Today’s Top Story

Study: Long-term Assessment of Revision Total Wrist Arthroplasty Outcomes

A study published in the March issue of the Journal of the AAOS (JAAOS): Global Research & Reviews ® evaluated outcomes of 76 revision total wrist arthroplasties performed over a 40-year period. Mean follow-up was 10.3 years. Most patients (91 percent) reported pain relief postoperatively, but there were high rates of complications and repeat revision surgery. The most frequent indications for repeat revision surgery included distal loosening (n = 11), deformity and pain (n = 8), periprosthetic infection (n = 3), and dislocation (n = 2).

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In Other News

Study: Impact of Perineal Post Distraction on Pain after Hip Arthroscopy

A retrospective study published online in Arthroscopy compared postoperative pain and recovery after hip arthroscopy with and without a perineal post for joint distraction. One hundred patients each were included for arthroscopy with and without a perineal post. Total operative, traction, and OR time were shorter in the nonperineal post group. Patients treated with a perineal post also had shorter time to discharge. Morphine use and pain scores were similar between groups. Age ≥ 25 years and elevated BMI were associated with increased morphine use, and female sex was associated with higher postoperative pain scores.

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Study Compares Early Versus Delayed Fixation of Bilateral Femur Fractures

A retrospective study published online in Injury identified factors impacting the timing of definitive fixation for bilateral femoral shaft fractures. In total, 328 patients treated between 1998 to 2019 were included and grouped based on time from injury to fixation (≤ 24 hours, n = 164; > 24 hours, n = 164). Delayed fixation was associated with higher Injury Severity Scores, higher lactate level at admission, and lower Glasgow Coma Scale compared to patients with earlier fixation. High-volume institution was the most common influence on time to fixation (78.6 percent), followed by lactate level at admission (64.4 percent).

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Study: Tension Band Wiring Versus Plate Fixation for Olecranon Fractures

A retrospective study published online in the Journal of Shoulder and Elbow Surgery determined risk factors for early complications and reoperation related to tension band wiring (TBW, n = 387) or plate fixation (PF, n = 47) for treatment of olecranon fractures. There were no significant differences in early complication rates (49 percent versus 62 percent) or reoperation (38 percent versus 53 percent) between the TBW and PF groups. Intramedullary placement of Kirschner wires was associated with increased complications in the TBW group compared to transcortical placement. Younger age and high-energy trauma were associated with increased reoperation rates.

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Study: Mini C-arm Contamination during Foot and Ankle Surgery

A study published online in Foot & Ankle International assessed the rate of mini C-arm drape contamination during foot and ankle surgery. Fifty surgeries that utilized mini C-arm fluoroscopy were included, and eight locations on the drape were sampled from each procedure. Contamination occurred in at least one location in 70 percent of surgeries, and six of the eight sampled locations had significantly higher contamination. The highest-risk areas were the “outer portion of the upper arm” and the “superior portion of the X-ray source,” which exhibited bacteria growth in 26 percent and 30 percent of cases, respectively.

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Young Latina Dreamed of Being a Surgeon

When Monica Payares, MD, FAAOS, was a child growing up in Colombia, she watched her two younger brothers struggle with the hip disorder Legg-Calve-Perthes disease. By the time she was 9 years old, she knew she wanted to be a pediatric orthopaedic surgeon, to fulfill an instinct to help and nurture injured children. This article spotlights how Dr. Payares’ deep-seated conviction helped her weather frequent discouragement—often racist and sexist—along the way to fulfilling her dream.

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JAAOS ® Announces Editor-in-Chief Designee

AAOS announced Peter S. Rose, MD, FAAOS, as the editor-in-chief designee of JAAOS ®. A professor of orthopaedics and division chair of orthopaedic oncology at Mayo Clinic in Rochester, Minn., Dr. Rose will begin overseeing the publication on Jan. 1, 2022.

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