February 27, 2019
Today’s Top Story

Study: What Is the Lifespan of a Knee Implant?

A systematic review published online in The Lancet determined how long a patient can expect their knee implant to last. Researchers queried MEDLINE and Embase for relevant case series and cohort studies published through July 21, 2018. Eligible articles reported 15 year or more survival of primary total knee replacement (TKR) and unicondylar knee replacement (UKR) in patients with osteoarthritis. National joint replacement registry reports were also reviewed and assessed separately. Thirty eligible articles spanning 33 case series provided data on all-cause survival for 6,490 TKRs (26 case series) and 742 UKRs (seven case series). There were no available case series for 25-year TKR survival. Australian and Finnish registry data provided 47 series spanning 299,291 TKRs and five series reporting on 7,714 UKRs. UKR 25-year estimated survival was 72 percent, per the database data; 25-year TKR and UKR survival rates were 82.3 percent and 69.8 percent, respectively, per the registry data. The researchers believe the registry data is more accurate.

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Other News

Study Measures Risk of Dislocation in Lumbosacral Spinal Fusions Prior to THA

Patients who undergo lumbosacral spinal fusions before total hip arthroplasty (THA) may have greater odds of dislocation within the first six months, according to a study published online in The Bone & Joint Journal. Between 1998 and 2015, 84 patients (97 THAs) underwent spinal fusion prior to primary THA. Patients were stratified into three groups based on lumbar fusion length and whether the sacrum was involved; they were matched 1:2 to primary THA patients who did not undergo spine fusion. One-year dislocation rates were 5.2 percent in the fusion group and 1.7 percent in the control group. Dislocation rates did not significantly differ between control patients and patients without a sacral fusion. When the sacrum was involved, the rate of dislocation was significantly higher than in controls, with longer lumbosacral fusions associated with more dislocations.

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Study Associates Age with Increased Contralateral Tendon Rupture after Achilles Tendon Rupture

According to a retrospective review published online in Knee Surgery, Sports Traumatology, Arthroscopy, age between 30 and 39 years was a risk factor for contralateral tendon rupture among Achilles tendon rupture patients. Researchers reviewed medical records for 226 consecutive Achilles tendon rupture patients and conducted telephone surveys to obtain patient characteristics and contralateral Achilles tendon rupture data. Cumulative incidences of contralateral Achilles tendon rupture at one, three, five, and seven years after Achilles tendon rupture were 0.4 percent, 1.8 percent, 3.4 percent, and 5.1 percent, respectively. Age between 30 and 39 years at the time of Achilles tendon rupture was the only significant risk factor associated with contralateral Achilles tendon rupture.

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Study: Outcomes for Tuberosity Healing in Older rTSA Patients with Humerus Fractures

A retrospective study published in the February issue of the Journal of Orthopaedic Trauma found that using a low profile onlay fracture stem to treat older reverse total shoulder arthroplasty (rTSA) patients with acute three- and four-part proximal humerus fractures could be associated with a high tuberosity union rate. Researchers reviewed data on 55 patients older than 65 years who underwent rTSA with a dedicated low profile onlay fracture stem using variable tuberosity fixation. The repaired greater tuberosities had an 83 percent union rate. Greater tuberosity union was associated with greater active external rotation.

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Study Compares Efficacy of Intraoperative Anti-PJI Agents

A study published online in The Journal of Arthroplasty found that povidone-iodine (PI) may be superior to other antiseptics in preventing periprosthetic joint infection (PJI) during primary total joint arthroplasty. Researchers compared the minimal inhibitory concentration (MIC) for PI, chlorhexidine gluconate (CHG), and vancomycin powder (VANC) against Methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Haemophilus influenzae, Pseudomonas aeruginosa, Burkholderia cepacia, and Escherichia coli. Time to death time points were zero, three, 30, and 60 minutes. The MICs were 0.63 percent for PI; 0.0031 percent for CHG; and 1.56 μg/mL for VANC. PI successfully killed all seven bacterial isolates at each time point.

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Patient Safety Committee Discusses How Professionalism Can Limit Psychological Harm

Professionalism issues, such as ineffective communication and poor team dynamics, can sometimes result in medical errors and harms. At a recent patient safety roundtable at the AAOS headquarters in Rosemont, Ill., the AAOS Patient Safety Committee discussed the advantages and disadvantages of professionalism as a framework for emphasizing the importance of surgeons receiving training and practicing these essential skills to avoid psychological harm in the current high-paced practice environment.

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Apply for the Shoulder & Elbow Program Committee Member Position

The Shoulder & Elbow Program Committee has an open member position. Over the course of a three-year term, the member will grade symposium in May and abstracts in June and July. The chair may serve as a moderator for paper sessions and critical evaluator of courses at the Annual Meeting. The application deadline is April 22.

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


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