Today’s Top Story

Study Compares Aspirin to Other Anticoagulants to Prevent VTE Prophylaxis following Joint Replacement

Aspirin was not significantly more effective compared to other anticoagulants in preventing postoperative venous thromboembolism (VTE) prophylaxis in total hip replacement (THR) and total knee replacement (TKR) patients, according to a systematic review and meta-analysis published online in JAMA Internal Medicine. Randomized, controlled trials (RCTs) were identified through searches of the MEDLINE, Embase, Web of Science, and Cochrane Library databases, as well as bibliographic searches. Search terms were related to the population, drug intervention, and outcome. Final analysis included 13 RCTs encompassing 6,060 total patients (mean age, 63 years; 57.2 percent were female). The relative risk (RR) of postoperative VTE for aspirin, compared to other anticoagulants, was 1.12; results were similar for deep vein thrombosis (DVT) (RR = 1.04) and pulmonary embolism (PE) (RR = 1.01). The use of aspirin versus other anticoagulants did not largely impact adverse event risk. Separate analyses of THRs and TKRs did not yield significant differences in VTE, DVT, and PE risks between aspirin versus other anticoagulants. Evidence ranged from low to high quality.

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In Other News

Study: Relative Axial Rotation Between Talar and Tibial Component in Mobile-bearing Ankle Arthroplasty

A study published online in Foot & Ankle International explored the relative axial rotation between the talar and tibial component in total ankle arthroplasty (TAA) intraoperatively and at least three years postoperatively. Intraoperative measurements were taken in 58 mobile-bearing TAA patients, and 48 patients underwent weight-bearing CT scans after a mean 6.3 years postoperatively. Pre- and postoperative ankle joint/tibial component and hindfoot alignment per conventional radiographs was compared to intra- and postoperative relative axial rotation of the talar and tibial component. The mean intraoperative axial talar component position, compared to the tibial component, was 1.7 degrees toward internal; postoperatively, the mean measurement was 1.4. A correlation was observed between the preoperative sagittal alignment of the distal tibia and the intraoperatively determined relative axial rotation between the talar and the tibial component.

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Study Evaluates Safety of Outpatient Reverse Shoulder Arthroplasty

According to a study published online in the Journal of Shoulder and Elbow Surgery, outpatient reverse total shoulder arthroplasty (RTSA) is a safe procedure and may have fewer complications compared to inpatient surgery. Patients who underwent either outpatient (n = 241) or inpatient (n = 373) RTSA performed by a single surgeon were compared for outcomes including American Shoulder and Elbow Surgeons, visual analog scale, and Single Assessment Numeric Evaluation scores; complications; readmission; and revision surgery. At one- and two-year follow-up, outpatient and inpatient RTSA patients all presented significantly improved clinical outcomes. The outpatient group had a significantly lower rate of complications than the inpatient group (7.0 percent versus 12.7 percent).

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Study: Do Preseason Soccer Training Sessions Correlate with In-season Injuries?

According to a study published online in The American Journal of Sports Medicine, elite soccer teams that have more preseason training sessions have “healthier” in-season periods. The Union of European Football Associations injury dataset was used to evaluate 44 teams for up to 15 seasons to assess the correlation between the number of team preseason training sessions and five in-season injury measures: (1) injury burden, (2) severe injury incidence, (3) training attendance, (4) match availability, and (5) injury incidence. The average number of preseason training sessions was 30 (range, 10–51 sessions). Teams with more preseason training sessions had less injury load during the in-season in four of the five measures. With each addition of 10 preseason training sessions, the in-season injury burden was 22 layoff days lower per 1,000 hours, the severe injury incidence was 0.18 severe injuries lower per 1,000 hours, the training attendance was 1.4 percentage points greater, and the match availability was 1.0 percentage point greater.

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Orthofix Signs $18 Million Limb Lengthening System Deal

Orthofix agreed to an $18 million deal with Germany-based Wittenstein SE to acquire its FITBONE intramedullary lengthening system. The device is currently intended for limb lengthening of the femur and tibia bones. The deal also gives Orthofix access to Fitspine, a similar technology in its early stages that is intended for early onset scoliosis.

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Consider Several Key Factors When Assessing Robotic Technology

There is a long history of innovation in supplemental technology for joint arthroplasty procedures, from the early intramedullary cutting jig decades ago to today’s digital soft-tissue balancers, computer navigation, and robotics. Currently, several robotic systems are approved for joint replacement procedures, and more are expected to come to market over the next two years.

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Call for Content: Submit an Article for AAOS Now

Do you have timely research or an interesting story to tell? AAOS Now is seeking editorial submissions from orthopaedic surgeons and orthopaedic- and practice-related product and service providers that qualify as subject matter experts. The magazine features various formats and opportunities to highlight your information or topic. AAOS Now encourages interested authors to contact staff prior to writing in order to review suggestions and provide feedback. Submit an article suggestion online or email AAOS Now Publisher Dennis Coyle at

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