Today’s Top Story

Study: Novel Multilayer-coating versus Standard TKA after 10-year Follow-up

In a randomized controlled trial published in The Journal of Arthroplasty, a multilayer hypoallergenic-coated implant led to similar patient-reported outcomes (PROs) as a standard implant in total knee arthroplasty (TKA). In total, 120 patients were randomized to standard or coated TKA. Patient serum metal ion levels, knee function, quality of life, and physical activity were assessed preoperatively until 10-year follow-up. Cobalt levels increased slightly in the standard TKA group at five and 10 years. Both groups demonstrated favorable PROs and excellent implant survival rates.

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In Other News

Study: No Difference in Rates of Conversion to Arthroplasty after IMN versus Sliding Screw for Hip Fractures

An observational cohort study published online in the Journal of Bone & Joint Surgery found intramedullary nails (IMNs) performed equally well when compared to sliding hip screws for extracapsular hip fractures. Utilizing the Swedish Fracture Register, 19,604 patients aged >60 years who had mean follow-up of one year were included in the analysis. The outcomes measured were incidence of conversion to arthroplasty and incidence of reoperation. IMNs were associated with higher rates of 31-A2 pertrochanteric fractures and reoperation; however, no other major differences were observed.

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Study: Multimodal Analgesic Intervention Lowered Short-term and Long-term Opioid Use after Orthopaedic Trauma

In a retrospective study published online in the Journal of Orthopaedic Trauma, implementation of a multimodal analgesic protocol was associated with reduced short-term and long-term opioid use in patients hospitalized after orthopaedic trauma. The intervention consisted of acetaminophen, ibuprofen, gabapentinoids, skeletal muscle relaxants, and standardized doses of opioids plus standardized pain management education before hospital discharge. Between intervention and control cohorts, patients in the intervention cohort received shorter days’ supply of opioids postoperatively (5.7 days versus 8.1 days). Long-term opioid use was significantly lower in the intervention cohort compared with the control cohort.

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Study: Outcomes of Operative versus Nonoperative Treatment for Undisplaced or Minimally Displaced Scaphoid Fractures

The Bone & Joint Journal published a systematic review comparing the effectiveness of operative and nonoperative treatments of undisplaced or minimally displaced ( <2 mm) scaphoid fractures. Seven databases were utilized to identify seven randomized controlled trials. Primary measures were wrist function at 12 months, complications with treatment, range of motion, grip strength, and union. There was no significant difference in function between operative and nonoperative groups; however, the complication rate was higher in operative treatments.

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Study Finds Age-and Sex-related Differences in Composition of Paraspinal Muscles in Patients with and without Lumbar Degenerative Diseases

In a study published in BMC Musculoskeletal Disorders, age- and sex-dependent differences were found in the morphology and composition of paraspinal muscles between patients with and without lumbar degenerative diseases (LDD). Overall, 370 patients with LDD and 327 asymptomatic individuals aged 18 to 85 years were included. Outcomes measured were cross-sectional area (CSA) of the erector spinae and fatty infiltration (FI) ratio of the multifidus and erector spinae. FI ratio was positively correlated with LDD severity. Males had greater CSA than females. Females had higher FI ratios than males. As age increased, CSA decreased and FI ratios gradually increased.

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August Issue of AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the August issue of AAOS Now, but the electronic edition is already available on the AAOS Now website. This month’s issue highlights the moral obligations of orthopaedic surgeons in the face of discrimination, the AAOS Board of Directors’ approval of the Technology Overview for Platelet-rich Plasma for Osteoarthritis of the Knee, and AAOS’ response to Medicare payment reform.

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Orthopaedic Registry Value and Advocacy in the U.S.

In a recent episode of the AAOS Advocacy Podcast on the Bone Beat Orthopaedic Podcast Channel, AAOS Advocacy Council Chair and podcast host Douglas Lundy, MD, MBA, FAAOS, sits down with James Huddleston III, MD, FAAOS, professor of orthopaedic surgery at Stanford Hospital and AAOS American Joint Replacement Registry Steering Committee vice chair, to discuss the role that advocacy has in advancing the quality of musculoskeletal care through the AAOS family of registries.

Listen to the episode…