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ABSTRACT Background Reliable scientific information is crucial for assessing hip function and evaluating the success of hip surgery. The Harris Hip Score (HHS) is the most widely used tool for measuring hip function and, in particular, the outcomes of hip surgery. The aim of this study was to conduct a systematic review of the literature to identify randomized controlled trials (RCTs) that reported the HHS for hip replacement treatment groups and to test whether there was a substantial difference between reporting only the postoperative HHS or the HHS difference (HHSdiff). Methods PubMed, CNKI, and Epistemonikos were searched until March 1, 2024. The risk of bias, level of evidence, and publication bias were assessed. As HHS is a continuous outcome, mean difference (MD) with 95% confidence intervals (CIs) was calculated using the Hartung–Knapp–Sidik–Jonkman method and a common‐effect/random‐effects model. The same approach was used for both postoperative HHS and HHSdiff. The effect of the two treatment groups studied (minimally invasive vs. conventional approach) on postoperative HHS was then compared with the effect of the two groups studied on the difference in HHS. Results A total of 41 RCTs, involving 3572 patients, with a low to high risk of bias and a low to moderate publication bias were included. The measured outcome parameters showed a low to moderate level of evidence. There was no relevant difference in the reporting of HHS only postoperatively or HHSdiff when comparing two hip replacement treatment groups in RCTs, measured at 0–0.5, 3, 6, and 12 months postoperatively. Conclusion The present study showed that there is no relevant difference between reporting of the HHS only postoperatively or HHSdiff when comparing two hip replacement treatment groups in RCTs. Both methods of HHS reporting produced comparable results in an identical cohort of 3765 patients undergoing hip replacement surgery.

Aims: The transepicondylar axis is a well-established reference for the determination of femoral component rotation in total knee arthroplasty (TKA). However, when severe bone loss is present in the femoral condyles, rotational alignment can be more complicated. There is a lack of validated landmarks in the supracondylar region of the distal femur. Therefore, the aim of this study was to analyze the correlation between the surgical transepicondylar axis (sTEA) and the suggested dorsal cortex line (DCL) in the coronal plane and the inter- and intraobserver reliability of its CT scan measurement. Methods: A total of 75 randomly selected CT scans were measured by three experienced surgeons independently. The DCL was defined in the coronal plane as a tangent to the dorsal femoral cortex located 75 mm above the joint line in the frontal plane. The difference between sTEA and DCL was calculated. Descriptive statistics and angulation correlations were generated for the sTEA and DCL, as well as for the distribution of measurement error for intra- and inter-rater reliability. Results: The external rotation of the DCL to the sTEA was a mean of 9.47° (SD 3.06°), and a median of 9.2° (IQR 7.45° to 11.60°), with a minimum value of 1.7° and maximum of 16.3°. The measurements of the DCL demonstrated very good to excellent test-retest and inter-rater reliability coefficients (intraclass correlation coefficient 0.80 to 0.99). Conclusion: This study reveals a correlation between the sTEA and the DCL. Overall, 10° of external rotation of the dorsal femoral cortical bone to the sTEA may serve as a reliable landmark for initial position of the femoral component. Surgeons should be aware that there are outliers in this study in up to 17% of the measurements, which potentially could result in deviations of femoral component rotation. Cite this article: Bone Jt Open 2024;5(12):1067–1071.

Background/Objectives: Orthopedic hip surgery has undergone advances driven by innovations in surgical techniques and improved patient care protocols. The aim was to synthesize and appraise all studies relevant to hip surgery published in Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) in 2022–2023. Methods: The search included all studies published in KSSTA from 1 January 2022 to 31 December 2023. Quality assessment was performed using appropriate tools for randomized controlled trials (RCTs), non-RCTs, and systematic reviews. Due to the diverse nature of the included studies, a narrative synthesis approach was used. Results: A total of 33 primary studies were included in this narrative review, of which 10 were reviews (5 systematic reviews), 1 was an RCT, and 22 were non-RCTs. A total of 11 were from the UK, 10 studies were from the USA, and 5 were from Canada. Femoroacetabular impingement (FAI) was investigated in a total of 23 studies, followed by hip micro-instability in 7 studies, dysplasia in 5 studies, and gluteal and hamstring tears in 4 studies. The RCT had a low risk of bias. Of the 22 non-RCTs, 16 had a low risk of bias, 5 had a moderate risk of bias, and 1 had a high risk of bias. All systematic reviews were of moderate quality. Conclusions: Hip arthroscopy is an effective treatment for FAI with promising early outcomes, especially when combined with closed capsular repair and appropriate rehabilitation. Surgeons should tailor their approach to capsular management to optimize recovery, as closed capsular repair may enhance functional outcomes. Additionally, preoperative tools like the HAR Index can help identify patients at higher risk of requiring hip arthroplasty after surgery. The conclusions of the included primary studies align with current general recommendations and contribute valuable insights to the field of hip orthopedics.

Purpose: The purpose of the present scoping review is to identify sources of heterogeneity in reporting domains that have the potential to improve surgical decision-making in reverse shoulder arthroplasty associated with glenoid bone grafting. Methods: A scoping review was conducted according to the JBI and PRISMA ScR guidelines. Articles covering glenoid bone grafting at the time of reverse shoulder replacement, published between 2012 and 2022 in MEDLINE, Scopus, Epistemonikos, Web of Science, and Cochrane Database of Systematic Reviews, were searched. Reporting of core outcome measures, as well as prosthesis-related variables, rehabilitation protocols, radiographic evaluation methods, and bone graft incorporation assessments, were collected. Results: For the final analysis, a total of 14 articles were considered. There were 649 operated shoulders with a mean patient age of 72 years, ranging from 48 to 85 years. Analysis of preoperative ranges of motion and patient-reported outcome measures revealed increased heterogeneity in patient selection between studies. Reporting of implant-related parameters was the most inconsistent. Rehabilitation protocols were scarcely reported. Assessment of graft incorporation and radiographic evaluation of choice revealed that there is no consistent method or measurement and the clinical relevance of radiolucent lines at the graft-glenoid bone interface is unclear. Conclusion: Addressing implant-related reporting gaps has the highest potential to improve surgical decision-making and provide orthopedic surgeons with a more comprehensive understanding of published results on glenoid bone grafting at the time of primary reverse shoulder arthroplasty.

IntroductionMobile applications targeting physiotherapeutic care after total joint replacements are increasing in popularity among end-users. However, these applications were primarily conceived out of financial interest and lack an evidence-based programs tailored to the specific needs of the target population. The primary objective of this study is to describe the conception of an evidence-based mobile health application that targets early postoperative physiotherapeutic care after total knee replacement (TKR).MethodsA literature search of eHealth applications targeting physical therapy after TKR was carried out. Articles were then screened and suggestions as well as recommendations were extracted to inform the design of a new application. The beta version of the application was then passed onto experts for evaluation. Final changes were then undertaken to account for the expert's opinions.ResultsSeveral reviews with recommendations for the design of applications targeting patients after total joint replacement were identified. Primarily, mobile applications targeting rehabilitative care after TKR need to be tailored to the needs of the elderly population. Additionally, no unified rehabilitative physiotherapeutic (PT) program was found reflecting a discrepancy regarding what exercises are most useful. A comparison of different programs yielded no significant difference favoring one single exercise regimen.DiscussionAs the elderly population was shown to be less proficient regarding the use of new technologies, the application at hand was explicitly made simple. Elements of different PT programs were incorporated and quadriceps strengthening exercises were included. application was composed based on the findings of the reviewed literature and then subsequently modified to incorporate the expert's suggestions. Experts mainly expressed concerns regarding the safety of patients during unsupervised physical therapy as well as the safety of the recorded data. Thus, password protection and a split between the physician's and the patient's interface was created.

Abstract Efforts to improve research standards in orthopaedics, sports medicine, physical therapy, and rehabilitation are ongoing. Rrehabilitation andomized Controlled Trials (RCTs) are widely regarded as the gold standard for the collection of primary data. Similarly, systematic reviews, due to their methodological rigor, have become the gold standard for evidence synthesis in medicine. However, while narrative reviews often lack scientific rigor and systematic reviews are not suited to addressing all research questions, other robust review formats are necessary. When the outcomes of interest are unknown or difficult to define in advance, scoping or mapping reviews are more appropriate, as they can address a broader range of questions within the field. Consequently, it is essential to establish rigorous methods for conducting scoping reviews across medical disciplines.

Specialist literature lacks evidence that explores associations between patient characteristics and the beneficial treatment effect of SuperPATH hemiarthroplasty (HA) compared with conventional approach (CA) HA. To investigate and identify patient‐related predictors of the effect size of the short‐term functional outcome of SuperPATH HA and CA HA by performing a systematic review and meta‐regression analysis of randomized controlled trials (RCTs). A systematic search of literature was performed in PubMed, CNKI, CENTRAL of The Cochrane Library, Clinical trials, and Google Scholar until August 25, 2023. For the continuous outcome parameter Harris hip score (HHS) ≤1 week and 3 months postoperatively, mean differences (MDs) with 95% confidence intervals (CIs) were calculated. A meta‐regression analysis was based on random‐effects meta‐analysis using the Hartung–Knapp–Sidik–Jonkman method for continuous covariates. A total of five RCTs with 404 patients were found. The following predictors of HHS ≤1 week postoperatively were identified: patient age (predictor estimate = 1.29; p

Anterior cruciate ligament (ACL) injuries are common in sports and often require surgical intervention, e.g., ACL reconstruction (ACLR), aimed at restoring knee stability and enabling a return to pre-injury activity levels. The choice of graft is crucial, impacting biomechanical properties, clinical outcomes, and complication rates, and is especially important in revision surgeries after graft failure. Over the past 30 years, trends in graft selection have evolved towards more individualized approaches, considering factors such as patient activity level, prior injuries, and tissue availability. In Europe, autografts like hamstring tendon (HT), bone-patellar tendon-bone (BTB), and quadriceps tendon (QT) are preferred, with the increasing use of QT grafts. This review synthesizes the current literature on graft selection and its influence on ACLR outcomes.

Determining whether preoperative performance-based knee function predicts postoperative performance-based knee function and whether patient-reported outcome measures (PROMs) completed by participants can detect these changes could significantly enhance the planning of postoperative rehabilitation for patients following total knee arthroplasty (TKA). This study aims to collect data on performance-based knee function using inertial measurement units (IMUs) worn by participants both preoperatively and postoperatively. PROMs will be completed by the patients before and after surgery to assess their ability to detect the same changes in performance-based knee function measured by the sensors. Additionally, the study will investigate the correlation between the degree of knee alignment correction and postoperative performance-based knee function in participants after TKA.

Abstract Purpose To identify biomarkers in human blood or urine at an early stage of knee osteoarthritis (OA) and to elucidate if any can accurately differentiate between healthy controls and early knee OA patients and be considered as a candidate for widespread clinical use for early diagnosis of the disease. Methods Medline, Embase and Web of Science were screened to identify comparative studies measuring differences in blood or urine biomarkers between healthy controls and knee OA patients at an early stage (grade 1 or 2 Kellgren–Laurence). Two independent reviewers screened the abstracts for eligibility, reviewed the full texts, assessed the methodological quality and extracted the data. The Joanna Briggs Institute critical appraisal tool for diagnostic test accuracy studies was used to assess the quality of the included studies. Due to relevant heterogeneity, meta‐analysis was not appropriate. Results Five studies met the eligibility criteria. The examined biomarkers were adropin, collagen type II metabolite, C‐terminal cross‐linked telopeptide of type II collagen, C‐terminal cross‐linked telopeptide of type I collagen, cartilage oligomeric matrix protein, matrix metalloproteinase 3, N‐terminal propeptide of procollagen type IIA, type I procollagen N‐terminal propeptides, N‐terminal osteocalcin, angiopoietin‐2, follistatin, granulocyte colony‐stimulating factor, hepatocyte growth factor, interleukin‐8, leptin, platelet‐derived growth factor‐BB, platelet endothelial cell adhesion molecule‐1, vascular endothelial growth factor and calprotectin and totalling 19 biomarkers. All of the biomarkers were studied only once in the selected papers. Conclusions There is no reliable biomarker available to differentiate between early knee OA in patients and healthy controls, but a potential role of a cluster of biomarkers to close this gap. There are several limitations, including inappropriate study designs, small sample sizes, nonconsecutive patient groups and inadequate statistical methods for evaluating biomarker performance in studies included. Level of Evidence Level III.

This study aimed to develop and evaluate the reliability of a surface electromyography-based (sEMG) index to quantify knee muscle coactivation in healthy recreational athletes during the Lower Quarter Y-Balance Test (YBT-LQ). A prospective observational repeated measures design was used to assess both intra- and inter-rater reliability. Forty males completed three trials, with two raters independently conducting assessments. sEMG signals from the vastus medialis, vastus lateralis, biceps femoris, and semitendinosus muscles were collected to calculate four coactivation indices (CoAIs) for different muscle pairs. The reliability evaluation of these CoAIs was based on intraclass correlation coefficients. The results revealed that the reliability of the CoAIs varied depending on the muscle pair, direction, and limb examined. The highest intra- and inter-rater reliability was noted for the left lower limb in the posterolateral direction. The lowest reliability was found for the right lower limb in the anterior direction. Statistical analyses indicated significant differences in specific CoAIs across different YBT-LQ directions. These findings highlight the potential of sEMG-based CoAIs for assessing knee muscle activity during the YBT-LQ in healthy male recreational athletes. However, choosing CoAIs is critical for reliable clinical and research assessments of knee stability and neuromuscular control.

In Roraima, banana cultivation is a significant socio-economic activity aimed at catering to both the domestic and regional markets. The banana-producing region (Musa spp) is concentrated in the southern part of the state, encompassing the municipalities of Caroebe, São João da Baliza, and Rorainópolis. Thus, the objective was to assess fruit damage and investigate severity and causes. The cultivars selected for the study were ‘Pacovan’, ‘Prata’, and ‘Missouri’. Five markets were visited for the study, with eleven points of sale sampled at each market. At each sampling point, newly arrived batche (bunches) was collected at three distinct times. The variable studied was the incidence of fruit damage at different ripening stages (type 2 and type 7). Data collected visually were subjected to Likert analysis and descriptive statistics. The results showed that mature bananas exposed directly on tarpaulin exhibited severe mechanical damage, such as abrasions and cuts due to direct contact with the rough surface of the tarpaulin and stacking during transport. Mature fruits transported in cardboard boxes had a lower incidence of damage and also served as a display for marketing. Mature green fruits were also affected during transport, with greater impact when in plastic bags or plastic boxes due to irregular and pointed surfaces. In the case of green-mature fruit, the damage incurred was less severe compared to mature fruit.

Objective The purpose of this study was to review the current literature regarding the non-operative treatment of isolated medial collateral ligament (MCL) injuries.Design Systematic review, registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/E9CP4).Data sources The Embase, MEDLINE and PEDro databases were searched; last search was performed on December 2023.Eligibility criteria Peer-reviewed original reports from studies that included information about individuals who sustained an isolated MCL injury with non-surgical treatment as an intervention, or reports comparing surgical with non-surgical treatment were eligible for inclusion. Included reports were synthesised qualitatively. Risk of bias was assessed with the Risk of Bias Assessment tool for Non-randomized Studies. Certainty of evidence was determined using the Grading of Recommendations Assessment Development and Evaluation.Results A total of 26 reports (1912 patients) were included, of which 18 were published before the year 2000 and 8 after. No differences in non-operative treatment were reported between grade I and II injuries, where immediate weight bearing and ambulation were tolerated, and rehabilitation comprised different types of strengthening exercises with poorly reported details. Some reports used immobilisation with a brace as a treatment method, while others did not use any equipment. The use of a brace and duration of use was inconsistently reported.Conclusion There is substantial heterogeneity and lack of detail regarding the non-operative treatment of isolated MCL injuries. This should prompt researchers and clinicians to produce high-quality evidence studies on the promising non-operative treatment of isolated MCL injuries to aid in decision-making and guide rehabilitation after MCL injury.Level of evidence Level I, systematic review.

BackgroundAs large language models (LLMs) are becoming increasingly integrated into different aspects of health care, questions about the implications for medical academic literature have begun to emerge. Key aspects such as authenticity in academic writing are at stake with artificial intelligence (AI) generating highly linguistically accurate and grammatically sound texts. ObjectiveThe objective of this study is to compare human-written with AI-generated scientific literature in orthopedics and sports medicine. MethodsFive original abstracts were selected from the PubMed database. These abstracts were subsequently rewritten with the assistance of 2 LLMs with different degrees of proficiency. Subsequently, researchers with varying degrees of expertise and with different areas of specialization were asked to rank the abstracts according to linguistic and methodological parameters. Finally, researchers had to classify the articles as AI generated or human written. ResultsNeither the researchers nor the AI-detection software could successfully identify the AI-generated texts. Furthermore, the criteria previously suggested in the literature did not correlate with whether the researchers deemed a text to be AI generated or whether they judged the article correctly based on these parameters. ConclusionsThe primary finding of this study was that researchers were unable to distinguish between LLM-generated and human-written texts. However, due to the small sample size, it is not possible to generalize the results of this study. As is the case with any tool used in academic research, the potential to cause harm can be mitigated by relying on the transparency and integrity of the researchers. With scientific integrity at stake, further research with a similar study design should be conducted to determine the magnitude of this issue.

In this work, we hypothesized that shifts in the food microbiome can be used as an indicator of unexpected contaminants or environmental changes. To test this hypothesis, we sequenced the total RNA of 31 high protein powder (HPP) samples of poultry meal pet food ingredients. We developed a microbiome analysis pipeline employing a key eukaryotic matrix filtering step that improved microbe detection specificity to >99.96% during in silico validation. The pipeline identified 119 microbial genera per HPP sample on average with 65 genera present in all samples. The most abundant of these were Bacteroides, Clostridium, Lactococcus, Aeromonas, and Citrobacter. We also observed shifts in the microbial community corresponding to ingredient composition differences. When comparing culture-based results for Salmonella with total RNA sequencing, we found that Salmonella growth did not correlate with multiple sequence analyses. We conclude that microbiome sequencing is useful to characterize complex food microbial communities, while additional work is required for predicting specific species' viability from total RNA sequencing.

Introduction: Early in the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) rapidly initiated COVID-19 surveillance by leveraging existing hospital networks to assess disease burden among hospitalized inpatients and inform prevention efforts. Materials and Methods: The Surveillance Platform for Enteric and Respiratory Infectious Organisms at Veterans Affairs Medical Centers (SUPERNOVA) is a network of five United States Veterans Affairs Medical Centers which serves nearly 400,000 Veterans annually and conducts laboratory-based passive and active monitoring for pathogens associated with acute gastroenteritis and acute respiratory illness among hospitalized Veterans. This paper presents surveillance methods for adapting the SUPERNOVA surveillance platform to prospectively evaluate COVID-19 epidemiology during a public health emergency, including detecting, characterizing, and monitoring patients with and without COVID-19 beginning in March 2020. To allow for case-control analyses, patients with COVID-19 and patients with non-COVID-19 acute respiratory illness were included. Results: SUPERNOVA included 1,235 participants with COVID-19 and 707 participants with other acute respiratory illnesses hospitalized during February through December 2020. Most participants were male (93.1%), with a median age of 70 years, and 45.8% non-Hispanic Black and 32.6% non-Hispanic White. Among those with COVID-19, 28.2% were transferred to an intensive care unit, 9.4% received invasive mechanical ventilation, and 13.9% died. Compared with controls, after adjusting for age, sex, and race/ethnicity, COVID-19 case-patients had significantly higher risk of mortality, respiratory failure, and invasive mechanical ventilation, and longer hospital stays. Discussion: Strengths of the SUPERNOVA platform for COVID-19 surveillance include the ability to collect and integrate multiple types of data, including clinical and illness outcome information, and SARS-CoV-2 laboratory test results from respiratory and serum specimens. Analysis of data from this platform also enables formal comparisons of participants with and without COVID-19. Surveillance data collected during a public health emergency from this key U.S. population of Veterans will be useful for epidemiologic investigations of COVID-19 spectrum of disease, underlying medical conditions, virus variants, and vaccine effectiveness, according to public health priorities and needs.

Pork branding is a common tool used to differentiate products based on quality to assist consumers in making purchasing decisions. Most pork processers have premium pork programs with different parameters related to color, mar-bling, and other quality factors, though many differences in specific criteria exist among programs. The objective of this study was to assess differences in pork quality and the associated eating experience of different premium and commodity pork loin programs available in the retail market. Loins (n=30/brand) from 7 branded (PRE A, B, C, D, and E) and commodity (COM A and B) programs were acquired and fabricated at 14–15 d post-box date into 2.54-cm chops for visual color, marbling, pH, intramuscular fat, drip loss, purge loss, shear force, and trained sensory panels. Overall, few differences were found among products for most of the quality traits evaluated. One commodity brand, COM B, had higher (P0.05) in initial juiciness, sustained juiciness, or any tenderness measurement. The only quality measurement that was associated with changes in eating experience was shear force value, with the PRE C product having the highest (P0.05) among any treatment for initial juiciness, sustained juiciness, and pork flavor intensity. The results from this study indicate that the range of pork quality differences sold domestically among the evaluated premium and commodity programs is minimal and does not result in associated differences in eating experience.

Background and Objectives: Muscle properties are critical for performance and injury risk, with changes occurring due to physical exertion, aging, and neurological conditions. The MyotonPro device offers a non-invasive method to comprehensively assess muscle biomechanical properties. This systematic review evaluates the reliability of MyotonPro across various muscles for diagnostic purposes. Materials and Methods: Following PRISMA guidelines, a comprehensive literature search was conducted in Medline (PubMed), Ovid (Med), Epistemonikos, Embase, Cochrane Library, Clinical trials.gov, and the WHO International Clinical Trials platform. Studies assessing the reliability of MyotonPro across different muscles were included. A methodological quality assessment was performed using established tools, and reviewers independently conducted data extraction. Statistical analysis involved summarizing intra-rater and inter-rater reliability measures across muscles. Results: A total of 48 studies assessing 31 muscles were included in the systematic review. The intra-rater and inter-rater reliability were consistently high for parameters such as frequency and stiffness in muscles of the lower and upper extremities, as well as other muscle groups. Despite methodological heterogeneity and limited data on specific parameters, MyotonPro demonstrated promising reliability for diagnostic purposes across diverse patient populations. Conclusions: The findings suggest the potential of MyotonPro in clinical assessments for accurate diagnosis, treatment planning, and monitoring of muscle properties. Further research is needed to address limitations and enhance the applicability of MyotonPro in clinical practice. Reliable muscle assessments are crucial for optimizing treatment outcomes and improving patient care in various healthcare settings.