‘We Stand with You’

AAOS President Joseph A. Bosco III, MD, FAAOS, released a statement standing in solidarity with the Academy’s members of color. Referring to the deaths of George Floyd and Ahmaud Arbery, Dr. Bosco said, “A more diverse Academy will lead to better care for our patients, including those of color. Your Academy will respond to these episodes by demonstrating the very best of human nature and compassion—values we continue to uphold as we face our future together.”

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A Public Health Crisis: Racism and Racial Disparities

The COVID-19 pandemic and the recent death of George Floyd have both brought to light continued racial disparities in the United States. In this article, Julie Balch Samora, MD, PhD, MPH, FAAOS, deputy editor of AAOS Now, calls racism a public health crisis and calls on orthopaedic surgeons to combat racism and minimize racial disparities. The article also discusses ways AAOS is working to increase diversity within the organization’s leadership and volunteer structure and what members can do to combat this public health crisis.

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In Other News

Study: Knee OA Risk After Different Injuries in Young Adults

A study published online in the British Journal of Sports Medicine compared the risk of osteoarthritis (OA) of the knee in young adults who sustained one of the following injuries: contusion, fracture, dislocation, meniscal tear, cartilage tear/other injury, collateral ligament tear, cruciate ligament tear, and injury to multiple structures. Final analysis included 5,247 patients with an injury and 142,825 without. Patients with a knee injury were more than five times as likely to be diagnosed with knee OA during the first 11 years of follow-up. Injuries associated with the greatest risk of knee OA were cruciate ligament, meniscal tear, and tibia plateau/patella fracture.

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Study: Does Early Radiographic Union Score for Hip Forecast Two-year Complications?

Radiographic Union Score for Hip (RUSH) at three months postoperatively was correlated with two-year complications in femoral neck fracture patients, according to a study published in the June issue of the Journal of Orthopaedic Trauma. Final analysis included 734 patients. At three and six months postoperatively, lower RUSH was associated with reoperation at two years. Every two-point RUSH decrease at three months was associated with a 16 percent increase in reoperation risk; a similar correlation was observed for two-point decreases at six months.

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Study: Complications, Cost of Proximal Interphalangeal, Metacarpophalangeal Joint Arthroplasty

A study published in the June issue of The Journal of Hand Surgery assessed national complication rates and cost variation in proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joint arthroplasty patients. Insurance claims for 2,859 patients who underwent MCP joint (36 percent) or PIP joint (64 percent) arthroplasty for OA of the hand or post-traumatic arthritis were evaluated. The average complication rate overall was 35 percent, but PIP joint arthroplasty patients had a higher rate of prosthetic fracture than MCP joint arthroplasty patients (3.4 percent versus 1.5 percent). Complications were associated with an additional cost of $1,076.

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Study Predicts Postoperative Opioid Use, Outcomes After Shoulder Arthroscopy

A study published online in Arthroscopy analyzed the correlation between pre- and postoperative opioid use, patient-reported outcome measures (PROMs), and revision in shoulder arthroscopy patients. Patients were stratified into two groups: opioid use (n = 184) and nonopioid use (n = 1,058). PROMs varied significantly between the groups. Preoperative opioid use was significantly correlated with reduced achievement of patient acceptable symptomatic state, increased likelihood to endorse persistent pain, and increased one-year postoperative opioid use. High-dose perioperative opioid intake was correlated with increased revision risk.

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AAOS Practice Management Resources

The Academy’s numerous free practice management resources provide knowledge, education, clinical tools, and professional support that help you meet the challenges of your chosen specialty and build mastery throughout your career. Access white papers, the Practice Management Advice Center, webinar recordings, and learn about topics such as Medicare Access and CHIP Reauthorization Act delivery reform and the Quality Payment Program.

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