Study: Increased ED Visits but Similar Revision, Infection Rates in TJA Patients Who Are Homeless
A retrospective study published online in the Journal of the AAOS ® reported that patients experiencing homelessness who undergo total joint arthroplasty (TJA) are 15.8 times more likely to have an ED visit within 90 days postoperatively compared to those who are not homeless. However, the authors noted that the benefits of TJA may outweigh the risk of poor outcomes in this population. Of 442 patients treated at an urban academic hospital, 28 self-reported being homeless. Homelessness was not associated with increased rates of 90-day readmission, revision, or prosthetic joint infection.
RCT: Lower Postoperative Pain with Intraosseous Morphine Injection in TKA
A randomized controlled trial (RCT) published online in The Journal of Arthroplasty found that adding morphine to standard intraosseous (IO) antibiotic prophylaxis in total knee arthroplasty (TKA) led to superior pain relief up to two weeks postoperatively compared with controls who did not receive morphine. Forty-eight patients were randomized 1:1 to IO injection with or without 10 mg morphine. Visual Analog Scale pain scores were significantly lower in the morphine group immediately following surgery and on postoperative days 1, 2, 8, and 9. The experimental group also had lower opioid consumption in the first 48 hours and during the second week postoperatively.
Study: Increased Rate of Femoral Head Cartilage Lesions after Hip Arthroscopy among Flexibility Sports Athletes
High-level athletes who compete in flexibility sports (FS) experienced higher rates of femoral head cartilage lesions (12.0 percent versus 2.0 percent) and ligamentum teres tears (48 percent versus 26 percent) after hip arthroscopy for femoroacetabular impingement compared with non-FS athletes, according to a study published online in the American Journal of Sports Medicine. Forty-seven FS athletes were matched to 130 non-FS athletes. Ninety-six percent of patients were female. Twenty-four percent of FS athletes were unable to return to sports due to ongoing hip issues; however, this rate was similar to the non-FS group.
Study: Fear of Movement, Emotional Distress Are Associated with Outcomes of Conservative Shoulder Pain Treatment
A study published online in BMC Musculoskeletal Disorders found that patients who reported higher fear of movement and emotional distress scores prior to care for shoulder pain had significantly worse Quick Disability of the Arm Shoulder and Hand (QuickDASH) scores after one year of treatment. In total, 138 patients referred to secondary outpatient care for shoulder pain were evaluated at baseline, three months, and at one year. For every point increase in baseline fear of movement or emotional distress, the QuickDASH score increased by 110 points and 19.9 points, respectively, over the follow-up year.
Study Compares PROMIS and SF36 Physical Function Scales in Trauma Patients
A study published in Injury reported a significant ceiling effect with the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) scale at baseline and 12 months after orthopaedic hip or extremity trauma, with 50.0 percent and 10.3 percent of patients achieving maximum scores at each time point, respectively. Sixty-eight patients completed the PROMIS-PF and the 36-item Short Form Survey Physical Component Score (SF36-PCS) at baseline and up to 12 months postoperatively. PROMIS-PF took significantly less time to complete than SF36-PCS (1.7 minutes versus 5.6 minutes). Standardized response means were comparable between measures.
RJOS Announces 2022 “He For She” and “She For He” Award Winners
The Ruth Jackson Orthopaedic Society (RJOS) has awarded the 2022 “He For She” Award to Seth Leopold, MD, FAAOS. Dr. Leopold was recognized for his mentorship and for amplifying gender-related issues in orthopaedics through his role as editor-in-chief of Clinical Orthopaedics and Related Research. In addition, the 2022 “She For She” Award was given to Lisa Cannada, MD, FAAOS. Dr. Cannada’s nominators commended her for sponsoring other women in orthopaedics and going above and beyond to personally support her female peers and mentees.
AAOS Releases Trends and Outcomes from the Registry Program
The AAOS Registry Program is pleased to announce the availability of two new clinical data reports: the American Joint Replacement Registry (AJRR) 2021 Annual Report Supplement and the AAOS Patient-Facing Registry Report. These reports, which were released during the AAOS 2022 Annual Meeting in Chicago, offer actionable information to guide physician and patient decision-making to improve care. The American Spine Registry, a collaborative effort between the American Association of Neurological Surgeons and AAOS, released a 2022 Fact Sheet during the meeting as well.
