Today’s Top Story

Study Evaluates VTE Rates in Revision Joint Arthroplasty

Rates of venous thromboembolism (VTE) among revision total knee arthroplasty (rTKA) and revision total hip arthroplasty (rTHA) patients did not change between 2008 and 2016, according to a study published online in The Journal of Arthroplasty. The National Surgical Quality Improvement Program database provided information on 30,406 patients who underwent rTKA and rTHA between 2008 and 2016. Researchers evaluated 30-day incidences of VTE, deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality for each year. Among rTKA patients, the overall incidences of 30-day VTE, DVT, PE, and mortality were 1.2 percent, 0.9 percent, 0.4 percent, and 0.5 percent, respectively. In bivariate analysis, there was no significant change in any of the four outcomes over the eight years studied. For rTHA, 30-day incidences of VTE, DVT, PE, and mortality were 1.0 percent, 0.7 percent, 0.4 percent, and 0.7 percent, respectively; there were no significant changes in these over the study period, but the rate of mortality significantly decreased.

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Other News

Study: Surgical Treatment of Post-traumatic Elbow Contracture in Young Patients

Operative management of post-traumatic elbow contracture may be helpful in patients aged < 21 years, according to a retrospective study published in the May/June issue of the Journal of Pediatric Orthopaedics. The study included 26 patients (mean age at time of injury, 12 years) who underwent surgery (mean age at time of surgery, 14 years) between 2006 and 2013 at two institutions. At final follow-up (mean, 42 months), elbow active flexion-extension and forearm rotation arcs increased by a mean of 49 degrees and 70 degrees, respectively. Patients who underwent ligament repair or reconstruction (n = 10) or required a postoperative continuous passive motion (CPM, n = 16) did not have largely different outcomes. Two recurrent contractures and two postoperative ulnar neuropathies occurred; in each case, one patient used a CPM and one did not.

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Study Assesses Outcomes of Primary Repair and Staged Reconstruction of Tendon Injuries in Young Patients

In a retrospective study published in the May/June issue of the Journal of Pediatric Orthopaedics, patients aged less than six years who underwent primary repair and staged reconstruction of zone I and II tendon injuries had satisfactory functional and subjective long-term outcomes. The study included 12 digits in 10 patients, of which seven had a primary repair and five had a two-stage reconstruction. At an average follow-up of eight years, both cohorts had similar mean total active and passive motion of the involved digit; 58 percent had a “good” or “excellent” American Society for Surgery of the Hand total active motion outcome—71 percent in the primary group and 40 percent in the reconstruction group. The groups had similar Pediatric Outcomes Data Collection Instrument (PODCI) Upper Extremity scores (primary group, 99; reconstruction group, 98) and PODCI Global Function scores (97 versus 91, respectively). There were no complications.

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Study: What Risk Factors Are Associated with Pyogenic Spinal Infection?

A study published online in The American Journal of Emergency Medicine identified risk factors of pyogenic spinal infection in patients who present to the emergency department (ED) with neck or back pain. Researchers reviewed cases of patients with neck or back pain that was suspected possible pyogenic spinal infection. The first phase of the study (January 2004 to March 2010) included patients with and without infection; the second phase (April 2010 to August 2018) included only patients with infection. The final analysis included 223 patients (median age, 55 years; 102 were male), of whom 89 had pyogenic spinal infection. Multivariate analysis of the first phase of the study found that the following predictors were associated with pyogenic spinal infection: recent soft-tissue infection or bacteremia, male sex, and fever before arriving to or in the ED.

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Supreme Court: HHS Violated Medicare Act in DSH Payment Change

The U.S. Supreme Court ruled 7-1 in favor of hospitals alleging that the Department of Health and Human Services’ (HHS) change to a payment policy was in violation of the Medicare Act. HHS altered the Medicare disproportionate share hospital (DSH) payment formula without a public notice-and-comment period.

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June AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the June 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 highlights how an orthopaedic surgeon volunteers his time to help injured animals, state and federal solutions to “surprise billing,” and tips on assessing lesions and masses.

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Apply for the Sports Medicine Content Committee Chair Position

The Sports Medicine Content Committee has an open chair position. Over the course of a three-year term, the chair will preside at up to two face-to-face meetings per year, as well as over several web and phone conferences. The chair will also attend and participate in three Council on Education meetings and four conference calls each year.

Learn more and submit your application…(member login required)


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