Today’s Top Story

Study: Poor Patient-reported Outcomes after Revision THA with Preoperative Opioid Use

A study published in the April 1 issue of the Journal of the AAOS ® evaluated the association between preoperative opioid use and patient-reported outcome measures before and after revision total hip arthroplasty (THA). The researchers enrolled 381 consecutive patients who underwent revision THA. The 104 patients who used preoperative opioids were matched to 208 controls using nearest-neighbor propensity score matching. Patients who used preoperative opioids had significantly lower patient-reported outcomes compared to the matched controls, including poorer physical function and mental health scores. Use of preoperative opioids was also associated with increased hospital stay.

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In Other News

Study Evaluates All-soft Tissue Quadriceps Tendon Autograft for Revision ACLR

A study published online in Arthroscopy evaluated outcomes of 100 patients who underwent revision ACL reconstruction (ACLR) using all-soft tissue quadriceps tendon autografts. After an average of 42 months of follow-up, patients’ mean International Knee Documentation Committee survey scores significantly improved (54.3 versus 82.8). Quadricep limb symmetry index also improved from 716 to 81.5 percent at 60 degrees per second isokinetic testing and from 76.6 percent to 83.9 percent at 180 degrees per second from six to 12 months, respectively. Eleven patients experienced graft failure. Quadricep or hamstring limb symmetry indices were similar between patients previously treated with hamstring versus patella tendon autografts.

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Study: Recurrent Instability after Return to Sport following Arthroscopic Bankart Repair

A retrospective study published online in the Journal of Shoulder and Elbow Surgery evaluated recurrent instability after arthroscopic Bankart repair in patients who returned to sport after participating in a criteria-based testing protocol. Thirty-six patients treated between 2016 and 2018 were followed for a minimum of one year. Undergoing a criteria-based return to sport testing protocol was associated with reduced rates of recurrent shoulder instability compared to patients who did not participate (5.0 percent versus 22.0 percent). There was no difference in time to recurrence between those who completed the protocol and those who did not (12.0 months versus 13.6 months).

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Study: Impact of Spinopelvic Parameters on Lumbar Decompression Surgery for Lumbar Stenosis

Spinopelvic parameters are not associated with outcomes of lumbar decompressive procedures for the treatment of lumbar spinal stenosis, according to a study published in the European Spine Journal. In total, 104 patients treated between 2016 and 2017 were divided based on relative lumbar lordosis, pelvic tilt, and sagittal vertical axis, measured via preoperative radiograph. No clinically important difference in outcomes was observed between the groups. However, there was a significant but weak statistical correlation between relative lumbar lordosis and pre- and postoperative Oswestry Disability Index scores, as well as a negative correlation between sagittal vertical axis and postoperative EuroQoL Five Dimension Questionnaire scores.

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Study: Chest Wall Injuries Do Not Increase Clavicle Fracture Fixation Complications

A retrospective study published online on BMC Musculoskeletal Disorders evaluated the incidence of complications in clavicle fracture fixation due to chest wall injuries. Out of 314 patients, who received a total of 316 clavicle fracture operations, 90 patients (28.7 percent) had chest wall injuries. Patients with chest wall injuries presented with higher age, BMI, and rib fractures. Overall and surgical complications were similar between groups. Complex chest wall injuries were associated with more unplanned 30-day hospital readmissions. Complex chest wall injury and number of rib fractures were independent predictors of unplanned 30-day readmissions.

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Your AAOS

OrthoInfo Helps Doctors Educate Patients

OrthoInfo, the AAOS patient education website, is a free member resource that provides orthopaedic surgeons and patients with authoritative, in-depth information about musculoskeletal health. The website features more than 400 articles, videos, and animations on common orthopaedic problems, surgical procedures, nonsurgical treatments, injury prevention, and healthy living. All content is developed and peer reviewed by AAOS members. Written in simple language, OrthoInfo articles can help your patients be better informed and participate more fully in their care and recovery.

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