Study: Higher Rates of Complications after TJA in Nonagenarian Patients
Compared with patients aged 80 to 84 years (octogenarians) or aged 70 to 74 years (septuagenarians), patients aged >90 years (nonagenarians) were 3.1 times more likely to have complications after total joint arthroplasty (TJA), according to a retrospective study published in the Nov. 15 issue of the Journal of the AAOS®. Fifty-eight nonagenarians were matched with 58 octogenarians and 58 septuagenarians. The rate of 90-day medical complications was 33 percent in nonagenarians, 14 percent in octogenarians, and 3 percent in septuagenarians. Nonagenarians had the highest rate of 90-day readmissions; however, it was similar to the other age groups.
Study Compares Outcomes of Quadriceps Tendon Autograft versus Hamstring Autograft in ACLR
Arthroscopy published a retrospective study comparing the five-year clinical and functional outcomes of quadriceps tendon (QT) autograft and hamstring tendon (HT) autograft in patients undergoing ACL reconstruction (ACLR). International Knee Documentation Committee (IKDC) score, Lysholm score, return to sport (RTS), and complications were compared between 37 QT autograft patients and 46 HT autograft patients with >5 years of follow-up. At two years, IKDC and Lysholm scores, RTS, and postoperative complications were comparable between groups. After five years, the QT group had significantly greater IKDC and Lysholm scores.
Study: Clinical and Patient-reported Outcomes after Conversion to Hemiarthroplasty after Failed TSA
A retrospective study published in the Journal of Shoulder and Elbow Surgery assessed clinical and patient-reported outcomes (PROs) of conversion to hemiarthroplasty (HA) after failed anatomic total shoulder arthroplasty (TSA). Microbiology, American Shoulder and Elbow Surgeons (ASES) scores, and Simple Shoulder Test (SST) scores were collected from 29 patients. Four patients required further conversion to TSA (two to anatomic and two to reverse). Three patients required a revision HA. SST scores improved from 4.1 to 7.3, and the mean ASES score was 64 at final follow-up. Overall, 59 percent of patients had ≥2 positive cultures with the same bacteria.
Study: Interlocking Intramedullary Nails versus Locking Plates to Treat Proximal Humerus Fractures
According to a retrospective study published in the Journal of Orthopaedic Surgery and Research, interlocking intramedullary nails were associated with increased operation times compared with locking plates when treating proximal humerus fractures. The main outcomes included operation time, blood loss, complications, and visual analog scale (VAS) scores. Overall, 36 patients were in the locking plate group, and 28 were in the interlocking intramedullary nail group. Intraoperative blood loss was higher in the locking plate group compared with the intramedullary nail group (137.4 mL versus 72.5 mL). Postoperative complications and VAS scores were comparable between groups.
Study: Effects of Tendo-Achilles Lengthening and Gastrocnemius Recession on Tibiopedal ROM after Total Ankle Replacement
Foot & Ankle International published a retrospective review examining how tendo-Achilles lengthening (TAL) or gastrocnemius recession (GR) during total ankle replacement impacts tibiopedal range of motion (ROM). Overall, 26 patients underwent TAL, 29 underwent GR, and 55 had no lengthening procedure. Radiographic tibiopedal dorsiflexion (DF) and plantarflexion (PF) were assessed at one-year follow-up. DF improved by 2.8 degrees and 60 degrees in the TAL and GR groups, respectively. PF decreased by 4.5 degrees in the TAL group and 7.2 degrees in the GR group. Overall ROM was similar between groups.
AAOS Is Clear in Its Response to CMS about Proposed Medicare Payment Policy Changes for 2023
The American Association of Orthopaedic Surgeons (AAOS) issued formal comments to the Centers for Medicare & Medicaid Services (CMS) on the agency’s proposed payment policy changes for calendar year 2023. In both letters, AAOS urged the agency to address growing healthcare costs, expand access to care, and ease the burden on physicians as they continue to navigate patient care amidst financial and practice-management challenges exacerbated by the COVID-19 pandemic.
AAOS is partnering with the American Association of Hip and Knee Surgeons to develop a Clinical Practice Guideline (CPG) for the Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures, and they are now seeking volunteers to serve on the development work group. This guideline will be an update of the 2012 guideline of the same title. Applications will be reviewed and approved on a first-come, first-served basis.
