Today’s Top Story
Study: Presence of bone marrow lesion may predict rate of radiographic change in knee joint space width.
Data from a multinational study published online in The Journal of Rheumatology suggest that the presence of bone marrow lesions (BMLs) on magnetic resonance imaging (MRI) scans of the knee may predict rate of radiographic change in joint space width. The researchers reviewed data on 176 participants in the placebo arm of the Strontium Ranelate Efficacy in Knee Osteoarthritis Trial. All participants were assessed via MRI at baseline and yearly for up to 3 years. The researchers found that 38.6 percent of participants were classified as BML-positive (BML ≥grade 2 at the tibiofemoral joint) at baseline. They found that patients who were BML-positive had a significantly higher rate of annualized change in joint space width; a relationship that remained robust after adjustment for age, sex, and baseline Kellgren-Lawrence grade. Read more…
Read the abstract…
Other News
Study: Ultrasound-guided or blind subacromial injection may offer similar clinical outcomes for subacromial impingement syndrome.
Findings published online in The American Journal of Sports Medicine (AJSM) indicate no significant difference in clinical outcome between ultrasound-guided subacromial injections and blind subacromial injections for subacromial impingement syndrome. The authors conducted a randomized, double-blind, controlled trial of 56 shoulders that received either a subacromial corticosteroid injection with (n = 28) or without (n = 28) ultrasound guidance. At 6-week follow-up, they found no significant difference in neither visual analog scale score for pain with overhead activities nor American Shoulder and Elbow Surgeons score. The authors write that four shoulders (14 percent) in the ultrasound group and 6 shoulders (21 percent) in the blind group eventually required surgery. Read more…
Study: What factors affect ACL reconstruction survival rates for adolescent patients?
A study published online in AJSM looks at 15-year survival rates for anterior cruciate ligament (ACL) reconstruction in adolescent patients. The researchers reviewed prospectively collected data on 242 patients aged 13 to 18 years who underwent single-incision endoscopic ACL reconstruction with either an autologous bone-patellar tendon-bone graft or a hamstring tendon graft. All procedures were performed by a single surgeon. At 15-year follow-up, they found that 75 patients (31 percent) had sustained a further ACL injury: 27 (11.2 percent) ACL graft rupture, 33 contralateral ACL (CACL) injury (13.6 percent), and 15 both an ACL graft rupture and a CACL injury (6.2 percent). The researchers found that survival of the ACL graft was less favorable in patients with a family history of ACL injury compared to those without a family history. In addition, survival of the CACL was less favorable in male patients than in female patients and in those who returned to competitive team ball sports than in those who did not. Read the abstract…
Study: Compared to MIPO, patients treated with IMN for certain tibia fractures more likely to undergo second surgery.
According to findings published in the Journal of Orthopaedic Trauma, minimally-invasive plating (MIPO) and intramedullary nailing (IMN) may offer similar outcomes for treatment of non- or minimally articular metaphyseal distal tibia fracture, yet patients treated with IMN may be more likely to undergo a secondary surgical procedure. The research team conducted a cohort study of 64 patients treated with MIPO (n = 37) or IMN (n = 27) conducted by a single surgeon. At minimum 1-year follow-up, they found that complications were similar between the two groups in the areas of nonunion, malalignment, wound complication, and infection. They note that American Orthopedic Foot and Ankle Surgeons and all SF-36v.2 domain scores were quantitatively higher for patients in the IMN cohort, although only Role Emotional reached a level of statistical superiority. In addition, 25.9 percent of patients in the IMN group underwent a secondary procedure for implant removal, compared to 8.3 percent of patients in the MIPO group. Read the abstract…
GAO: FDA Center for Drug Evaluation and Research should improve quality of postmarket safety data.
A report released by the U.S. Government Accountability Office (GAO) states that the U.S. Food and Drug Administration (FDA) needs to correct problems with its postmarket safety data and ensure that such data can be easily used for oversight. The writers note that about one-quarter of drug applications approved by the FDA Center for Drug Evaluation and Research (CDER) between Oct. 1, 2006, and Dec. 31, 2014, made use of at least one expedited application program. GAO states that FDA lacks reliable, readily accessible data on tracked safety issues and postmarket studies needed to meet certain postmarket safety reporting responsibilities and to conduct systematic oversight. Evaluations of the CDER database revealed problems with completeness, timeliness, and accuracy of data. “These problems,” GAO states, “as well as problems with the way data are recorded that impair their accessibility, have prevented FDA from publishing statutorily required reports on certain potential safety issues and postmarket studies in a timely manner, and have restricted the agency’s ability to perform systematic oversight of postmarket drug safety.” Read more…
Read the complete report (PDF)…
Study: Trauma team staff may face risk of burnout.
Information from a focus group survey published in the January/February issue of the Journal of Trauma Nursing suggests that hospital trauma team members may be at risk for burnout and so-called “compassion fatigue.” The researchers surveyed 12 members of the nursing staff at a single, Level I trauma center. They found that most reported low levels of stress based on the Holmes–Rahe Life Stress Inventory. However, based on the Professional Quality of Life (ProQOL) Scales, 33.3 percent scored a combination of low compassion satisfaction and high burnout, while another 25 percent scored moderate burnout. Overall, 75 percent were considered at-risk, with either high (25 percent) or moderate (50 percent) secondary traumatic stress. Interpreting the ProQOL scales in combination, the researchers state that 42 percent of participants were identified as at-risk and 16.7 percent identified at high-risk due to burnout. Read more…
Read the complete study…
Study: Less physical maturity among boys, higher weight among girls, linked to longer recovery times for concussion.
Findings from a study published online in The Journal of Pediatrics suggest that less physically developed male athletes and heavier female athletes may face longer concussion recovery times. The authors conducted a prospective cohort study of 145 ice hockey players, aged 13-18 years, with concussion. They found that mean symptom duration was 44.5 ± 48.7 days. Overall, 48.3 percent of patients had concussion symptoms lasting 28 days or longer. The authors noted that “Early” Pubertal Category Score was the strongest predictor of prolonged symptoms among males, while heavier weight increased the odds of experiencing prolonged symptoms among females. Read more…
Read the abstract…
Last call: Call for volunteers: AMA representative for ACGME Review Committee for Orthopaedic Surgery.
AAOS seeks to nominate members to the Accreditation Council for Graduate Medical Education (ACGME) Review Committee for Orthopaedic Surgery. Applicants for this position must be current American Medical Association (AMA) members with at least 5 years of experience as a program director in an ACGME-accredited program and for whom no more than 3 years have elapsed since serving in that capacity. Service experience in orthopaedic societies or other national professional organizations, academic appointment at the rank of associate professor or professor, and scholarly achievements are also required. In addition, applicants must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. All applicants must provide the following: an online AAOS CAP application, a current full curriculum vitae, a current abbreviated curriculum vitae (not to exceed three pages), a 100-word biosketch, a letter of interest highlighting his or her expertise in the subject area, a statement that he or she is able to participate in full capacity, and a completed electronic application for AMA Nomination for External Leadership Position—RC-OS. Learn more and submit your application…(member login required)
Note: In observance of the Martin Luther King Day holiday, AAOS offices will be closed and AAOS Headline News Now will not be published on Monday, Jan. 18. Publication will resume on Jan. 20.
