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| Today’s Top Story
Study Measures Value of BMI to Predict PJI after TKA
According to a retrospective review published online in The Journal of Arthroplasty, body mass index (BMI) could be more reliable than local measures of adiposity at the surgical site for predicting periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Data were collected on patient demographics, surgical duration, and one-year postoperative infection status for 4,745 primary TKA patients treated between January 2013 and December 2016. Prepatellar adipose thickness, bony width of the tibial plateau, and total soft tissue knee width were assessed using preoperative weight-bearing and lateral X-rays. Using the ratio of bone to total knee width, the researchers calculated the knee adipose index (KAI). Both adiposity local measures varied significantly when compared to BMI; neither of the knee adipose measurements corresponded with PJI risk BMI > 35 kg/m 2 was a significant risk factor for PJI. Correlations were observed between longer surgical duration and both BMI and local adipose tissue measures (KAI and prepatellar fat thickness).
Read the abstract… |
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| In Other News
Study: Do Early Postoperative Radiographs Affect Satisfaction in Orthopaedic Trauma Patients?
According to a study published in the Feb. 1 issue of the Journal of the AAOS, eliminating routine early postoperative radiographs in orthopaedic trauma patients did not impact patient satisfaction with the clinic visit but did have an effect on satisfaction with the surgeon’s injury explanation. A total of 100 patients with acute fracture fixation were included in the study. Half of patients received two-week follow-up radiographs, and the other half did not. All patients filled out a clinic visit satisfaction survey. The researchers saw no between-group differences in overall clinic visit satisfaction or complications, but patients who received radiographs felt more satisfied with the surgeon’s injury and progression explanations.
Read the abstract… |
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| Study Establishes the Learning Curve for the Arthroscopic Latarjet Procedure
A study published online in the Journal of Shoulder and Elbow Surgery identified how many arthroscopic Latarjet procedures specialist shoulder surgeons need to perform in order to attain steady-state operative efficiency. This retrospective review included individual data from 573 patients treated by 12 surgeons spanning five countries. Learning measure outcomes included operative time, CT bone-block positioning, complications, and patient-reported outcome measures (PROMs). High-volume surgeons attained steady-state operative efficiency after 30 to 50 cases, while surgeons who performed fewer cases had a constant reduction in operative time and did not hit a plateau. Completing fewer than 14 procedures did not result in reduced operative time. Bone-block positioning accuracy per postoperative CT presented constant improvement and did not hit a plateau after 53 cases. No correlation was observed between higher operative volume and PROMs or complications.
Read the abstract… |
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| Study: MCID of PROMIS in Nonshoulder Hand and Upper Extremity Patients
A study published online in The Journal of Hand Surgery provided reference values to indicate meaningful changes for the Patient-reported Outcomes Measurement Information System (PROMIS) and legacy instruments in nonshoulder hand and upper extremity patients. Patients aged 18 years or older who visited a tertiary academic outpatient hand surgery clinic completed PROMs between January 2015 and August 2017. Outcome measurement instruments included the PROMIS upper extremity (UE), physical function (PF), and pain interference computer adaptive test (CAT) instruments, as well as the quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. Minimal clinically important differences (MCIDs) were estimated using a mean change anchor-based method; scores between anchor groups were compared between those reporting no change versus slight improvements in function and pain. Over the course of the study, all instrument scores demonstrated significant improvements. The anchor-based MCID estimates were 1.0 for the PROMIS UE CAT, 1.7 for the PROMIS PF CAT, and 6.8 for the QuickDASH.
Read the abstract… |
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| Opinion: Progress Has Been Made in Opioid Crisis, But Work Remains to be Done
In an op-ed published in The Hill, Adam Bruggeman, MD, a spine surgeon in Texas, discussed the progress that has been made in the opioid crisis but also acknowledged that significant hurdles remain. Dr. Bruggeman, who is board certified in both orthopaedic surgery and addiction medicine and president of the Texas Orthopaedic Association, wrote, “Future efforts must ensure that the most effective treatments are being supported and that providers and patients are free to choose the best individualized treatment plans without undue outside influence, whether financial or legislative.”
Read more… |
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| AAOS Now
Psychologist Discusses Psychosocial Factors and Recovery after Military or Civilian Trauma
To further delve into the issues raised by the clinical practice guideline (CPG) on the Evaluation of Psychosocial Factors Influencing Recovery from Adult Orthopaedic Trauma, AAOS Now conducted an interview with Benjamin Keizer, PhD, psychologist and the military cochair of the development workgroup. Dr. Keizer is a licensed psychologist at the Center for the Intrepid, San Antonio Military Medical Center, Fort Sam Houston, Texas.
Read more…
Read more about the new CPG… |
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| Your AAOS
Take Part in an AUC Workgroup
AAOS is seeking volunteers to take part on the voting panel for the development of the appropriate use criteria (AUC) for the Use of Multimodal Perioperative Pharmacologic Pain Management. The deadline to submit an application for this project is Feb. 14.
Learn more and submit your application… |
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