Today’s Top Story

Study Compares Outpatient THA in Ambulatory Surgical Center versus Hospital Outpatient Settings

A study published online in The Journal of Arthroplasty observed similar outcomes in outpatient total hip arthroplasty (THA) performed in ambulatory surgical center (ASC) and hospital outpatient (HOP) settings. Between 2013 and 2018, two surgeons performed 3,063 THAs, of which 965 cases were outpatient: 335 ASC and 630 HOP. There were 37 (3.8 percent) 90-day complications; rates did not differ between the groups (ASC, n = 13, 3.9 percent versus HOP, n = 24, 3.8 percent). There were also no significant differences in ASC versus HOP patients in rates of revision (0 percent versus 0.3 percent, respectively), all-cause reoperation (0.3 percent versus 0.8 percent, respectively), readmission (0.6 percent versus 1.4 percent, respectively), or emergency department visits (0.9 percent versus 0.3 percent, respectively).

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In Other News

Study: Tranexamic Acid Could Reduce Bleeding in Bilateral TKA

The use of tranexamic acid (TXA) during simultaneous bilateral total knee arthroplasty (TKA) may safely reduce blood loss and transfusion risk, according to a retrospective study published online in BMC Musculoskeletal Disorders. Patients were stratified into three groups: intravenous (IV) group (1 g IV TXA five to 10 minutes prior to the incision), combined group (1 g IV TXA plus intra-articular injection of 1 g TXA prior to the closure of every knee), and control group (no TXA). The control group had a higher mean total blood loss (1,685 mL) compared to the IV (1,061 mL) and combined (988.3 mL) groups, as well as higher maximum hemoglobin (33.4 g/L) and hematocrit (0.131 g/L) drop compared to the IV (28.8 g/L and 0.082 g/L, respectively) and combined (28.5 g/L and 0.074 g/L, respectively) groups.

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Study Evaluates Effect of Genetic Predisposition to Increased Serum Calcium on BMD, Fracture Risk

Patients genetically predisposed to greater serum calcium levels may not have greater estimated bone mineral density (BMD) or reduced fracture risk, according to a study published online in The BMJ. Researchers identified genetic determinants of serum calcium levels in up to 61,079 patients. The association between genetic predisposition to increased serum calcium and BMD was evaluated in 426,824 patients with normal-range calcium levels. A fracture genome-wide association meta-analysis was performed and included 76,549 cases and 470,164 controls, also with normal-range calcium levels. There was no correlation between an increase of 0.13 mmol/L or 0.51 mg/dL in genetically derived serum calcium and increased estimated BMD or reduced fracture risk.

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Study: MRI versus MRA in Diagnosis of Triangular Fibrocartilage Complex Tears

Magnetic resonance arthrography (MRA) may be more accurate than conventional wrist MRI in diagnosing triangular fibrocartilage complex (TFCC) tears, according to a study published in the August issue of Injury. Sixty patients with suspected TFCC tears underwent wrist MRI and MRA; outcomes were compared to those of arthroscopy, which confirmed TFCC tears in 40 patients. MRA identified 38 tears and produced two false-negative and zero false-positive results. MRI identified 26 tears, eight false-positives, and 13 false-negatives.

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Trump Administration Final Rule Could Benefit Rural Hospitals

Under the Trump administration’s newly announced final rule, low-wage index hospitals may see an increase in wage index. According to Centers for Medicare & Medicaid Services Administrator Seema Vera, the final rule will “improve the way Medicare pays hospitals, which will help many rural hospitals maintain their healthcare labor force, to ensure that patients have access to high-quality, affordable health care.”

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AAOS Now

Female Orthopaedic Surgeons Are Commonly Asked Inappropriate Questions During Residency Interviews

During orthopaedic residency interviews, more than half of female applicants were asked inappropriate questions—those based on sex, race, color, religion, or national origin—and that percentage has not improved over nearly five decades, according to a study published in the July 15 issue of the Journal of the AAOS (JAAOS). Overall, 61.7 percent of respondents reported that they received an inappropriate question or comment during an interview. The proportion neither increased nor decreased over time. In contrast, the proportion of respondents who reported that they were informed of what constituted an inappropriate question before interviewing increased markedly over time, from a low of 15.9 percent in the 1980s to a high of 714 percent during the 2010s.

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Your AAOS

Personalize Your OVT Member Profile

Take five minutes to update your member profile on the newly expanded Orthopaedic Video Theater (OVT). Click on the person icon in the top right corner of the OVT landing page, select “My Profile,” and choose the specialty topics of most interest to you. You can also update your contact information and add an image and brief biography. By keeping your profile current, you get a much more personalized learning experience that addresses your needs, interests, and preferences.

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