Study: Incidence and Impact of Musculoskeletal Pain on Orthopaedic Surgical Residents
A study published in the March issue of the Journal of the AAOS: Global Research & Reviews ® surveyed 76 orthopaedic surgical residents regarding work-related musculoskeletal pain. Most respondents (97 percent) reported procedural-related musculoskeletal pain, with an average pain Numerical Rating Scale score of 3.52 out of 10. Musculoskeletal pain rated ≥ 4 was most common in the lower back (35.0 percent), neck (29.7 percent), and feet (25.7 percent). Higher musculoskeletal pain was associated with lower work satisfaction, burnout, and callousness toward others. Musculoskeletal pain also impacted resident behaviors, including over-the-counter medication use, stamina, concentration, and irritability.
Study Assesses How Surgical Timing Impacts RCR Functional Outcomes
A retrospective study published online in the Journal of Shoulder and Elbow Surgery evaluated how surgical timing impacted rotator cuff repair (RCR) outcomes in 206 patients after two years. Surgery within four months of injury led to an improvement of 10.3 points for American Shoulder and Elbow Surgeons scores, 1.8 points for Simple Shoulder Test, 8.6 points for Single Assessment Numeric Evaluation, and 0.93 points for visual analog scale pain score compared to those treated after four months. Treatment within three weeks was associated with significantly improved functional scores compared to patients treated between three weeks and four months.
Study: Preoperative Risk Factors of BMD Loss after THA with Implant
A retrospective study published online in BMC Musculoskeletal Disorders identified preoperative risk factors of severe zone 7 bone mineral density (BMD) loss one year after total hip arthroplasty (THA). In total, 48 patients who underwent THA with implantation of a Zweymüller-type femoral prosthesis between 2011 and 2015 were included. Univariate regression analysis found Canal Flare Index (CFI) and lower preoperative lumbar BMD on the anterior-posterior and lateral sides were correlated with zone 7 BMD loss. Multivariate analysis found CFI and lower preoperative lumbar BMD on the lateral side were independently associated with zone 7 BMD loss.
Study: Intrawound Vancomycin Powder Reduces Infection in Tibia Fracture Repair
A randomized study published online in JAMA Surgery assessed the efficacy of intrawound vancomycin powder in reducing deep surgical site infections after treatment for tibial plateau or pilon fracture. In total, 980 patients treated between 2015 and 2017 were followed for one year (with 1,000 mg vancomycin powder, n = 481; without, n = 499). Infection occurred in 29 patients treated with vancomycin powder and 46 patients in the control group, for a 3.4 percent risk difference in favor of the experimental group. Post hoc analysis found the vancomycin powder effect was a result of its reduction in gram-positive infections.
Study Compares Simultaneous Bilateral Versus Unilateral DCMO for Hallux Valgus Fixation
A retrospective study published online in Foot & Ankle International compared simultaneous bilateral and unilateral distal chevron metatarsal osteotomy (DCMO) for hallux valgus in patients aged ≥ 60 years. Ninety feet from 60 patients were included (bilateral, n = 30; unilateral, n = 30) and followed for ≥ 18 months. Mean hallux valgus angle improved from 34.2 to 5.4 degrees and first-to-second intermetatarsal angle improved from 15.8 to 6.8 degrees, with similar correction between groups. Hallux varus occurred in three feet in the bilateral and one in the unilateral group. One unilaterally treated foot had mechanical instability with callus formation.
Martha Murray, MD, FAAOS, FAOA, professor of orthopaedic surgery at Harvard Medical School and a sports medicine surgeon at Boston Children’s Hospital, has worked for the past 15 years to develop an alternative treatment for ACL tears. Her research ultimately led to the FDA’s recent granting of de novo approval for the Bridge-Enhanced® ACL Repair (BEAR®) Implant, the only medical technology to demonstrate healing of a torn ACL, which differs from the long-held approach to perform an ACL reconstruction with a graft of tendon. This interview spotlights Dr. Murray’s work in developing this technology.
Register for Crosstalk Symposium on Osteoarthritis
The Crosstalk Symposium on Osteoarthritis (OA) will take place on April 16 from 8 a.m. to 11:30 a.m. PT. This half-day symposium will be a virtual meeting to convene researchers from institutions across the United States and Europe to recognize OA as a disease of the whole joint. The symposium will discuss the latest discoveries in joint crosstalk in health and disease; complement the conversation in clinical OA research and stimulate translation; recruit and promote new talent within the field, including groups beyond basic musculoskeletal care; and identify priority research areas and strategies to drive progress.
