Is Topical or IV TXA More Effective in Reducing Opioid Consumption following THA?
A prospective randomized controlled trial in BMC Musculoskeletal Disorders investigated the efficacy of topical versus IV tranexamic acid (TXA) in reducing early postoperative pain in patients undergoing total hip arthroplasty (THA). A total of 161 patients were randomized into the topical or IV group. The primary outcome measurements were hip pain and opioid use within three days postsurgery. Hip pain scores were significantly lower in the topical group one day postsurgery. Opioid use was lower in the topical TXA group one and two days postsurgery. No differences were observed between groups concerning total blood loss or postoperative complications.
Study Compares Outcomes of Patellar Resurfacing after Cruciate-retaining versus Posterior-stabilized TKA
According to a systematic review and meta-analysis in the Bone & Joint Journal, patellar resurfacing performed with cruciate-retaining (CR) implants resulted in lower rates of anterior knee pain compared with posterior-stabilized (PS) implants during total knee arthroplasty (TKA). Comparing the incidence of anterior knee pain, knee-specific patient-reported outcome measures, complication rates, and reoperation rates, 4,135 TKAs from 33 studies were identified. Overall, anterior knee pain rates were significantly higher in unresurfaced knees. There were no significant differences in complication rates or infection rates between CR and PS groups; however, PS implants resulted in better Knee Society function and Oxford Knee scores.
Study: Cannulated Screws to Treat Posteromedial Rotatory Instability Associated with Shorter Surgical Time
International Orthopaedics published a retrospective study comparing the efficacy of buttress plate versus cannulated screw to treat anteromedial coronoid fracture with posteromedial rotatory instability. Sixteen and 11 patients comprised the buttress plate and cannulate screw groups, respectively. The main outcome measurements were elbow range of motion, visual analog scale, and Disabilities of the Arm, Shoulder, and Hand score. There were no significant differences observed in terms of clinical outcomes; however, the surgical time was significantly shorter in the cannulated screw group (85.45 minutes) than the buttress plate group (93.81 minutes).
Study Finds Negative Correlation between Sagittal Angle of Posterior Malleolus Fractures and Posterior Fragment Area
A retrospective study of 120 patients with posterior malleolus fractures (PMFs) investigating the relationship between sagittal angle (SA) and PMF stability was published in Orthopaedic Surgery. Posterior fragment area (PFA) along with fragment area ratio (FAR) and SA were measured. Fragment width diameter ratio (FWR), fragment length ratio (FLR), fragment height (FH), and contact area (CA) were also measured to better evaluate morphological characteristics. SA was found to be negatively correlated with PFA and FAR. The study found a significant correlation between FWR, FLR, FH, CA, and SA.
Physician-owned Hospitals’ Negotiated and Cash Prices Lower than Nearby Facilities
Physician-owned general acute care hospitals charge less than other nonphysician-owned facilities in their region for several common shoppable care services, according to an analysis published June 23 in JAMA Network Open. The review, which looked at a sample of 156 physician-owned hospitals (POHs) and 1,116 non-POHs, found median commercial negotiated and cash prices to be roughly a third lower at POHs in the same hospital referral region as a non-POH. The findings relate to the ongoing effort of AAOS and others to lift the ban on new POHs, which is hampering market competition in an increasingly consolidated healthcare system.
Introducing the AAOS PROMs Workgroup: the Why and the Who
Patient-reported outcome measures (PROMs) in clinical care can provide immense value in predicting outcomes, making patient-specific care decisions, and measuring pain and function after orthopaedic procedures. The recently formed AAOS PROMs Workgroup is working to equip AAOS members with user-friendly resources to increase awareness of the benefits of PROM utilization. The group will help increase access to low-cost technological solutions and ensure that orthopaedic surgeons have a voice in the legislative and payer process of implementing PROMs in clinical care.
Introducing Group Chats in the AAOS Membership App
Your professional network just got bigger! Exclusive to the AAOS Membership App, the new group chat feature allows you to chat securely with three or more AAOS members at once. Use this feature to consult with colleagues, make new connections, exchange valuable insights, and more. On an AAOS Committee? Use the new group chat function to keep your AAOS conversations organized and in one place.
