Today’s Top Story

Study Compares Complication Rates in Revision THA for Infection versus Aseptic THA

Patients who undergo revision total hip arthroplasty (rTHA) due to infection may be more likely to sustain postoperative complications compared to aseptic rTHA patients, according to a study published in the July issue of Clinical Orthopaedics and Related Research. Researchers queried the American College of Surgeons (ACS) National Surgical Quality Improvement Program database for information on 30-day surgical outcomes, including postoperative complications, return to the operating room (OR), readmission, and mortality in rTHA patients from about 400 centers between 2012 and 2015. Patients undergoing surgery due to infection had higher rates of 30-day major complications and return to the OR. There were no significant differences in 30-day readmission or mortality. There was a correlation between preoperative malnutrition and return to the OR, 30-day readmission, and 30-day mortality.

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In Other News

Study Finds Satisfactory Long-term Outcomes Following Anteromedial Tibial Tubercle Transfer

A study published in the July issue of Arthroscopy observed good 15-year clinical and radiographic outcomes for patients who underwent anteromedial tibial tubercle transfer (anteromedialization [AMZ]) for lateral and/or distal patellar facet arthrosis. The analysis included 15 patients (17 knees, all patients were female); mean age at surgery was 29.5 years, and patients were followed for a mean of 17.1 years. Overall, 16 patients (94 percent of knees) reported satisfactory results; they stated that they would undergo the surgery again under the same circumstances. Three-quarters of patients had an average pain score of 2.1; 35 percent of knees could engage in recreational activities, and in 18 percent, patients said they were minimally active. Two patients required and successfully underwent post-AMZ symptomatic medial patellar subluxation, 59 percent of knees underwent hardware removal, and 41 percent required additional procedures, but there were no arthroplasty conversions.

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Study: Is First Metatarsophalangeal Joint Arthrodesis Safe in Young Active Patients?

According to a study published in the July issue of Foot & Ankle International, young patients who undergo first metatarsophalangeal (MTP) joint arthrodesis may be able to return to sport and activity postoperatively. Researchers conducted a registry review to gather data on MTP arthrodesis patients aged 18 to 55 years. Of 73 eligible patients, 50 (68 percent) were available at a mean 5.1 years of follow-up; mean age at time of surgery was 49.7 years. The most common physical activities among the patient population were walking, biking, weightlifting, swimming, running, and golf. After surgery, patients rated 27.4 percent of activities as less difficult, 51.2 percent as the same, and 21.4 percent as more difficult compared to before surgery. In less than six months, patients returned to 44.6 percent of their preoperative physical activities, and maximal participation level was achieved in 88.6 percent of activities. Nearly all patients (n = 48, 96 percent) reported procedural satisfaction.

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Study Assesses Unilateral External Fixation in Humeral Shaft Fractures

Humeral shaft fracture patients may benefit from unilateral external fixation, according to a retrospective study published in the July issue of the Journal of Orthopaedic Trauma. Data were evaluated for 107 external fixation patients (109 humeral shaft fractures). The primary outcomes were union rate, time to fracture healing, and return to preinjury sports activity, as well as the Disabilities of the Arm, Shoulder and Hand (DASH) score; Constant score; and Mayo Elbow Performance Index. At a mean 99.2 days, the union rate was 97.2 percent (n = 106); there were two delayed unions and one nonunion. At final follow-up, the mean Constant score was 85.6, Mayo Elbow Performance Index was 97.4, and DASH score was 7.4. Patients who played sports preinjury all returned to sport after treatment. Obesity was a risk factor for delayed fracture healing. Functional outcomes were most significantly influenced by comorbidity.

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Fatal Drug Overdose Rate on the Decline

For the first time in about a decade, drug overdoses may be on the decline, according to provisional data from the Centers for Disease Control and Prevention (CDC). The data suggest that drug overdose deaths declined by 5.1 percent from 2017 to 2018. Final data will be available later this year.

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Read the CDC report…


Health and Human Services Pain Management Task Force Sends Final Report to Congress

Last year, the Department of Health and Human Services (HHS) convened a Pain Management Best Practices Inter-agency Task Force through a mandate in the Comprehensive Addiction and Recovery Act of 2016. The task force brought together 29 individuals with significant expertise across a broad spectrum of backgrounds and specialties to propose updates to best practices and issue recommendations for addressing identified gaps or inconsistencies. The final report, published on May 30, details “gaps, inconsistencies, and recommendations for future treatment of both acute and chronic pain.”

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Read more about the HHS task force…


AAOS Endorses Firearms Injury Prevention Consensus Statements

The AAOS Board of Directors voted to endorse the multidisciplinary nine consensus statements that resulted from the ACS Medical Summit on Firearm Injury Prevention: A Public Approach to Reduce Death and Disability in the US. This endorsement demonstrates AAOS’ commitment to advancing partnerships that drive greater impact around injury prevention and aligns with a consensus of others to reduce the burden of injury.

Read the consensus statements…

Read the executive summary…


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