Study: Lower Transfusion and Readmission Rates with Extramedullary versus Intramedullary Implants for Stable Intertrochanteric Fractures
Compared with intramedullary implants, extramedullary implants were associated with lower rates of transfusion, readmission, and discharge to a nonhome location in patients with closed nondisplaced stable intertrochanteric fractures, according to a retrospective study published in the May 15 issue of the Journal of the AAOS ®. The researchers identified 3,244 patients from the National Surgical Quality Improvement Program Database (intramedullary implants, 77.7 percent). Surgical complications were similar between implant types.
Study: Implant Survival after Unexpected Positive Intraoperative Cultures in Presumed Aseptic Revision TKA
A retrospective study published online in The Journal of Arthroplasty reported a 9.8 percent prevalence of unexpected positive intraoperative cultures (UPC) among presumed aseptic revision total knee arthroplasty (TKA). In total, 775 aseptic revisions were identified from an institutional database. The two- and five-year infection-free survival rates were 97.4 percent and 95.3 percent, respectively, and 98.7 percent of cases were infection-free from the initial UPC microorganism at five years. One-third of subsequent prosthetic joint infection-related failures were caused by the same microorganism as the UPC.
Study Finds High Reoperation Rates after ORIF for Proximal Humerus Fractures
A systematic review of 12 studies, published online in the Journal of Shoulder and Elbow Surgery, reported relatively high rates of avascular necrosis (20.0 percent) and reoperation (95.6 percent) after ORIF (open reduction–internal fixation) of proximal humerus fractures. Average follow-up was 2.9 years. Nonunion was observed in 3.0 percent and conversion to arthroplasty occurred in 10.7 percent of cases. Five percent of reoperations were revision ORIF and 22.2 percent were hardware removal.
Study: Changes in Median Nerve Cross-sectional Area after Carpal Tunnel Release and Association with Outcomes
A study published online in The Journal of Hand Surgery found a weak, positive correlation between postoperative improvements in the median nerve cross-sectional area (CSA) and the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) symptom severity and function subscales after carpal tunnel release (CTR). The proximal and distal CSAs were evaluated via ultrasound before and after CTR in 172 wrists. Visual analog scale scores, BCTQ scores, and electrodiagnostic tests significantly improved at three months post-CTR. The mean preoperative and postoperative proximal CSA measurements were 16.4 mm 2 and 12.1 mm 2, respectively, and distal CSA measurements were 13.6 mm 2 and 11.0 mm 2, respectively.
Study: Favorable Outcomes of Management of Symptomatic Rib Nonunion with Plates and Bone Grafting
Treatment of symptomatic rib nonunion with rib plates and autogenous iliac crest bone grafting led to high union rates and low complication rates, according to a study published in the May issue of the Journal of Orthopaedic Trauma. Fifty-one nonunions with chronic instability were included. Eighteen patients (72 percent) were available at a mean follow-up of 46.1 months. All ribs achieved radiographic union at a mean of 12.3 weeks postoperatively. Eighty-nine percent reported satisfaction with the surgery and 83 percent reported mild to no pain at final follow-up. Five patients had complications that resolved with treatment.
Surgical Treatment for Adult Cervical Deformity: Changes in Approaches and Outcomes since 2013
In a study presented at the AAOS 2022 Annual Meeting, Peter G. Passias, MD, FAAOS, and colleagues investigated how surgical treatment for adult cervical deformity has changed over the past decade. “Surgeons are opting for more physiologically shaped reconstructions, reserving aggressive pedicle subtraction osteotomies and vertebral column resections for cases of rigid kyphotic cervical deformity with an apex of deformity in a hyperkyphotic upper thoracic spine, or more commonly at the cervicothoracic junction,” the authors wrote.
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