Today’s Top Story

AAOS 2019 Annual Meeting Your Academy 2019: Honorees Receive Diversity, Tipton, and Humanitarian Awards

During yesterday’s Your Academy 2019 event at the AAOS 2019 Annual Meeting, three well-respected physicians were presented with awards, honoring their work in orthopaedics. The following recipients were recognized:

Other News

Study Finds Increased Loosening and Revision Risk in THA Patients with Pelvic Irradiation

Total hip arthroplasty (THA) patients who underwent radiation therapy to the pelvis prior to surgery could have an increased risk for aseptic loosening and revision THA compared to previously published data on healthy THA patients, according to a meta-analysis published online in The Journal of Arthroplasty. Researchers assessed eight studies in which the primary outcomes were aseptic loosening and revision THA rates. Of 232 hips with a weighted mean 52 months of follow-up, the aseptic loosening and revision THA rates were 10 percent and 12 percent, respectively. THAs with cementless cups had slightly lower rates: 8 percent and 10 percent, respectively.

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AAOS 2019 Annual Meeting Paper Presentation: Pediatric Patients with Labral Tears Can be Treated Nonoperatively

Pediatric patients with MRI-confirmed labral tears can be managed nonoperatively with an approach that incorporates rest, physical therapy (PT), modification of sports movements, and an occasional steroid injection, according to a study that will be presented today during the AAOS 2019 Annual Meeting. A total of 100 patients with groin-based pain, a positive impingement test, and no prior hip surgery were enrolled. The nonoperative protocol included an initial period of rest, PT, and activity modification (n = 16). Patients who remained symptomatic were then offered an image-guided intra-articular steroid injection (n = 12). Patients with recurrent symptoms were then offered arthroscopic treatment (n = 13). At presentation, the average modified Harris Hip Score (mHHS) was 66.3. At follow-up, all treatment cohorts showed statistically significant improvements in mHHS that exceeded the minimal clinically important difference for the outcome measure.

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Study: Injections May Increase Risk for Revision Rotator Cuff Repair

According to a retrospective study published in the March issue of Arthroscopy, patients undergoing primary rotator cuff repair (RCR) who receive preoperative shoulder injections may be more likely to require revision RCR. Researchers queried the MarketScan database for information on arthroscopic RCR patients between 2010 and 2014. They identified 4,959 patients, of whom 392 required revision RCR within three years. Patients who received shoulder injections within the six months preceding the index surgery were significantly more likely to require revision surgery. The adjusted odds ratios were: zero to three months prior, 1.375; three to six months prior, 1.822; and six to 12 months prior, 1.237.

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Hospitals May Have to Pay for Delay in DSH Cuts

Disproportionate-share hospital (DSH) cuts that have long been delayed are scheduled to take effect Oct. 1. Another delay is possible, but other sources of hospital funding may be at risk to help fund the cuts. A hospital lobbyist who asked to remain anonymous told Modern Healthcare that committee staff said about half of the necessary funds will have to come from hospitals.

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FDA Prepares to Modernize Its 510(k) Pathway to Keep Pace with Medical Device Advancements

Most medical devices used in the United States are cleared for marketing through the Food and Drug Administration’s (FDA) 510(k) pathway. Established by the 1976 Medical Device Amendments to the Federal Food, Drug, and Cosmetics Act, the 510(k) pathway is based on the concept of substantial equivalence. To ensure that products are “continually improving,” the FDA is considering making public a list of cleared devices that demonstrate substantial equivalence to older predicate devices, with a focus on predicates that are more than 10 years old.

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AAOS Board Approves New AUC for the Management of SSIs

The AAOS Board of Directors approved new Appropriate Use Criteria (AUC) for the Management of Surgical Site Infections (SSIs). This AUC is presented via an online diagnostic tool and includes treatment recommendations for diagnosed SSI with or without hardware and/or biological implant present. The new AUC supports an existing AAOS Clinical Practice Guideline titled, “Management of SSIs.”

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