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| Today’s Top Story
Study: Conversion to Below- or Above-knee Amputation after Transmetatarsal Amputation
A retrospective study published in the August 15 issue of the Journal of the AAOS ® investigated risk factors associated with mortality and conversion to below-knee amputation (BKA) or above-knee amputation (AKA) after transmetatarsal amputation (TMA). A total of 286 TMAs were reviewed for revision surgery, amputation, or mortality. Analysis indicated that women, patients aged 57 to 64 years, and patients with a history of revascularization were more likely to require subsequent BKA or AKA. History of end-stage renal disease and cardiovascular disease were associated with higher mortality rates after TMA.
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| In Other News
Study: Similar Outcomes after Revision TSA in an Inpatient versus Outpatient Setting
A systematic review published online in the Journal of Shoulder and Elbow Surgery found no increased risks of complications, readmission, or reoperation after outpatient revision total shoulder arthroplasty (TSA) compared to inpatient revision TSA. Utilizing the American College of Surgeons National Surgical Quality Improvement Program to identify patients that underwent revision and primary TSA in inpatient and outpatient settings, the researchers included 1,456 and 2,360 patients, respectively. When comparing revision TSA with primary TSA, outpatient revision TSA had higher complication, readmission, and reoperation rates. However, no significant differences were noted between outpatient and inpatient revision TSA.
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| Study: Age Alone Does Not Impact Joint Survivorship after Arthroscopic Partial Meniscectomy for Degenerative Medial Tears
A retrospective study reviewing the effect of age on joint survivorship after arthroscopic partial meniscectomy (APM) for degenerative medial meniscus tears (DMTs) was published online in Knee Surgery, Sports Traumatology, Arthroscopy. Patients were matched and divided into two groups: older (aged >60 years) and younger (<60 years). Joint survival rates were compared before and after propensity score matching (PSM). Of 633 knees, there were no statistically significant differences in survival rates between groups; however, survivorship rates after APM were affected by factors associated with aging (i.e., cartilage status, meniscal tear pattern).
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| Study: Thromboembolic Complications after IMN for Lower Extremity Diaphyseal Fractures in COVID-positive Patients
In a retrospective chart review published online in the Journal of Orthopaedic Trauma, COVID-positive patients undergoing intramedullary nailing (IMN) of tibial or femoral shaft fractures experienced no thromboembolic complications. Of the 36 patients included in the study, 21 patients had femoral fractures and 15 patients had tibial shaft fractures. While there were no thromboembolic events, five patients developed pulmonary issues; however, each of those patients either had baseline chronic obstructive pulmonary disease, were immune-compromised, or sustained polytraumatic injuries.
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| Study: Number of Preoperative Corticosteroid Injections Does Not Impact Outcomes of Trapeziectomy and Suspensionplasty
The Journal of Hand Surgery published a retrospective chart review that demonstrated no apparent detrimental effects with an increased number of preoperative corticosteroid injections after trapeziectomy and suspensionplasty. The 60 patients included in the review were separated into groups based on the number of injections received preoperatively (zero, one, two, or three or more). Preoperative and final radiographs were evaluated over a 10-year period. When comparing groups, no significant differences were observed in thumb metacarpal subsidence, nondissociative carpal instability, patient-reported outcomes, or revision rates.
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| AAOS Now
New Clinical Practice Guideline Covers Surgical Site Infections after Major Extremity Trauma
The AAOS Board of Directors approved the Clinical Practice Guideline (CPG) and correlating Appropriate Use Criteria on the Prevention of Surgical Site Infections (SSIs) after Major Extremity Trauma. The CPG, which was developed in collaboration with the Major Extremity Trauma Research Consortium, provides 14 strong or moderate recommendations based on available evidence about preoperative, perioperative, and postoperative interventions to decrease SSIs following major extremity trauma. The guideline also addresses modifiable factors that are associated with increased risk for SSI.
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| Your AAOS
Hundreds of Surgical Techniques Modules Available Free to AAOS Members
Build your surgical and clinical decision-making skills with unique educational experiences available on the AAOS online learning platform. Explore the surgical instruction interactive learning modules that assess your knowledge, patient management, and clinical decision making. Available free to AAOS members, these microlearning experiences provide quick and exciting lessons for hundreds of procedural techniques. Topics include advanced reconstruction, foot and ankle, hand and wrist, shoulder and elbow, hip and knee, spine, and sports medicine.
View the learning platform… (member login required) |
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