Today’s Top Story

Study: Alpha-defensin Test Accurately Diagnoses PJI in Inflammatory Disease Patients

A retrospective review published online in The Journal of Arthroplasty found that the alpha-defensin test was an accurate diagnostic tool for periprosthetic joint infection (PJI) in revision total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients with systemic inflammatory disease. Researchers reviewed 41 revision THA and TKA patients with inflammatory diseases who received either one-stage revision arthroplasty, the first stage of two-stage revision arthroplasty, or irrigation and débridement. The alpha-defensin test had a 100 percent specificity and positive predictive value, 97 percent accuracy for diagnosing PJI, 96 percent negative predictive value, and 93 percent sensitivity. One patient with polymyositis had a false-negative result.

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Read the AAOS guideline on diagnosis and prevention of PJI…

Other News

Study: Preoperatively Predicting Discharge Disposition after Shoulder Arthroplasty

In a study published in the May 1 issue of the Journal of the AAOS, researchers developed a nomogram to preoperatively predict a patient’s discharge disposition following elective shoulder arthroplasty. The National Surgical Quality Improvement Program database was queried for elective shoulder arthroplasty patients between 2012 and 2015. A total of 8,363 surgeries were identified; most patients (n = 7,492, 88.5 percent) were discharged to home, while the rest (n = 962, 11.5 percent) were discharged to a post-acute care facility. The strongest predictor of discharge disposition was preoperative functional status, followed by American Society of Anesthesiologists class and age.

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Study Assesses Association Between Cotton Osteotomy and PROs

A study published in the May issue of Foot & Ankle International evaluated the relationship between patient-reported outcomes (PROs) and postoperative alignment of the medial cuneiform in stage II adult-acquired flatfoot deformity (AAFD) patients. There were 63 feet (61 patients) with stage II AAFD that required a Cotton osteotomy. Patients were stratified into mild plantarflexion (cuneiform articular angle [CAA] ≥ –2 degrees) and moderate plantarflexion (CAA < –2 degrees) groups. There was a significant positive correlation between postoperative CAA and postoperative Foot and Ankle Outcome Score symptoms, daily activities, sports activities, and quality of life subscales. The mild plantarflexion group had significantly better outcomes compared to the moderate plantarflexion group. The researchers recommended avoiding excessive plantarflexion of the medial cuneiform.

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Study Compares Satisfaction Rates in Spine versus Nonspine Clinics

In a retrospective review published in the May issue of Clinical Spine Surgery, patients reported lower satisfaction rates at neurosurgical spine clinics compared to nonspine clinics. Researchers evaluated 40 questions from the Press Ganey survey about physician and nursing care, personal concerns, admission, rooms, meals, operating room, treatment and discharge conditions, visitor accommodations, and overall clinic assessment. Responses from 578 neurosurgical spine clinic patients and 1,048 neurosurgical nonspine clinic patients were included. Patients from the spine clinic reported lower satisfaction in the following areas: aggregate, physician and nurse care, personal concerns, rooms, admission and visitor conditions, and overall clinic assessment.

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Commercials Required to Advertise Drug Prices

The Centers for Medicare & Medicaid Services ruled that drug manufacturers must include the cost of their product in television advertisements if the price is higher than $35 for a month’s supply or usual course of therapy. According to the Department of Health and Human Services, the 10 most commonly advertised drugs have prices ranging from under $500 to more than $16,000 for a month’s supply or usual course of therapy.

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Cannabinoids Can Serve as Alternatives to Narcotic Pain Medication for Fracture Healing

As the United States faces an opioid epidemic, many providers are either choosing or being forced to limit the number of narcotics they prescribe for pain in orthopaedic patients. Pain management in orthopaedic patients can be challenging, especially chronic pain. There is a tremendous need for safe alternatives that do not result in tolerance or dependence. Cannabidiol, a major nonpsychotropic cannabis constituent, has been shown to decrease pain—especially chronic and neuropathic pain—and may enhance bone metabolism.

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Apply for the Practice Management Instructional Course Committee Member Position

The Practice Management Instructional Course Committee has three open member positions. Over the course of a two-year term, members grade instructional course lecture applications, provide input to the Central Instructional Courses Committee regarding course curriculum and faculty suggestions, and evaluate courses at the Annual Meeting. The application deadline is May 24.

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


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