August 21, 2019
 
Today’s Top Story

Study: Is Waiting for Joint Arthroplasty ‘Worse Than Death?’

Nearly one in five patients waiting to undergo total hip arthroplasty (THA) may be in a health state “worse than death (WTD),” while a smaller percentage awaiting total knee arthroplasty (TKA) may be in a state WTD, according to a cross-sectional analysis published online in The Bone & Joint Journal. The study included 2,073 THAs and 2,168 TKAs. Researchers evaluated any association between a EuroQol five-dimension (EQ-5D) questionnaire score less than zero and variables including deprivation quintile, comorbidities, and functional outcomes measured by the Oxford Hip Score (OHS) or Oxford Knee Score (OKS). One year postoperatively, 1,555 THAs and 1,700 TKAs underwent EQ-5D and OHS or OKS again. In total, 391 (19 percent) THA patients and 263 (12 percent) TKA patients were WTD prior to surgery. In THA patients, factors associated with WTD included preoperative OHS, deprivation, and chronic obstructive pulmonary disease, and in TKA, factors included OKS, peripheral arterial disease, and inflammatory arthropathy. Preoperative WTD was predictive of significantly poorer one-year OHS and OKS and satisfaction rates compared to patients who were not WTD before surgery.

Read the study…

 
 
 
 
In Other News

Study Compares Volar versus Dorsal Osteotomy for Symptomatic Distal Radius Malunions

A retrospective review published online in The Journal of Hand Surgery observed more favorable outcomes associated with volar osteotomy compared to dorsal osteotomy for the treatment of symptomatic distal radius malunions. Patients who underwent either treatment at one of three institutions between 2005 and 2017 were included. Final analysis included 53 cases: 37 volar osteotomies and 16 dorsal osteotomies; mean follow-up was 84.6 months. Volar osteotomy patients had a better postoperative flexion-extension arc (72.9 degrees) and pronation-supination arc (124.9 degrees) compared to the dorsal osteotomy group (94.9 degrees and 146.2 degrees, respectively), as well as a better Quick Disabilities of the Arm, Shoulder, and Hand function score (12.87 versus 6.65, respectively). In the volar osteotomy group, seven (18.9 percent) cases had complications compared to eight (50 percent) cases in the dorsal osteotomy group. Radiographic outcomes immediately postoperatively and at final follow-up did not largely differ.

Read the abstract…

 
 
 
 
Study Analyzes Cannulated Screw and Kirschner Fixation for Pediatric Medial and Lateral Malleolar Epiphyseal Fractures

According to a retrospective review published online in the Journal of Orthopaedic Surgery and Research, children with medial and lateral malleolar epiphyseal fractures may benefit from cannulated screw and Kirschner fixation after closed reduction. Between January 2010 and December 2015, 36 children (average age, 11.3 years; 22 were boys) underwent cannulated screw and Kirschner fixation after closed reduction at a single hospital. Patients underwent monthly follow-up (average length of follow-up, 25 months), which included the Baird-Jackson ankle score. Average healing time was 2.8 months. The average Baird-Jackson ankle score was 94; 13 cases were scored as “excellent,” 19 as “good,” four as “fair,” and zero as “poor.” Preinjury function was achieved after an average 3.5 months. There were no reported cases of nonunions, secondary displacements, dysfunction, pain, instability, or premature epiphyseal closure.

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Study Evaluates Use of Lateral Spine Images in Vertebral Fracture with Fracture Prevention Therapy

According to a study published online in the Journal of Bone and Mineral Research, the use of targeted lateral spine images (VFA) may significantly help identify high-risk fracture patients and provide prevention therapy in patients with fracture history. The Manitoba Bone Density Program database provided information on 6,652 treatment-naïve patients with at least 90 days of follow-up who underwent VFA imaging, of whom 923 (13.9 percent) had at least one confirmed vertebral fracture. According to their bone density reports, patients with a prevalent vertebral fracture identified on bone density VFA (positive VFA) were at high risk of another fracture and were eligible for fracture prevention therapy. A total of 2,127 patients started fracture prevention medication—52.3 percent with positive VFA and 28.4 percent with negative VFA. The association was much more significant among patients who were initially believed to have low or moderate fracture risk (before VFA) compared to those with high fracture risk.

Read the abstract…

 
 
 
CMS Updating Overall Hospital Quality Star Ratings

The Centers for Medicare & Medicaid Services (CMS) plans to make changes to the quality measurement methodology of its Overall Hospital Quality Star Ratings in 2021. The Star Ratings will be updated in 2020 using the current methodology. Star Ratings evaluate hospitals’ quality on a five-point scale.

Read the CMS press release…

 
 
 
AAOS Now

Surgeon General of U.S. Army Talks About Leadership, Career Opportunities

Lieutenant General Nadja Y. West is the 44th Surgeon General of the U.S. Army and Commanding General of the U.S. Army Medical Command. General West is the highest-ranking female graduate of the U.S. Military Academy, and she is the first African-American and second woman to serve as Surgeon General of the U.S. Army. When Anthony E. Johnson, MD, was chief of orthopaedics in the Department of Specialty Care at Fort Eustis, General West was the commander at McDonald Army Community Hospital. Dr. Johnson spoke with General West to get her insights on leadership and military medicine career opportunities.

Read more…

 
 
 
Your AAOS

Act Now to Nominate AAOS Leadership

The 2020 Nominating Committee is actively soliciting nominees for individuals to serve on the Board of Directors in the following positions:

  • Second Vice President
  • Board Member-at-Large (over age 45 on March 30, 2020)
  • Board Member-at-Large (younger than age 45 on March 30, 2020)

Nominations close on Aug. 30. Members can review the position descriptions—including information about responsibilities, desired experience, and time commitments—as well as submit nomination(s) online.

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

 

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