Today’s Top Story

Study: Factors Associated with Poor Long-term ACL Reconstruction Outcomes

Anterior cruciate ligament (ACL) reconstruction patients with combined injury and patellofemoral cartilage defects defined on MRI may be more likely to have worse long-term outcomes, according to a study published online in Arthritis Care & Research. Researchers evaluated the Knee Injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee (IKDC) questionnaire, and 3T MRI assessment at one and five years postoperatively in 80 patients (mean age, 32 years). Compared to patients with an isolated injury, those with a combined injury had significantly worse one-year KOOS-sport and IKDC scores, as well as worse five-year KOOS-pain, KOOS-symptoms, KOOS-quality of life (QoL), and IKDC scores. The presence of patellofemoral cartilage defects at one year was associated with worse five-year outcomes for KOOS-symptoms, KOOS-sport, KOOS-QoL, and IKDC scores. Five-year patellofemoral cartilage defects were linked to poorer five-year KOOS-symptoms and KOOS-QoL scores.

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Other News

Study Compares Revision of aTSA to rTSA Versus Primary rTSA

According to a matched cohort study published in the Feb. 15 issue of the Journal of the AAOS, patients undergoing conversion of anatomic total shoulder arthroplasty (aTSA) to reverse total shoulder arthroplasty (rTSA) for rotator cuff failure or component loosening may have similar outcomes as those undergoing primary rTSA. Researchers used a database to retrospectively identify patients converted from aTSA to rTSA (n = 35) and matched them to primary rTSA patients (n = 70). At final follow-up, the two cohorts had similar visual analog scale pain and American Shoulder and Elbow Surgeons scores. Subjective shoulder value scores and complications were worse in the revision group.

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Study Measures Lifespan of a Hip Implant

According to a systematic review published online in The Lancet, a hip implant could be expected to last an estimated 25 years in about 58 percent of patients. Researchers queried MEDLINE and Embase through Sept. 12, 2017, to identify articles reporting 15-year hip implant survival in patients with osteoarthritis. They collected national joint replacement registry data from Australia and Finland to assess separately Final analysis included 44 series (13,212 total hip replacements [THRs]) from the literature search and 92 series (212,676 THRs) from joint replacement registry data. The 25-year collective hip replacement survival was 77.6 percent based on case series data and 57.9 percent based on joint replacement registries. The researchers believe the national registry data are less likely to be biased.

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Study Evaluates Long-term Buechel-Pappas Ankle Arthroplasty Follow-up

A study published online in Foot & Ankle International found improved long-term survivorship rates for Buechel-Pappas (BP) implants in total ankle arthroplasty (TAA) Researchers evaluated data for 86 patients (101 BP implants) between 1993 and 2010. Patient-reported outcome measures included Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), Short Form-36 (SF-36) Stand Version 2.0 Health Survey, and three anchor questions. Ten-year survival rate for the BP implant was 86 percent; 31 patients (36 percent) underwent 55 reoperations, and 13 patients (15 percent) required a revision procedure. Patients with inflammatory joint disease and noninflammatory joint disease had similar survivorship rates, as did patients with tibiotalar neutral and nonneutral alignment. Among 21 patients with a mean 16.8 years of follow-up, the mean FAOS activities of daily living (ADL) and FAAM ADL subscale scores were 75 and 56, respectively. Mean SF-36 scores were 34 for the physical component summary and 51 for the mental component summary.

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Proposed Healthcare Legislation Targets Hospital Consolidation, Cost Transparency

A new healthcare proposal from Rep. Bruce Westerman (R-Ark.) attempts to disincentivize hospital mergers and increase hospital price transparency. Under the proposal, hospitals (except those in rural areas with low market share) would have to accept Medicare reimbursement rates from commercial payers. Federal Trade Commission funding would increase by 400 percent in order to grow its antitrust staff, which is tasked with investigating hospital consolidation. Hospitals would also have to digitally share the average costs of their 100 most common services.

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Read a summary of the Fair Care Act…

 
 
 
AAOS Now

Communication and Resolution Programs Can Help When Something Goes Wrong and a Patient Is Harmed

Instances of patient harm used to be followed by a lack of transparent communication with patients, which fostered adversarial relationships among patients, physicians, and medical centers. Now, apologies are an accepted, protected part of communication, and sometimes settlement offers are made. Communication and resolution programs—principled, comprehensive processes designed to meet certain patient needs after medical errors result in harm—are a formal extension of recent approaches to apologies and settlements.

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Your AAOS

OVT Plus 2019 Award Winners to be Honored at Annual Meeting

Each year, the Orthopaedic Video Theater (OVT) is a highlight of the AAOS Annual Meeting, where award-winning and honorable mention videos in the longstanding OVT Plus surgical technique video collection are showcased. The newly expanded OVT—a free benefit of AAOS membership—now offers authors more ways to submit videos. Visit the OVT in Academy Hall at the Annual Meeting to view the collection—including 128 new videos posted this year. You’ll also find monitors featuring this year’s 10 award-winning videos and seven that received honorable mention.

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Register for the Annual Meeting…

 

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