October 9, 2019
 
Today’s Top Story

Study: Factors that Influence Upper Femur Anatomy

A study published in the October issue of The Journal of Arthroplasty found that age and sex may be directly related to variations in anatomical parameters of the proximal femur. The study included the pelvis and bilateral femora of 628 healthy patients (mean age, 61.5 years; 394 were male). Patients underwent evaluation via a three-dimensional CT scan-based system using algorithm-calculated landmarks. Demographic parameters taken into consideration were age, sex, body mass index (BMI), and ethnicity. Researchers calculated each patient’s neck-shaft angle (NSA), femoral neck version, femoral offset (FO), and femoral canal flare index (fCFI). The mean NSA was 124.7 degrees, femoral neck version was 14.5 degrees, FO was 42.9 mm, and fCFI was 3.4. Females had more valgus and anteverted hips. Upon multivariate analysis, older patients had lower NSA and fCFI and higher FO. There was no association between ethnicity or BMI and any of the measured parameters.

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In Other News

Study Analyzes Elbow Hemiarthroplasty Outcomes

A study published in the Oct. 1 issue of the Journal of the AAOS observed two-year outcomes for patients who underwent hemiarthroplasty of the elbow for post-traumatic arthritis. Between 2002 and 2012, 16 elbows were treated and followed for at least two years or until revision surgery. Primary outcome measures were pre- and postoperative Mayo Elbow Performance Score (MEPS), complications, and revisions. Mean age at surgery was 45 years, and all patients had a history of at least one prior elbow surgery. At follow-up (average, 51 months), five patients had undergone additional surgery; two patients underwent total elbow arthroplasty (TEA). Among the surviving implants, range of motion significantly improved from preoperatively to follow-up. Of the patients who were not revised to TEA, MEPS included five excellent results, three good results, five fair results, and one poor result.

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Study Finds No Impact of Lower-extremity TJA on Shoulder Arthroplasty

According to a study published online in the Journal of Shoulder and Elbow Surgery, patients who underwent total joint arthroplasty (TJA) and shoulder arthroplasty did not have different outcomes compared to patients who only underwent shoulder arthroplasty, regardless of the order in which the surgeries were performed. Using Kaiser Permanente’s shoulder arthroplasty registry, researchers identified 4,751 shoulder arthroplasties performed between 2009 and 2015. Of the total cases, 1,285 (27 percent) underwent TJA before shoulder surgery, and 483 (10.2 percent) underwent TJA after shoulder surgery. There were no differences in all-cause shoulder revision risk in patients who underwent TJA before or after shoulder arthroplasty compared to those who only underwent shoulder surgery.

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Study: How do Orthopaedic Foot and Ankle Surgeons Discuss Smoking with Patients?

A study published in the September/October issue of Current Orthopaedic Practice found that most orthopaedic foot and ankle surgeons consider smoking cessation important for reducing perioperative complications and improving outcomes. Members of the American Orthopaedic Foot and Ankle Society were contacted via email to complete an anonymous survey. A total of 785 surgeons participated; the number of questions answered varied among respondents depending on how previous questions were answered. Of 774 surgeons, 708 (91.5 percent) reported worse outcomes in smokers. About 60 percent (n = 437/724) of surgeons said they counseled all smoking patients, and 96.5 percent (n = 696/721) counseled patients when planning surgery. Most (n = 616/778, 79.2 percent) said they would deny or delay surgery in patients using tobacco. Half (n = 321/648, 49.5 percent) said they do not check systemic nicotine levels preoperatively, 50 (7.7 percent) always check before surgery, 57 (8.8 percent) check infrequently, and 34 percent check only rarely or occasionally.

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A Quarter of Healthcare Spending Attributable to Waste

According to a report published online in JAMA, the cost of waste in the U.S. healthcare system may be between $760 billion and $935 billion, constituting about 25 percent of total healthcare spending. With waste-reduction interventions, the researchers projected an estimated savings between $191 billion and $282 billion.

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AAOS Now

Gain Actionable Insights for Your Quality Practices

Having insight means developing deeper understanding, which is exactly how AAOS practice performance tools can add value to your practice and improve the quality of your patient care. AAOS provides the resources you need to stay current with the latest evidence-based orthopaedic practices, as well as comparative data to help measure and assess your performance. Some of the tools, which are outlined in this article, include the AAOS RegistryInsights ®, AAOS Registry Program, and quality resources.

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Your AAOS

AAOS Board Approves New AUC for the Diagnosis and Management of Acute Compartment Syndrome

The AAOS Board of Directors has approved new appropriate use criteria (AUC) for the Diagnosis and Management of Acute Compartment Syndrome. This AUC is presented via an online diagnostic tool and includes treatment recommendations for adults suspected of extremity acute compartment syndrome without evidence of irreversible damage. The new AUC supports an existing AAOS clinical practice guideline, “Management of Acute Compartment Syndrome.”

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