Study: Lower Rates of Dislocation and Revision for Instability for Robotic-Assisted versus Manual THA
Robotic-assisted total hip arthroplasty (R-THA) led to significantly reduced rates of dislocation at 90 days postoperatively compared with conventional THA, according to a retrospective study published online in The Journal of Arthroplasty. Of 2,247 patients treated at a single center, 523 received an R-THA. The rates of dislocation were 0.6 percent for R-THA and 2.5 percent for conventional THA. No R-THA cases required revision for instability, compared with 46 percent of conventional THAs. Cup anteversion was higher in the R-THA group, and cup inclination was lower.
RCT: Augmented Repair versus Reconstruction of Superficial MCL Injuries
A randomized controlled trial (RCT) of 54 patients, published online in the American Journal of Sports Medicine, compared one-year outcomes of superficial medial collateral ligament (sMCL) augmentation repair or sMCL autograft reconstruction. There were no significant between-group differences in valgus stress radiographs at six months. One-year Lysholm and International Knee Documentation Committee scores were significantly higher in the reconstruction versus repair groups, though Tegner scores were similar. Patient satisfaction was also similar.
Study: Improvement after RSA following Failed Superior Capsular Reconstruction
A retrospective study published in the Journal of Shoulder and Elbow Surgery reported reduced improvement with reverse shoulder arthroplasty (RSA) following failed superior capsular reconstruction (SCR) compared with RSA for failed rotator cuff repair (RCR). Forty-five patients undergoing RSA for failed SCR were matched with 45 patients undergoing RSA for failed RCR. Post-RSA range of motion, complications, and revisions were similar between groups. The SCR group reported higher pain and lower functional scores than the RCR group, but rates of achieving a substantial clinical benefit were similar. No patients in the SCR group met Patient Acceptable Symptom Status for the Single Assessment Numeric Evaluation, versus 56.7 percent of RCR patients.
Study: Low Inter-rater Reliability of Lawrence and Botte Classification for Fifth Metatarsal Fracture
A study published in Clinical Orthopaedics and Related Research reported a “concerningly” low level of inter-rater reliability with the use of the Lawrence and Botte classification system of fifth metatarsal base fracture Thirty sets of radiographs were evaluated by three foot and ankle specialists and eight foot and ankle fellows, then re-evaluated after two weeks. Observed inter-rater agreement was 77 percent and chance agreement was 33 percent. The authors noted that the assessment of the interface between Zones 2 and 3 demonstrated less reliability compared to assessments of Zones 1 and 2.
Managing Surgeon Stress from Poor Outcomes Is Critical
Peter D. Pardubsky, MD, FAAOS, FASSH, responds to the October 2021 Editor’s Message, “It’s Time for Physicians to Talk about Our Mental Health,” in which AAOS Now Deputy Editor Julie Balch Samora, MD, PhD, MPH, FAAOS, FAOA, transparently discussed personal experiences with second victim syndrome. “As a result of reading her article, I feel that I can better support my colleagues and particularly my new younger partners as the ‘wise senior’ physician when we encounter such difficulties,” Dr. Pardubsky wrote.
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