November 28, 2018
Today’s Top Story

Study Examines Rotator Cuff Attrition During Conservative Treatment for Impingement Syndrome

A retrospective study published online in Archives of Orthopaedic Trauma and Surgery found that spurs protruding from the acromial undersurface did not cause rotator cuff tears during conservative treatment for impingement syndrome. Data were collected for 119 patients with an intact rotator cuff who underwent conservative treatment for a spur protruding from the undersurface of the acromion. Researchers evaluated functional outcomes based on the visual analog scale for pain; subjective shoulder value; American Shoulder and Elbow Surgeons score; University of California, Los Angeles (UCLA) shoulder score; and active range of motion (ROM). Cuff integrity was determined through follow-up MRI, CT angiography, or ultrasound at least two years following initial presentation. Follow-up imaging studies did not identify any new rotator cuff tears, but 18 patients (15 percent) required arthroscopic acromioplasty. Arthroscopic examinations revealed moderate to severe cuff attrition. Pain level, shoulder function, and ROM all improved at final follow-up.

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Other News

Study: UKA for Treatment of AVN Yields Positive Outcomes

In a long-term, retrospective study published online in The Journal of Arthroplasty, patients who underwent unicompartmental knee arthroplasty (UKA) to treat avascular osteonecrosis of the knee (AVN) had high survival rates and stable clinical outcomes. Between 1989 and 2001, two senior surgeons performed 29 consecutive UKAs in 28 patients (19 females; mean age, 67 years; mean body mass index, 27 kg/m 2) with medial unicompartmental AVN diagnosed by radiography, MRI, and postoperative sample analysis. Etiologies were spontaneous/idiopathic AVN in 19 knees (66 percent) and secondary AVN in 10 knees (33 percent). Mean patient follow-up was 21 years. After 15 years, 92 percent of components survived without any revision. The latest follow-up was 26 years, at which time revision-free survival was 83 percent, mean Knee Society’s Knee Scoring System (KSS) was 89 points, and functional KSS was 83 points. There was no difference in survivorship between patients with spontaneous or secondary osteonecrosis of the knee.

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Study Evaluates Long-term Outcomes in Birmingham Hip Resurfacing Implant Patients

In a long-term study published online in The Journal of Bone & Joint Surgery, patients who underwent surface replacement arthroplasty via the Birmingham Hip Resurfacing (BHR) implant had positive clinical outcomes. Researchers collected patient-reported outcomes and complication and revision data for 324 hips five years after undergoing surgery at a single institution. Postoperative modified Harris hip score and UCLA scores greatly improved (to 89.9 and 8.0, respectively). Five and 10 years postoperatively, the Kaplan-Meier estimated rate of survival for all-cause revision was 97.2 percent and 93.8 percent, respectively. Fourteen patients (4.3 percent of all hips) underwent revision. In a matched-cohort analysis, postoperative UCLA scores were significantly better for BHR patients than total hip arthroplasty (THA) patients (8.0 versus 7.6, respectively). High postoperative activity levels were associated with a smaller median UCLA score; BHR patients were more likely than THA patients to remain active (61 percent versus 20 percent, respectively).

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Study: Midfoot Charcot Reconstruction with Intramedullary Beaming Associated with Adverse Outcomes

According to a study published online in Foot & Ankle International, midfoot Charcot reconstruction with intramedullary beaming may provide patients with an ulcer-free, plantigrade foot but may also have high rates of complication. Researchers assessed 25 patients who underwent corrective osteotomy with internal beam fixation between January 2013 and July 2016. After a minimum of one year, patients underwent a physical examination and weightbearing radiographs, as well as self-reported outcome measures. In 84 percent of patients, an ulcer-free, stable, plantigrade foot was achieved. From preoperative to final postoperative weightbearing measurements, the radiographic lateral angle median improved by nine degrees, and the anteroposterior Meary angle median improved by 15 degrees. Six patients (24 percent) developed a deep infection, which researchers correlated with the presence of a preoperative ulcer. At a mean 15 months postoperatively, four patients (16 percent) required amputation as a result of deep infection.

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Study: Monosegmental Stabilization with Fusion Is Effective Treatment for Thoracolumbar Spine Fractures

A study published online in International Orthopaedics found that monosegmental stabilization with fusion is a safe and effective way to treat patients with thoracolumbar spine fractures. Researchers retrospectively reviewed 20 monosegmental stabilization patients at a single institution; patients were followed for a minimum of two years. Clinical and radiological assessments were conducted preoperatively, postoperatively, and at final follow-up. Denis pain and work scale, somatic kyphosis (SK), somatic height (SH), and compression percentage (CP) data were collected. Mean preoperative, postoperative, and final follow-up SK angles between the upper and lower end plate of the fractured vertebra were 23.6 degrees, 12.8 degrees, and 13.9 degrees, respectively. Mean SH was 21.9 mm preoperatively, 26.5 mm postoperatively, and 24.8 mm at final follow-up. The mean preoperative, postoperative, and final follow-up CP values were 66.7 percent, 80.9 percent, and 75.3 percent, respectively. Three-quarters of patients reported no or moderate pain at final follow-up, at which time 95 percent of patients had returned to work full time.

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AJRR Releases 2018 Annual Report

The complete 2018 American Joint Replacement Registry (AJRR) Annual Report is now available for download. The report’s findings stem from more than 1 million cumulative procedures performed between 2012 and 2017. AAOS previously teamed up with AJRR through the AAOS Registry Program to deliver significant promises to registry stakeholders.

Read more…

Download the report…


Apply for the Patient Safety Committee Member-at-large Position

The Patient Safety Committee has an open member-at-large position, a two-year term that runs from March 18, 2019, through March 12, 2021. The Patient Safety Committee tracks current patient safety and infectious disease trends related to orthopaedic surgery and uses this information to educate the fellowship. The committee also interacts with regulatory agencies and other organizations to improve patient safety. The deadline to apply is Dec. 17.

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


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