
    ISSN (online) 1944-7876
    ISSN 1071-1007
    DOI 10.1177/10711007231165752
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  3. Article ; Online: Epidemiology and Sex-Specific Analysis of Basketball-Related Lower Extremity Fractures: A 10-Year Analysis of National Injury Data.

    Yendluri, Avanish / Chiang, Joshua J / Nietsch, Katrina S / Obana, Kyle K / Trofa, David P / Kelly, John D / Parisien, Robert L

    Sports health

    2024  , Page(s) 19417381231223479

    Abstract: Background: Basketball-related fractures involving the lower extremities frequently present to emergency departments (ED) in the United States (US). This study aimed to identify the primary mechanisms, distribution, and trends of these injuries.: ... ...

    Abstract Background: Basketball-related fractures involving the lower extremities frequently present to emergency departments (ED) in the United States (US). This study aimed to identify the primary mechanisms, distribution, and trends of these injuries.
    Hypothesis: We hypothesize that (1) lower extremity fracture frequency will decrease from 2013 to 2022, (2) the ankle will be the most common fracture site, and (3) noncontact twisting will be the most common injury mechanism.
    Study design: Descriptive epidemiological.
    Level of evidence: Level 3.
    Methods: The National Electronic Injury Surveillance System (NEISS) was queried for lower extremity fractures from basketball presenting to US EDs from January 1, 2013 to December 31, 2022. Patient demographics, injury location, and disposition were recorded. The injury mechanism was characterized using the provided narrative. National estimates (NEs) were calculated using the NEISS statistical sample weight. Injury trends were evaluated by linear regression.
    Results: There were 6259 cases (NE: 185,836) of basketball-related lower extremity fractures. Linear regression analysis of annual trends demonstrated a significant decrease in lower extremity fractures over the study period (2013-2022:
    Conclusion: Basketball-related lower extremity fractures decreased from 2013 to 2022, with the ankle being the most common fracture site and most fractures arising from a noncontact twist. Increasing utilization of outpatient clinics may have contributed to the decline, particularly for ankle and foot fractures. The prevalence of ankle fractures and twisting-related injuries reinforces the importance of protective footwear and targeted strengthening protocols.
    Language English
    Publishing date 2024-01-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2508802-6
    ISSN 1941-0921 ; 1941-7381
    ISSN (online) 1941-0921
    ISSN 1941-7381
    DOI 10.1177/19417381231223479
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  4. Article ; Online: The Finger, Wrist, and Shoulder are the Most Commonly Injured Areas in Youth Volleyball Players but the Incidence of Injuries Decreased Overall Between 2012 and 2022.

    Obana, Kyle K / Singh, Priya / Namiri, Nikan K / Levine, William N / Parsons, Bradford O / Trofa, David P / Parisien, Robert L

    Arthroscopy, sports medicine, and rehabilitation

    2024  Volume 6, Issue 1, Page(s) 100862

    Abstract: Purpose: To analyze epidemiology, mechanisms, and diagnoses of upper extremity volleyball injuries in youth who present to United States emergency departments.: Methods: Data from the National Electronic Injury Surveillance System were analyzed for ... ...

    Abstract Purpose: To analyze epidemiology, mechanisms, and diagnoses of upper extremity volleyball injuries in youth who present to United States emergency departments.
    Methods: Data from the National Electronic Injury Surveillance System were analyzed for upper extremity volleyball injuries in patients ≤18 years old from January 1, 2012, to December 31, 2022. Data were collected for body part, diagnosis, mechanism of injury, and disposition. Weighted national estimates were calculated using the hospitals' corresponding statistical sample weights. Linear regressions were used to analyze annual trends. χ
    Results: A weighted national estimate of 131,624 upper extremity volleyball-related injuries occurred in the study period. Average age was 13.9 ± 2.3 years. Female patients constituted 77.6% of patients; 99.3% of patients did not require admission. The most common body parts injured were fingers (43.0%), wrists (22.8%), and shoulders (12.2%). The most common identifiable mechanisms of injury were impacts with the floor (19.4%), impacts with the ball (14.7%), and spikes/serves (5.7%). Most common diagnoses were strains/sprains (42.6%) and fractures (19.5%). Most common locations of fracture were fingers (57.4% of all fractures), wrists (16.6%), and lower arms (12.4%). There was a decrease of 544 overall injuries per year (
    Conclusions: Youth volleyball players are at risk of upper extremity injury, particularly involving the fingers, wrist, and shoulder. Despite increasing national participation in youth volleyball, there is a decreasing incidence of upper extremity injuries.
    Level of evidence: Level IV, prognostic case series.
    Language English
    Publishing date 2024-01-20
    Publishing country United States
    Document type Journal Article
    ISSN 2666-061X
    ISSN (online) 2666-061X
    DOI 10.1016/j.asmr.2023.100862
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  5. Article ; Online: The Current Utilization of Patient-reported Outcome Measurement Information System in Shoulder, Elbow, and Sports Medicine.

    Trofa, David P / Desai, Sohil S / Li, Xinning / Makhni, Eric C

    The Journal of the American Academy of Orthopaedic Surgeons

    2022  Volume 30, Issue 12, Page(s) 554–562

    Abstract: Clinical research using patient-reported outcome measures has been critical within the field of shoulder, elbow, and sports medicine in helping clinicians deliver evidence-based and value-based medicine. Recently, however, clinicians have advocated for ... ...

    Abstract Clinical research using patient-reported outcome measures has been critical within the field of shoulder, elbow, and sports medicine in helping clinicians deliver evidence-based and value-based medicine. Recently, however, clinicians have advocated for improving the process of obtaining clinically meaningful information from patients while decreasing survey fatigue and increasing compliance. To that end, the National Institutes of Health created the Patient-Reported Outcome Measures Information System (PROMIS) in which a number of institutions and research investigations have adopted for reporting outcomes. A special focus has also been placed on PROMIS Computer Adaptive Testing forms, which tailor questioning through item response theory. The purpose of this study was to provide insight into the utilization, advantages, and disadvantages of PROMIS within the field of shoulder, elbow, and sports medicine and provide a comparison with legacy patient-reported outcome measure measurements.
    MeSH term(s) Elbow ; Humans ; Information Systems ; Patient Reported Outcome Measures ; Shoulder ; Sports Medicine
    Language English
    Publishing date 2022-06-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200524-1
    ISSN 1940-5480 ; 1067-151X
    ISSN (online) 1940-5480
    ISSN 1067-151X
    DOI 10.5435/JAAOS-D-22-00030
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    Zs.A 4048: Show issues Location:
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  6. Article ; Online: Particulated Juvenile Articular Cartilage Allograft Transplantation for Patellofemoral Defects Shows Favorable Return-to-Sport Rates and Patient-Reported Outcomes.

    Pearsall, Christian / Chen, Aaron Z / Reynolds, Alan W / Saltzman, Bryan M / Ahmad, Christopher S / Popkin, Charles A / Redler, Lauren H / Trofa, David P

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2024  

    Abstract: Purpose: To report return-to-sport rates, postoperative patient-reported outcomes (PROs), complication rates, and reoperation rates of a cohort of patients undergoing particulated juvenile articular cartilage (PJAC) allograft transplantation for ... ...

    Abstract Purpose: To report return-to-sport rates, postoperative patient-reported outcomes (PROs), complication rates, and reoperation rates of a cohort of patients undergoing particulated juvenile articular cartilage (PJAC) allograft transplantation for patellofemoral articular cartilage defects.
    Methods: We performed a single-institution retrospective review of all patients with patellofemoral articular cartilage defects who received PJAC allograft transplantation from 2014 to 2022. Baseline demographic characteristics and surgical data, including concomitant surgical procedures, were collected. Clinical outcomes recorded included return-to-sport rates, complications, reoperations, and the following PRO scores: Kujala knee score, Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference score, and PROMIS Physical Function score.
    Results: Forty-one knees with a mean age of 23.4 ± 9.7 years and mean follow-up period of 30.3 months (range, 12-107 months) were included. The mean postoperative PROMIS Pain Interference, PROMIS Physical Function, and Kujala knee scores were 47.4 ± 7.7, 52.2 ± 10.8, and 81.7 ± 16.1, respectively, reflecting low residual anterior knee pain and a return to normal function. For patients playing organized sports at the high school and collegiate levels, the overall return-to-sport rate was 100% (17 of 17). During follow-up, complications developed in 12 knees (29.3%), the most common of which was anterior-based knee pain, and 6 knees (14.6%) required a total of 8 reoperations, which occurred from 6 to 32 months postoperatively.
    Conclusions: The 100% return-to-sport rate and satisfactory PRO scores in our study suggest that PJAC allograft transplantation can effectively address patellofemoral cartilage defects in many patients. The complication and reoperation rates of 29.3% and 14.6%, respectively, are consistent with the challenging and heterogeneous etiology and treatment of patellofemoral articular defects.
    Level of evidence: Level IV, case series.
    Language English
    Publishing date 2024-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2024.02.018
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    Zs.A 2046: Show issues Location:
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  7. Article ; Online: Perioperative outcomes in isolated versus multiligamentous anterior cruciate ligament reconstruction: a retrospective cohort analysis.

    Zhong, Jack / Lee, Nathan J / Crutchfield, Connor / Mueller, John / Ahmad, Christopher / Trofa, David / Lynch, T S

    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

    2024  Volume 34, Issue 3, Page(s) 1597–1607

    Abstract: Purpose: The outcomes of anterior cruciate ligament reconstruction in the setting of multiligamentous knee injury (M-ACLR) have not been well characterized compared to isolated ACLR (I-ACLR). This study aims to characterize and compare short-term ... ...

    Abstract Purpose: The outcomes of anterior cruciate ligament reconstruction in the setting of multiligamentous knee injury (M-ACLR) have not been well characterized compared to isolated ACLR (I-ACLR). This study aims to characterize and compare short-term outcomes between I-ACLR and M-ACLR.
    Methods: This is a retrospective cohort analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2017. Current Procedural Terminology codes were used to identify and compare elective I- and M-ACLR patients, excluding patients undergoing concomitant meniscal or chondral procedures. Patient demographics and outcomes after I- and M-ACLR were compared using bivariate analysis. Multiple logistic regression analyzed if multiligamentous ACLR was an independent risk factor for adverse outcomes.
    Results: There was a total of 13,131 ACLR cases, of which 341 were multiligamentous cases. The modified fragility index-5 was higher in multiligamentous ACLR (p < 0.001). Multiligamentous ACLR had worse perioperative outcomes, with higher rate of all complications (3.8%, p = 0.013), operative time > 1.5 h (p < 0.001), length of stay (LOS) ≥ 1 day (p < 0.001), wound complication (2.1%, p = 0.001), and intra- or post-op transfusions (p < 0.001). In multiple logistic regression, multiligamentous ACLR was an independent risk factor for LOS ≥ 1 (odds ratio [OR] 5.8), and intra-/post-op transfusion (OR 215.1) and wound complications (OR 2.4). M-ACLR was not an independent risk factor for any complication, reoperation at 30 days, readmission, urinary tract infection (UTI), or venous thromboembolism (VTE).
    Conclusion: M-ACLR generally had worse outcomes than I-ACLR, including longer LOS, need for perioperative transfusions, and wound complications.
    MeSH term(s) Humans ; Retrospective Studies ; Cohort Studies ; Knee Injuries/surgery ; Meniscus/surgery ; Anterior Cruciate Ligament Reconstruction/adverse effects ; Anterior Cruciate Ligament Reconstruction/methods ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Injuries/etiology
    Language English
    Publishing date 2024-02-16
    Publishing country France
    Document type Journal Article
    ZDB-ID 1231084-0
    ISSN 1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
    ISSN (online) 1432-1068
    ISSN 1633-8065 ; 0948-4817 ; 0940-3264
    DOI 10.1007/s00590-024-03848-3
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    Zs.A 3479: Show issues Location:
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  8. Article ; Online: Patients With Posterior Cruciate Ligament Injuries Obtain Information Regarding Diagnosis, Management, and Recovery from Low-Quality Online Resources.

    Obana, Kyle K / Law, Christian / Mastroianni, Michael A / Abdelaziz, Abed / Alexander, Frank J / Ahmad, Christopher S / Trofa, David P

    The Physician and sportsmedicine

    2024  , Page(s) 1–7

    Abstract: Objectives: This study investigates the most common online patient questions pertaining to posterior cruciate ligament (PCL) injuries and the quality of the websites providing information.: Methods: Four PCL search queries were entered into the ... ...

    Abstract Objectives: This study investigates the most common online patient questions pertaining to posterior cruciate ligament (PCL) injuries and the quality of the websites providing information.
    Methods: Four PCL search queries were entered into the Google Web Search. Questions under the 'People also ask' tab were expanded in order and 100 results for each query were included (400 total). Questions were categorized based on Rothwell's Classification of Questions (Fact, Policy, Value). Websites were categorized by source (Academic, Commercial, Government, Medical Practice, Single Surgeon Personal, Social Media). Website quality was evaluated based on the Journal of the American Medical Association (JAMA) Benchmark Criteria. Pearson's chi-squared was used to assess categorical data. Cohen's kappa was used to assess inter-rater reliability.
    Results: Most questions fell into the Rothwell Fact category (54.3%). The most common question topics were Diagnosis/Evaluation (18.0%), Indications/Management (15.5%), and Timeline of Recovery (15.3%). The least common question topics were Technical Details of Procedure (1.5%), Cost (0.5%), and Longevity (0.5%). The most common websites were Medical Practice (31.8%) and Commercial (24.3%), while the least common were Government (8.5%) and Social Media (1.5%). The average JAMA score for websites was 1.49 ± 1.36. Government websites had the highest JAMA score (3.00 ± 1.26) and constituted 42.5% of all websites with a score of 4/4. Comparatively, Single Surgeon Personal websites had the lowest JAMA score (0.76 ± 0.87, range [0-2]). PubMed articles constituted 70.6% (24/34) of Government websites, 70.8% (17/24) had a JAMA score of 4 and 20.8% (5/24) had a score of 3.
    Conclusion: Patients search the internet for information regarding diagnosis, treatment, and recovery of PCL injuries and are less interested in the details of the procedure, cost, and longevity of treatment. The low JAMA score reflects the heterogenous quality and transparency of online information. Physicians can use this information to help guide patient expectations pre- and post-operatively.
    Language English
    Publishing date 2024-04-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 753046-8
    ISSN 2326-3660 ; 0091-3847
    ISSN (online) 2326-3660
    ISSN 0091-3847
    DOI 10.1080/00913847.2024.2346462
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  9. Article ; Online: The Quality of YouTube Content on Ulnar Collateral Ligament Injuries Is Low: A Systematic Review of Video Content.

    Czerwonka, Natalia / Reynolds, Alan W / Saltzman, Bryan M / Alexander, Frank / Trofa, David P / Ahmad, Christopher S

    Arthroscopy, sports medicine, and rehabilitation

    2023  Volume 5, Issue 6, Page(s) 100769

    Abstract: Purpose: To provide an evaluation of the quality of diagnostic and treatment information regarding ulnar collateral ligament injuries on YouTube.: Methods: YouTube was searched using the terms "ulnar collateral ligament," "Tommy John surgery," and " ... ...

    Abstract Purpose: To provide an evaluation of the quality of diagnostic and treatment information regarding ulnar collateral ligament injuries on YouTube.
    Methods: YouTube was searched using the terms "ulnar collateral ligament," "Tommy John surgery," and "UCL surgery." The first 100 results for each 3 terms were screened for inclusion. Each included video was graded based on its diagnostic and treatment content and assigned a quality assessment rating. Video characteristics such as duration, views, and "likes" were recorded and compared between video sources and quality assessment ratings.
    Results: A total of 120 videos were included in the final analysis. Only 17.5% provided very useful to excellent quality content. Only 3 videos (2.5%) provided excellent quality content; these were all physician-sponsored videos. These 3 videos only achieved an excellent score for diagnostic content; no video achieved an excellent score for treatment content. Most videos were scored as somewhat useful for both diagnostic (40%) and treatment (56.7%) content. Videos classified as somewhat useful had the highest number of average views (27,197), with a mean duration of 7 minutes 40 seconds. The most common video source was physician sponsored (32%), followed by educational (26%). Physician videos had the lowest number of views (5,842 views).
    Conclusions: The quality of ulnar collateral ligament-related information on YouTube is low. Differential diagnoses for related symptoms, accurate surgical indications, and thorough discussions of adverse outcomes were the most lacking information. Physician-sponsored and educational videos provided the highest-quality information but had the lowest number of average views.
    Clinical relevance: Because most Internet users in the United States search for information regarding their medical issues online, it is important to understand the quality of available online medical information. Knowing this can help inform the necessary next steps to improve the quality and comprehensibility of online medical information.
    Language English
    Publishing date 2023-08-08
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2666-061X
    ISSN (online) 2666-061X
    DOI 10.1016/j.asmr.2023.100769
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  10. Article: Patient-reported outcomes measurement information system instruments in knee arthroplasty patients: a systematic review of the literature.

    Czerwonka, Natalia / Gupta, Puneet / Desai, Sohil S / Hickernell, Thomas R / Neuwirth, Alexander L / Trofa, David P

    Knee surgery & related research

    2023  Volume 35, Issue 1, Page(s) 27

    Abstract: Background: The purpose of this study is to provide a systematic review of the literature pertaining to Patient-Reported Outcome Measurement Information System (PROMIS) validation and utilization as an outcomes metric in total knee arthroplasty (TKA) ... ...

    Abstract Background: The purpose of this study is to provide a systematic review of the literature pertaining to Patient-Reported Outcome Measurement Information System (PROMIS) validation and utilization as an outcomes metric in total knee arthroplasty (TKA) patients. This is the first systematic review on PROMIS use in total knee arthroplasty patients.
    Methods: A systematic search of the Pubmed/MEDLINE and Embase databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study characteristics, patient demographics, psychometric properties (Pearson and Spearman correlation) with legacy patient-reported outcome measurement (PROM) instruments, floor and ceiling effects, responsiveness, and minimum clinically important difference (MCID) and PROMIS outcomes were recorded and analyzed.
    Results: Fifteen studies investigating PROMIS in 11,140 patients were included. The weighted-average Pearson correlation coefficient comparing PROMIS domains with legacy patient-reported outcome measurements in total knee arthroplasty patients was 0.62 [standard error (SE) = 0.06] and the weighted-average Spearman correlation comparing PROMIS domains with legacy patient-reported outcome measurements in total knee arthroplasty patients was 0.59 (SE = 0.06), demonstrating moderate-to-strong correlation and validity. There were no differences in weighted average floor [0.03% (SE = 3.1) versus 0% (SE = 0.1) versus 0.01% (SE = 1.1); p = 0.25] or ceiling effects [0.01% (SE = 0.7) versus 0.02% (SE = 1.4) versus 0.04% (SE = 3.5); p = 0.36] between PROMIS and legacy instruments. The weighted average for percentage of patients achieving MCID was 59.1% for global physical health (GPH), 26.0% for global mental health (GMH), 52.7% for physical function (PF), 67.2% for pain interference (PI), and 37.2% for depression.
    Conclusion: Notably, PROMIS global physical health, physical function, and pain interference were found to be significantly responsive, with PROMIS pain interference most effectively capturing clinical improvement as evidenced by the achievement of MCID.
    Language English
    Publishing date 2023-12-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2673841-7
    ISSN 2234-2451 ; 2234-0726
    ISSN (online) 2234-2451
    ISSN 2234-0726
    DOI 10.1186/s43019-023-00201-6
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