September 28, 2018 | Today’s News

Study: Differences Caused by Knee Scooter Flexion

Knee position when using a scooter device may be linked to venous stasis, according to a comparative study published online in Foot & Ankle International. Thirteen healthy participants were included in the study. Researchers assessed comparative measurements while participants were standing and using the knee scooter. Standing versus using the scooter device was associated with a significant decrease in mean velocity (6.5 cm/s versus 3.2 cm/s) and volumetric flow rate (227.8 mL/min versus 106.2 mL/min). There were no significant differences associated with vessel diameter (0.82 cm versus 0.78 cm) and peak velocities (19.8 cm/s versus 14.7 cm/s).

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Study: Outcomes of Percutaneous Transiliac-transsacral Screw Fixation in Geriatric Patients

Percutaneous transiliac-transsacral screw fixation of sacral fragility fractures may be associated with lessened pain, improved ambulation, and increased rates of disposition to home, according to research published in the September issue of the Journal of Orthopaedic Trauma. The retrospective cohort study included 41 older patients with an isolated sacral fragility fracture between August 2015 and August 2017 who were treated either operatively (n = 16) or nonoperatively (n = 25). Patients treated operatively reported greater improvements in pain than patients treated nonsurgically (visual analog scale, 3.9 points versus 0.6 points). All patients in the operative cohort were ambulatory at time of discharge compared to 72 percent of the nonoperative group. Patients treated surgically also ambulated at greater distances than nonoperative patients (95 ft versus 35 ft). Three-quarters of surgical patients were discharged to home compared to only 20 percent of the nonoperative group. The groups saw similar lengths of stay (operative group, 3.6 days; nonoperative group, 4.2 days), and neither group reported complications related to surgery.

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A nonformal literature review published in the September issue of the Clinical Journal of Sport Medicine found that nonsteroidal anti-inflammatory drugs (NSAIDs) may be effective for athletes but could come with adverse events that should be considered. Side effects associated with NSAIDs include gastrointestinal symptoms, such as heartburn, nausea, diarrhea, and occult fecal blood loss; as well as headache, vasodilatation, asthma, and weight gain related to fluid retention, which may impact an athlete’s return to sport. NSAIDs may also increase the risk of internal bleeding and impaired bone healing. While most NSAIDs are administered orally, intramuscular ketorolac injections are an option but come with potential, unquantifiable risks.

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Total hip arthroplasty (THA) through the direct anterior approach (DAA) may be a safe option for patients with femoral neck fractures (FNF), according to research published in The Journal of Arthroplasty. The study included 150 patients with displaced FNF who received THA through the DAA and 150 matched patients who were treated electively. Both groups saw similar surgery-related complication rates. Blood loss, operation duration, and hospital length of stay (LOS) were all increased in the FNF cohort. Mortality was also increased for FNF patients but was lower than what was reported in the literature. Hospital LOS and mortality appeared to be impacted by the patient’s age, American Society of Anaesthesiologists score, and time-to-operation. Researchers stated that mortality rates could be improved for FNF patients with early intervention and perioperative stabilization.

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A retrospective study published online in the Journal of Shoulder and Elbow Surgery found that although scapular fractures after reverse shoulder arthroplasty (RSA) are rare, they may lead to worse final functional outcomes compared to RSA patients who do not sustain a fracture. In a multicenter study, 1,953 Grammont-style RSAs in 1,745 patients were reviewed, of which 1,035 (953 patients) had a minimum five-years of follow-up. Twenty-six patients (1.3 percent) had a scapular fracture, 19 of whom (10 acromial base, nine spine fractures) had a minimum five-years of follow-up. Three patients had an undiagnosed fracture that was diagnosed at the last follow-up. Sixteen patients (three traumatic, 13 without antecedent trauma) underwent nonoperative treatment. The fracture healed in eight patients (four acromion, four spine).

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Understanding the Impact of AI on Orthopaedic Surgery

It seems we hear daily about advances in artificial intelligence (AI)—from self-driving cars, face recognition, and hacker protection to stock portfolios and more. There is no doubt AI will find its way into our specialty, if it hasn’t already. We have countless treatment algorithms, classification systems, outcomes databases, and myriad complications to reduce. We are currently developing big data through registries like the American Joint Replacement Registry (AJRR), and as we look to find a useful home for AI in orthopaedics, AJRR could be one place to start.

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Apply for Biomedical Engineering Committee Member Position

The Biomedical Engineering Committee has an open member position, a two-year term that runs from March 17, 2019, through March 21, 2021. The committee monitors and reviews scientific regulatory developments in the field of biomedical engineering as they relate to orthopaedic surgery. The application deadline is Oct. 13.

Learn more and submit your application…(member login required)