Today’s Top Story

Study Assesses Bacterial Colonization Rates in Osteosynthetic Implant Patients

Patients with osteosynthetic implants around the knee may be more likely to have bacterial colonization compared to patients with implants around the hip, according to a study published online in The Journal of Arthroplasty. Asymptomatic patients who had their implants removed due to soft-tissue irritations prior to total joint arthroplasty were evaluated; patients with infection symptoms were excluded. Bacterial growth was stratified as negative (no growth), contaminated (nonsignificant growth), or colonized (significant growth). Of 203 implants, about a quarter (n = 54, 27 percent) had positive sonication cultures; eight of 34 (24 percent) occurred after orthopaedic surgery. A total of 22 cultures (11 percent) had significant growth, with much higher rates in implants around the knee (14 percent) than the hip (2 percent).

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Other News

Study: Does Obesity Affect Open Ankle Fracture Outcomes?

A study published in the June 1 issue of the Journal of the AAOS assessed the impact of obesity on complications in patients with open ankle fracture. Data were gathered from the National Inpatient Sample. Of the total cohort, 10.1 percent were obese. Adjusted analyses found that obese patients had longer length of stay, higher total costs, and greater risk for any complication. The researchers suggested that future studies seek to improve outcomes in this patient population and reduce the cost of care.

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Study Evaluates Long-term Outcomes of Fusion for Adolescent Idiopathic Scoliosis

A study published online in The Journal of Bone & Joint Surgery measured 10-year outcomes for selective fusion in adolescent idiopathic scoliosis patients. Final analysis included 51 patients with selective fusions (21 main thoracic [MT], 30 thoracolumbar/lumbar [TL/L] curve) and at least 10 years of follow-up. After 10 years, average correction of instrumented MT and TL/L curves were 51 percent and 60 percent, respectively. Five years after surgery, the uninstrumented, compensatory curves were approaching fused curve magnitude, and correction was maintained at 10 years. No patients required additional surgery, and Scoliosis Research Society Questionnaire scores remained unchanged.

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Study: Which RA Medications Increase Fracture Risk?

Certain medications may increase the risk for fracture in patients with rheumatoid arthritis (RA), according to a study published online in Annals of the Rheumatic Diseases. FORWARD, a longitudinal observational registry, was queried for data on RA patients without prior fracture. Data on disease-modifying antirheumatic drug (DMARD) use were stratified into four groups: methotrexate monotherapy-reference, tumor necrosis factor-α inhibitors (TNFi), non-TNFi biologics, and others; the use of non-DMARDs and glucocorticoids were stratified by current/ever use and treatment duration. Of 11,412 patients, there were 914 fractures. Adjusted analyses found a significant correlation between fracture risk and use of glucocorticoids for at least three months at any dose, weak or strong opioids, and selective serotonin reuptake inhibitors (SSRIs). Among opioid users, fracture risk increased within the first month of use, and among SSRI users, fracture risk increased within more than three months of use. The use of statins and TNFi were both associated with decreased risk for vertebral fracture. There was no association between increased fracture risk and use of proton pump inhibitors or psychotropic medications.

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Healthcare Spending Forecasted to Hit $3.6 Trillion

A report from Fitch Solutions predicted that pharmaceutical spending in the United States will grow by 2.5 percent this year, exceeding $370 billion, while overall healthcare spending will reach $3.6 trillion. Looking ahead to 2023, the report predicted pharmaceutical sales will represent about 1.7 percent of the national gross domestic product, while overall healthcare spending will hit $4.3 trillion.

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AAOS Now

Inpatient Opioid Use Should Guide Discharge Prescribing in Surgery Patients

A retrospective review found that inpatient opioid use may be a helpful guide for safe and effective opioid prescribing when orthopaedic surgery patients are discharged. The approach could help limit overprescribing and decrease early postoperative habituation, tolerance, and refill needs. Trevor Grace, MD, presented the study during the AAOS 2019 Annual Meeting.

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Your AAOS

Final Call: Apply for Volunteer Opportunities

Consider applying for the following positions:

  • Committee on Ethics and Outside Interests member position—applications are accepted until June 10
  • Resolutions Committee member position—applications are accepted until June 10
  • Bylaws Committee member position—applications are accepted until June 10
  • OrthoInfo Sports Medicine Section Editor member position—applications are accepted until June 14
  • Committee on Professionalism member position—applications are accepted until June 16

Learn more and submit applications…(member login required)

 

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