January 31, 2020 | Today’s News

Study: Effects of Iron Deficiency Anemia on TKA Outcomes

A study published online in The Journal of Arthroplasty assessed whether iron deficiency anemia impacts hospital length of stay (LOS), 90-day readmissions, costs of care, and medical and implant-related complications in primary total knee arthroplasty (TKA) patients. A nationwide administrative claims database was queried to identify patients with (n = 94,053) and without (n = 470,264) iron deficiency anemia undergoing primary TKA. Patients with anemia, compared to those without, had longer hospital LOS (four days versus three days), higher readmission rates (25.8 percent versus 16.3 percent), greater day of surgery ($13,079.42 versus $11,758.25) and total global 90-day episode of care ($17,635.13 versus $14,439.06) costs, and higher odds of medical (3.53 percent versus 1.33 percent) and implant-related (3.80 percent versus 2.68 percent) complications.

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Study Examines Intra-abdominal Pressure Changes During Hip Arthroscopy

A prospective, multicenter study published online in Arthroscopy evaluated the effects of and patient characteristics associated with changes in intra-abdominal pressure (IAP) during hip arthroscopy. Data were collected for patients undergoing surgery for femoroacetabular impingement (FAI). A bladder catheter was used to measure IAP every 30 minutes intraoperatively. Evaluated risk factors included traction time, duration of surgery, previous abdominal surgery, capsule repair, psoas tenotomy, and surgical approach. Final analysis included 105 symptomatic FAI patients. Preoperative IAP differed significantly from IAP levels at different intraoperative time points. A continuous increase in IAP persisted from the start of surgery until the first 60 minutes, after which IAP did not significantly increase. The evaluated risk factors were not correlated with increased IAP.

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A study published online in the Journal of Shoulder and Elbow Surgery compared three acute surgical techniques used to treat proximal humerus fracture. A total of 425 fractures (average patient age, 65 years) were stratified by treatment technique: open reduction internal fixation (ORIF, n = 211), hemiarthroplasty (HA, n = 108), and reverse shoulder arthroplasty (RSA, n = 106). Factors including age, American Society of Anesthesiologists physical status classification, and fracture classification were taken into account. Radiographic outcomes; postoperative falls; and postoperative motions at three, six, and at least 12 months were assessed. All three groups presented significant improvements in forward flexion from three to six months. Final motion did not differ among the groups. The ORIF group had the highest rate of radiographic union (89 percent), while rates did not largely differ between the HA (79 percent) and RSA (77 percent) groups. RSA patients had the lowest rate of reoperation (6.6 percent), followed by HA (15.7 percent) and ORIF (175 percent) patients. At least one postoperative fall occurred in 23 percent of patients, of which about 73 percent resulted in fractures.

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According to a retrospective study published online in the European Spine Journal, CT scans were a feasible tool to take Hounsfield unit (HU) measurements at the lumbar and sacral spine compared to standard dual-energy X-ray absorptiometry (DXA). Fifty patients with a CT scan of the lumbar and sacral spines and a DXA scan were included. HU measurements were taken in intact vertebral bodies L4, L5, and S1. HU results derived from the CT scan were compared to the DXA-derived T-score and bone mineral density; comparisons were made between patients with normal bone density (n = 26) and impaired bone density (n = 24). HU measurement in L4, L5, and S1 accurately identified patients with normal and impaired bone densities. The following HU measurements were correlated with 100 percent sensitivity to detect normal bone: L4, higher than 161; L5, higher than 157; and S1, higher than 207.

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The House of Representatives hopes to come up with a solution for surprise medical billing within this work period, which ends the week of Feb. 10, according to House Majority Leader Steny Hoyer (D-Md.). The House Energy and Commerce and Ways and Means committees have been unable to agree on the best approach to resolve this issue. The Ways and Means Committee issued a one-page outline in December 2019 highlighting their ideas.

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Academy Member Makes History with Induction into American Academy of Arts and Sciences

On Oct. 12, 2019, Cato T. Laurencin, MD, PhD, FAAOS, was inducted into the American Academy of Arts and Sciences—just the fifth orthopaedic surgeon elected in the organization’s history and currently the only orthopaedic surgeon who is an active member. “I’m honored to be a Fellow of the American Academy of Arts and Sciences,” Dr. Laurencin said during an interview with AAOS Now. “It’s a special academy in that it encompasses people from medicine and science to the arts and humanities.”

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Apply for Volunteer Opportunities

Consider applying for the following positions:

• Education Assessments and Examinations Committee member position (spine)—applications are accepted until Feb. 3
• Foot and Ankle Program Committee member position—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
• Musculoskeletal Tumor and Metabolic Disease Program Committee member position—applications are accepted until Feb. 3
• Shoulder and Elbow Content Committee member position—applications are accepted until Feb. 3

Learn more and submit applications…(member login required)