Generative artificial intelligence, large language models and ChatGPT in musculoskeletal Oncology: Current applications and future potential.

Generative artificial intelligence (AI), particularly large language models (LLMs), has emerged as a transformative technology across all medical specialties, including musculoskeletal (MSK) oncology. These models, such as ChatGPT and others, can process natural language, synthesize vast amounts of information, and generate contextually relevant outputs that resemble human communication. In orthopedic oncology, LLMs show promise in facilitating literature reviews, enhancing patient education, and supporting clinical decision-making by analyzing multidimensional data while providing improved logic-based reasoning.

Global and regional disparities in access to specialist sarcoma services.

Aims: Cancer care guidelines have been developed in many subspecialities, usually in advanced health systems. However, there are notable global disparities in healthcare access, which can impact sarcoma care. Unfortunately, there is a lack of global data on this subject.

Surgical dislocation of the hip without trochanteric osteotomy for the treatment of bone tumors around the hip.

Purpose: Bone tumors around the hip pose significant surgical challenges. While surgical dislocation with a trochanteric flip osteotomy through a posterior approach is commonly used, it is associated with known complications. This study is the first to report outcomes using surgical hip dislocation without a trochanteric osteotomy for this purpose.

Defining Core Competencies for Generalists in Musculoskeletal Oncology: A Latin-American Consensus for Medical Education.

Inappropriate or delayed initial management of musculoskeletal neoplasms can lead to severe consequences, emphasizing the need to define core competencies for frontline practitioners. Such competencies can guide medical education and residency training objectives. This study aimed to identify core clinical competencies required by general practitioners and general orthopedic surgeons without oncologic training for the initial management of musculoskeletal tumors, with a focus on implications for medical education.

Identifying consensus and areas for future research in chondrosarcoma : a report from the Birmingham Orthopaedic Oncology Meeting.

Aims: The Birmingham Orthopaedic Oncology Meeting (BOOM), held in January 2024, convened 309 delegates from 53 countries to discuss and refine 21 consensus statements on the optimal management of chondrosarcoma.

Methods: With representation from Europe (43%; n = 133), North America (17%; n = 53), South America (16%; n = 49), Asia (13%; n = 40), Australasia (5%; n = 16), the Middle East (4%; n = 12), and Africa (2%; n = 6), the combined experience of treating bone sarcomas among attendees totalled approximately 30,000 cases annually, equivalent to 66 years of experience in the UK alone. The meeting's process began with the formation of a local organizing committee, regional leads, and a scientific committee comprising representatives from 150 specialist units across 47 countries.

Long-term outcome after a limb salvage procedure using a femoral head allograft following the resection of a synovial sarcoma affecting the hindfoot.

The hindfoot is an uncommon site for malignant tumours. While limb salvage procedures are now more common for treating bone sarcoma, there is limited information available on hindfoot reconstruction alternatives because of its low incidence and its challenging outcomes. We present a case report of a man in his late 60s with synovial sarcoma affecting the right heel (calcaneus and soft tissue).

From FUSE to a hands-on electrosurgery course using a cadaveric model.

Introduction: Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices.

Methods: We developed a simulated training course for first-year general surgery and orthopedic residents.

Radiographic Assessment of Bone Quality Using 4 Radiographic Indexes: Canal Diaphysis Ratio Is Superior.

Background: Osteoporosis increases the risk of periprosthetic fracture and loosening in hip arthroplasty. Many methods have been proposed to assess bone quality in X-rays, including both qualitative such as the Dorr classification and quantitative such as the Calcar-Canal Ratio (CCR) and Cortical-Thickness index/Canal-Bone ratio (CTI/CBR). The Canal-Diaphysis ratio (CDR) has been described as a predictor for hip fragility fractures; however, its relationship with bone mineral density (BMD) has not been described.

[Diagnosis and referral of musculoskeletal tumors].

Musculoskeletal tumors are uncommon. However, the true burden of all bone and soft tissue tumors of extremities is underestimated. Usually, the diagnosis of sarcomas is missed or delayed.

Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up.

Introduction: Hip fracture patients have been severely affected by the COVID-19 pandemic; however, the sub acute effects of a concomitant SARS-CoV-2 infection and the outcomes in highly exposed developing countries are still unknown. Our objective is to describe the morbidity and mortality of elderly patients admitted for a hip fracture during the COVID-19 pandemic in Chile, with a minimum 90-day follow-up. Also, to elucidate predictors for mortality and to compare mortality results with the pre-pandemic era.

Methicillin-resistant colonization in patients undergoing primary total hip arthroplasty.

Nasal and skin colonization by methicillin-resistant (MRSA) are linked to a higher incidence of infection after total joint replacement. The prevalence of colonization is poorly defined in Latin American countries. The aim of the present study was to determine the prevalence of MRSA colonization in the nostrils and groin using real-time polymerase chain reaction (RT-PCR) in patients undergoing total hip arthroplasty (THA).

Contamination rate of the surgical gowns during total hip arthroplasty.

Introduction: Surgical instrument contamination during total joint replacement is a matter of major concern. Available recommendations suggest changing suction tips, gloves and avoiding light handle manipulation during the procedure. There is a paucity of data regarding surgical gown contamination.

[Management of hip fractures in the elderly. A national survey among Chilean orthopaedic surgeons].

Background: As the population ages, patients exposed to osteoporotic fractures increase, especially hip fracture, which is the most severe and costly.

Aim: To characterize surgical practices in the management of hip fractures in older patients through a nationwide survey of specialized hip surgeons dedicated to the care of these patients.

Material And Methods: A survey composed of 32 questions was formulated, including demographic factors, preoperative evaluation, definitive treatment, and postoperative management.

The influence of the CT scan in the evaluation and treatment of nondisplaced femoral neck fractures in the elderly.

Background: The management of nondisplaced femoral neck fractures (FNFs) has evolved, with emphasis in radiographic features such as posterior displacement. However, the role of advanced imaging in this scenario is still not well defined. Therefore, our objective is to assess the impact of a computed tomography scan (CT) on interobserver agreement (IA) of fracture classification, posterior tilt measurement, and treatment decisions in nondisplaced FNF in elderly patients.

[Perioperative care of older patients with hip fractures].

The number of osteoporotic fractures is increasing along with population aging. Most patients with these type of fractures are older than 65 years, with multiple chronic conditions and different degrees of disability. Hip fracture is the most relevant osteoporotic fracture due to its frequency, costs, severity and complications.

[Primary musculo-skeletal echinococcosis of chronic evolution].

Cystic echinococcosis is a chronic parasitic zoonosis of high prevalence in Chile. We report a clinical case of a 66-year-old man, domiciled in an urban area of the Maule Region, who presents skeletal muscle cystic echinococcosis. Consultation for pain, volume increase and left thigh fistula that gives out crystalline fluid.

Surgical dislocation of the hip without trochanteric osteotomy.

Background: Surgical dislocation of the hip remains an important alternative in hip preservation surgery, especially when a dynamic access to the hip is needed and arthroscopy is not a suitable option. We describe a novel technique for operative dislocation of the hip without trochanteric osteotomy and the clinical results of our patients.

Methods: Surgical dislocation of the hip without trochanteric osteotomy was done through a modified lateral approach in all of the cases.

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Background: Distinguishing a benign enchondroma from a low-grade chondrosarcoma is a common diagnostic challenge for orthopaedic oncologists. Low interrater agreement has been observed for the diagnosis of cartilaginous neoplasms among radiologists and pathologists, but, to our knowledge, no study has evaluated inter- and intraobserver agreement among orthopaedic oncologists grading these lesions using initial clinical and imaging information. Determining such agreement is important since it reflects the certainty in the diagnosis by orthopaedic oncologists.

Comparison of complications and length of hospital stay between orthopedic and orthogeriatric treatment in elderly patients with a hip fracture.

Hip fractures in the elderly individuals are a complex problem. Our objective was to determine whether orthogeriatric treatment is effective in terms of reducing length of hospital stay, morbidity, and mortality of elderly patients with a hip fracture compared with orthopedic (traditional) treatment. From July 2009 to May 2011, patients older than 65 years with a hip fracture were followed prospectively.