October 14, 2019
 
Today’s Top Story

Study: Risk Factors Associated with ACL Injury at Time of Anterior Tibial Spine Fractures

A study published in the October issue of the Journal of Pediatric Orthopaedics identified prevalence, demographics, and characteristics of pediatric patients who sustained an anterior tibial spine fracture (ATSF) at the time of anterior cruciate ligament (ACL) injury. Data were collected on 129 ATSF patients aged > 16 years, including age, sex, injury mechanism, ATSF type, MRI evaluation, treatment modality, ACL injury, and concomitant meniscal/chondral injuries. ACL injury presence was determined via MRI or intraoperatively. Among the ATSF patients, 19 percent (n = 25) had concomitant ACL injury. ACL injury was significantly more likely to occur in patients with type II or III ATSF than type I ATSF. Patients with ATSF and concomitant ACL injury were significantly older and more likely to be male. There was no association between ATSF injury mechanism and ACL injury. ACL injury detection sensitivity was low for preoperative MRI relative to intraoperative assessment. Additional meniscal or chondral injury was present in half of patients with ATSF and concomitant ACL injury.

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In Other News

Study: Frailty Index Predicts Short-term Functional Recovery in Hip Fracture

The 19-item modified Frailty Index (mFI) could be a useful tool to forecast short-term functional recovery in hip fracture patients, according to a study published online in Injury. Operative hip fracture patients were retrospectively analyzed for the main exposure of frailty defined by the mFI. The primary outcome was functional recovery, per the motor-Functional Independence Measure (FIM) score, and other considerations included postoperative complication and discharge disposition. Final analysis included 274 patients (mean age, 837 years; 80.7 percent were female). Patients with higher mFI scores had lower functional recovery, lower efficiency per the motor-FIM score, and higher likelihood for complications and not being discharged to home. Multiple logistic regression analyses yielded a significant correlation between higher mFI score and increase likelihood of lower functional recovery, postoperative complication, and not discharging to home.

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Study Assesses Cost Awareness of Shoulder Surgeons

Shoulder surgeons performing rotator cuff repairs (RCRs) are aware of the costs of their practice and may be willing to change their practice to decrease costs, according to a study published online in the Journal of Shoulder and Elbow Surgery. Participants completed a 21-item survey distributed through the email list services of the American Shoulder and Elbow Surgeons and Arthroscopy Association of North America. Pertinent data included demographics; RCR variables, including technique, number of companies used, and procedures per month; and knowledge of costs. A total of 345 surgeons from 23 countries responded; most (89 percent) were from the United States. Of the 70.7 percent (n = 275) of surgeons who identified as “cost-conscious,” 62.9 percent would be willing to switch suture anchor brands to lower costs if incentivized. The cost-conscious cohort was more likely to have received their fellowship training in shoulder and elbow (51.8 percent versus 38.5 percent), be paid based on productivity (73.5 percent versus 61.4 percent), and receive shared profits (854 percent versus 75.0 percent).

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Study Finds Race-based Differences in Bone Histomorphometry Among Dialysis Patients

Young black patients who undergo dialysis may have greater cortical thickness compared to white patients, according to a study published in the October issue of Bone. A total of 52 black and white young adult dialysis patients were age- and sex-matched 1:1. There were no significant between-group differences in turnover, mineralization, and volume parameters in trabecular bone. When patients were stratified by renal osteodystrophy type, white patients had twice the rate of mineralization defects. Black patients had shorter osteoid maturation time and lower osteoid volume. When controlling for trabecular turnover and mineralization, black patients had 36.2 percent greater cortical thickness than white patients.

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Global Orthopaedic Device Market to Top $55 Billion by 2025

A report from Global Market Insights predicted that the global orthopaedic device market will surpass $55 billion by 2025, driven largely by the increasing older population and greater prevalence of degenerative bone diseases. The U.S. orthopaedic device market comprised the largest share of the global market in 2018 and is predicted to grow 2.4 percent through 2025. With joint replacements becoming more common and decreasing in cost, the global joint reconstruction market is predicted to reach $22.4 billion by 2025.

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AAOS Now

Osteoporosis and Fragility Fractures: Reinvigorating a National Public Health Priority

On May 15, the Senate Special Committee on Aging issued a Request for Information on reducing the risk of falls and fall-related injuries and prominently cited the impact of hip fractures following falls. The Fragility Fracture Alliance, which AAOS launched in 2014 and has grown to include many other clinical professional organizations, responded, affirming the significance of this public health issue and making recommendations to improve the care of those who have experienced falls, fall-related injuries, and fragility fractures.

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Your AAOS

Free Surgical Risk Reduction Toolkit

The best way to improve patient outcomes and help patients have a successful recovery from surgery is to avoid the complications that may lead to increased length of stay, hospital readmission, and multiple operations. Get equipped with quick reference strategies to mitigate preoperative, intraoperative, and postoperative risk factors that may contribute to surgical complications with the free Surgical Risk Reduction Toolkit.

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