October 4, 2019
Today’s Top Story

Study Evaluates Association Between Quadriceps Muscle Strength and Knee Pain in Gait Function after TKA

A study published in the October issue of the American Journal of Physical Medicine & Rehabilitation observed a correlation between objective performance-based physical function, self-reported physical function, quality of life, and gait function one month after unilateral total knee arthroplasty (TKA). Data for 195 unilateral primary TKA patients were analyzed for the following: isometric knee extensor and flexor strength of both knees; gait parameters; six-minute walk test; timed up-and-go test; timed stair-climbing test; knee flexion and extension range of motion (ROM) of surgical knee; Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and functional levels; EuroQol five-dimensions questionnaire; and visual analog scale (VAS) for knee pain. Bivariate analyses yielded a significant positive correlation between postoperative gait speed and endurance and postoperative peak torque of the extensor and flexor of both knees, cadence, and stride length, as well as a significant negative correlation with timed up-and-go; stair-climbing test ascent; stair-climbing test descent; VAS scale; and WOMAC pain, stiffness, and functional levels. Linear regression analyses observed a correlation between postoperative peak torque of the extensors of both knees, as well as VAS for knee pain and postoperative gait speed and endurance.

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In Other News

Study: Internal Fixation for Femoral Neck Fracture Treatment in Older Patients

The use of internal fixation in older patients with nondisplaced or minimally displaced femoral neck fractures may have a high complication rate, according to a systematic review published online in Injury. Researchers queried PubMed, Embase, and CENTRAL databases for relevant studies on patients aged 60 years or older with nondisplaced or minimally displaced (Garden I or II) femoral neck fractures who were treated with internal fixation. The primary outcome measure was reoperation, and other outcomes included mortality, patient-reported outcomes, hospital length of stay, infection, and transfusions. The search yielded 27 relevant studies that reported outcomes for 21,155 patients who underwent internal fixation. The pooled reoperation risk was 14.1 percent, and one-year mortality risk was 14.6 percent based on the reporting in 15 studies.

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Study: Long-term Reoperation Rates for Lumbar Herniated Intervertebral Disk Disease

A study published in the Oct. 1 issue of Spine observed no significant differences in 10-year reoperation rates among lumbar herniated intervertebral disk disease (HIVD) patients who received varying surgical techniques. Long-term reoperation rates were evaluated for patients who received open diskectomy, laminectomy, percutaneous endoscopic lumbar diskectomy, and fusion using data from the National Health Insurance Service-National Sample Cohort of Republic of Korea. A total of 1,856 patients were included and followed for eight to 10 years. The overall cumulative incidence of reoperation was 4 percent at one year, 6 percent at two years, 8 percent at three years, 11 percent at five years, and 16 percent at 10 years. After 10 years, the cumulative reoperation incidences based on surgical technique were: open diskectomy, 16 percent; laminectomy, 14 percent; percutaneous endoscopic lumbar diskectomy, 16 percent; and fusion, 10 percent. The distribution of reoperation types varied largely based on the first surgical technique. Open diskectomy was used in 80 percent of reoperation patients after open diskectomy and 81 percent after percutaneous endoscopic lumbar diskectomy.

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Study Analyzes Different Outcome Measurements after Rotator Cuff Repair

A retrospective study published online in the Journal of Shoulder and Elbow Surgery compared outcomes for primary rotator cuff repair (RCR) as reported by the Single Assessment Numeric Evaluation (SANE) score versus the American Shoulder and Elbow Surgeons (ASES) score and Western Ontario Rotator Cuff (WORC) index score. Between 2010 and 2017, a single surgeon performed primary RCR on 333 patients. Preoperative SANE, ASES, and WORC index scores were reviewed. Patients were followed for a mean 37.5 months. The SANE and ASES scores were significantly correlated in the preoperative and one-year follow-up periods, as were the SANE and WORC index scores. Stratification analysis observed that correlations between SANE scores and ASES and WORC index scores were significant when patients were stratified by sex, age, cuff tear size, and workers’ compensation status.

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FDA and DEA Warn Against Illegal Online Opioid Sales

The Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) sent four joint letters to online networks in charge of 10 websites that illegally sell unapproved and misbranded versions of opioid medicines. The letters called on the networks to immediately terminate sales. The networks that received warning letters are Divyata, Euphoria Healthcare Pvt Ltd., JCM Dropship, and Meds4U.

Read the FDA press release…


Study Evaluates Nonsurgical Treatment for Incomplete Fractures after Low-velocity Gunshot Wounds

A study published in the Sept. 15 issue of the Journal of the AAOSS (JAAOS) found that nonsurgical management of incomplete fractures of the femur caused by low-velocity gunshot wounds (GSWs) is the appropriate course of treatment. Final analysis included 46 patients with incomplete, nondisplaced femur fractures and an average follow-up of 36 months. The study’s lead investigator, Mai P. Nguyen, MD, said the clinical takeaway of the study is that patients with incomplete femur fractures from low-velocity GSWs can avoid surgical intervention and advance to “weight-bearing as tolerated” at six weeks post-injury.

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Read the JAAOS article…


Final Call: Nominate a Story for the 2020 Media Orthopaedic Reporting Excellence (MORE) Awards

Have you been quoted in a news article or interviewed by a consumer radio or television outlet? Did you know the Academy recognizes members of the media for accurate orthopaedic reporting via its MORE Awards? This program recognizes journalists and media outlets for stories published between Oct. 1, 2018, and Oct. 1, 2019, that effectively report on musculoskeletal health issues, healthy behaviors, high-quality care, and prevention and treatment of orthopaedic issues or injuries. Send a link to the story to media@aaos.org and staff will follow up. The last day to submit nominations is Oct. 8, at 5 p.m. C.T.

Learn more and submit nominations…


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