Study Evaluates Outcomes in Revision ACLR with Double-bundle Anterior Technique
According to a study published online in Arthroscopy, most patients who undergo primary anatomic double-bundled (DB) anterior cruciate ligament reconstruction (ACLR) who require revision could be treated with one-stage revision with the DB method using preexisting tunnels. Researchers retrospectively reviewed 487 patients who underwent primary anatomic DB ACLR; 40 subsequently required revision ACLR. Most patients (n = 38, 95 percent) underwent one-stage revision with the DB technique and did not sustain compromised graft positioning. Two patients underwent two-stage revision. Range of motion, objective laxity, Lysholm score, Hospital for Special Surgery score, International Knee Documentation Committee subjective score, and Tegner score did not largely differ between the primary and revision ACLR groups.
Study: VTE Risk in Shoulder Arthroplasty Patients with a History of Cancer
A study published in the Jan. 15 issue of the Journal of the AAOS examined the risk for postoperative venous thromboembolism (VTE) and other complications following total shoulder arthroplasty (TSA) in patients with a history of cancer. Male patients with a history of prostate cancer and female patients with a history of breast cancer undergoing anatomic TSA for primary osteoarthritis were identified through a national insurance database and matched 3:1 to control patients. Patients in both cancer groups had a significantly higher acute VTE risk than the control patients, but there were no significant differences in rates of other complications.
Study: Subsequent Pain or Injury Risk in Workers’ Compensation Patients after Foot or Ankle Surgery
A study published in the January issue of Foot & Ankle International compared rates of subsequent pain or injury (SPI) in workers’ compensation (WC) patients compared to non-WC patients following foot or ankle surgery. Researchers conducted a retrospective chart review on records for surgeries performed by a single surgeon between 2009 and 2015. WC (n = 56) and non-WC (n = 165) patients were compared for rates of SPI, which was defined as a new injury at a different anatomical location between two months and two years after the index surgery. The SPI rate was higher in the WC group than the non-WC group (23.2 percent versus 7.3 percent). In both groups, the most common sites for SPI were the hip, knee, and contralateral foot and ankle. In the WC population, SPI risk factors included legal representation and older age. In the non-WC population, female sex was a risk factor for SPI.
Study Examines Impact of Postoperative Rehabilitation after Spine Surgery
A secondary analysis of a randomized, controlled trial (RCT) published in the January issue of The Spine Journal evaluated the correlation between rehabilitation and duration of postoperative sick leave, return to work, and working ability in patients who underwent surgery for lumbar disk herniation. The RCT compared patients referred to rehabilitation four to six weeks postoperatively (rehab) versus patients discharged to home with no planned rehabilitation course (home). Final analysis included 146 patients; follow-up rate after two years was 78 percent. Postoperative sick leave period was about nine weeks in both groups. One year postoperatively, 79 percent of the home group and 74 percent of the rehab group returned to work. Both groups had improved working ability from baseline to one year; this improvement persisted in both groups at two years. A correlation was observed between preoperative duration of leg pain and working ability and duration of postoperative sick leave.
Fewer Accountable Care Organizations Taking Part in Medicare Program
The Medicare Shared Savings Program saw a drop in participating accountable care organizations (ACOs). Currently, 517 ACOs are in the program, while there were 561 in 2018. The National Association of ACOs attributed this decline to changes Medicare made to its ACO program.
AAOS members will soon receive the print edition of the January issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue highlights include the use of virtual reality in orthopaedics, the launch of the American Spine Registry, a clinical practice guideline for Limb Salvage or Early Amputation, and more.
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 Jan. 24.
