November 5, 2018
Today’s Top Story

Study Finds No Differences in Recovery Following TKA With or Without Tourniquet Use

Rehabilitation-related results following total knee arthroplasty (TKA) with or without tourniquet did not differ significantly, according to a study published online in Knee Surgery, Sports Traumatology, Arthroscopy. TKA patients were randomly selected to undergo surgery with (n = 38) or without (n = 43) tourniquet. They found that tourniquet use had no effect on knee flexion. Patients who underwent surgery without tourniquet experienced more pain 24 hours postoperatively. At day one, analgesia consumption did not differ significantly between the tourniquet and no tourniquet groups (24 percent and 28 percent, respectively). After three months, the no tourniquet group had slightly better mobility, but the difference was insignificant.

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Other News

Study: Association Between Depression and Patient-reported Outcomes after TJA

Total joint arthroplasty (TJA) patients with depression but good mental health at baseline reported outcomes similar to those of normal controls in a prospective study published online in the Journal of Bone and Joint Surgery. Researchers used the Short Form-12 Mental Component Summary (SF-12 MCS) to measure baseline mental health in 469 primary elective TJA patients (485 procedures). They defined poor mental health as having a preoperative SF-12 MCS score ≤ 45.6 points, while an SF-12 MCS score > 45.6 points indicated good mental health. Patients were classified into four groups: no depression and good mental health (n = 305), depression and good mental health (n = 57), no depression and poor mental health (n = 50), and depression and poor mental health (n = 60). Patients with depression and good mental health had outcomes comparable to healthy patients. Patients without depression saw the most significant gains in outcomes. Only the depression and poor mental health group did not achieve good mental health at final follow-up, but these patients had similar gains in physical function compared to patients without depression.

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Study: Outcomes for Hallux Valgus Patients Treated with Proximal Opening Wedge First Metatarsal Osteotomy with Distal Chevron Osteotomy

A study published online in Foot & Ankle International found complications may be likely when treating moderate to severe hallux valgus with proximal opening wedge first metatarsal osteotomy with distal chevron osteotomy. Researchers evaluated intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and the American Orthopaedic Foot & Ankle Society metatarsophalangeal-interphalangeal hallux score (AOFAS MTP-IP hallux score) in 33 patients (four males, 29 females; 36 feet; mean age, 60.7 years) at six weeks, six months, and after an average of 28 months postoperatively. From preoperation to final follow-up, IMA, HVA, and DMMA all improved significantly from 19.1 to 6.0 degrees, 45.4 to 9.1 degrees, and 20.9 to 64 degrees, respectively. Average postoperative AOFAS MTP-IP hallux score was 88.1 points. Ten complications were noted: hallux varus (three feet), hallux valgus recurrence (three feet), wound infection (two feet), nonunion (one foot), and loss of fixation (one foot).

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Study Evaluates Role of Glenoid Version, Inclination, and Rotator Interval Dimension in Older Patients with Anterior Shoulder Dislocation

Glenoid shape may be more significant than its spatial position in patients older than 40 years with anterior shoulder dislocation, according to a study published online in the Archives of Orthopaedic and Trauma Surgery. Researchers assessed MRI outcomes performed on traumatic shoulder dislocation patients (n = 61; mean age, 59 years) and compared them to 73 MRI outcomes from patients who underwent imaging for a different reason (n = 73; mean age, 57 years). In the dislocation group, mean glenoid version was –4.9 degrees (retroversion) compared to –5.4 degrees in the comparison group. Mean inclination for the shoulder injury group was 9.8 degrees (reclination) and 10.8 degrees in the control group. Mean rotator interval base, height, and rotator interval area for the traumatic shoulder injury group were 46 mm, 14 mm, and 33 mm 2, respectively, compared to 41 mm, 16 mm, and 34 mm 2, respectively, for the control group.

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Orthopaedic PAC Biggest Healthcare PAC Contributor to Midterm Elections

According to the Center for Responsive Politics, the healthcare industry has collectively given $46.7 million to candidates for the midterm elections, which take place on Nov. 6. Individual employee contributions bring the total to nearly $200 million, the highest amount for any other midterm election going back to 1990. AAOS’ political action committee (PAC) made the largest contribution, giving $1.37 million to candidates of both parties. Its largest single contribution of $250,000 was made to the Congressional Leadership Fund, a GOP super PAC. John T. Gill, MD, chair of AAOS’ PAC, said in a statement, “Like many other healthcare groups, we’re having to contribute more this cycle while health care remains a central issue and competitive races are occurring across the country.”

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S. aureus Infects and Hides in Living Osteocytes in PJIs

Research presented at the 2018 Musculoskeletal Infection Society Annual Scientific Meeting highlighted Staphylococcus aureus (S. aureus) bacteria and the role they play in periprosthetic joint infections (PJIs). Staphylococci, particularly the S. aureus species, have been shown to cause PJI. Researchers analyzed reciprocal responses in the host cell and pathogen when S. aureus infect human osteocytes. The research was awarded the Jeanette Wilkins Award for Best Basic Science Paper.

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AAOS CPG on the Monitoring and Diagnosis of Acute Compartment Syndrome—Public Commentary

The AAOS Clinical Practice Guideline (CPG) on the Monitoring and Diagnosis of Acute Compartment Syndrome has completed peer review and is entering the public commentary stage. To receive instructions on how to provide comments on the document, contact Mary DeMars at The period of public commentary will be open until Friday, Nov. 9.


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