Today’s Top Story

Study: Does BMI Impact 30-day Complications after Revision Joint Arthroplasty?

A study published online in The Journal of Arthroplasty evaluated the relationship between body mass index (BMI) and 30-day complications following aseptic revision total knee arthroplasty (rTKA) and aseptic revision total hip arthroplasty (rTHA). Data were collected from the American College of Surgeons National Surgical Quality Improvement Project database for 18,866 patients (rTHA, n = 9,093; rTKA, n = 9,773); 30-day readmission, reoperation, and major and minor complication rates were compared for normal weight (BMI, 18.5–25 kg/m 2), overweight (BMI, 25.1–30 kg/m 2), obese (BMI, 30.1–40 kg/m 2), and morbidly obese (BMI, > 40 kg/m 2) patients. Increasing BMI in rTKA patients was associated with increasing readmission and reoperation rates. In univariate analysis, morbidly obese rTHA patients had greater odds for reoperation; however, in multivariate analysis, there was no correlation between increasing BMI and increased risk for readmission or reoperation in rTHA patients.

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Other News

Study Finds Low Short-term Symmetrical Knee Function Rates after ACLR

About one in five patients who undergo primary anterior cruciate ligament (ACL) reconstruction (ACLR) achieved symmetrical knee function six months after surgery, according to a study published online in Knee Surgery, Sports Traumatology, Arthroscopy. At six-month follow-up, patients who underwent primary ACLR between 2000 and 2015 were evaluated using the isokinetic quadriceps and hamstring muscles strength tests and single leg hop test. Symmetrical knee function was defined as a limb symmetry index (LSI) of at least 90 percent in all three assessments. Among 4,093 patients (mean age, 28.3 years; 54.3 percent male), 3,541 had data available for all three tests. An LSI of 90 percent or greater was achieved by 67.9 percent of patients for the single leg hop test, 47.3 percent for hamstring muscles strength test, and 35.7 percent for isokinetic quadriceps muscle strength test; 19.6 percent of patients achieved at least 90 percent LSI in all three assessments. Age ≥ 30 years and medial meniscus resection and repair decreased the odds of achieving symmetrical knee function, whereas use of hamstring tendon autograft as opposed to bone-patellar tendon-bone autograft increased the odds.

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Study: Do Frailty and Malnutrition Increase Risks in Hip Fracture Patients?

According to a study published in the March issue of the Journal of Orthopaedic Trauma, frail, malnourished hip fracture patients may have greater odds of postoperative complications and mortality. Albumin levels, total lymphocyte count (TLC) levels, complication data, and modified frailty index (mFI) data were collected from 377 isolated hip fracture patients upon admission. A total of 62.6 percent and 17.5 percent of patients were malnourished, as defined by a TLC lower than 1,500 cells/mm 3 and albumin of lower than 3.5 g/dL, respectively. Albumin and TLC were weakly associated with frailty. Patients who were malnourished, as defined by albumin levels, and had an mFI of 0.18 or greater had a 69 percent positive predictive value for postoperative complications. The combination of albumin-measured malnutrition and frailty was associated with a 23.3 percent positive predictive value for mortality.

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Study Identifies Risk Factors for Pain after Ankle Surgery

Psychological distress and severe preoperative pain may be predictors of postoperative acute and chronic pain after ankle surgery for osteoarthritis, according to a study published online in Foot & Ankle International. Researchers evaluated duration, severity, type of preoperative pain, psychological distress, opioid consumption, and type of surgery in 49 patients. Most patients (87 percent) had preoperative chronic pain, and 34 percent had a high postoperative pain trajectory, of whom 44 percent had 18-month chronic pain. A higher preoperative level of opioid consumption, higher incidence of preoperative neuropathic pain, higher Brief Pain Inventory (BPI) score, and higher psychological distress score were predictors of developing a high acute pain trajectory. Patients with a higher BPI score, higher psychological distress score, and higher preoperative pain intensity had an increased risk for developing chronic pain. No correlation was observed between type of ankle surgery and pain.

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Study: Timing of VTE Prophylaxis in Severe Pelvic Fractures

Patients with isolated severe pelvic fracture may have improved survival rates and reduced venous thromboembolic (VTE) complications if they receive early VTE prophylaxis (VTEp), according to a study published online in Injury. Researchers used data from the Trauma Quality Improvement Program to identify patients with blunt severe pelvic fractures who received VTEp with unfractionated heparin or low-molecular-weight heparin (LMWH). Of the 2,752 patients included in the study, 2,007 (72.9 percent) received early (< 72 hours) VTEp, and 745 (27.1 percent) received late VTEp. Most patients (n = 2,349, 85.4 percent) received LMWH. Late VTEp patients were nearly twice as likely to sustain VTE compared to early VTEp patients (4.3 percent versus 2.2 percent). Late VTEp was an independent risk factor for VTE and in-hospital mortality. LMWH was an independent protective factor for VTE and mortality.

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AAOS Strives to Reduce Surgical Risk with New Online Toolkit

The new online AAOS Surgical Risk Reduction Toolkit (SRR Toolkit) was created to provide AAOS members with the best tools and resources to answer questions about patient-specific risks and steps that can be taken to reduce them. The SRR Toolkit helps identify these risk factors that can be medically optimized throughout the care episode, as well as provide resources to help doctors and patients manage and optimize specific risks.

Read more…

View the SRR Toolkit…


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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