January 28, 2019
Today’s Top Story

Study: Older Age and Cardiac Disease are Predictors of Cardiac Events After TJA

According to a systematic review published online in the Journal of Orthopaedic Surgery and Research, older age and previous cardiac disease are risk factors for adverse cardiac events following total joint arthroplasty (TJA). Researchers queried Scopus, PubMed, Cumulative Index of Nursing and Allied Health Literature, and Cochrane for studies published since 2008 that analyzed cardiac complication risk factors in elective primary total hip arthroplasty and total knee arthroplasty (TKA) patients aged 18 years or older with osteoarthritis. Among the 15 studies selected, most found that increasing age and a history of cardiac disease were associated with cardiac complication risk. Less substantive evidence suggested that male sex and cerebrovascular disease may also increase the complication risk.

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Other News

Study: Morbid Obesity Increases Reoperation Risk in Revision TKA

Morbidly obese revision TKA patients may be more likely to require reoperation or rerevision, according to a study published online in The Journal of Arthroplasty. Two groups of 87 patients with either a body mass index (BMI) greater than 40 kg/m 2 (morbidly obese) or a BMI less than 40 kg/m 2 (nonmorbidly obese) were matched 1:1 based on age at time of revision, sex, and reason for revision. In the morbidly obese group, 34.5 percent of patients required reoperation compared to 16.1 percent of nonmorbidly obese patients. Rerevision rates were 27.6 percent in the morbidly obese cohort and 12.6 percent in the nonmorbidly obese group. Ten-year survivorship for reoperation and subsequent revision was significantly lower in the morbidly obese group. Nonmorbidly obese patients had better Western Ontario and McMaster Universities Osteoarthritis Index scores, Knee Society Scores, and Short-Form 12 mental components.

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Study: Do Vitamin D Supplements Affect Hip BMD?

A study published online in The American Journal of Clinical Nutrition evaluated the effects of vitamin D supplements on bone mineral density (BMD) at the hip in a geriatric cohort. A total of 379 patients (mean age, 75 years; 52 percent male) were randomized to receive one of three vitamin D doses once a month: 12,000 international units (IU), 24,000 IU, or 48,000 IU. Mean plasma 25-hydroxyvitamin D (25[OH]D) concentration at baseline was 40 nmol/L. After one year, the mean 25(OH)D was 55.9 nmol/L in the 12,000 IU dose group, 64.6 nmol/L in the 24,000 IU dose group, and 70 nmol/L in the 48,000 IU dose group. Change in BMD did not significantly differ among the groups. Patients in all three cohorts had decreased parathyroid hormone concentrations; the 48,000 IU dose group had a significantly greater decrease than the 12,000 IU dose group.

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Study: Tobacco Users Report Poorer Clinical Outcomes Following Open Arthrolysis

A study published online in the Archives of Orthopaedic and Trauma Surgery found that patients undergoing open arthrolysis for post-traumatic elbow stiffness who use tobacco may have poorer clinical outcomes and higher complication rates than former tobacco users or nonusers. Researchers stratified 145 open arthrolysis patients who underwent the same surgery performed by the same surgeon into three groups: current tobacco users (n = 37), former users (n = 28), and nonusers (n = 80). Current tobacco users had the worst postoperative outcomes for range of motion, Mayo Elbow Performance Score, visual analog scale for pain, Dellon classification for ulnar nerve symptoms, and total complication rates. Former users and nonusers did not have significantly different outcomes.

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Rate of Insured Adults Hits Four-year Low

The fourth quarter of 2018 saw the highest rate of U.S. adults without health insurance since the inception of the Affordable Care Act in 2014, according to a Gallup report. End-of-year data for 2018 revealed 13.7 percent of American adults did not have health insurance. Two-year trends indicated that the most significant increases in uninsured rates have been among women, households with annual incomes of less than $48,000, and adults younger than 35 years.

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Antimicrobial Stewardship in Orthopaedics

Antimicrobial resistance (AMR) causes two million infections and 23,000 deaths each year in the United States alone and more than 700,000 deaths worldwide. AMR infections are predicted to claim more lives than heart disease and cancer by 2050. Overuse and inappropriate use of antimicrobials are the main drivers of resistance.

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OVT Now Available as a Free Benefit of AAOS Membership

The Orthopaedic Video Theater (OVT) provides trusted and relevant surgical videos from globally renowned experts across the orthopaedic landscape. You can view expanded content on more channels, including the longstanding OVT Plus collection of nearly 800 surgical technique videos, as well as user-submitted videos. Content from leading institutions, industry, and societies will soon be available. Discover more ways to submit your videos and get published faster on the new video platform. Plus, earn continuing medical education (CME) credit, with 265 CME hours available, and discover relevant content in your areas of work and interest!

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