Today’s Top Story

Study: Does Targeting Residual Varus Alignment in TKA Improve Functional Outcomes?

A study published online in The Knee found that residual varus alignment following total knee arthroplasty (TKA) may not improve functional outcomes. Bilateral TKA patients were stratified into residual varus alignment (n = 32) and neutral alignment (n = 45) groups and followed for two years. The primary outcome was the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC); other outcomes included range of motion, Knee Society knee and function scores, spatiotemporal gait parameters, dynamic alignment, knee flexion angle, knee adduction moment (KAM), and internal knee extension moment. After two years, the mean difference of WOMAC score between the two groups was 0.3. There were no significant differences in any of the secondary outcomes, except KAM and dynamic alignment: The residual varus alignment group had increased KAM, with a 19 percent higher maximum KAM.

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Other News

Study Evaluates Outcomes Associated with Different Anesthesia Methods

In a study published online in BMC Anesthesiology, varying anesthesia methods used in orthopaedic surgeries were associated with different outcomes. PubMed, Embase, and the Cochrane Library were queried for relevant studies through March 10, 2018. Final analysis included 23 studies comprising 2,393 patients. Nerve block analgesia was associated with reduced postoperative nausea or vomiting and urine retention compared to epidural anesthesia. Both interscalene block and local infiltration anesthesia significantly reduced back pain compared to epidural anesthesia.

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Study: Older Hip Fracture Patients May Benefit from ‘Combined Hip Procedure’

In a study published online in The Bone & Joint Journal, researchers compared outcomes for older hip fracture patients who underwent open reduction and internal fixation (ORIF) (n = 14) or a “combined hip procedure” (CHP) (n = 13)—a combination of ORIF and total hip arthroplasty (THA). A total of 27 patients (mean age, 72.2 years) were treated for similar acetabular fractures. THA survival rate in the CHP group was 100 percent compared to 28.6 percent in the ORIF group. The CHP group had no deep infections or deaths at one year, but three-year survival rates were lower in the CHP group.

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Study: Hepatitis B Increases Complication Risk in TJA Patients

Patients with hepatitis B virus (HBV) have a greater risk for complications following total joint arthroplasty (TJA), according to a retrospective study published online in BMC Musculoskeletal Disorders. Of 196 TJA patients between 2013 and 2016, 49 had HBV and 147 did not. Among the total patient cohort, 5.5 percent of patients were infected with HBV for the first time. HBV patients had significantly higher complication rates compared to patients without HBV (10.2 percent versus 4.7 percent). Compared to non-HBV patients, those with HBV had increased odds of surgical-related complications (6.1 percent versus 3.4 percent) and general medical complications (4.1 percent versus 1.3 percent). When applying regression models, HBV patients had a 25 percent increased complication risk compared to the non-HBV group.

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Study Assesses Change to Medicare’s Hospital Readmissions Reduction Program

In a cross-sectional study published online in JAMA Internal Medicine, researchers associated hospital stratification under Medicare’s Hospital Readmissions Reduction Program with a significant change in excess readmissions penalties. A total of 3,049 hospitals were included in the study. Teaching hospitals and large hospitals were more likely to have reduced penalties. Compared to for-profit hospitals, not-for-profit hospitals had lower odds of reduced penalties. Northeast hospitals were more likely than those in the Midwest and South to have a penalty reduction. Hospitals with patients from the most disadvantaged neighborhoods, with a high incidence of disabilities, and with the highest Medicaid eligibility cutoffs were significantly more likely to have reduced penalties.

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AAOS Now

Four Tips for Avoiding Data Breaches

According to a new report by Radware, the average cost of a cyberattack now exceeds $1 million. Furthermore, 37 percent of the organizations that have been attacked experienced subsequent damage to their reputation. Michael J Sacopulos, JD, founder and president of Medical Risk Institute, provided some practical approaches for minimizing risk of breaches and costly cyber fallout.

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Your AAOS

Final Call: Apply for the OKU Evaluation Committee Member Position

The Orthopaedic Knowledge Update (OKU) Evaluation Committee has an open member position. Over the course of a three-year term, the member will complete two writing assignments totaling about 20 questions for the OKU self-assessment examination. The member will also participate in the test item peer-review process, as well as one to two virtual web-based Item Review Meetings. The application deadline is today, April 22.

Learn more and submit your application…(member login required)

 

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