Today’s Top Story
Study: IV and IA TXA may reduce blood loss for TKA patients compared to IV TXA alone.
Data from a study published in the May 18 issue of The Journal of Bone & Joint Surgery suggest that combined administration of intravenous (IV) and intra-articular (IA) tranexamic acid (TXA) may be associated with reduced blood loss compared to IV TXA alone for patients who undergo total knee arthroplasty (TKA). The authors conducted a randomized, double-blind, placebo-controlled trial of 60 TKA patients treated with either combined administration of TXA consisting of 1 g administered intravenously preoperatively and 3 g diluted in 100 mL of saline solution administered intra-articularly after closure of the capsule, or 1 g of TXA administered intravenously only and 100 mL of saline solution administered intra-articularly. They found that the mean 24-hour blood loss was 466 mL in the TXA IV and IA group and 743 mL in the TXA IV and placebo group. In addition, second-day blood loss was 644 mL in the TXA IV and IA cohort and 1,017 mL in the TXA IV and placebo cohort.
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Other News
Suits accuse device manufacturer of unauthorized “human experimentation.”
The Associated Press reports that medical device manufacturer Synthes and others are the subject of two civil suits that claim the company improperly allowed a bone cement product manufactured by its Norian subsidiary to be used in the treatment of vertebral compression fractures without approval from the U.S. Food and Drug Administration (FDA). The companies and four top executives were indicted in 2009 on charges of conducting unauthorized clinical trials despite warnings that the bone cement was associated with blood clots and patient mortality. The first trial is scheduled to begin in June.
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Study: Many hip fracture patients may not be warned of potential for osteoporosis.
Research presented at the annual scientific meeting of the American Geriatrics Society suggests that more than 70 percent of older hip fracture patients may not be informed of the potential for osteoporosis, despite that condition’s association with hip fracture. The research team conducted a telephone survey of 42 hip fracture patients aged 75 years or older and found that 57 percent reported that their hospital physicians had not suggested osteoporosis medication following hip fracture, and 25 percent said they would reject taking such prescribed drugs. Overall, 36 percent of respondents said they hadn’t received a prescription for osteoporosis medication. For many of the remainder, treatment consisted simply of calcium and vitamin D.
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Study: Age, obesity, and OA associated with increased risk of THA following hip arthroscopy.
According to findings published in the April issue of the journal Arthroscopy, older patients, obese patients, and those with osteoarthritis (OA) may be at increased risk of conversion to total hip arthroplasty (THA) following hip arthroscopy. The researchers reviewed data from the State Ambulatory Surgery Databases and State Inpatient Databases for California and Florida on 7,351 patients who underwent hip arthroscopy. They found that 11.7 percent of patients underwent THA within 2 years. The conversion rate was lowest in patients aged younger than 40 years and highest in the 60- to 69-year-old cohort. The researchers noted an increased risk of THA conversion in older patients and in patients with osteoarthritis or obesity at the time of hip arthroscopy. In addition, patients treated at high-volume hip arthroscopy centers had a lower THA conversion rate than those treated at low-volume centers.
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Study: Delayed removal from play may extend concussion recovery time.
A study published in the April issue of the Journal of Athletic Training finds that athletes who delay treatment for concussion may risk increased recovery time. The authors conducted a cross-sectional study of 97 college athletes with concussion, 50 of whom were not immediately removed from activity. They found that concussed athletes who continued to play missed an average of 4.9 more days of playing time compared to those who were immediately removed. In addition, athletes who continued playing were approximately 2.2 times more likely to experience a prolonged recovery (8 or more days) compared with those who were immediately removed.
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California.
The California Medical Association (CMA) has expressed support for a state bill that would require drug companies to notify programs such as Medi-Cal and CalPERS when drug prices are increased, or when high-price drugs are coming to market. The bill also would require health plans to report on which drugs are driving the most spending among their enrollees. CMA says it supports possible ways to provide more public drug pricing information and protect against sudden price increases, and announced opposition to a scheduled November ballot initiative that would tie contracts by state agencies for purchase of prescription drugs to the discounted price offered to the U. S. Department of Veterans Affairs. CMA states the measure would create a new authorization hurdle for physicians and patients while not having a marked curbing effect on drug prices.
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Call for volunteers: ACGME Review Committee for Orthopaedic Surgery.
AAOS seeks to nominate one resident member to the ACGME Review Committee for Orthopaedic Surgery. The resident member participates as a full voting member in all Review Committee activities, including program review and policy discussion. Applicants for this position must be resident members or resident members osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application; a statement of support from the program director; a current curriculum vitae; and a letter from the resident outlining his or her educational goals, professional interests and intent to serve, if selected. Supporting materials must be submitted to Kyle Shah by Friday, July 22, 2016 at 11:59 p.m. (CT), at shah@aaos.org.
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