Study: Telemedicine Program Increases Tobacco Cessation Before TJA
A study published online in NEJM Catalyst Innovations in Care Delivery examined the efficacy of using telemedicine to increase tobacco cessation among patients undergoing total joint arthroplasty (TJA). Orthopaedic literature has established that perioperative tobacco cessation reduces the risk of complications from TJA, as well as lowers hospital readmissions. Using their virtual program, researchers were able to successfully lower preoperative rates of tobacco use, which was associated with reduced surgical complications.
Study: Effect of Preoperative Factors on Time Between Surgeries in Bilateral TSA
A retrospective study published online in the Journal of Shoulder and Elbow Surgery evaluated factors associated with timing to contralateral surgery for patients who received bilateral total shoulder arthroplasty (TSA). A total of 332 patients who underwent either bilateral TSA or reverse TSA (RTSA) were stratified by time between surgeries. Preoperative factors were assessed for associations between different time groups. Osteoarthritis, radiographic bilateral shoulder disease, and TSA as the first surgery were all associated with increased odds of contralateral surgery within one year of TSA or RTSA.
Study: Outcomes of CEFs for Treatment of Open Tibial Plafond Fractures
A retrospective study published online in Foot & Ankle International measured outcomes associated with open tibial plafond fractures treated with circular external fixators (CEFs). A total of 52 patients were included. Outcomes assessed included union rate, deep infection, severe complications, and limb alignment. The union rate was 79 percent, and deep infection occurred in 8 percent of patients. Amputation or free flap coverage of the affected limb was not required for any patients. Use of CEFs resulted in variation in final radiographic limb alignment
Study: Underlying COPD Associated with THA Complications
A study published online in The Journal of Arthroplasty determined whether underlying chronic obstructive pulmonary disease (COPD) is associated with complications after total hip arthroplasty (THA). The PearlDiver Mariners database was utilized to identify 97,786 patients with and 338,243 patients without COPD who underwent THA between 2010 and 2018. COPD was associated with increased risk of 30-day readmission, pneumonia, dislocations, joint prosthetic infections, and periprosthetic fracture. Patients with COPD also had higher revision rates at one year (3.3 percent) compared to patients without COPD.
Study: Fracture Risk Among Younger Patients with RA
A retrospective study published online in Osteoporosis International investigated fracture risk in patients with rheumatoid arthritis (RA) aged younger than 50 years. A total of 36,858 adults with RA were compared to matched controls. Women aged younger than 50 years with RA had significantly higher odds of first fracture compared to controls; however, their risk of second fracture was raised but not significantly. Men aged younger than 50 years with RA had nonsignificant increases in fracture risk. Factors found to increase fracture risk in younger patients with RA included previous fracture, glucocorticoid prescription, smoking, and bisphosphonate prescription.
New Challenges and Proven Strategies for Optimal Surgeon-patient Communication
Studies have demonstrated that with improved physician-patient communication, there is higher patient satisfaction, increased compliance with proposed treatments, and overall improved outcomes. Communication skills are particularly important for orthopaedic surgeons because establishing trust with patients presenting for surgical evaluation is essential. This article discusses key principles to connecting with the patient early into the healthcare visit and building better communication.
Take Part in the Voting Panel for an Appropriate Use Criteria
AAOS is seeking volunteers to take part in the voting panel for the development of the Prevention of Surgical Site Infections Following Major Extremity Trauma Appropriate Use Criteria. Due to limited space, applications will be reviewed and approved on a first come, first served basis.
