January 7, 2019
Today’s Top Story

Study Associates Use of Bisphosphonates with Lower Revision TJA Rate

Total joint arthroplasty (TJA) patients who use bisphosphonates (BPs) after surgery may be less likely to require implant revision, according to a study published online in Knee Surgery, Sports Traumatology, Arthroscopy. The study involved 331,660 patients who underwent total knee arthroplasty (TKA) and 56,043 patients who underwent total hip arthroplasty (THA) between 2002 and 2012. Patients were followed until 2016. Among TKA and THA patients, 8,447 (2.5 percent) and 2,851 (5.0 percent), respectively, had aseptic loosening that required revision surgery. Among the TKA patients, revision rates were 1.4 percent for BP users and 2.9 percent for non-BP users. For the THA cohort, revision rates were 2.8 percent and 5.3 percent for BP users and non-BP users, respectively. Patients who took BP medication for longer than one year had significantly lower odds of revision compared to those who took it for less than a year.

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Other News

Study Compares Hip Surgeries for Fracture

A retrospective study published in the Dec. 1 issue of the Journal of the AAOS compared short-term complications associated with cephalomedullary hip screws (CMHSs) and sliding hip screws (SHSs) to treat intertrochanteric hip fractures. Researchers gathered data on 14,415 peritrochanteric hip fracture patients using the American College of Surgeons National Quality Improvement Program database. SHS patients tended to have better health and lower American College of Surgeon classes, preoperative bleeding, hypertension, pulmonary risk factors, and congestive heart failure, as well as higher preoperative hematocrit. CMHS patients had higher rates of 30-day mortality, bleeding, pulmonary complications, and clotting events. SHS patients had greater urinary tract infection rates and lengths of stay.

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Study Assesses Maisonneuve Fracture Pathoanatomy

A study published online in the Archives of Orthopaedic and Trauma Surgery analyzed the pathoanatomy of Maisonneuve fracture (MF) based on radiographs, CT scans, and intraoperative findings. Ankle and lower leg radiographs were gathered for 54 patients; 43 patients underwent a CT scan, of whom 34 also underwent three-dimensional CT reconstructions. Among the 51 patients who underwent surgery, 38 had open surgery. Most patients (n = 43, 80 percent) had a posterior malleolus fracture. Half of patients (n = 27) had an injured deltoid ligament; 20 patients (37 percent) had a fractured medial malleolus. In seven patients (13 percent), medial structures remained intact. The researchers recommended that CT exams be the norm for MF patients and that MRI be an alternative in special circumstances.

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Study: Reducing Odds of Infection in High-risk Revision Arthroplasty Patients

Closed incisional negative pressure wound therapy (ciNPWT) may be beneficial in revision arthroplasty patients who are at a high risk for infection, according to a study published online in The Journal of Arthroplasty. One hundred sixty consecutive patients undergoing election revision arthroplasty were randomized to receive a ciNPWT device (n = 80) or the standard of care silver-impregnated wound dressing (control group, n = 80). One ciNPWT patient was lost to follow-up and not included in the final analysis. The control group had a higher rate of postoperative wound complications than the ciNPWT group (23.8 percent versus 8 percent). The number of readmissions was not significantly different between the groups: 19 in the control group and 16 in the ciNPWT cohort. However, reoperations were more frequent in the control group (n = 10) than in the ciNPWT group (n = 2).

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Study: Kinesio Taping Is Not More Effective Than Other Interventions for Low Back Pain

A systematic review published in the Jan. 1 issue of Spine did not find Kinesio Taping (KT) to be superior in treating chronic nonspecific low back pain compared to other options. Researchers queried PubMed, EMBASE, PEDro, SciELO, and LILACS through Feb. 26, 2018, to identify randomized, controlled trials (RCTs) that involved adults with back pain. Eligible trials compared KT to no intervention or placebo, or KT combined with exercise versus exercise alone. Eleven RCTs evaluating a total of 743 patients were included. Two clinical trials conducted short-term follow-up comparing KT to no intervention. Four studies compared short-term follow-ups for KT and placebo, and two trials compared KT to placebo with intermediate-term follow-up. Five studies compared combination KT-exercise or electrotherapy to exercise or electrotherapy alone. Most of the results did not yield significant differences.

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Cybersecurity Is Not Just a Software and Hardware Issue

In 2018, the Department of Health and Human Services warned about the dangers of ransomware attacks on healthcare organizations. Because medical fraud takes longer to detect than financial or retail fraud, the healthcare industry is an easy and attractive target. Federal oversight agencies have continued to raise awareness and strategize on ways healthcare organizations can protect themselves.

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Access MOC Tools

As your source for lifelong learning, AAOS offers a variety of learning activities to help you fulfill continuing medical education (CME) requirements, prepare for exams, and manage your maintenance of board certification (MOC) process with ease. Attend review courses for all stages of certification, explore a variety of interactive online learning modules, or choose from a collection of self-assessment examinations in your specialty. The AAOS Learning Portfolio also helps you track CME credits by event and year.

Learn more about AAOS’ MOC resources…


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