Study: Low Interobserver Agreement with CDC Surgical Wound Class Definitions
A study published in the Dec. 15 issue of the Journal of the AAOS ® found poor interobserver reliability between orthopaedic surgeons using the Centers for Disease Control and Prevention (CDC) surgical wound class definitions. Thirty-nine surgeons at a single institution completed a questionnaire of 30 clinical vignettes, where surgeons were asked to determine the appropriate wound class based on the information provided. Interobserver agreement was 66 percent, and six of 39 respondents (15.4 percent) rated the current wound classification system as adequate for orthopaedic surgery.
Study: Acetabular Component Anteversion in THA with Concomitant Spine Pathology
In patients undergoing total hip arthroplasty (THA) with a direct anterior approach, moderate to severe concomitant spinal pathology is associated with an increase of 5.9 degrees in component anteversion when transitioning from supine to standing position. The findings of this retrospective study were published online in The Journal of Arthroplasty. Perioperative radiographs from 643 THA cases were assessed. Lumbar pathology severity increased with increasing changes in anteversion. Mean supine anteversion was lower in patients with worsening lumbar pathology compared with those without lumbar pathology.
Study: RTSA Is Beneficial in Patients Aged ≥80 Years, with Similar Satisfaction to Younger Patients
A retrospective study published online in the Journal of Shoulder and Elbow Surgery reported significant improvements after reverse total shoulder arthroplasty (RTSA) among patients aged older than 80 years. Older patients also had similar rates of adverse events and revision as patients aged between 60 and 79 years (≥80 years, n = 369; <80 years, n = 1,764). At two-year follow-up, older patients scored lower than younger patients in functional and range of motion scores, but both groups demonstrated substantial clinical benefit, with comparable satisfaction scores (93 percent versus 92 percent, respectively).
Study Finds Low Rate of Conversion to Arthrodesis after Proximal Row Carpectomy
A retrospective study published online in the Journal of Hand Surgery reported a 5.3 percent rate of conversion to total wrist arthrodesis among 1,070 patients who underwent proximal row carpectomy (PRC). PRCs performed over a 26-year period were identified from the National Veteran’s Health database. Fifty-seven patients required conversion to arthrodesis. Age was the only identified predictive factor for conversion; patients aged younger than 50 years had increased risk of conversion compared with older patients.
Interview Study Investigates Concerns of Patients Recovering from Open Tibial Fractures
Recovery of physical mobility, values about treatment, fears regarding poor recovery, and psychological coping strategies were reported as important themes for patients recovering from an open tibial fracture, according to a qualitative study published online in Clinical Orthopaedics and Related Research. Twenty-six patients with varying injury severity were interviewed. Task-focused coping strategies were considered a “proactive” approach to recovery, but patients reported that educational resources about their recovery process were “scant.”
Orthopaedic Surgeons Well Suited for First Responder Roles
Most orthopaedic surgeons, unless they are formally affiliated with a public safety agency such as a fire or police department, do not think of themselves as dedicated “first responders.” Yet, they do fulfill that role in several ways. An Instructional Course Lecture at the AAOS 2021 Annual Meeting in San Diego delved into ways surgeons may serve as first responders outside the hospital: as good Samaritans; as team physicians; and as physicians on tactical emergency medical support teams, including special weapons and tactics teams—as well as in disaster recovery regions and situations.
Reach New Heights at AAOS 2022 in Chicago March 22–26
The AAOS Annual Meeting is back in its traditional place on the calendar this March for the first time in three years. Make your plans to attend and take your knowledge, skills, and research to new heights. New for 2022, the AAOS Member registration fee now includes three complimentary Instructional Course Lectures—a $210 value.
