Study Finds Higher Incidence of Intraoperative Periprosthetic Fractures in THA Patients with Osteoporosis
A retrospective study published online in The Journal of Arthroplasty found that patients with a history of osteoporosis undergoing total hip arthroplasty (THA) had an increased risk of intraoperative periprosthetic fractures while patients undergoing total knee arthroplasty (TKA) did not. Patients with osteopetrosis (534 THA and 972 TKA) were compared with matched cohorts. The primary outcomes included postoperative surgical complications, hospital readmissions, and ED visits. When compared to the matched cohort, osteopetrosis THA patients had a significantly higher incidence of intraoperative periprosthetic fractures. There were no significant differences between osteopetrosis TKA patients and the matched cohort.
Study: Medicaid Payer Status Associated with Increased Readmission and Hospital Stay following Shoulder Arthroplasty
A propensity score-matched analysis published online in the Journal of Elbow and Shoulder Surgery examined readmission and reoperation rates, hospital length of stay (LOS), and direct costs following primary shoulder arthroplasty in a Medicaid population. Utilizing the National Readmission Database, 4,667 Medicaid and 161,147 non-Medicaid patients were identified. Medicaid patients had 90-day all-cause readmission rates of 11.6 percent versus 9.3 percent for non-Medicaid patients. Medicaid patients also had an increased risk of readmission (2 percent versus 1.3 percent) and LOS >2 days (28.4 percent versus 25.7percent) and greater direct costs (median of $17,612 versus $16,775).
Study: Reliability of Weightbearing Cone-beam CT for Syndesmotic Ankle Injuries
Clinical Orthopaedics and Related Research published a systematic review evaluating weightbearing cone-beam CT in syndesmotic ankle injuries. Studies assessing syndesmotic instability in Medline, Pubmed, Embase, and Emcare were reviewed. Eleven studies comprising 559 ankles were included in the analysis. A negative association between age and syndesmosis volume was observed. Mean tibiofibular syndesmosis area increased from 112.5 mm 2 to 157.5 mm 2 after injury. The syndesmotic area proved to be a reliable parameter in the assessment of syndesmotic injuries as it increased in the presence of instability during weightbearing status.
Study: Predictors of Distal Phalangeal Nonunion after Fingertip Replantation
A retrospective study published online in the Journal of Hand Surgery identified risk factors and predictors of radiographic distal phalangeal nonunion after fingertip replantation. Demographics, nonunion, complications, and secondary operations were included in the analysis of 111 patients and 116 digits. At 12-month follow-up, 16 digits showed nonunion or complications. Of the digits that showed nonunion or complications, nine digits had asymptomatic nonunion without a secondary operation and five underwent additional operations. Multivariate analysis suggested that post-fixation fracture gap was a significant predictor of distal phalangeal nonunion.
Study: Characteristics and Correlation between Facet Joints and Osteoarthritis in Patients with Lumbar Foraminal Stenosis
The Journal of Pain Research published an article online investigating degeneration patterns of facet joints (FJ) in patients with lumbar foraminal stenosis (LFS) and the associations between quantitative parameters and FJ osteoarthritis (FJOA). A total of 171 patients with LFS were included. Outcome measures included FJ orientation, FJ tropism, superior articular process cross-sectional area (SAPA), and FJ area at the L3/4, L4/5, and L5/S1 spinal levels. LFS was significantly associated with FJ tropism and SAPA. Furthermore, there was a significant correlation between FJOA and both SAPA and FJ area at each spinal level.
Webinar Addresses Diversity in Global Orthopaedics
Earlier this year, AAOS and the International Orthopaedic Diversity Alliance cosponsored a webinar titled “Creating a Global Orthopaedic Culture in Which Everyone Can Thrive” to call attention to the need for diversity, equity, and inclusion in orthopaedics. The webinar featured orthopaedic surgeons from all over the world, from the United States to Saudi Arabia, and the diverse group of physicians discussed unique regional challenges to fostering diversity in the specialty.
August Podcast Episodes Discuss Unity in Advocacy and Professional Growth
The latest episode of the AAOS Advocacy Podcast features a former AAOS president making the case that coming together and staying focused on ortho-partisan issues—despite differences in specialization and political ideology—is necessary to advocate for patients’ best interests and to be heard in a politically fragmented environment. The August episode of the AAOS Career Podcast also discussed advocacy as an opportunity for surgeons to develop important skills, such as effective communication and the art of negotiation.
