October 16, 2019
Today’s Top Story

Study Analyzes Long-term Impact of Obesity on THA Outcomes

Obese patients who undergo total hip arthroplasty (THA) may have lower postoperative satisfaction rates and walking capacity 10 years after surgery, according to a study published online in The Journal of Arthroplasty. THA patients were stratified into two groups: nonobese (body mass index [BMI] < 30 kg/m 2) and obese (BMI ≥ 30 kg/m 2). Preoperative numerical pain rating and Oxford Hip Scores were recorded; these assessments, as well as the six-minute walk test and Likert satisfaction scale, were all conducted at three months, one year, five years, and 10 years postoperatively. Final analysis included 191 patients. Hip pain and function did not significantly differ between the groups. At 10-year follow-up, obese THA patients had poorer walking capacity, lower satisfaction, and more walking aid use.

Read the abstract…

In Other News

Study: Low TXA Utilization Rate in Shoulder Arthroplasty Despite Improved Outcomes

According to a study published in the Oct. 1 issue of the Journal of the AAOS, tranexamic acid (TXA) is not widely utilized in shoulder arthroplasty, but when it is, it may reduce transfusion risk. National claims data spanning 2010 to 2016 were used to evaluate 82,512 shoulder arthroplasty patients who were stratified into two groups based on whether they did (n = 10,582) or did not receive perioperative TXA. Associations between TXA and blood transfusion risk, combined complications (including thromboembolic events, acute renal failure, cerebral infarction, and acute myocardial infarction), and hospital length of stay (LOS) and cost were all analyzed. The use of TXA strongly increased over time. In adjusted analyses, the use of TXA compared to no TXA reduced transfusion risk by 36 percent; the combined risk for complications was reduced by 35 percent. LOS decreased by 6.2 percent with TXA use, but hospitalization costs did not change.

Read the abstract…

Study Measures Rate of Substantial Sacroiliac Joint Degeneration in Healthy Patients

A study published online in the European Spine Journal determined factors associated with substantial degeneration of the sacroiliac (SI) joint in healthy adults undergoing comprehensive medical checkups. A total of 553 healthy middle-aged adults underwent two comprehensive health screenings (including blood tests and whole-body CT scan) at an interval of 5.9 years. Factors associated with joint degeneration, the relationship of the laterality of degeneration between the SI and L4/5 facet joint, L5/S facet joint, and the natural course of SI joint degeneration over time were assessed. At the first screening, 70 (12.7 percent) patients presented type 2 or 3 degeneration of the SI joints. Per multivariate analysis, risk factors for SI joint degeneration included female sex; pubic symphysis degeneration, L4/5, and L5/S facet joint degeneration; high BMI; and several blood parameters. Laterality of SI joint degeneration was much more common than that of L4/5 or L5/S facet joint degeneration. After 10 years, the progression rate of SI joint degeneration from no degeneration to substantial degeneration was 3.4 percent and for progression from slight degeneration was 35.5 percent.

Read the abstract…

Study Determines Usefulness of Ultrasonography in Identifying Deltoid Ligament Disruption

A study published online in Foot & Ankle International found that ultrasonography may be an accurate tool in the analysis of deltoid ligament disruption. Eligible patients had a nondisplaced or minimally displaced fibula fracture identified on a standard radiograph and underwent gravity stress radiography and ultrasonography. The layer type, integrity, and tear site of the deltoid ligament were all evaluated. Final analysis included a consecutive series of 81 patients, of whom 64 (79 percent) had a deltoid ligament disruption. The majority of tears were partial, with only eight (12.5 percent) complete tears. The mean medial clear space value among intact deltoid ligaments was 2.7 mm compared to 5.9 mm in deltoid ligament tears. The ultrasonography exhibited 100 percent sensitivity, 90 percent specificity, 97 percent positive predictive value, and 100 percent negative predictive value in the deltoid ligament assessment; in comparison, the respective gravity radiography values were 97 percent, 100 percent, 100 percent, and 90 percent.

Read the abstract…

Proposed Accounting Rule Could Severely Impact Hospitals’ Debt Ratios

Hospital leaders criticized an accounting rule proposed by the Financial Accounting Standards Board (FASB). According to FASB, the rule in question, Topic 470, would streamline current debt classification principles and address criticism from stakeholders who have said the current process is overly complicated. By current standards, variable-rate debt obligations (VRDOs) can be considered long-term obligations, assuming they are remarketed or have long-term credit letters. The new rule would no longer allow VRDOs to be considered current.

Read more…(login may be required)

Read the proposed rule…


October AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the October issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue includes key changes in the Centers for Medicare & Medicaid Services’ proposed payments rule for fiscal year 2020, an analysis of the best treatment for full-thickness osteochondral defects, and part two of a two-part series on the use of low-level laser therapy for musculoskeletal pain.

Read more…


Apply for Volunteer Opportunities

Consider applying for the following positions:

  • Foot and Ankle Content Committee member position—applications are accepted until Oct. 18
  • Medical Liability Committee member position—applications are accepted until Oct. 21
  • Medical Liability Committee chair position—applications are accepted until Oct. 21
  • Research Development Committee member-at-large position—applications are accepted until Oct. 22
  • Liaison Activities member position (alternate delegate: house of delegates)—applications are accepted until Oct. 25
  • Diversity Advisory Board chair position—applications are accepted until Oct. 28

Learn more and submit applications…(member login required)


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