October 29, 2018
Today’s Top Story

Study: Role of Frailty in Primary and Revision THA Outcomes

Patient frailty increased mortality and perioperative complications following primary and revision total hip arthroplasty (THA), according to a study published online in The Journal of Arthroplasty. The study included 6,502 primary THA patients and 2,138 revision THA patients (median age, 68 years). Overall, 22.7 percent were classified as frail, 32.9 percent as vulnerable, and 44.4 percent as nonfrail. Frail patients were more likely to be female, older, and sicker, and received more general anesthesia. Frail patients had increased risks of wound complications/hematoma and reoperation while in the hospital compared with nonfrail patients. At 90 days and one year, frail patients had greater risks of mortality, infection, dislocation, wound complications/hematoma, and reoperation. The researchers found no significant associations with aseptic loosening, periprosthetic fracture, or heterotopic ossification.

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Other News

Study: Biofeedback May Be Effective in Postoperative TKA Patients

A literature review published online in Knee Surgery, Sports Traumatology, Arthroscopy found that biofeedback could positively influence clinical outcomes in total knee arthroplasty (TKA) patients. Researchers used Embase, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials to identify 11 studies: seven randomized, controlled studies; three cohort studies; and one cross-sectional study. The studies included 416 unilateral TKA patients; the average number of patients per study was 37.8. Nine of the 11 studies reported significant improvement in activity scores or pain, and two found that biofeedback had no significant impact on outcomes. Biofeedback devices used in the studies included a goniometer, force plate, balance board, treadmill, and/or electromyography. Visual biofeedback was more common than audio. Five of six methods displayed potential for improving mobility and decreasing pain.

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Study: Positive Outcomes of Synthetic Polytetrafluoroethylene Patch Use in Irreparable Rotator Cuff Tear Repair

In a retrospective cohort study published online in The American Journal of Sports Medicine, patients with irreparable rotator cuff tears had positive clinical outcomes when treated with a synthetic polytetrafluoroethylene patch to bridge the tear. Researchers assessed 58 patients with a synthetic patch inserted as an interposition graft for large and/or irreparable rotator cuff tears. Shoulder pain, function, range of motion, and strength were assessed preoperatively and at six weeks, 12 weeks, six months and a minimum of two years postoperatively. At mean 36-month follow-up, 90 percent of patches (n = 53) were still in place. Three patches failed at the patch-tendon interface, and one patient (two shoulders/patches) required reverse total shoulder replacements. At six months, patient-ranked shoulder stiffness, frequency of pain with activity and sleep, level of pain at rest and overhead, and overall shoulder function improved from bad to very good. At minimum two-year follow-up, the most significant strength increases were supraspinatus and external rotation. The greatest improvement in passive range of motion occurred between 12 months and final follow-up.

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New Medicare Payment Model Bases Drug Prices on International Prices

The Trump administration unveiled an Advance Notice of Proposed Rulemaking that requests for information on a model that may lower drug prices, making them comparable to those of other advanced countries. Physicians will also be paid a flat fee for administering Medicare Part B prescriptions, rather than a percentage of the drug’s price. The plan could save Medicare beneficiaries and the government an estimated $17.2 billion over five years. AAOS is reviewing these proposals and will comment.

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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 demars@aaos.org. The period of public commentary will be open until Friday, Nov. 9.


Orthopaedic Surgeon by Day, Rock Star by Night

After Foo Fighters frontman and former Nirvana drummer Dave Grohl sustained an ankle fracture during a performance in 2015, he followed up with orthopaedic surgeon Lew Schon, MD, FACS, of the Department of Orthopaedic Surgery at MedStar Union Memorial Hospital in Baltimore. Mr. Grohl later invited Dr. Schon, also a musician, to perform onstage with the band at Boston’s Fenway Park. Dr. Schon discussed his time in the spotlight, friendship with Mr. Grohl, and love of music.

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AAOS Announces Launch of Shoulder and Elbow Registry

AAOS announced the launch of its Shoulder and Elbow Registry (SER) to collect data on shoulder and elbow surgeries nationwide. In 2019, the SER will expand from collecting total shoulder arthroplasty procedures to include rotator cuff repair and total elbow arthroplasty procedures data.

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