Study: Enhanced Education Does Not Reduce Postoperative Opioid Use
According to a study published in the April 1 issue of the Journal of the AAOS ®, enhanced opioid education before elective lower extremity surgery did not reduce postoperative opioid use. In total, 120 patients were randomized 1:1 to an interactive education program or standard education. Patients were followed for one year. Number of opioids and prescriptions filled were similar between groups. Most patients did not use any opioids after 30 days postoperatively, regardless of intervention Sixteen standard education and 18 interactive education patients filled at least one prescription after six months postoperatively.
Study: Lateralized Humeral Offset May Improve External Rotation in RSA
Restoring baseline or lateralized humeral offset (HO) in patients undergoing reverse shoulder arthroplasty (RSA) significantly improved postoperative external rotation (ER), according to a retrospective study published online in the Journal of Shoulder and Elbow Surgery. In total, 109 shoulders were included. HO was medialized in 63 shoulders and lateralized in 46 shoulders. Average forward elevation, subjective shoulder value, and American Shoulder and Elbow Surgeons score were comparable between medialized and lateralized shoulders, but ER was significantly improved in lateralized shoulders
Study: Tibial Slope Is Related to Risk of Trauma to the Posteromedial Structure during Bicruciate-retaining TKA
In a study published online in The Knee, patients undergoing bicruciate-retaining total knee arthroplasty (TKA) with a larger posterior tibial slope (PTS) and a smaller coronal tibial slope (CTS) were at increased risk of trauma to the posteromedial structure during tibial bone resection. Fifty patients with varus knee osteoarthritis were assessed. CTS and medial PTS were measured using a CT-based system. The researchers evaluated the association between tibial morphology and distance from a simulated tibial cutting plane set neutral to the coronal plane. Thirty-eight percent had negative insertion values. MPTS was negatively correlated with insertion value, while CTS was positively correlated.
Study Investigates Rib Fracture Outcomes among Indigenous Patients
A study of rib fracture outcomes in Indigenous (Māori) and non-Māori patients in New Zealand, published online in Injury, reported higher rates of readmissions in Māori patients. Overall, 407 patients (Māori, 15 percent) from 14 hospitals were assessed. Mean age was 57.4 years and the median number of fractured ribs was four. Two percent of patients required surgical stabilization. Pneumonia occurred in 11 percent. Readmissions and mortality occurred in 8 percent and 2 percent, respectively. Odds of pneumonia increased with each additional rib fracture. Older age and Māori ethnicity were both significantly associated with greater odds of readmissions.
Study: Symmetrical Postoperative Kinematics in Patients with TAA
Total ankle arthroplasty (TAA) with a trabecular metal implant led to symmetrical walking kinematics and double heel-rise exercises at a mean follow up of 5.4 years, with minor differences in tibiotalar kinematics compared with controls, according to a study published online in Foot & Ankle International. Six TAA patients were compared to six non-TAA controls. Participants underwent biplanar fluoroscopy during exercise. Researchers compared tibiotalar and subtalar kinematics for TAA with untreated contralateral and control limbs. TAA patients demonstrated reduced dorsi-plantar flexion and peak dorsiflexion while walking but had otherwise symmetrical activities.
Vigilance Warranted: The ‘Nightstick Fracture’ Often Signals Intimate Partner Violence
Up to one-third of women who sustain a fracture to the ulna bone of the forearm, colloquially known as “nightstick” fractures, may be victims of intimate partner violence (IPV), according to a study by David Sing, MD, and researchers. The authors surmise that screening for IPV is lacking, and recommend “that orthopaedic surgeons maintain a high degree of suspicion of IPV when treating nightstick fractures, particularly if they are minimally displaced.”
AAOS is seeking volunteers to review the Surgical Management for Osteoarthritis of the Knee Clinical Practice Guideline. Applications will be reviewed and approved on a first come, first served basis.
