September 11, 2019
 
Today’s Top Story

Study Measures Risk of Subsequent Arthroplasties in TKA and THA Patients with Osteoarthritis

Patients who undergo total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis (OA) may be more likely to undergo further arthroplasties in the future, according to a study published online in Clinical Orthopaedics and Related Research. The Osteoarthritis Initiative project was used to collect data on 332 primary TKA patients and 132 THA patients who underwent surgery for OA. Mean follow-up was four years After eight years, the cumulative incidence of contralateral TKA after the index TKA was 40 percent, and the incidence of any THA after TKA was 13 percent. The cumulative contralateral THA incidence after index THA was 8 percent, and the incidence of any TKA after THA was 32 percent. Contralateral TKA risk factors included younger age and loss of medial joint space width with a varus deformity.

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In Other News

Study Compares Treatment Techniques for Acromioclavicular Dislocation

In a study published online in the Journal of Shoulder and Elbow Surgery, researchers compared arthroscopic and open repair in acromioclavicular joint dislocation III and IV. A total of 52 patients were randomized to an arthroscopic repair group (ARG) or open repair group (ORG). Clinical outcomes included Constant-Murley Score (CMS), visual analog scale (VAS) score, and coracoclavicular (CC) distance, which were measured preoperatively and at three months, six months, one year, and two years postoperatively. Both groups had similar CMS preoperatively (ARG, 40.68 versus ORG, 40.70) and two years postoperatively (84.18 versus 84.45, respectively). One day postoperatively, VAS scores in the ARG and ORG were 60.59 and 64.50, respectively, decreasing to 18.04 and 17.87, respectively, after six months. Preoperative CC distance was 29.27 mm in the ARG and 28.16 mm in the ORG and decreased to 9.86 mm and 10.54 mm, respectively, one day after surgery. Surgical time was significantly longer in the ARG (80 minutes) compared to the ORG (52.79 minutes), and cost of consumables was significantly higher in the ARG ($1,729.95) than the ORG ($851.87)

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Study Observes Association between Wedge-shaped Vertebrae and Upper Lumbar Disk Herniation

According to a retrospective study published online in the Journal of Orthopaedic Surgery and Research, wedge-shaped vertebrae (WSV) may be a risk factor for symptomatic upper lumbar disk herniation (ULDH). The study matched 65 ULDH patients to 65 lower lumbar disk herniation (LLDH) patients. WSV incidence was greater in the ULDH group (n = 29, 44.6 percent) than the LLDH group (n = 14, 25.1 percent). There were significant between-group differences in WSV, wedging angle of the vertebrae (WAV), and thoracolumbar kyphotic angle (TL). WAV and TL were independently associated with ULDH.

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Study Compares Characteristics of Thumb Carpometacarpal OA Patients Undergoing Operative or Nonoperative Care

According to a cross-sectional study published online in Clinical Orthopaedics and Related Research, patients waiting to undergo surgery for thumb carpometacarpal (CMC-1) OA may have significantly poorer symptoms and psychological profiles and higher expectations compared to CMC-1 OA patients not scheduled for surgery. Patients were stratified into two groups: surgery (n = 208) and nonsurgery (n = 376). Compared to those receiving nonoperative treatment, surgery patients had longer symptom duration; had higher pain, treatment credibility, and expectations; and more often received a second opinion, as well as had worse hand function, satisfaction, health-related quality of life, illness perception, and pain catastrophizing. When adjusting for sociodemographic, clinical, and psychological factors, the following were associated with surgical treatment: longer symptom duration, second opinion visit, lower hand satisfaction, higher treatment expectation, and worse personal control and emotional response.

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Study Evaluates Efficacy of 70-degree Arthroscope in Tennis Elbow

A retrospective study published in the September issue of the Journal of Shoulder and Elbow Surgery found that the use of 70-degree arthroscope in arthroscopic débridement for chronic recalcitrant tennis elbow may not be beneficial. Among 68 consecutive patients who underwent treatment, a 30-degree scope was used in 41 patients and an additional 70-degree scope was used in the other 27. Outcomes included VAS for pain and the Quick Disabilities of the Arm, Shoulder and Hand (quickDASH) questionnaire at three, six, and 12 or more months post-surgery. Both groups had significant improvements in VAS pain and quickDASH scores at all timepoints, but there were no significant between-group differences. The proportion of patients with excellent outcomes and clinically meaningful improvements was similar in both cohorts.

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AAOS Now

September AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the September 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 a study that observed a high prevalence of depression in shoulder surgery patients; an interview with Manny Sethi, MD, who is running for an open U.S. Senate seat; and more information from the 2018 Orthopaedic Practice in the United States survey.

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Your AAOS

Call for Content: Submit an Article for AAOS Now

Do you have timely research or an interesting story to tell? AAOS Now is seeking editorial submissions from orthopaedic surgeons and orthopaedic- and practice-related product and service providers that qualify as subject matter experts. The magazine features various formats and opportunities to highlight your information or topic. AAOS Now encourages interested authors to contact staff prior to writing in order to review suggestions and provide feedback. Submit an article suggestion online or email AAOS Now Publisher Dennis Coyle at coyle@aaos.org.

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