January 9, 2019
Today’s Top Story

Study: Transfusion Risk with Tranexamic Acid Versus Fibrin Sealant in Arthroplasty Patients

Hip fracture patients treated with prosthetic replacement have similar blood loss and transfusion risks regardless of whether they receive fibrin sealant (FS) or topical tranexamic acid (TXA), according to a study published online in the Archives of Orthopaedic and Trauma Surgery. A total of 158 hip fracture patients received 10 mL of FS (n = 56) or 1 g of topical TXA (n = 52) administered at the end of surgery, or usual hemostasis (control group, n = 50). The primary outcome was blood loss collected with drains, while secondary outcomes were total blood loss, hidden blood loss, transfusion rate, average hospital stay, complications, adverse events (AEs), and mortality. The TXA group had the least total blood collected in the drains (148.6 mL), followed by FS (168.2 mL) and the control group (201.5 mL), although the differences were not statistically significant. Differences in transfusion rates among the groups were also not significant (TXA group, 32.7 percent; FS group, 42.9 percent; control group, 44 percent). No complications or AEs occurred as a result of any treatment method.

Read the abstract…

Other News

Study: Positive Long-term Outcomes for Arthroscopic Rotator Cuff Repair

More than a decade after surgery, patients may maintain positive clinical and radiologic outcomes following arthroscopic transosseous rotator cuff repair (TORCR), according to a study published online in the Journal of Shoulder and Elbow Surgery. The study included 69 patients with full-thickness supraspinatus tendon tears with or without infraspinatus tendon tears who were treated with arthroscopic TORCR between 1998 and 2003. Overall, 56 patients (81 percent; mean age, 58 years) were available for final follow-up at an average of 15 years. Researchers recorded patients’ Subjective Shoulder Value, Constant Score (CS), University of California at Los Angeles (UCLA) score, and American Shoulder and Elbow Surgeons (ASES) score. Two-thirds of patients underwent MRI. At final evaluation, mean CS score was 84 points, mean UCLA score was 33 points, mean ASES score was 92 points, and mean Subjective Shoulder Value was 89 percent. Among patients who underwent MRI, nine (27 percent) had symptomatic repair failure. Four patients (7 percent) required revision surgery after a symptomatic rerupture; the overall retear rate was 33 percent. Compared to patients who had retears, those with intact repairs at final follow-up had increased CS and abduction strength.

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Study: Semi-extended Parapatellar Versus Infrapatellar Tibial Nailing

A study published in the January issue of the Journal of Orthopaedic Trauma observed similar outcomes for knee symptoms, but not pain, treated with open, semi-extended, parapatellar tibial nailing (SEK) and traditional infrapatellar tibial nailing (FK) techniques. Researchers randomized 47 patients with Orthopaedic Trauma Association/AO Foundation-classified 42A–C tibial shaft fracture to treatment with a SEK (n = 24) or an FK (n = 23) technique. There were no significant differences in demographics, injury, or surgery-related variables between groups. Symptom scores were similar between both cohorts, but the SEK technique was associated with decreasing knee pain.

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U.S. Supreme Court Considers Risk of Fracture Associated with Osteoporosis Drug

Merck & Co. appeared in the U.S. Supreme Court this week in response to hundreds of lawsuits alleging the company did not properly warn patients that its osteoporosis drug alendronic acid could result in an increased risk of thigh bone fracture. Some of the court justices noted that the Food and Drug Administration had expressed uncertainty about the potential fracture risk. Two judges suggested that it was Merck’s duty to present the warning appropriately to its consumers.

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Number of New Healthcare Hires Hits Record High

The healthcare industry witnessed a spike in new hires in December 2018 that has not been seen since February 1990, according to a report from Modern Healthcare. The article cites a monthly report from the Bureau of Labor Statistics (BLS), which states that 50,200 healthcare jobs were added last month. The industry has not added 40,000 new jobs in one month since October 2015. Total healthcare jobs in December 2018 reached 10.79 percent—an all-time high.

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Read the BLS report…


January AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the January 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 insight into orthopaedic humanitarian outreach, a pediatric surgeon on a mission to make his patients smile, a study on lumbar spinal stenosis, and more.

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Last Call: Take Part in CPG and AUC Work Groups

AAOS is seeking volunteers to take part in work groups for the development of clinical practice guidelines (CPGs) and appropriate use criteria (AUC). Applications are currently open for the following projects: The Decision to Pursue Limb Salvage or Perform Early Amputation and The Diagnosis and Management of Acute Compartment Syndrome. The deadline to submit an application for both projects is Jan. 11.

Learn more and submit your application…


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