Today’s Top Story

Study: Why Do Newly Symptomatic Degenerative Rotator Cuff Tear Patients Opt for Surgery?

A study published in the January issue of the Journal of Shoulder and Elbow Surgery established factors associated with the decision to undergo operative treatment in patients with newly painful degenerative rotator cuff tears. Degenerative rotator cuff tears without pain were assessed to determine when pain set in and tears became larger. Tears that newly became painful were assessed for patient- (age, occupation, activity level) and tear-specific (tear type, size, and progression; American Shoulder and Elbow Surgeons [ASES] score; muscle degeneration) factors predictive of surgical treatment. A total of 169 newly painful shoulders were identified, of which 48 underwent surgery. The following factors were predictive of operative treatment: younger age, pain development earlier in surveillance, a greater increase in pain, a decline in ASES score, and a history of contralateral shoulder surgery. Half of the total shoulders (n = 85) enlarged within two years of the onset of pain. No correlations were observed between the choice to receive surgery and tear type, enlargement, or size. There were no significant between-group differences in muscle degeneration severity, occupational status, hand dominance, Shoulder Activity Score, or RAND-12 mental health or physical scales.

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In Other News

Study: Best Practice Guidelines for FAI Syndrome Management

A study published in the Jan. 15 issue of the Journal of the AAOS established best practice guidelines (BPGs) for the treatment of femoroacetabular impingement (FAI) syndrome. Surveys were completed by 15 North American surgeons who discussed current best practices and voted for or against the inclusion of certain information. Consensus was defined as agreement by more than 80 percent; items near consensus (70 percent to 80 percent) were examined further at the American Orthopaedic Society for Sports Medicine Annual Meeting. The surgeons had a mean 12.3 years of practice and performed a mean 249 hip arthroscopies per year. The final BPGs included 27 preoperative recommendations, 15 intraoperative practices, and 10 postoperative protocols; the final draft had 100 percent participant support.

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Study: Opioid-use Disorders in Hospitalized Patients with Spinal Conditions

A study published in the Jan. 15 issue of Spine examined trends in opioid-use disorders among hospitalized patients with spinal conditions. National Inpatient Sample data spanning 2005 through 2014 were examined to assess hospitalized patients with cervical and lumbar spinal conditions treated for opioid use, dependence, poisoning, and cervical lumbar spinal diseases and procedures. Opioid-use disorder trends were quantified by the compound annual growth rate (CAGR). The rate of hospitalizations with spinal conditions and treatment increased from 2005 to 2011 and decreased between 2011 and 2014. Overall length of stay decreased; therefore, the CAGR was –1.60 percent. Close to 3 percent of hospitalized patients with spinal conditions and treatments also had an opioid-use disorder diagnosis, for a CAGR of 6.47 percent. The following factors were correlated with opioid-use disorders: cannabis-use disorders, substance use, mental health condition, younger age, white race, male sex, higher household income, and public insurance or uninsured.

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Study Measures Prevalence of Systemic Inflammatory Response Syndrome in Children Versus Adults

According to a study published in the January issue of the Journal of Pediatric Orthopaedics, children sustain systematic inflammatory response system (SIRS) at a similar rate to that of adults, but they are less likely to experience adult respiratory distress syndrome (ARDS). Data spanning January 2005 to December 2015 were gathered from a single level 1 pediatric trauma center database for patients with injury severity scores greater than 16. SIRS trends were compared based on whether patients did or did not have an orthopaedic injury (OI); OI patients were then evaluated for pulmonary complications and death. Within four days of hospitalization, 81.4 percent of OI patients and 69.1 percent of non-OI patents reached the SIRS threshold; nine in-hospital deaths occurred. Three OI patients presented ARDS criteria, and three OI patients died: two within one day of presentation and one within two days; all three patients who died had severe brain trauma. A trend was observed for increasing age groups and increasing proportion of patients with SIRS. Independent risk factors for SIRS during the first four days of hospitalization were increasing injury severity score and increasing age.

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Surgeries Are Postponed Amid Surgical Gown Shortage

Surgical gown manufacturer Cardinal Health recalled more than nine million surgical gowns, resulting in a nationwide shortage of gowns. The voluntary recall came when the company discovered some of the gowns were produced in “unapproved locations that did not maintain proper environmental conditions as required by law, were not registered with the Food and Drug Administration, and were not qualified by Cardinal Health,” according to a statement.

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AAOS Aims to Increase Diversity—Strategically

As the Academy begins its second year of implementing the 2019–2023 Strategic Plan, its efforts and initiatives to deliver on its goal to promote diversity are coming into focus and entering into action. On the organizational front, the Diversity Advisory Board (DAB) will be sharpening its mandate to better execute strategy and improve diversity at the Board, council, committee, and volunteer levels. This year, the DAB will broaden its reach with a change in reporting structure from infrequent interaction with the Board of Directors to a direct line to the new Membership Council.

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Apply for Volunteer Opportunities

Consider applying for the following positions:

  • Adult Reconstruction Knee Program Committee member positions—applications are accepted until Feb. 3
  • Committee on Devices, Biologics, and Technology member-at-large position—applications are accepted until Feb. 3
  • Council on Education member-at-large position—applications are accepted until Feb. 3
  • Education Assessments and Examinations Committee member position (spine)—applications are accepted until Feb. 3
  • Hand and Wrist Program Committee member position—applications are accepted until Feb. 3
  • Hand and Wrist Instructional Course Committee member position—applications are accepted until Feb. 3
  • Health Care Systems Committee section leader quality programs position—applications are accepted until Feb. 3

Learn more and submit applications…(member login required)