Today’s Top Story

Study Finds Patella Height May Not Impact TKA Outcomes

Total knee arthroplasty (TKA) with preoperative patella alta or patella baja had similar clinical and radiological outcomes compared to TKA with normal preoperative patella height, according to a study published in the March issue of The Journal of Arthroplasty. A total of 4,103 TKAs were performed at a single institution; patella height was measured using the Blackburne-Peel (BP) method. TKAs were stratified into three groups: normal patella height (0.54 < BP index ≤ 1.06, n = 2,248), patella alta (BP index > 1.06, n = 223), and patella baja (BP index ≤ 0.54, n = 307). Patients were followed for a mean 39.3 months. Knee Society Score knee and function scores did not significantly differ among the three groups, and all three cohorts had survival rates above 91 percent at 10 years. Patella baja patients had significantly decreased maximal flexion (118.2 degrees versus 115.5 degrees) and higher patellar fracture rates (0.9 percent versus 2 percent).

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Other News

Study Identifies Predictors of Research Productivity and OITE Score During Residency

A study published in the March 15 issue of the Journal of the AAOS identified factors associated with high performance on the Orthopaedic In-training Exam (OITE) and research productivity among residents. Researchers administered a survey that collected information on demographics, United States Medical Licensing Examination (USMLE) and OITE scores, and authored publications. A total of 274 surveys were completed. There was a positive association between USMLE step 1 and 2 scores and recent OITE percentile. Pre-residency authorship and post-graduate training year both independently correlated with authorship during residency.

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Study Uses 3D Simulator to Forecast Brace Success in Scoliosis Patients

In a study published online in the European Spine Journal, researchers predicted with moderate-to-good accuracy the impact of brace in scoliosis patients using a high-fidelity three-dimensional (3D) shape of the patient’s trunk. The study included 29 moderate idiopathic scoliosis patients aged nine to 15 years indicated for brace treatment: 20 right thoracic and 14 left lumbar patients. Researchers created 3D “avatars” using an “anatomy transfer” technology. Engineers performed biomedical simulations without any knowledge of how the patient’s brace impacted outcomes, and outcomes were compared for the in-brace Cobb angle effect (real effect) and the virtual numeric in-brace Cobb angle (simulation effect). The real and simulated Cobb angles were 11 degrees and 17 degrees, respectively; 76 percent of the real in-brace Cobb angles were predicted within 10 degrees.

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Study: New Opioid Prescriptions Significantly Decreased Over Five-year Period

A study published online in The New England Journal of Medicine found that the rate of initial opioid prescriptions decreased by more than half over the course of five years. Researchers used administrative claims data from July 2012 to December 2017 to approximate monthly initial opioid prescription incidence, and they estimated the percentage of patients initiating opioid therapy based on duration and dose. Among patients without previous opioid use, the monthly new opioid prescription incidence dropped by 54 percent from 1.63 percent in July 2012 to 0.75 percent in December 2017. The number of providers initiating new opioid therapy in patients also declined. Among providers who did initiate new opioid prescriptions, long-term and high-dose prescriptions continued at a monthly rate of 115,378 prescriptions per 15,897,673 patients.

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Justice Department Says ACA Is Unconstitutional

On Monday, the Department of Justice broadened its stance on the Affordable Care Act (ACA) and said the law should be completely eliminated. The new position reflects a December 2018 ruling by U.S. District Judge Reed O’Connor, who said that without the ACA’s individual mandate penalty, the entire law cannot stand. The Justice Department said it “is not urging that any portion of the district court’s judgment be reversed” and intends to file a brief at a later date.

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Read the Justice Department’s letter…


Dr. Crawford’s Barrier-breaking Career Inspires Surgeons and Residents

Although there are many outstanding orthopaedic surgeons, Alvin H. Crawford, MD, truly stands out from the crowd. He grew up as an African-American male in the segregated south and, with the support of his family, went on to pursue an incredible career in pediatric orthopaedics. AAOS Now spoke with Dr. Crawford about his impressive career.

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Apply for the Spine Program Committee Member Position

The Spine Program Committee has two open member positions. Over the course of a three-year term, the members will rate podium and poster abstracts and symposium for the Annual Meeting. Members will also select and/or serve as moderators for podium sessions at the Annual Meeting. The application deadline is April 22.

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


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