Study: High Mortality Rates after Hip Fracture Surgery in Patients with COVID-19 Infection
A systematic review published in Current Orthopaedic Practice reported high rates of in-hospital and 30-day mortality among patients with COVID-19 who undergo hip fracture surgery. Eleven studies were included, comprising 336 patients. Three studies reported in-hospital mortality, and the pooled rate was 29.8 percent. Eight studies with 30-day mortality data reported a pooled rate of 35.0 percent The mean length of stay was 11.29 days.
Study: Five-year Follow-up after TKA with Patient-specific Instrumentation
A randomized controlled study with more than five years of follow-up data found that patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) is not superior to traditional cutting block techniques regarding improved alignment or functional outcomes. The study was published in The Journal of Arthroplasty. Fifty-seven patients (PSI, n = 38) were assessed. There were no significant differences between PSI or conventional techniques in the coronal femoral, coronal tibial, tibiofemoral, or sagittal femoral angles or in the posterior tibia slope. Both PSI and conventional techniques demonstrated similar improvement in EQ-5D, Oxford Knee Scores, and International Knee Society Scores.
Study Investigates Cost-effectiveness of RC Repair with Graft Augmentation
A study published online in Arthroscopy reported that extracellular matrix augmentation may be a cost-effective option for primary rotator cuff (RC) repair, with improved long-term outcomes and reduced revision compared with repair without augmentation. The researchers used a decision tree model to compare RC repair with or without augmentation. Graft augmentation had greater upfront costs than no augmentation ($16,039 versus $12,763). Augmentation led to an improvement of 2.29 quality-adjusted life-years (QALYs) versus 2.05 QALYs without augmentation. The incremental cost-effectiveness ratio for graft augmentation was $14,000 per QALY (under the $50,000/QALY threshold).
Study: Injury Severity, Genitourinary Disease Are Associated with Mortality in Older Trauma Patients
A retrospective study published online in Injury identified independent risk factors of mortality up to six months after orthopaedic trauma in patients aged >60 years. In total, 174 patients treated over a 10-year period were assessed. The average mortality rate was 47.7 percent. Injury Severity Score >30 was a significant independent predictor of mortality. Other mortality risk factors included genitourinary disease, increased age, ICU stay, multiple organ dysfunction syndrome, and anticoagulant use. High-energy trauma and psychiatric disease were significantly associated with risk of mortality in the first month after injury.
Study Investigates Benefit of Closed-suction Drainage in Thoracolumbar Spinal Surgery
A systematic review published online in the European Spine Journal found no significant benefit with the use of closed-suction drainage in elective thoracolumbar spinal surgery. Twenty-four studies, comprising 8,579 patients, were assessed. Drainage duration of >72 hours was associated with a higher incidence of surgical site infections. There was insufficient evidence to show that drainage improved postoperative hematoma and neurological complications. Length of stay and costs may be higher in patients who receive drainage, but depend on the surgery type, the authors noted.
Medical Practices Face Labor Shortages During Pandemic
Ajay Srivastava, MD, and Jim Long, MA, CMPE, reflect on the challenges of recruitment and retention of qualified healthcare personnel during the pandemic. “The COVID-19 pandemic has worsened this significant staff shortage, especially in entry-level positions and jobs where the hourly wage is typically lower than skilled positions,” they write. “The labor shortage has made it difficult to operate an independent medical practice.”
Extend Your AAOS 2022 Learning with Gold Registration
Now is the time to secure your registration for the upcoming AAOS Annual Meeting this March 22–26 in Chicago. The best of the best in orthopaedics will present over the course of 5 days. Don’t miss a session by selecting the Gold Registration package at checkout and securing the best rates on AAOS Annual Meeting OnDemand, providing you peace of mind throughout the meeting that you can easily revisit sessions you attended or catch what you missed.
