April 9, 2021 | Today’s News

Study: Variability in Orthopaedic Surgery Residency Away Rotations

A study published in the April 1 issue of the Journal of the AAOS ® surveyed orthopaedic surgery residency program directors regarding away rotation selection and structure. Sixty-one program directors from accredited residency programs in the U.S. responded anonymously. The number of away students accepted overall and at one time varied across programs. Most programs (94 percent) evaluated students immediately following their rotation, most frequently by fellow residents. Only 46.0 percent of program directors evaluated students post-rotation. When selecting candidates, 38.5 percent of programs guaranteed interviews for visiting students, and 80.0 percent required students to return for interview day.

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Survey: Prior Authorization Policies Led to Delays in Care during the Pandemic

A survey conducted by the American Medical Association queried 1,000 practicing physicians regarding the prior authorization requirements, which some health insurers temporarily relaxed during the COVID-19 pandemic. As of Dec. 2020, nearly 70 percent of respondents said that insurers had either reverted to past requirements or never relaxed these policies in the first place. Most physicians (94.0 percent) reported delays in care while waiting for authorization, and 79.0 percent reported patients abandoning treatment due to authorization struggles with insurers. Reforming prior authorization and coverage review processes is a high priority for the AAOS and is a tier one issue on its 2021 Unified Advocacy Agenda.

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Rotator cuff fatty infiltration and muscle atrophy do not impact outcomes of reverse total shoulder arthroplasty (RTSA) for glenohumeral arthritis, according to a study published online in the Journal of Shoulder and Elbow Surgery. In total, 81 patients who underwent RTSA with a lateralized glenosphere were followed for two years. Twenty-two patients (27.1 percent) and 43 patients (53.1 percent) had moderate to severe combined infraspinatus and teres minor or global rotator cuff fatty infiltration, respectively. However, outcomes were similar to patients with only mild fatty infiltration. Fatty infiltration and muscle atrophy were not significantly associated with postoperative range of motion.

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A retrospective study published online in BMC Musculoskeletal Disorders assessed synchronous and sequential cementless bilateral total hip arthroplasty (THA) for osseous anklyosed hips with ankylosis spondylitis. Twenty-three patients were divided by synchronous versus sequential THA. Both groups showed improvements in Harris Hip Scores and range of motion. Synchronous THA required more blood transfusions and longer time to walking postoperatively compared to sequential THA. Both groups achieved similar bilateral femoral offset, leg length discrepancy, hospital expense, and patient satisfaction. Three hips per group experienced heterotopic ossification. One patient treated synchronously experienced intraoperative femoral fracture, and another experienced hip dislocation and delayed union.

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A retrospective study published online in the Journal of Hand Surgery identified risk factors of surgical treatment of thumb carpometacarpal arthritis. The cohort comprised 1,994 patients treated for thumb carpometacarpal arthritis between 2015 and 2018, including 170 patients (9.0 percent) treated surgically. Median time to surgery from initial appointment was 114 days. Patient-reported Outcomes Measurement Information System Depression scores correlated with Pain Interference and Physical Function scores, while previously diagnosed depression or anxiety were associated with lower perceived Physical Function at presentation. Upon regression analysis, prior contralateral thumb carpometacarpal surgery, younger age, and treating institution were associated with a patient requiring surgery.

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A study published online in Arthroscopy compared radiographic outcomes of retro- versus supra-tubercle opening-wedge high tibial osteotomy (OW-HTO). Individuals who underwent biplanar OW-HTO between 2017 and 2018 were included (n = 94 knees), 50 of whom were treated with supra-tubercle and 44 treated with retro-tubercle OW-HTO. Patellar height and tilt angle were significantly decreased following supra-tubercle OW-HTO. Retro-tubercle OW-HTO led to decreased patellar tilt angle and increased posterior tibial slope, retro-tuberosity gap distance, and retro-tuberosity tip distance. The retro-tubercle procedure was also associated with greater risk of tuberosity fracture and delayed union compared to supra-tubercle OW-HTO.

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Submit Manuscripts for the 2022 Kappa Delta and OREF Clinical Research Awards

AAOS is soliciting manuscripts for the 2022 Kappa Delta Orthopaedic Research Awards and the Orthopaedic Research and Education Foundation (OREF) Clinical Research Award. Up to two $20,000 Kappa Delta awards (Elizabeth Winston Lanier Award and Ann Doner Vaughn Award), one $20,000 Kappa Delta Young Investigator award, and one $20,000 OREF award will be bestowed, provided manuscripts of requisite quality are submitted. Manuscripts should represent a large body of cohesive scientific work generally reflecting years of investigation. Manuscripts must be submitted by members (or candidate members) of AAOS, the Orthopaedic Research Society (ORS), the Canadian Orthopaedic Association, or the Canadian Orthopaedic Research Society. The awards will be presented at the AAOS 2022 Annual Meeting, and recipients will be invited to speak at the ORS 2022 Annual Meeting. Submissions are due by 11:59 p.m. CDT on July 1.

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