Today’s Top Story

Study Evaluates Common Malpractice Litigations in TJA

According to a study published online in The Journal of Arthroplasty, the most common reasons for litigation in total knee arthroplasty (TKA) and total hip arthroplasty (THA) were infection and nerve injury, respectively, and outcomes tended to favor the surgeon. Researchers queried the Westlaw legal research database for TKA and THA cases between 2008 and 2018. They documented lawsuit causes, patient characteristics, state/outcome of verdict or settlement, and indemnity payments. Of the 148 records (55 percent female) analyzed, 83 (56 percent) were for TKA and 65 (44 percent) were for THA. Malpractice litigation most commonly resulted from infection (22 percent) and nerve injury (20 percent); 33 percent of TKA lawsuits were due to infection, and 38 percent of THA lawsuits stemmed from nerve injury. Procedural, diagnostic, and post-surgical errors were cited in 72 percent, 55 percent, and 32 percent of cases, respectively. In 74 percent of cases, verdicts ruled in favor of the defendant; 21 percent ruled in favor of the plaintiff, while 5 percent of cases resulted in a settlement.

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Other News

Study: Foot Ankle Offset May be a Reproducible Tool for Hindfoot Alignment

Foot ankle offset (FAO) could be an accurate and reproducible way to assess hindfoot alignment, according to a study published online in Foot & Ankle International. A total of 249 feet (126 patients) required bilateral weightbearing CT (WBCT) between September 2017 and April 2018. Following a clinical hindfoot alignment assessment, patients were stratified into three groups: normal alignment group (G1), valgus group (G2), and varus group (G3). WBCT images were used to measure FAO and long axial view (HACT); intraclass correlation coefficients were utilized to determine the reproducibility of FAO and HACT. The mean FAO and HACT values were: G1, 1.2 percent versus 3.9 percent, respectively; G2, 8.1 percent versus 9.7 percent, respectively; and G3, –6.6 percent versus –8.2 percent, respectively. Intraobserver reliability for FAO and HACT was 0.987 and 0.949, respectively; interobserver reliability was 0.988 and 0.949, respectively. HACT and FAO had a good linear correlation.

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Study Identifies Repairability Predictors in Rotator Cuff Tears

In a study published online in BMC Musculoskeletal Disorders, researchers identified preoperative factors associated with the repairability of large-sized and massive rotator cuff tears. The study included 66 patients (11 large-sized tears and 55 massive tears), of whom 54 underwent complete repair and 12 underwent partial repair. The following factors were associated with repairability: age, mediolateral and anteroposterior tear size, rotator cuff arthropathy, superior migration of humeral head, fatty infiltration and atrophy of the supraspinatus muscle, and fatty infiltration of infraspinatus muscle. The receiver operating characteristic curve determined the following cutoff levels for each predictor: age ≥ 65 years, mediolateral tear size ≥ 36 mm, anteroposterior tear size ≥ 22 mm, Hamada’s rotator cuff arthropathy ≥ grade 2, acromiohumeral interval ≥ 6 mm, supraspinatus fatty infiltration ≥ stage 3, the presence of supraspinatus muscle atrophy, and infraspinatus fatty infiltration ≥ stage 1.

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Study: No Association Between Weight and Perioperative Outcomes in Scoliosis Patients

A study published in the March 15 issue of Spine compared perioperative outcomes between overweight and healthy weight adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion. Both groups had 46 propensity-matched patients. Primary outcomes included operative time, intraoperative blood loss, total patient-controlled analgesia (PCA) morphine usage, and perioperative complications. The operation time was 145.2 minutes for the healthy weight cohort and 154.4 minutes for the overweight group. Intraoperative blood loss rates were 955 mL and 1,011 mL, respectively. The overweight group had higher total PCA morphine use (30.4 mg) than the healthy weight group (16.2 mg). One complication occurred: A patient in the overweight group developed intraoperative seizure.

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GAO: Little Change in Distribution of Private Health Insurance Enrollment

According to a report from the Government Accountability Office (GAO), just a few health insurance issuers held the majority of the market in 2015 and 2016. In at least 37 states, the three largest issuers dominated more than 80 percent of the market. In individual market exchanges, three or fewer issuers controlled at least 80 percent of the market in the 46 of 49 states for which GAO had data. In small employers, three or fewer issuers dominated 80 percent or more of the market in 42 of 46 exchanges in states where data were available. The most recent data are similar to those of previous years, as reported by GAO.

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Have You Heard About the New OVT?

AAOS members have long recognized the Orthopaedic Video Theater (OVT) as the premier destination for viewing high-quality, peer-reviewed educational video content at the AAOS Annual Meeting. One of OVT’s recent highlights is that citations from all honorable mentions and award-winning videos from each AAOS Annual Meeting will be published in the Journal of the AAOS. This addition will not only elevate the profile of the authors but also underscore the academic and educational value of these video contributions.

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View the OVT…


Apply for the Sports Medicine/Arthroscopy Program Committee Member Position

The Sports Medicine/Arthroscopy Program Committee has four open member positions. Over the course of a three-year term, the members will rate podium and poster abstracts, as well as symposia 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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