September 6, 2019
Today’s Top Story

Study Identifies Predictors of Revision in Young THA Patients

According to a study published online in BMC Musculoskeletal Disorders, surgical approach, head size, and bearing type may be associated with revision risk among primary total hip arthroplasty (THA) patients aged younger than 55 years. The Dutch Arthroplasty Registry was queried for data on all primary THA patients younger than 55 years who underwent surgery between 2007 and 2017. Age, sex, primary diagnosis, American Society of Anesthesiologists classification, surgical approach, fixation method, bearing type, head size, and year of surgery were all considered. Of 19,682 patients, the five-year primary THA survival was 95.3 percent. The following factors were associated with increased revision risk: use of the posterolateral approach (versus anterior), a head diameter ≥ 38 mm (versus 32 mm), and metal-on-metal bearings (versus ceramic-on-polyethylene).

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In Other News

Study: Preoperative Weight Loss Reduces Hospital Length of Stay for Obese TKA Patients

Morbidly obese patients who lost at least 20 pounds before total knee arthroplasty (TKA) had shorter hospital length of stay (LOS), according to a study published online in The Journal of Bone & Joint Surgery. A retrospective review of cohort data that were prospectively collected from 2011 to 2016 at a tertiary institution identified 203 patients who were morbidly obese at least 90 days prior to TKA and had their body mass index measured again at the immediate preoperative visit. Prior to surgery, 41 percent of patients lost at least five pounds, 29 percent lost at least 10 pounds, and 14 percent lost at least 20 pounds. Loss of 20 pounds or more was associated with lower adjusted odds of discharge to a facility, lower odds of extended LOS of at least four days, and an absolute shorter LOS (mean difference, −0.87 days). There were no differences in operative time or improvement in Patient-reported Outcomes Measurement Information System physical component score. Patients who lost five or 10 pounds did not see any differences in outcomes.

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Study: Causes of High Dislocation Rate in Constrained Condylar Knee Arthroplasty for Valgus Deformity

A study published online in the Journal of Orthopaedic Surgery and Research sought to determine factors related to a high dislocation rate among patients with valgus deformity undergoing TKA with the use of constrained condylar knee (CCK) prostheses. Patients who underwent primary CCK TKA between July 2008 and October 2015 were stratified into two groups: those with (cases) and without (controls) postoperative knee dislocation. Of 43 consecutive CCK TKA patients, four (9.3 percent) sustained postoperative dislocation of the knee. Most patient characteristics did not largely differ between the groups, but dislocation patients were more likely to have the lateral collateral ligament and popliteus tendon released intraoperatively.

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HHS Announces Nearly $2 Billion in Funding to Tackle the Opioid Crisis

The Department of Health and Human Services (HHS) announced $1.8 billion in funding to combat the opioid crisis by expanding access to treatment and supporting near real-time data on the drug overdose crisis. The Centers for Disease Control and Prevention will spend $900 million over the next three years for 47 states, the District of Columbia, and two territories to build out drug-use surveillance programs in an effort to reduce the lag between the calculation of overprescribing, addiction, and overdose rates and finding an appropriate response.

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Read the HHS press release…

FDA Issues Warning Letter to Stemell, Inc., for Unapproved Use of Stem Cell Therapy

The Food and Drug Administration (FDA) issued a warning to Stemell, Inc., of San Juan Capistrano, Calif., and Peyman Taeidi, PhD, the president and chief executive officer, for manufacturing and distributing unapproved stem cell products. The letter stems from the FDA’s March visit to Stemell, which revealed that the company was manufacturing products derived from human umbilical cord blood and umbilical cord for use in recipients unrelated to the donors of the products. These Stemell products are not intended for homologous use only and fail to meet other criteria, according to the agency.

Read the FDA news release…

Read the FDA’s letter…


Taking Joint Replacement to the Outpatient Setting: AAOS Course Sets You on the Right Track

On Oct. 18, AAOS will host a new single-day course titled, “AAOS Outpatient and Rapid Recovery in Total Joint Replacement,” which will address the increasing demand for same-day discharge after total joint replacement. Expert faculty will provide tips for safely implementing an outpatient rapid recovery program in your own institution or practice. Course directors R. Michael Meneghini, MD, and William G. Hamilton, MD, spoke with AAOS Now about what attendees can expect and gain from this event.

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Hundreds of Surgical Techniques Modules Available Free to AAOS Members

Build your surgical and clinical decision-making skills with unique educational experiences available on the AAOS online learning platform. Explore the surgical instruction interactive learning modules that assess your knowledge, patient management, and clinical decision making. Available free to AAOS members, these microlearning experiences provide quick and exciting lessons for hundreds of procedural techniques. Topics include advanced reconstruction, foot and ankle, hand and wrist, shoulder and elbow, hip and knee, spine, and sports medicine.

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