Today’s Top Story

Study: Does Malnutrition Affect TJA Outcomes?

Total joint arthroplasty (TJA) patients with malnutrition may have an increased risk of 90-day postoperative complications, according to a study published online in The Journal of Arthroplasty. Between 2013 and 2018, 4,047 TJA patients underwent surgery at a single institution (total knee arthroplasty, n = 2,058; total hip arthroplasty, n = 1,989). Within the first 90 days postoperatively, 5.6 percent of patients experienced a readmission and 9.6 percent required at least one emergency department (ED) visit. Malnutrition prevalence was 3.6 percent. The malnutrition cohort had a longer average length of stay (3.5 days versus 2.2 days) and was more likely to require a readmission (16 percent versus 5 percent) or ED visit (18 percent versus 9 percent).

Read the abstract…

Other News

Study: Smartphone Application Use in Orthopaedics

A systematic literature review published in the May/June issue of Current Orthopaedic Practice evaluated the prevalence of smartphone applications in the orthopaedic field. Medline and Embase were queried using some of the following search terms: “smartphone,” “phone,” “cellphone,” “iPhone,” “iPad,” and “Android”; 17,430 Medline and 35,166 Embase articles were found. Articles were eligible for inclusion if they were written in English and included the text word queries “orthopedic,” “orthopedics,” “orthopaedic,” or “orthopaedics.” The final analysis included 34 articles. Researchers found that smartphone applications have been useful in a variety of ways in orthopaedics. Articles already in the literature reviewed applications that assist in angular management, preoperative templating, and quantification of gait.

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Study Compares Anterior Versus Posterior Approaches in Multilevel Cervical Spondylotic Myelopathy

Patients with multilevel cervical spondylotic myelopathy may have worse outcomes if they undergo an anterior therapy approach compared to posterior, according to a meta-analysis published in the June issue of the Archives of Orthopaedic and Trauma Surgery. PubMed, Cochrane, and Embase databases were queried through January 2018, yielding 24 relevant studies with 959 anterior approach patients and 1,072 posterior approach patients. Compared to the posterior cohort, the anterior group had a significantly higher Japanese Orthopaedic Association score, operation time, neurological recovery rate, and complication rate. Blood loss and range of motion did not largely differ between the groups.

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Study Evaluates Complications After Intra-articular Ankle or Subtalar Joint Corticosteroid Injection

A study published in the June issue of Foot & Ankle International determined complication rates and risk factors after corticosteroid injection of the ankle or subtalar-joint. Data were evaluated on 1,708 adult patients who received an intra-articular ankle or subtalar joint injection from January 2000 through April 2016 with no prior intra-articular injection of corticosteroid into the ankle or subtalar joint. Within the first 90 days post-injection, 99 patients (5.8 percent) had 104 adverse events (AEs). The most common AEs were flare (n = 78) and skin reaction (n = 10). In multivariable logistic regression analysis, there was a correlation between subtalar intra-articular injection and AE development.

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CMS to Update e-prescribing Standards

The Centers for Medicare & Medicaid Services (CMS) has proposed an update to Medicare Part D’s prior authorization process in an effort to improve patient access to medications. The suggested rule would optimize the prior authorization process, ensuring that patients receive necessary prescription drugs.

Read the CMS press release…


Robotic Technology in Unicompartmental Knee Arthroplasty: Early Results Appear Promising

During the AAOS 2019 Annual Meeting, Jess H. Lonner, MD, discussed outcomes associated with robot-assisted unicompartmental knee arthroplasty (UKA) compared to conventional surgery. UKAs have a 90 percent to 94 percent survivorship at 10–15 years when performed by high-volume surgeons, according to the literature. Unfortunately, when looking at international registry and U.S. insurance databases, “[UKAs] will fail at a higher rate than total knee arthroplasties,” Dr. Lonner shared.

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New JAAOS Features

The Journal of the AAOS (JAAOS) recently unveiled two new features geared toward the mentorship and education of young orthopaedic surgeons. The first is The Training Room, a new section of The Yellow Journal featuring articles submitted to JAAOS on topics such as orthopaedic resident education, simulation-based training, musculoskeletal education in medical school, and more. The second is a blog related to The Training Room, called Sounds From The Training Room, which features articles written by members of an editorial board known as the Mentorship Consortium.

Visit The Training Room…

Visit Sounds From The Training Room…


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