Today’s Top Story

Study Examines Correlation Between Postoperative Glucose and Outcomes after Arthroplasty for PJI

According to a retrospective study published online in The Journal of Arthroplasty, postoperative glucose variability may be predictive of adverse outcomes following arthroplasty for the treatment of periprosthetic joint infection (PJI). Records for patients with PJI of the hip and knee that included at least one year of follow-up and either two glucose values per day or more than three overall during the reimplantation were evaluated. Adverse outcomes were treatment failure, reinfection, reoperation, and mortality. Further analyses were conducted based on diabetes status. Final analysis included 341 PJIs. Glucose variability after reimplantation was tied to greater risk of treatment failure, reinfection, and reoperation. The associations persisted among nondiabetic patients (n = 260) but not diabetic patients (n = 81).

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In Other News

Study Explores Information Orthopaedic Surgeons Present Online

A study published in the Jan. 15 issue of the Journal of the AAOS analyzed the online presence of orthopaedic surgeons. Researchers randomly selected 1 percent of physicians from each state using the AAOS membership directory. They performed a Google search for each surgeon to collect data on practice type, physician subspecialty, website focus, and the quality of patient education presented. Final analysis included 246 orthopaedic surgeons (93.1 percent were male); 48.0 percent of surgeons had been AAOS members for less than 10 years, 28.9 percent for 11 to 20 years, and 23.2 percent for more than 20 years. Nearly all surgeons (94.3 percent) had at least one online profile. About two-thirds (66.8 percent) belonged to a group or solo private practice, but 48.7 percent were also based out of a hospital. The majority of profiles (62.5 percent) had an intermediate level of educational content, and 18.1 percent had no educational content.

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Study: Sex-specific Analysis of Foot and Ankle Injuries in Orthopaedic Literature

A study published online in Foot & Ankle International (FAI) assessed the reporting of sex-specific analysis (SSA) pertaining to foot and ankle injuries in high-impact orthopaedic journals. Eligible studies were published during calendar years 2011 and 2016 in the following journals: FAI; Foot and Ankle Surgery; American Journal of Sports Medicine; Arthroscopy; and Knee Surgery, Sports Traumatology, Arthroscopy. Studies were stratified based on whether they did or did not involve SSA. Final analysis included 473 studies encompassing 273,128 patients, of whom 43.9 percent (n = 119,967) were female. Sex was a statistical model variable in 16.7 percent (n = 79) of studies; 13.0 percent of studies in 2011 and 19.3 percent in 2016 reported SSA. Only FAI significantly increased its SSA reporting from 2011 to 2016. Of the 79 studies that reported SSA, 30 percent (n = 24) presented significant between-sex differences.

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Study: How Do Body Position and Axial Load Impact Spinal Stiffness?

A study published online in the European Spine Journal evaluated the impact of body position and axial load on spinal stiffness among healthy young adults. The study included 100 patients (mean age, 23 years; 50 percent were female) who underwent three tests to determine their posterior-to-anterior lumbar and thoracic spinal stiffness: prone, standing, and standing while carrying 50 percent of their body weight. The three tests each included three trials. Spinal stiffness was reliable in all test situations. Spinal stiffness was significantly higher while standing than in the prone position but was significantly lower when carrying the load of half the patient’s body weight than when standing without the load.

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Federal Income Tax Rates were Highest in the Healthcare Industry in 2018

According to a report from the Institute on Taxation and Economic Policy, the healthcare and pharmaceuticals and medical products industries had the highest federal income tax rates in 2018. The healthcare industry paid a 207 percent rate, while the pharmaceuticals and medical products industry paid 22.0 percent. The industries are two of four whose rates surpassed 20 percent (internet services and retailing was 20.2 percent, while computers, office equipment, software, data was 20.4 percent) that year.

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Inaugural Single Fellowship Match Produces Interesting Results

April 2019 marked the inaugural single orthopaedic fellowship match. In previous years, sports medicine, shoulder and elbow, adult reconstruction, tumor, spine, foot and ankle, pediatrics, trauma, and hand surgery were separate matches, most of which occurred on different dates throughout the year. However, a combined match offers an opportunity for applicants to apply to both more competitive and less competitive specialties, perhaps as a safeguard against not matching at all.

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Final Call: Submit an Application for the Mark Frankle, MD, Health Care Policy Award

The American Shoulder and Elbow Surgeons (ASES), in partnership with the AAOS Orthopaedic Political Action Committee, is seeking applications for the Mark Frankle, MD, Health Care Policy Award, which provides selected ASES fellows unprecedented involvement in federal and state legislative policy. Each applicant must be an ASES resident fellow or candidate/associate member Winners will receive a fellowship at the AAOS Office of Government Relations in Washington, D.C.; $12,500 for fellowship expenses; an opportunity to present findings at the ASES Annual Meeting in October in New York City; and exposure to health policy through Capitol Hill visits and events such as the AAOS National Orthopaedic Conference and AAOS Board of Specialty Societies and Board of Councilors session. The deadline to submit an application is Jan. 15. Contact Steve Mlodoch, membership and special projects coordinator for ASES, at with any questions.

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