Study Evaluates Outcomes Following Meniscal Repair for Longitudinal Tears of the Lateral Meniscus Plus ACL Reconstruction
A study published online in The American Journal of Sports Medicine assessed outcomes more than two years after repair of longitudinal tears of the lateral meniscus plus ACL reconstruction. Between 2010 and 2017, 39 patients underwent primary anatomic ACL reconstruction and repair for concomitant longitudinal lateral meniscus tears; they were matched to 39 controls who underwent ACL reconstruction without any concomitant injuries. Both groups were followed for a mean of at least 42 months. No significant between-group differences were observed related to clinical outcomes, lateral joint space narrowing on radiographs, and chondral status at the lateral compartment. The concomitant injury group had significant lateral and posterior meniscal extrusion progression.
Study Assesses Impact of BMI on THA by Diabetes and Insulin Dependence Status
A study published in the Jan. 15 issue of the Journal of the AAOS ® assessed how BMI affected the risk for adverse events (AEs) among patients undergoing total hip arthroplasty (THA) who were nondiabetic (ND), had noninsulin-dependent diabetes mellitus (NIDDM), and had insulin-dependent diabetes mellitus (IDDM). Odds ratio of serious AEs were calculated in each group, making comparisons between diabetic patients with BMI ≥ 40 kg/m 2 versus ND patients with a normal BMI (18.5–24.9 kg/m 2). There were 108,177 total patients. Serious AE risks were similar between ND and NIDDM patients, while IDDM patients had a significantly greater risk.
Study Compares Complication Rates Between Inpatient Versus Same-day Discharge Arthroscopic RCR
A study published in the January issue of Arthroscopy compared postoperative complications between inpatient versus same-day discharge arthroscopic rotator cuff repair (RCR). A total of 2,812 matched patients underwent either outpatient (50 percent) or inpatient RCR. The inpatient group had significantly higher rates of 90-day total AEs (TAEs), medical AEs (MAEs), and surgical AEs (SAEs). On multivariate analysis, factors independently predictive of TAEs were inpatient RCR, greater Charlson Comorbidity Index (CCI), and anxiety/depression. Predictors of SAEs were open biceps tenodesis and inpatient RCR. Factors associated with MAEs were greater CCI, anxiety/depression, and inpatient RCR.
Study Assesses Use of TXA in Adolescent Idiopathic Scoliosis
A meta-analysis published online in the Journal of Orthopaedic Surgery and Research found that tranexamic acid (TXA) appeared safe and effective in adolescent idiopathic scoliosis surgery. Retrospective cohort studies (n = 3) and randomized, controlled trials (n = 2) published from 1960 through 2019 were identified through electronic database searches. Data included total blood loss, a need for transfusion and transfusion criteria, surgery time, and the evidence of intra- and postoperative complications. The five studies encompassed 334 total patients. TXA was found to significantly reduce blood loss, with a weighted mean difference of −525.14. TXA was not associated with any significant thromboembolic event.
New Administration Issues Health Care Executive Orders
The Biden administration began its tenure on Jan. 20 by issuing multiple executive orders, including several that directly impact the public health response to COVID-19. The orders direct the United States to halt the process of withdrawing from and rejoin the World Health Organization, with Anthony Fauci, MD, appointed as head of the U.S. delegation. Another order requires that masks be worn and physical distancing be maintained at all times on federal lands, in federal buildings, and by federal employees and contractors. This action comes as part of the Administration’s “100 Days Masking Challenge” aimed at curbing the pandemic. The administration has also ordered a regulatory freeze in order to review rules that the previous administration finalized in its last weeks. This process will occur in tandem with the development of a modern and equitable regulatory review system at the Office of Management and Budget.
AAOS Develops Landmark Resource Outlining the Value-based Care Landscape
AAOS released the first-ever provider-specific payment continuum outlining the musculoskeletal value-based care landscape. This endeavor comes in response to the unprecedented acceleration of new alternative payment models and care delivery transformation initiatives to reduce healthcare costs and improve outcomes for patients.
Volunteers Needed to Review CPG for the Management of Osteoarthritis of the Knee
AAOS is seeking volunteers to peer review the Clinical Practice Guideline (CPG) on the Management of Osteoarthritis of the Knee (nonarthroplasty), 3rd Edition prior to its publication. This is a complete update of the 2013 CPG. The deadline to volunteer is Jan. 29.
