Today’s Top Story

Study Compares Outcomes for UKA versus TKA

A study published online in The Journal of Arthroplasty compared complications, reoperation risks, hospital readmission rates, and 90-day mortality between unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) patients. Researchers evaluated Medicare data and the MarketScan Commercial and Medicare Supplemental Databases. TKA patients had significantly higher rates of wound complication, pulmonary embolism, stiffness, periprosthetic joint infection, myocardial infarction, readmission, and death compared to UKA patients. However, TKA survivorship was higher than UKA survivorship. Seven years postoperatively, UKA and TKA survivorship rates in the Medicare cohort were 80.9 percent and 95.7 percent, respectively; survivorship rates in the MarketScan cohort were 74.4 percent and 91.9 percent, respectively.

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Other News

Study Finds Good Long-term Outcomes for Remplissage in Shoulder Arthroscopy

In a study published in the May issue of Arthroscopy, patients had good long-term outcomes after Bankart repair in combination with remplissage. Between November 2004 and January 2008, 79 patients underwent surgical Bankart repair with or without remplissage and were followed for a mean 128 months; 12 patients were lost to follow-up. Among the 39 Bankart stabilization-only patients, the mean Instability Severity Index score was 2.3 compared to 1.8 among the 28 Bankart plus remplissage patients. In the Bankart-only group, three patients had recurrence with new dislocation, and eight patients had apprehension; in the Bankart plus remplissage group, there were no cases of recurrence or apprehension. Rowe scores changed from 54.3 to 83.8 in the Bankart-only group and 51.8 to 92.3 in the Bankart plus remplissage group; Walch-Diplay scores rose from 46.8 to 85.6 and 58.7 to 91.4, respectively.

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Study Evaluates Talonavicular and Talonavicular-cuneiform Arthrodesis for Müller-Weiss Disease

A retrospective study published in the May issue of Foot & Ankle International found favorable outcomes for patients with Müller-Weiss disease treated by talonavicular (TN) or talonavicular-cuneiform (TNC) arthrodesis. Between 2008 and 2015, 34 patients (36 feet) were treated by TN or TNC arthrodesis at a single institution. Feet were staged based on the Maceira staging system (stage II: n = 9; stage III: n = 10; stage IV: n = 9; stage V: n = 8). Preoperative and follow-up assessments evaluated the American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scale, the visual analog scale (VAS) score, and relative radiologic parameters. After a mean follow-up of 38.2 months, AOFAS scores improved from 41.5 to 85.3, and the VAS score decreased from 5.7 to 0.9. Decreases were observed in the Tomeno-Méary angle (–6.7 degrees to 0.7 degrees), anteroposterior (AP) talar–first metatarsal angle (–15.8 degrees to –7.0 degrees), and AP talonavicular coverage angle (–27.0 degrees to –7.8 degrees). Increases were observed in the calcaneal pitch angle (13.7 degrees to 22.0 degrees) and AP talocalcaneal angle (14.7 degrees to 22.1 degrees).

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Study Measures Rates of Surgical Complications, Reoperations, and Readmissions in Herniated Lumbar Disk Patients

According to a study published online in The Bone & Joint Journal, complication rates after surgery for lumbar disk herniation may be lower than previous estimates. The study included 34,639 herniated lumbar disk surgeries conducted in Norwegian public hospitals between 1999 and 2013. Of the total operations, 2.7 percent had a surgical complication, 2.1 percent had 90-day repeat surgery, 2.4 percent had a 90-day nonsurgical readmission, and 6.7 percent experienced at least one of the aforementioned unfavorable events. Older age and comorbidity were predictors of adverse events.

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Study: Medical Interns Spend Little Time with Patients

According to a study published online in JAMA Internal Medicine, first-year internal medical students spend more time doing indirect patient care activities than interacting with patients or completing educational activities. The study included 80 interns (mean age, 28.7 years; 55 percent male), spanning 194 shifts totaling 2,173 hours. During a 24-hour period, interns spent a mean 15.9 hours (66 percent) in indirect patient care, primarily medical record and documentation interaction. A mean three hours (13 percent) were dedicated to direct patient care, while 1.8 hours (7 percent) were spent in education.

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It’s Time to Bridge the Gap for Women in Orthopaedics

AAOS President Kristy L. Weber, MD, shares her insight into how far women have come in the field of medicine and how much work remains to be done in orthopaedics, highlighting AAOS’ five-year Strategic Plan to bring more gender diversity to the Academy.

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