Study: Association between Intraoperative Dexamethasone Utilization and Periprosthetic Joint Infection after TJA
The Journal of Arthroplasty published a retrospective study online that investigated the rates of periprosthetic joint infection (PJI) and complications in patients undergoing elective total knee (TKA) and total hip arthroplasty (THA) who received intraoperative dexamethasone. Utilizing a national database, a total of 1,322,025 patients undergoing primary elective total joint arthroplasty (TJA) were identified. Of the 857,496 TKA patients, dexamethasone was associated with lower risk of PJI. THA patients demonstrated comparable results. Additionally, intraoperative dexamethasone use was associated with lower risk of thromboembolic, pulmonary, renal, and wound complications.
Study: Outcomes of Direct Anterior THA in the Treatment of Femoral Neck Fractures
According to a retrospective cohort study published online in Current Orthopaedic Practice, the overall complication rate using the direct anterior approach for total hip arthroplasty (THA) in patients with displaced femoral neck fractures was 8.1 percent. Thirty-seven patients received cementless components and were followed over a four-year period. Complications, intraoperative greater trochanter fractures, and in-hospital mortality were assessed. One intraoperative greater trochanter fracture and one in-hospital mortality were recorded; however, no reported postoperative periprosthetic fractures, dislocations, or revision arthroplasties occurred.
Study: Outcomes of a Novel TSA System Using Multiplanar Osteotomy and a Stemless, Elliptical Humeral Head
According to a retrospective study published in the Journal of Elbow and Shoulder Surgery, a novel total shoulder arthroplasty (TSA) system using both a multiplanar osteotomy (MPO) and elliptical humeral head was associated with improved range of motion (ROM) and center of rotation (COR) when compared with standard TSA. Initial and subsequent cohorts consisted of 25 patients undergoing standard TSA or TSA using an MPO/elliptical humeral head. For mean forward flexion and external rotation, there was significantly greater ROM in the MPO/elliptical group. The average change in COR for the MPO/elliptical group was 1.8 mm compared with 2.7 mm in the standard group, which was statistically significant.
Study: Interfacility Transfer Patients with Lower Extremity Trauma Are at Higher Risk for Major Complications
A retrospective study published online in the Journal of Orthopaedic Trauma found that interfacility transfer (IT) patients undergoing operative management for lower extremity orthopedic trauma are at a significantly increased risk of major complications and readmission. Preoperative comorbidities, adverse events, length of stay, and readmissions in the 30-day postoperative period were measured in 39,497 IT patients and direct admission (DA) patients. IT patients had significantly higher rates of mortality (3.3 percent versus 1.4 percent), major complications (10.2 percent versus 6.1 percent), and readmission rates (5.8 percent versus 4.8 percent) compared with DA patients.
Study: Cross-sectional and Structural Property Changes Observed in Nonsurgically Treated Achilles Tendon Ruptures
A randomized controlled trial published online in The American Journal of Sports Medicine found early tensile loading in nonsurgically treated Achilles tendon ruptures did not lead to higher elastic modulus in the healing tendon. Forty patients were randomized to an early tensile loading or control group. Patients were followed clinically and via CT at seven, 19, and 52 weeks. While there were no significant differences in elastic modulus between groups at 52 weeks, the tendon cross-sectional area was 302 mm in the loaded group compared with 252 mm in the control group.
A New Dynasty? Team from UT Houston Wins the AAOS Resident Rumble for Third Consecutive Year
The AAOS 2022 virtual Resident Rumble was a fierce series of competitions held April 6 to June 1. The events consisted of online trivia competitions, sponsored by DePuy Synthes, that mixed orthopaedic-based trivia with pop-culture trivia. The final round was between previous 2021 defending champions UT Houston and William Beaumont Army Medical Center, and ultimately UT Houston made it a “three-peat” and came out victorious.
AAOS Approves Updated Evidence-based CPG for the Management of ACL Injuries
The AAOS Board of Directors approved the update to the 2014 Management of Anterior Cruciate Ligament (ACL) Injuries Clinical Practice Guideline (CPG) This CPG updated 12 of the 24 evidence-based recommendations from the original guideline and resulted in five strong and three moderate-strength recommendations. The update also included two new recommendations and six options to assist clinicians managing both skeletally immature and mature patients diagnosed with an ACL injury.
