November 8, 2019
 
Today’s Top Story

Study: Impact of Nuisance Symptoms in TJR on Patient Satisfaction

A study published online in The Journal of Arthroplasty found that while nuisance symptoms may be common among total joint replacement (TJR) patients, they do not significantly impact patient satisfaction. TJR patients were surveyed one year postoperatively about the prevalence of common nuisance symptoms (localized pain, swelling, instability, and stiffness) and their impact on patient satisfaction using a 10-point visual analog scale (VAS). Results from 545 TJR patients were included: 335 knees (61 percent) and 210 hips (39 percent). Among knee patients, the most common nuisance symptoms and their effect on satisfaction were difficulty kneeling (78.2 percent, VAS 4.3), limited ability to run/jump (71.6 percent, VAS 3.3), and numbness around incision (46.3 percent, VAS 3.8). One year postoperatively, 94 percent of knee patients reported at least one nuisance symptom and a mean satisfaction of nine out of 10. Among hip patients, the most common nuisance symptoms and their effect on satisfaction were limited ability to run/jump (68.6 percent, VAS 3.4), thigh muscle pain (44.8 percent, VAS 3.0), and limping when walking (37.6 percent, VAS 4.1). One year postoperatively, 88 percent of hip patients reported at least one nuisance symptom and a mean satisfaction of 8.9 out of 10.

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In Other News

Study Compares Metallic versus Biodegradable Suture Anchors in Rotator Cuff Repair

A study published online in BMC Musculoskeletal Disorders observed no significant differences between single row arthroscopic rotator cuff repair (RCR) using metallic versus biodegradable suture anchors for rotator cuff tears < 5 cm. A total of 110 arthroscopic RCR patients were stratified into two groups: metal suture (group 1, n = 51) and biodegradable suture anchors (group 2, n = 59). Patients were followed up at a mean 4.05 years. Groups 1 and 2 did not have significantly different mean modified University of California, Los Angeles shoulder score (26.9 versus 27.7), mean Wolfgang score (13.3 versus 14.0), or mean Oxford Shoulder Score (23.7 points versus 20.7 points). The mean active anterior elevation was 163.5 degrees in group 1 and 163.6 degrees in group 2, and the mean active external rotation was 46.0 degrees and 446 degrees, respectively. The mean strength in anterior elevation was 48.02 N in group 1 and 43.12 N in group 2; the mean strength in external rotation was 48.02 N and 46.06 N, respectively; and the mean strength in internal rotation was 67.62 N and 68.60 N, respectively.

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Study: Association Between Arterial Calcifications on Hand Radiographs and Coronary Artery Disease

A study published online in The Journal of Hand Surgery observed that patients with coronary artery disease (CAD) may be more likely than patients without CAD to present arterial calcifications on hand radiographs. Patients with hand radiographs and CAD screening from a single institution were reviewed, excluding patients with chronic kidney disease, end-stage renal disease, or incomplete hand films. Patients were stratified into two groups: CAD (n = 155) and no CAD (n = 55). Mean age of the total cohort was 72 years, body mass index was 28.8 kg/m 2, and 54 percent of the cohort was male. Comorbidities included hypertension (91 percent), hyperlipidemia (87 percent), diabetes (39 percent), cerebrovascular accident (9 percent), and history of tobacco use (53 percent). A higher proportion of CAD patients had arterial calcifications on hand radiographs (43 percent) than non-CAD patients (11 percent). When controlling for confounding factors, arterial calcifications on hand plain films was associated with a 6.2-fold increased risk for CAD.

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Study Evaluates Spinal Trauma in Cambodia

A study published in the October issue of the Journal of the AAOS Global Research & Reviews evaluated the epidemiology and outcomes of spinal trauma at a hospital in Cambodia. Researchers collected patient demographics, American Spinal Injury Association (ASIA) score on presentation, injury location, and cause of injury for 316 patients. Outcomes included hospital length of stay (LOS) and surgical intervention. The leading causes of spinal injury were falls (50.6 percent), motor vehicle accidents (29.3 percent), and other accidents (20.1 percent). Falling from height was associated with higher surgery rates, and ASIA scores were worse for men. Mean age was younger among ASIA A–C patients (3817 years) than D–E patients (42.88 years). Cervical spine injuries were most likely to be caused by motor vehicle accidents, and falls were most significantly correlated with thoracic and lumbar trauma. Younger, working men had the most significant risk for severe spinal injury, more surgery, and longer LOS.

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Stryker Purchases Wright Medical Group

Stryker is purchasing Wright Medical Group for approximately $5.4 billion. This tops the last large purchase made by Stryker, when it bought K2m Group Holdings Inc., last year for $1.4 billion. The latest deal is set to close during the second half of 2020. This marks one of the most significant medical deals of the year.

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AAOS Now

Are We Inclusive or Exclusive?

This article is part one in a three-part series of interviews seeking recommendations to make orthopaedics more open and inclusive. Julie Balch Samora, MD, PhD, interviewed eight members of the LGBTQ (lesbian, gay, bisexual, transgender, and queer [or questioning]) community at various stages of their orthopaedic careers to glean an understanding of not only their individual experiences but also how the orthopaedic community can make the environment more welcoming, diverse, and inclusive.

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Your AAOS

Register for the AAOS Annual Meeting

The AAOS Annual Meeting is where trusted leaders in advancing musculoskeletal health meet. No other meeting delivers the opportunity to engage in excellence across education, innovation, and collaboration all at one time, in one place. Join the Academy in Orlando, Fla., March 24–28, 2020, and create a unique experience customized to your specialization and education needs. Register now.

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