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Today’s Top Story
Study: Cost Savings and Outcomes of Generic CMN Nails in Peritrochanteric Femur Fractures
In a single-center study published in the Journal of the AAOS ®, generic cephalomedullary nails (CMN) for peritrochanteric femur fractures cost approximately 38 percent less than conventional nails. Ninety patients who received generic nails were compared with 329 patients with conventional nails. Incidence of postoperative infection was greater with use of generic versus conventional nails (1.2 percent versus 0.0 percent). Complications occurred in 7.0 percent and revision in 5.4 percent, with comparable rates between groups. Nail selection did not significantly impact rates of symptomatic hardware, hardware failure, delayed union, or nonunion.
Read the study… |
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In Other News
Study: Lymphedema Is a Significant Risk Factor for THA Complications
A history of lymphedema was associated with increased risk of complications, reoperation, and infection after total hip arthroplasty (THA), according to a study published in the Journal of Bone & Joint Surgery. An institutional registry was queried and 83 THA patients with ipsilateral lymphedema were matched 1:6 to 498 controls. The hazard ratio for patients with lymphedema was 1.97 for risk of complications, 3.16 for all-cause reoperation, and 4.48 for infection. Five-year infection-free survival was 90.3 percent in the lymphedema group compared with 97.7 percent of controls.
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Study: Instability Is a Major Cause of Failure of Nonoperative Management for ACL Rupture
For patients who undergo nonoperative treatment of an ACL rupture, instability concerns, pain during activity, and low patient perception of knee function were associated with the later need for ACL reconstruction (ACLR), according to a study published in the American Journal of Sports Medicine. Eighty-two patients underwent rehabilitation therapy plus optional delayed ACLR. By two-year follow-up, 41 patients underwent ACLR after a median of 6.4 months. Most reconstructions occurred between three and six months. Ninety percent of delayed ACLR patients reported instability concerns as a cause for surgery.
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Study Assesses Variables Impacting Patient Satisfaction after Hand and Wrist Treatment
A study published online in Clinical Orthopaedics and Related Research identified factors associated with patient satisfaction with treatment for hand and wrist conditions. In total, 1,824 patients with three months of follow-up data were analyzed. The factors most strongly influencing patient satisfaction included a greater decrease in pain during physical load, positive experience with learning the pros and cons of treatment, greater improvement in hand function, positive experience with advice for at-home care, greater feelings of personal “control” over their illness, positive treatment expectations, longer expected illness duration, and a smaller number of symptoms at baseline.
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Survey of Female Arthroplasty Surgeons Finds High Rate of Occupational MSK Injuries
A survey of 63 female adult reconstruction surgeons, published online in The Journal of Arthroplasty, reported that 68.3 percent had occupational musculoskeletal (MSK) injuries, predominately in the forearm, wrist, and hand (79.1 percent). Other injured areas included shoulder (48.8 percent) and lower back (44.2 percent). Forty-eight percent required temporary work modifications, 10.0 percent required time off work due to their injuries, and 10.9 percent required surgical treatment. Of those with a history of pregnancy, 65.4 percent reported a workplace exacerbation of a pregnancy-related MSK condition (back pain, pubic symphysis pain, and carpal tunnel syndrome).
Read the abstract… |
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AAOS Now
Augmentation of Fracture Repair: Is Anything Ready for Prime Time?
At the symposium “Augmentation of Fracture Repair: Is Anything Ready for Prime Time?” presented at the AAOS 2021 Annual Meeting, panelists led a discussion of the latest advancements in treatment of fractures, such as new grafting techniques, infection prevention, and more. The symposium was moderated by Emil H. Schemitsch, MD, FAAOS, and featured insight on topics such as management of nonunion with a critical-size bone defect, considerations for the use of local antibiotic powder in open wounds, and comparisons of delivery vehicles for local antibiotic therapy.
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