October 10, 2018
Today’s Top Story

Study: Increased FRAX Score May Predict Vertebral Fractures in Multiple Myeloma Patients

A retrospective study published online in the journal Bone found that an elevated Fracture Risk Assessment Tool (FRAX) score was predictive of vertebral fracture in patients with multiple myeloma Researchers collected data from patients (median age, 61 years) enrolled in Total Therapy Protocols (TT4 and TT5) between August 2008 and September 2017. They calculated FRAX scores and obtained baseline PET and MRI imaging For TT4 patients (low-risk myeloma), the median major osteoporotic score (MOS) was 5.6 compared to 6.2 for TT5 patients (high-risk myeloma). The median hip fracture score (HFS) for TT4 patients and TT5 patients was 0.5 and 0.7, respectively. Patients with increased MOS (> 2) and HFS (> 4.5) were at an increased risk for fracture diagnosis.

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Other News

Sports Medicine Licensure Clarity Act Signed Into Law

On Friday, President Donald Trump signed into law the Sports Medicine Licensure Clarity Act, which protects traveling physicians and allows traveling athletes to be treated by healthcare professionals who are familiar with their medical history. AAOS has supported this legislation since 2015. AAOS President David A. Halsey, MD, said the bill’s passage “represents years of hard work trying to get it across the finish line, and it is a significant win—not only for practicing sports medicine professionals, but also for the large percentage of orthopaedists involved in the treatment and care of sports-related injuries.”

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Study: Chronic Low Back Pain and Lumbar Deformities are More Common in Parkinson’s Disease Patients

An observational study published online in the European Spine Journal found that patients with Parkinson’s disease (PD) may be at an increased risk of low back pain (LBP) and lumbar degeneration. Researchers assessed LBP in 97 PD patients and 97 controls using the Oswestry Low Back Pain Disability Questionnaire and visual analog scales. LBP was more common among PD patients than controls (87.6 percent versus 62.6 percent, respectively), with longer duration and higher pain intensity. Higher PD stages and motor scores were associated with pain intensity and disability scores. Of the PD patients with LBP, 79.6 percent had lumbar arthrosis, 38.8 percent had scoliosis, and 24.1 percent had spondylolisthesis. Many PD patients with LBP did not receive specialized orthopaedic treatment.

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Study Identifies Optimal Viewing Angles to Identify Screw Penetration in Proximal Humeral Fractures

A study published online in BMC Musculoskeletal Disorders found that in order to minimize primary screw penetration during surgery for proximal humeral fractures, the best viewing angle may be a zero degree to 10 degree axillary view with 30 degree abduction combined with two horizontal angles in the range of –30 degrees to –10 degrees and 10 degrees to 35 degrees for routine fluoroscopy during surgery. Three fresh-frozen human cadaveric bodies with six intact shoulders were put in the beach chair position with PHILOS plates on the proximal humerus. In the coronal plane, angles between zero degrees and 10 degrees allowed researchers to see all screws except numbers eight and nine, which were identified in the horizontal plane from 30 degrees to –10 degrees and 10 degrees to 35 degrees, respectively.

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Study Examines Dislocation Risk Factors and Treatment Options after rTHA

A literature review published online in the Journal of Orthopaedics and Traumatology found that the use of a larger femoral and acetabular component, elevated rim liner, and dual mobility implants may reduce the risk of dislocation following revision total hip arthroplasty (rTHA). Researchers reviewed 33 articles to identify risk factors for dislocation. In addition to the use of larger prosthetic components, constrained bearing inserts may be used as a salvage procedure because, while they reduce the rate of dislocation, they do not reduce the rate of re-revision. Although using certain components intraoperatively may minimize risk, patient-related risk factors such as abductor deficiency, a history of instability, and complex acetabular defect, should also be considered and evaluated prior to surgery.

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Study Details How to Improve RTS Rates in Young Athletes with Shoulder Instability

According to research presented at the American Orthopaedic Society for Sports Medicine 2018 Annual Meeting, reserving arthroscopic shoulder stabilization for athletes with three or fewer episodes of preoperative instability resulted in high return-to-sport (RTS) rates and low revision surgery rates for athletes aged younger than 22 years old. High-risk athletes who had four or more instability episodes should be considered for open surgery. When significant bone loss and bipolar lesions occur, bone augmentation surgery can be performed. The findings emphasized the importance of preoperative evaluations.

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ResStudy Provides Residents with More Than 3,700 Questions to Advance Learning

ResStudy now offers more exclusive content for residents, with questions from six years of Orthopaedic In-Training Examinations, Orthopaedic Knowledge Update self-assessment examinations, and multiple Special Interest Exams across 11 topics. Residents have access to more than 3,700 questions from AAOS self-assessment exams available exclusively on ResStudy, which is now accessible on the new AAOS online learning platform, with a mobile-friendly and highly visual interface.

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