Today’s Top Story

Study: Smoking Increases Complications, Costs in THA

A study published online in The Journal of Arthroplasty evaluated how smoking impacts complications and costs in total hip arthroplasty (THA). In 2014, 63,446 primary THA admissions were recorded in the Nationwide Inpatient Sample, corresponding to an estimated 317,230 cases across the United States. The smoking rate was 20.7 percent. Smokers tended to be younger (63.5 years versus 64.8 years) and had significantly longer hospital lengths of stay (LOS) and higher total hospital costs. In adjusted multivariable analysis, smokers had significantly higher risk for myocardial infarction, cardiac arrest, pneumonia, urinary tract infection, sepsis, acute renal failure, discharge to a skilled nursing facility, and mortality.

Read the abstract…

Read the Academy’s clinical practice guideline on the association between tobacco use and complication risk after THA…

Other News

Study Compares Standard Versus Extended Culture Duration in PJI

In a retrospective review published in the May 1 issue of the Journal of the AAOS, standard and extended surgical culture durations had similar outcomes in patients with periprosthetic joint infection (PJI). Of 189 PJI patients, 102 (54 percent) had standard cultures (five days), and 87 (46 percent) had extended cultures (14 days). Overall culture yield, monomicrobial growth, and polymicrobial growth did not significantly differ between the two groups. At final follow-up, treatment success was 53 percent in the standard group and 52 percent in the extended group. The extended cohort had five cases involving Propionibacterium acnes (P. acnes), while none were observed in the standard group. Of the five P. acnes patients in the extended group, four only had one positive P. acnes culture and grew additional organisms.

Read the abstract…

Study Associates Preoperative Narcotic Use with Increased TSA Complications

Total shoulder arthroplasty (TSA) patients who use narcotics prior to surgery may experience different postoperative outcomes compared to narcotic-naïve patients, according to a study published in the May/June issue of Current Orthopaedic Practice. Of 152 primary TSA patients, 27 had at least a three-month history of narcotic pain medication use prior to surgery. Visual analog scale (VAS) scores did not largely differ between the groups two weeks postoperatively, but at six and 12 weeks, previous narcotic users had significantly higher VAS and cumulative narcotic requirement compared to the narcotic-naïve cohort. Hospital LOS, complications, and readmission rates did not significantly differ between the groups.

Read the abstract…

Study: Platelet-rich Plasma Versus Lidocaine in Elbow Tendinopathy

Platelet-rich plasma (PRP) provided similar outcomes to lidocaine as a tenotomy adjuvant in patients with elbow tendinopathy, according to a double-blind, randomized trial published online in the Journal of Orthopaedic Surgery and Research. Ultrasound-guided tenotomy with either PRP or lidocaine was given to 71 recalcitrant elbow tendinopathy patients. The primary endpoint was the proportion of patients who achieved more than 25 percent reduction in disability per the Spanish version of the Disabilities of the Arm, Shoulder and Hand questionnaires at six and 12 months. At six months, about 79 percent (n = 18) of the lidocaine group and about 73 percent (n = 19) of the PRP group achieved improved function greater than 25 percent. In the PRP group, about 85 percent (n = 22) of patients achieved more than 25 percent pain reduction compared to about 72 percent (n = 21) in the lidocaine group. At 12 months, improved function rates were about 70 percent (n = 17) and 76 percent (n = 19) in the lidocaine and PRP groups, respectively, and improved pain rates were 76 percent (n = 19) and about 91 percent (n = 20), respectively.

Read the study…

Patients Unwilling to Pay High Prices at Academic Medical Centers

In a recent survey conducted by PricewaterhouseCoopers’ Health Research Institute, half of patients said they would not pay higher prices for specialty care at an academic medical center. These facilities are reportedly expanding their clinical, research, and education missions in an effort to evolve with the changing healthcare industry.

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Read the report…


Committed Orthopaedic Surgeons Assume New Roles on the 2019 AAOS Board of Directors

At the conclusion of the AAOS 2019 Annual Meeting, the AAOS Board of Directors had six members transition into new roles: Kristy L. Weber, MD, president; Joseph A. Bosco III, MD, first vice-president; Daniel K. Guy, MD, second vice-president; Alan S. Hilibrand, MD, MBA, treasurer; James R. Ficke, MD, member-at-large; and Rachel Y. Goldstein, MD, member-at-large. The Board of Councilors and Board of Specialty Societies also welcomed new members.

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Nominate a Colleague for the AAOS Diversity, Humanitarian, or Tipton Leadership Awards

AAOS is now accepting nominations for the 2020 Diversity and Humanitarian Awards and the William W. Tipton Jr, MD, Orthopaedic Leadership Award. These awards are presented at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession. The last day to submit nominations for the Humanitarian Award is May 17; the last day to submit nominations for the Diversity and Tipton Awards is June 14.

Learn more and submit nominations…


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