Today’s Top Story

Study Compares Time to Reach Discharge Criteria after TKR

A prospective study published online in The Journal of Bone & Joint Surgery found no significant difference in time to reach discharge criteria for total knee replacement (TKR) patients who received periarticular injection combined with adductor canal block compared to periarticular injection alone. A total of 56 TKR patients received periarticular injection, and 55 received injection with adductor canal block; all patients also received intraoperative neuraxial anesthesia and varying pharmaceutical analgesics. The median time to achieve discharge criteria in the combination group was 25.8 hours compared to 26.4 hours in the injection alone group. At 24 hours post-anesthesia, the combination group reported lower worst pain and more pain relief than the injection alone group.

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Other News

Study: How Does Back Pain Affect Material Handling Workers?

A study published online in BMC Musculoskeletal Disorders evaluated personal risk factors associated with low back pain (LBP) in material handling workers. The research consortium had five members: National Institute of Occupational Safety and Health, The Ohio State University, University of Wisconsin-Milwaukee, Texas A&M University, and University of Utah. Final analysis included questionnaire responses from nearly 2,000 workers. Three common questions were answered pertaining to 12-month LBP history: Have you had LBP lasting seven days? Have you sought medical care for LBP? Have you taken time off of work due to LBP? Overall, 25 percent of patients reported LBP lasting longer than seven days, 14 percent sought medical care, and 10 percent lost time at work over the last 12 months. Researchers observed significant differences in responses based on region.

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Study Identifies Fracture Risk Factors in Type 1 Diabetes Patients

A cross-sectional study published in the August issue of Bone determined clinical diabetes-related risk factors for fragility fractures in patients with type 1 diabetes (T1D). A total of 600 T1D patients filled out a questionnaire asking about their bone fragility fracture history. Of the 111 patients (18.5 percent) who reported at least one fracture, 26.2 percent had more than one fracture. Average age among fracture patients was 41.9 years, disease duration was 19.9 years, body mass index was 24.4 kg/m 2, and five-year glycated hemoglobin A1c (HbA1c) was 7.6 percent (60 mmol/mol). Adjusted analyses found that a higher creatinine clearance rate was associated with reduced fracture risk, while neuropathy increased the odds of fracture. The risk for two or more fractures was highest among patients with HbA1c 7.9 percent or greater and disease duration 26 years or longer.

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Study Measures Accuracy of Sequencing Assays in Diagnosing PJI

According to a meta-analysis published online in The Journal of Arthroplasty, gene sequencing assays could favorably diagnose prosthetic joint infection (PJI). The review included 12 studies with 1,965 patients. Pooled sensitivity and specificity were 0.81 and 0.94, respectively. Positive and negative likelihood ratios were 14.2 and 0.20, respectively, and the area under the curve was 0.94. One subgroup analysis associated antibiotics with reduced sensitivity, and another found that sequencing by synthesis improved specificity compared to other next-generation sequencing methods.

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CMS Seeks Public Input on Patients over Paperwork

The Centers for Medicare & Medicaid Services (CMS) is calling on the public for ways to bolster the Patients over Paperwork initiative. The recent Request for Information asks patients and their families, members of the medical community, and healthcare stakeholders for input on how clinicians can provide high-quality care rather than being burdened with excessive administrative work.

Read the CMS press release…


Minimizing Opioid Consumption in TJA

At the AAOS 2019 Annual Meeting Instructional Course Lecture titled “Minimizing Opioids in Total Joint Arthroplasty (TJA),” panelists offered strategies for pain management before, during, and after surgery to reduce narcotics use by patients undergoing total hip arthroplasty and total knee arthroplasty. Moderator Mark W. Pagnano, MD, discussed his organization’s “contemporary, multimodal approach,” and Tad M. Mabry, MD, discussed contemporary protocols for pain management under the concept of “opioid stewardship.” This is part one in a two-part series.

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AAOS Member Michael Suk, MD, Elected to AMA Board of Trustees

AAOS member Michael Suk, MD, was elected to the American Medical Association (AMA) Board of Trustees. Dr. Suk has been involved with the AMA for almost 30 years, having served as an AAOS delegate and current chair of the newly formed Mobility Caucus. He will further help to represent the orthopaedic specialty in his new role on the board.

Read the AAOS press release…


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