November 16, 2018
Today’s Top Story

Study Compares Treatments for Articular Cartilage Defects of the Talus

A study published online in Knee Surgery, Sports Traumatology, Arthroscopy found no benefit associated with the addition of an acellular collagen I/III matrix to arthroscopic microfracture to manage articular cartilage defects of the talus. Patients with an articular cartilage defect of the talus who were treated with arthroscopic microfracture alone (n = 16) were matched for age, sex, and body mass index to patients who received arthroscopic autologous matrix-induced chondrogenesis using a collagen I/III matrix (AMIC). Patients were followed for a minimum of five years. Researchers used the Hanover Scoring System (HSS) for the ankle and a visual analog scale (VAS) to evaluate clinical outcomes. Preoperative scores did not differ between the groups, and both cohorts had significant improvement in pre- and postoperative scores. Median HSS values were similar for the microfracture group (82 points) and AMIC group (88 points), as were VAS pain (microfracture, 0.95; AMIC, 1.0), function (microfracture, 8.4; AMIC, 9.0), and satisfaction (microfracture, 8.9; AMIC, 9.45). Tissue regeneration in the affected area did not differ between the two groups.

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Other News

Study: PRO Scores for Revision Shoulder Arthroplasty Based on Etiology

A retrospective review published in the December issue of the Journal of Orthopaedics found that revision of reverse total shoulder arthroplasty (rTSA) was associated with the most improved patient-reported outcome (PRO) scores compared to shoulder hemiarthroplasty or TSA. Researchers evaluated PRO scores and range of motion for 23 consecutive revision shoulder arthroplasty (RevSA) patients with a minimum two-year follow-up. They compared data based on type of revision procedure and indication. EuroQol-5 Dimension-quality of life, VAS pain, and American Shoulder and Elbow Surgeons (ASES) scores, as well as forward elevation, all showed improvement following RevSA. Patients undergoing revision of rTSA had the most significant improvements in VAS pain and ASES scores, as well as forward elevation. RevSA for infection was associated with the least improvements.

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Study: Poor Outcomes Associated with HCV Patients who Undergo Hip Fracture Surgery

In a retrospective study published in the November issue of the Journal of Orthopaedic Trauma, researchers observed a negative correlation between noncirrhotic hepatitis C virus (HCV) infection and patients operatively treated for hip fracture. Patients were classified as having a concurrent diagnosis of noncirrhotic HCV infection (HCV+) (n = 5,377) or without HCV diagnosis (HCV–) (n = 4,712,159). Despite younger age and fewer medical comorbidities, the HCV+ group had longer hospital lengths of stay, higher nonroutine discharge rates, and higher rates of complications compared to HCV– patients.

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Study Evaluates Complexities Associated with Performing Lumbar Single-level Posterior Fusion Procedures with 3D-flouroscopy

Prior experience may not be necessary to perform lumbar single-level posterior fusion procedures using 3D-fluoroscopy for real-time image-guided pedicle screw (PS) insertions, according to a prospective, single-center cohort study published in the November issue of the Archives of Orthopaedic and Trauma Surgery. Between August 2011 and July 2016, a single surgeon with no image-guided surgery experience inserted 320 navigated PSs during 80 lumbar single-level posterior fusion procedures. Researchers gathered data on PS misplacements, navigation-related pre- and intraoperative time demand, and procedural 3D-radiation dose. They categorized this information into 16 subgroups of five consecutive procedures to assess improving PS insertion accuracy, decreasing navigation-related time demand, and reduction of 3D-radiation dose. The subgroups had a 96.6 percent PS insertion accuracy rate. Subgroup one had an average navigation-related presurgical time from patient positioning on the operating table to skin incision of 61 minutes; this decreased to 28 minutes in subgroup 16. Mean 3D-radiation dose per surgery in subgroup one was 919 millgrays cm and 66 milligrays cm in subgroup 16.

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FDA Issues Warning for Implanted Pumps for Intrathecal Administration of Medicines for Pain Management

The Food & Drug Administration (FDA) released an advisory regarding the use of implanted pumps for pain management. Patients may be receiving pain medicines that are not FDA-approved for use with the implanted pump. Although patients may experience some relief from using pain medicines not approved for intrathecal administration in their implanted pumps, inappropriate use of the pump could lead to dosing errors, pump failures, and other safety issues, according to the agency.

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AAOS Now

Study Follows Up on Skeletally Immature Patients with Osteochondritis Dissecans in the Knee

A recent study found positive long-term clinical outcomes in skeletally immature patients with osteochondritis dissecans (OCD) in the knee. Previous studies have reported that about 4 percent of primary knee osteoarthritis in men is the result of undiagnosed OCD lesions. Managing OCD lesions remains controversial, said Aaron J. Krych, MD, of the Mayo Clinic in Rochester, Minn., who presented the study during the American Orthopaedic Society for Sports Medicine Annual Meeting.

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Your AAOS

AAOS Nominating Committee Recommends 2019 Slate

As required by AAOS Bylaws, the AAOS Nominating Committee released its recommended slate of nominees 120 days in advance of the AAOS business meeting held during the Annual Meeting. Chaired by David D. Teuscher, MD, the 2019 Nominating Committee included: Sara L. Edwards, MD (Calif.); Richard J. Hawkins, MD (S.C.); Lawrence S. Halperin, MD (Fla.), Board of Councilors/Board of Specialties representative; John D. Kelly IV, MD (Pa.); William M Ricci, MD (N.Y.); Richard H. Rothman, MD (Pa.) (deceased); and Jennifer M. Weiss, MD (Calif.).

 

After an expansive search process, the development of Plans for Active Management of conflicts of interest and extensive discussion, the 2019 Nominating Committee recommended the following individuals to serve in the specified AAOS leadership positions:

  •  Second vice-president: Daniel K. Guy, MD (Ga.)
  •  Member-at-large (no age designation): James R. Ficke, MD (Md.)
  •  Member-at-large (under age 45): Rachel Y. Goldstein, MD, MPH (Calif.)

The AAOS Nominating Committee also recommended four nominees and two alternate nominees to the American Board of Orthopaedic Surgery board of directors:

  •  Martin I. Boyer, MD (Mo.)
  •  Dawn LaPorte, MD (Md.)
  •  Charles L. Nelson, MD (Pa.)
  •  Robert C. Schenck, MD (N.M.)
  •  Bruce V. Darden, II, MD (N.C.) (Alternate)
  •  Michael D. Daubs, MD (Nev.) (Alternate)

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