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| Today’s Top Story
Study: Racial Differences in TJA Outcomes before and after the CJR Program
A retrospective study published in the June 1 issue of the Journal of Bone & Joint Surgery reported that racial differences persist in pre-, intra-, and postoperative factors and outcomes of total joint arthroplasty (TJA), even after implementation of the Comprehensive Care for Joint Replacement (CJR) program. Data from 1,483,221 TJAs were identified from Medicare claims data (2013 to 2018). In both 2013 and 2018, Black patients required more transfusions and were more likely to be discharged to institutional post-acute care and readmitted within 90 days. The CJR program was associated with reduced racial differences in 90-day and 180-day readmissions.
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| In Other News
Study: Trends in Treatment for Meniscal Tears and Use of Arthroscopic Meniscal Repair
The rate of arthroscopic meniscal repair in patients aged under 30 years is increasing over time, according to a study published online in Arthroscopy. Treatment for meniscus repair was identified in 1,383,161 patients treated between 2010 and 2017. Half of patients received surgery, primarily meniscal debridement (96.6 percent). The rate of meniscal repair increased from 2.7 percent to 4.4 percent over the study period. Younger patients (aged 10 to 19 years) were more likely to undergo meniscal repair than patients aged ≥60 years. The revision rate after index meniscal repair was 10.6 percent.
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| Study: MCID and SCB Thresholds for VAS Pain Scores after Hand Surgery
A study published online in The Journal of Hand Surgery identified a minimal clinically important difference (MCID) threshold of 1.6 to 1.9 when interpreting Visual Analog Scale pain scores in patients who underwent nonshoulder hand and upper extremity surgery. A substantial clinical benefit (SCB) threshold was identified as scores of 2.2 to 2.6. In total, 667 and 148 patients were included in the MCID and SCB analyses, respectively. Receiver operating curve analysis found “acceptable” discrimination with the SCB threshold for detecting a “much improved” pain status.
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| Study: 3D Planning and PSI Use in Intra-Articular Opening Wedge Osteotomy for Varus Ankle Deformity
The use of computer-assisted preoperative planning and patient-specific instrumentation (PSI) in intra-articular opening wedge osteotomy led to satisfactory functional recovery in patients with varus ankle deformities, according to a retrospective study published online in BMC Musculoskeletal Disorders. Nineteen patients were included, and mean follow-up was 32.2 months. Average union time was 4.4 months. There were significant improvements in the tibial anterior surface, talar tilt, tibial medial malleolar, and talocalcaneal angles. The tibial lateral surface angle was not corrected significantly. The complications rate was 15.8 percent. Visual Analog Scale and American Orthopaedic Foot & Ankle Society scores improved significantly, but not range of motion.
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| Study: How Does Dosing of Cefazolin Prophylaxis Impact Infection Risk after Spinal Fusion?
A retrospective study published online in The Spine Journal reported that spine surgery patients “frequently” received an inadequate weight-based dose of cefazolin prophylaxis and that inadequate dosing was associated with greater risk of postoperative infection in lumbar fusion. In total, 2,643 patients undergoing posterior cervical or lumbar spinal fusion were included. The postoperative infection rate was 3.6 percent, and this figure was higher in the inadequate dosing group compared with the adequate dosing group (5.86 percent versus 2.58 percent). Adequate dosing was not a predictor of decreased infection in posterior cervical fusion patients.
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| AAOS Now
Jon Meacham Shares Leadership Lessons from U.S. History
During the Your Academy event at the AAOS 2022 Annual Meeting, celebrated writer, reviewer, and historian Jon Meacham took the stage as Presidential Guest Speaker. He delivered an informative address on presidential leadership and spoke of how different presidents have tackled different crises and made decisions that affected generations to come. Off stage, Stuart J. Fischer, MD, FAAOS, spoke with Mr. Meacham about the lessons he has learned about leadership from studying history, reviewing presidential decisions, and even meeting past U.S. presidents for his books.
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| Your AAOS
American Joint Replacement Registry Adds Exactech as Sponsor
The AAOS announces Exactech as the latest industry sponsor of the American Joint Replacement Registry (AJRR). Support from Exactech allows the AJRR to further invest in the technology and science that is needed to evolve the Registry and better meet the needs of all major stakeholders, including physicians, patients, payors, regulatory groups, and industry partners.
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