Today’s Top Story

Study Associates Far Proximal Cup Position in THA with Positive Outcomes

Primary total hip arthroplasty (THA) with a far proximal cup position could be an effective treatment for patients with severe dysplastic hip osteoarthritis (OA), according to a study published in the May issue of The Journal of Arthroplasty. A total of 50 patients (61 hips) underwent THA for severe dysplastic OA and had a far proximal cup position. Patients were stratified into three groups based on the height of implanted cups with increasing vertical distance from the interteardrop line: group A, 55–65 mm; group B, 65–75 mm; and group C, > 75 mm. Group C had a significant decrease in Lower Extremity Functional Score (45.3) compared to groups A (66.7) and B (67.9). All three groups had a significant increase in Tegner Activity Score from pre- (2.2) to postoperative (4.1). The mean overall Harris Hip Score (HHS) was 89.3 and was highest in group B (94.3), followed by groups A (89.5) and C (78.3). There were significant decreases for HHS domains of quality of life and gait in group C. Overall, patients reported high levels of satisfaction.

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Other News

Study Yields Mixed Results for Atasoy Flap in Pediatric Distal Finger Trauma Patients

A retrospective study published online in The Journal of Hand Surgery evaluated long-term outcomes for children who received Atasoy flap (AF) for distal finger trauma. Thirty patients (mean age at trauma, 6.4 years) were included in the study; 21 had finger damage in Ishikawa subzone II. There were no incidences of necrosis or infection. About two-thirds (n = 20, 67 percent) of patients had good epicritical tactile sensitivity, while half (n = 15) had a hook nail deformity, and about three-quarters (n = 22, 73 percent) had hyponychial scarring. Pulp shape was normal in 43 percent (n = 13) of patients.

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Study: Mood Disorders Do Not Impact TSA Outcomes

Anxiety and depression did not affect outcomes in patients undergoing total shoulder arthroplasty (TSA), according to a study published in the May/June issue of Current Orthopaedic Practice. Researchers collected visual analog scale (VAS) pain scores preoperatively and at two, six, and 12 weeks postoperatively. Rate of oral morphine equivalents (OMEs) use was documented during the hospital stay, as well as for discharge medications and prescriptions given at two, six, and 12 weeks. Of 133 primary anatomic TSAs, 29 patients (32 shoulders) had mood disorders (anxiety and/or depression), while 101 did not. There were no significant between-group differences in terms of VAS scores, OME narcotic use, hospital lengths of stay, and postoperative complications.

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Study Identifies Risk Factors for Radiographic Adjacent Segment Degeneration after Spinal Fusion

A retrospective study published online in the Journal of Orthopaedic Surgery and Research determined which degenerative lumbar stenosis patients undergoing multilevel posterior lumbar spinal fusion surgery have the highest risk for radiographic adjacent segment degeneration (ASD). From January 2013 to December 2016, 71 degenerative lumbar stenosis patients underwent operative treatment. Patients were stratified into two groups: in group A (n = 22), the proximal fixed vertebral lamina and posterior ligamentous complex (PLC) were not resected; and in group B (n = 49), the proximal fixed vertebral lamina and PLC were resected completely. There were no cases of symptomatic ASD during follow-up. Group B had a significantly greater risk for radiographic ASD. The following factors were significantly associated with radiographic ASD: preoperative modified Pfirrmann grade > 3, a high degree of preoperative pelvic incidence, and more decompressed levels.

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Brainlab AG Recalls Spine & Trauma 3D Navigation Due to Inaccurate Display

Brainlab AG has recalled the Spine & Trauma 3D Navigation Software used with the Brainlab Spine & Trauma Navigation System. The software may potentially display incorrect information during surgery that could prevent the surgeon from accurately navigating surgical tools inside the patient before and during minimally invasive surgical procedures. The inaccuracies may result in damage to the patient’s body; a second, otherwise unnecessary, surgical procedure; or serious life-threatening injuries or death. The Food and Drug Administration (FDA) has identified this as a class I recall—the most serious kind. Brainlab notified consignees of the problem on March 1 and plans to stop distributing this software as soon as an updated version is released and available.

Read the full FDA statement…


Best Practices Help with Managing Failed Implants

The conclusion of a two-part series on the management of failed implants discusses what to do if an implant has failed or been recalled, advice on patient monitoring, how to preserve retrieved implants, and how to navigate potential legal issues.

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Final Call: Apply for the AHRQ’s USPSTF Member Position

The Agency for Healthcare Research and Quality (AHRQ)’s U.S. Preventive Services Task Force (USPSTF) has two open member positions. Over the course of a four-year term, the members will be responsible for prioritizing topics, designing research plans, reviewing and commenting on systematic evidence reviews, discussing and making recommendations on preventive services, reviewing stakeholder comments, drafting final recommendation documents, and participating in workgroups on specific topics and methods. Members will also attend three two-day meetings each year in Washington, D.C. The application deadline is May 5.

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


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