December 12, 2018
Today’s Top Story

Study Finds Long-term Survivorship for TKA Using Cementless Tibial Tray

A study published online in The Journal of Arthroplasty found high survivorship rates and acceptable patient-reported outcomes for mobile bearing total knee arthroplasty (TKA) with a cementless tibial tray at a minimum 17-year follow-up. Researchers evaluated 500 primary TKAs in 467 patients. The primary endpoint was all-cause revision. After a mean 18.1 years, 141 knees (28.2 percent) were available for review. Cumulative survivorship was 97.4 percent; 13 knees underwent revision: three for deep infection, three bearing-only revisions for spinout, three for tibial tray subsidence, two secondary patella resurfacings, one aseptic loosening, and one for suspected aseptic loosening. Mean American Knee Society scores for evaluation and function were 83 and 48, respectively; mean Oxford Knee Score was 32.1; and mean Bartlett patellar score was 21.6.

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Other News

Study Finds Correlation Between Weakening in Hip External Rotators and Lower Extremity Injury

A decrease of average power (AP) in the external rotators (ERs) of the hip may predict the development of lower extremity (LE) injury, according to a study published in the November issue of the Clinical Journal of Sports Medicine. Isokinetic hip strength measurements of abductors, adductors, internal rotators, and ERs were tested in 89 physical education students (mean age, 19.53 years; all female). Researchers used a weekly online questionnaire and a three-month retrospective control questionnaire for follow-up. An experienced doctor diagnosed 34 patients with an LE injury during follow-up. The only significant risk factor for LE injury was decreased AP on concentric ER strength.

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Study Compares Complication Risks in Minimally Invasive and Open Repair of Achilles Tendon Rupture

Patients undergoing treatment for acute Achilles tendon rupture may face fewer complications with minimally invasive treatment compared to open surgical repair, according to a literature review published online in The Journal of Bone & Joint Surgery. Eligible studies were randomized, controlled trials that compared minimally invasive surgery and open repair of acute Achilles tendon ruptures. In the eight studies reviewed, 182 patients were treated with minimally invasive surgery and 176 with open repair. The risk of overall complications and wound infection was lower in minimally invasive patients compared to open surgery patients, and minimally invasive patients were more likely to report positive subjective results Rates of reruptures, sural nerve injury, return to preinjury activity level, time to return to work, and ankle range of motion did not largely differ between the groups.

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Study Identifies Sleeping Position That Reduces Glenohumeral Pain

Certain sleep postures may be associated with decreased glenohumeral shoulder pain and rotator cuff tendinopathy (RCT), according to a cross-sectional analysis published online in BMC Musculoskeletal Disorders. The study included 761 workers (average age, 41 years; 68.9 percent female) who reported glenohumeral shoulder pain within the last 30 days. The workers identified their primary and secondary preferred sleeping positions from a choice of six diagrams. They also underwent a structured physical examination to determine the presence of RCT. Researchers hypothesized that overhead sleep postures and sleeping on the side would increase glenohumeral shoulder pain and RCT, but no association was found. The two sleep postures that researchers predicted would cause pain—“freefaller” and “starfish”—were actually found to be more protective.

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Number of Hospitals Receiving Hospital Value-based Purchasing Program Bonuses Decreases

An estimated 55 percent of hospitals will receive Medicare bonuses through the Hospital Value-based Purchasing Program in 2019 compared to 57 percent in 2018, according to data from the Centers for Medicare & Medicaid Services (CMS). Despite this decrease, Total Performance Scores improved from a mean 37.4 percent in fiscal year (FY) 2018 to 38.1 percent in FY 2019, CMS reported.

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December AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the December issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue includes information on the passage of the Sports Medicine Licensure Clarity Act, Annual Meeting updates, the Academy’s stance on professionalism and culture, and more.

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AAOS Board of Directors Approves CPG on Acute Compartment Syndrome

On Dec. 7, the Academy’s Board of Directors approved the Clinical Practice Guideline (CPG) on the Management of Acute Compartment Syndrome, the first of a series developed in collaboration with the Major Extremity Trauma Research Consortium and funded by a Department of Defense research grant. This CPG aims to guide the diagnosis and treatment of acute compartment syndrome by providing evidence-based recommendations for 12 key decisions that affect the management of patients with extremity trauma.

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