July 6, 2023 | Today’s News

Resident Involvement in Hip Fracture Surgery Associated with Overall Improvement in Patient Care

Evaluating the outcomes of hip fracture surgery before and after the introduction of an orthopaedic residency program, a retrospective chart review in the Journal of the AAOS^® found that resident involvement was associated with decreased lengths of stay (LOS) and direct costs. A total of 662 hip fracture surgeries were included in the study, and the outcomes were surgical time, LOS, readmission rates, and direct and indirect costs. Residents were engaged in 45.8 percent of cases. When they were involved, surgical time was significantly longer (91.2 versus 78.9 minutes); however, direct costs were reduced by eight percent.

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Study: Recently Diagnosed COVID-positive TJA Patients at Greater Risk of Postsurgery Complications

The Journal of Bone and Joint Surgery published a retrospective study which found that patients with a recent COVID-19 diagnosis prior to undergoing total joint arthroplasty (TJA) were at greater risk of 30-day mortality TJA patients were identified using the National COVID Cohort Collaborative Data Enclave and were divided into either the COVID-positive group (n = 3,516) or COVID-negative group (n = 81,531). The outcome measurement was incidence of postoperative complications (e.g., venous thromboembolism, pneumonia, acute myocardial infarction, readmission rates, and 30-day mortality). COVID-positive patients were at an increased risk of pneumonia, acute myocardial infarction, and sepsis.

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A retrospective study in the Journal of Shoulder and Elbow Surgery examined the incidence and patient-related risk factors for dislocation after reverse shoulder arthroplasty (RSA). A total of 6,621 patients were included in the analysis, and the mean follow-up was 19.4 months. The overall rate of dislocation was 2.1 percent. For primary and revision RSAs, the rate of dislocation was 1.6 percent and 6.5 percent, respectively. Patient-related factors that were independently associated with dislocation included postoperative subluxations prior to radiographically confirmed dislocation, primary diagnosis of fracture nonunion, revision arthroplasty, primary diagnosis of rotator cuff disease, and male sex.

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To evaluate the effectiveness of intraarticular injection of adipose-derived mesenchymal stem cells (ADMSC) in patients with knee osteoarthritis, a randomized controlled trial in the American Journal of Sports Medicine assessed the clinical outcomes of 261 patients. The primary outcomes were the 100 mm visual analog scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function measured at baseline and three and six months postinjection. Compared to the control group, patients in the ADMSC group showed significantly better improvements in VAS (25.2 versus 15.5) and total WOMAC scores (21.7 versus 14.3).

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Orthopaedic Priorities Advance at 2023 Annual Meeting of the AMA House of Delegates

At the recent Annual Meeting of the American Medical Association (AMA) House of Delegates (HOD), several new policies were adopted to advance access to musculoskeletal care. Among them were a directive to help overhaul the Medicare payment system, policy to support physician-owned hospitals, recommendations for augmented intelligence, and adopted AAOS-authored policy for timely, cost-effective Qualified Clinical Data Registry access to Medicare claims data. AAOS Delegation Chair Heidi M. Hullinger, MD, FAAOS, led orthopaedics’ representation within the policymaking body, and AAOS-supported Michael Suk, MD, JD, MPH, MBA, FAAOS, was reelected to the AMA Board of Trustees.

Learn more about orthopaedics’ representation in the AMA HOD…

Professionalism in Research: Understanding the Fundamentals

Research is the foundation on which patient care is built. The orthopaedic profession accepts the integrity of the research process, and the importance of fundamental research ethics led to the incorporation of Research and Academic Responsibilities as a component of the AAOS Standards of Professionalism. The code reflects best practices in research and was developed via a consensus process.

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This Sarcoma Awareness Month, the AAOS MsTR Shares Sarcoma Patient and Surgeon Stories

AAOS and the Musculoskeletal Tumor Society are working hard through the Musculoskeletal Tumor Registry (MsTR) to help clinicians and health systems track function, complications, and outcomes in patients treated for rare bone and soft-tissue tumors. The registry fills a gap in current sarcoma care by focusing on quality of life and functional outcomes at a scale not previously attempted, potentially answering treatment and outcome questions that are otherwise unable to be answered due to the rarity of the disease process. MsTR is helping pave the way to find a cure and believes that sarcoma deserves recognition year-round, not just in July.

Learn more about MsTR and view patient and surgeon stories…