The Academy’s leadership extends its thoughts and prayers for members, their patients, and their families in areas of Louisiana and Texas that were negatively impacted by Hurricane Laura. AAOS has been in contact with the Louisiana Orthopaedic Association and the Texas Orthopaedic Association to provide encouragement and facilitate open lines of communication for assisting members and colleagues. The Academy will continue to communicate through its website and social media as it learns more about the specific needs from the local orthopaedic community.
Study Compares Gap Balancing Versus Measured Resection for TKA
A meta-analysis published in the September issue of Archives of Orthopaedic and Trauma Surgery observed comparable outcomes between gap balancing compared to measured resection for primary total knee arthroplasty (TKA). Twenty-five clinical trials encompassing 2,971 procedures were reviewed. There were no between-group differences in Short-Form 12 mental and physical scores, range of motion, Knee Society Score (KSS), KSS Function, Oxford Knee Score, or Western Ontario and McMaster Universities Osteoarthritis Index. The gap balancing group had a significant elevated joint line and longer operative time. Revision surgery, aseptic loosening, and prosthetic infections did not largely differ between the groups.
Study: Which Hip Fracture Patients Benefit Most from Fascia Iliaca Regional Anesthesia?
A study published in the September issue of the Journal of Orthopaedic Trauma evaluated perioperative fascia iliaca regional anesthesia (FIRA) based on hip fracture type in patients aged older than 60 years. Final analysis included 949 patients, of whom 194 received FIRA. Femoral neck fracture patients who received FIRA used fewer morphine milligram equivalents (MMEs) preoperatively and on postoperative day (POD) one. Intertrochanteric fracture and cephalomedullary nail patients both used fewer MMEs on PODs one and two, while hip arthroplasty patients receiving FIRA used fewer MMEs on POD one. No correlation was observed between FIRA and MME reduction in percutaneous pinning and sliding hip screw patients
Study: RCR with a Triple-loaded Medially Based Single-row Technique Augmented with Marrow Vents
A study published online in Arthroscopy assessed outcomes of arthroscopic repair of medium to large rotator cuff tears using a triple-loaded medially based single-row repair technique augmented with marrow vents. Ninety-one patients (mean age, 59.7 years; mean tear size, 2.6 cm in anterior-posterior dimension) undergoing rotator cuff repair (RCR) were retrospectively reviewed. Complete satisfaction was reported in 83 shoulders (91 percent). The median Western Ontario Rotator Cuff score was 95.2 percent of normal; patients with an intact repair had significantly better scores than those with a full-thickness recurrent defect. At a median 32 months, 84 shoulders (92 percent) presented intact repair on MRI.
Study: Are PROMs Used in Pediatric Orthopaedics Validated?
According to a study published online in the Journal of Pediatric Orthopaedics, most pediatric orthopaedic studies that used patient-reported outcome measurements (PROMs) included at least one that was not completely validated for their study population. Of 653 clinical pediatric orthopaedic studies from 2014 through 2017, 104 (16 percent) reported PROMs. Of the 163 times PROMs were used, 120 (73 percent) were not completely validated. The two most common reasons PROMs were not completely validated were: (1) they had been validated in adults but not pediatrics (n = 47; 28.5 percent), and (2) PROMs had been designated in the literature as invalid for pediatrics (n = 27; 16.4 percent).
NIH Provides Guidance Summary on the Use of Corticosteroids
Injectable and oral corticosteroids are commonly used to reduce inflammation and manage pain in patients with musculoskeletal disease. Concerns regarding the use of injectable and oral corticosteroids in musculoskeletal care come from guidelines for systemic steroid use in patients being treated for active COVID-19 disease, such as those from the National Institutes of Health (NIH). Within the guidelines, the NIH provides evidence-based recommendations for mechanically ventilated patients with COVID-19 with and without acute respiratory distress syndrome.
OrthoInfo, the AAOS patient education website, is seeking an editor-in-chief to help guide its continued success. The website is a leading online resource for orthopaedic information; approximately 2.5 million internet users from around the world visit OrthoInfo each month. The website features more than 400 articles and videos on orthopaedic conditions, surgical procedures, nonsurgical treatments, and injury prevention. The editor-in-chief leads the OrthoInfo Editorial Board in content development, recruits new authors, and peer reviews articles each month. The editor-in-chief also serves on the AAOS Communications Committee. The application deadline is Sept. 25
