Study Assesses Use of Cementless Implants for THA in Adults with Childhood Infection History
A study published in the July issue of The Journal of Arthroplasty evaluated clinical and radiographic outcomes of total hip arthroplasty (THA) patients with sequelae from a childhood hip infection who received cementless implants. A total of 165 patients (165 hips) were included. The average Harris Hip Score increased from 27 preoperatively to 91 at final follow-up. Partial, nonprogressive radiolucencies were observed in nine cementless acetabular components at final follow-up. Eleven hips sustained intraoperative periprosthetic fractures. Postoperative complications included sciatic nerve injury (n = 5), periprosthetic infection (n = 3), dislocation (n = 1), femoral periprosthetic fracture (n = 1), femoral nerve injury (n = 1), and squeaking from a ceramic bearing surface.
Study Validates ACL Reconstruction Preoperative Expectations Survey
A study published in the June 15 issue of the Journal of the AAOS ® highlighted the development and validation of the Hospital for Special Surgery Anterior Cruciate Ligament (ACL)–expectation score. The development phase of the study included 72 patients and the validation phase consisted of 80. Ten questions were included in the final survey instrument. Scores did not largely differ between men and women or between age quartiles. A Cronbach alpha of 0.745 for all items indicated excellent internal consistency. For test-retest reliability, the intraclass correlation coefficient was considered strong at 0.774.
The Centers for Medicare & Medicaid Services (CMS) announced that clinicians participating in the Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) who were significantly affected by the COVID-19 pandemic may submit an extreme and uncontrollable circumstances application to entirely opt-out of data submission to the MIPS program for 2020 performance year. Alternatively, they can apply to have any or all MIPS performance categories reweighted. MIPS-eligible clinicians can also still receive credit for the new COVID-19 clinical trials improvement activity if they (1) participate in a COVID-19 clinical trial and enter the data into a platform or (2) care for COVID-19 patients and submit these data to a clinical data registry to be used for future study.
Study Applies Treatment Effect Method to Assess Reverse Shoulder Arthroplasty Outcomes
A study published online in BMC Musculoskeletal Disorders employed the treatment effect method to evaluate outcomes of reverse shoulder arthroplasty (RSA). Final analysis covered 183 patients with complete two-year follow-up. The American Shoulder and Elbow Surgeons score increased from 20.5 to 78.7 two years postoperatively. Treatment effects (TEs) ranged from 1.00 to 0.09; no patients had a negative TE. Patients with better Hamada grades had better TEs. A higher American Society of Anesthesiologists score was correlated with a lower TE. Mean TEs were 0.77 at six months, 0.81 at one year, 0.76 at two years, and 0.73 at five years.
Study Measures Impact of Obesity on Operative Torsional Ankle Fracture Outcomes
A study published online in Injury assessed the effect of obesity on complications, secondary operations, and functional outcomes in patients who underwent surgery for torsional ankle fracture. Torsional ankle injury patients were stratified into two groups: obese (body mass index [BMI] ≥ 30 kg/m 2) (n = 316) and nonobese (n = 316). The mean BMI in the obese group was 36.7 kg/m 2, and the mean age of the whole cohort was 44.6 years. Among obese patients, trends were observed toward more dislocations, complications, and wound healing problems. Rates of secondary procedures did not largely differ between the groups.
Who Has Access to Elective Orthopaedic Surgery During a Pandemic?
On Jan. 31, the Department of Health and Human Services declared that the United States was in a state of public health emergency due to the 2019 novel coronavirus (COVID-19). Both the Centers for Disease Control and Prevention and the U.S. Surgeon General recommended postponing elective procedures in an effort to limit exposure to the virus, preserve personal protective equipment, and reduce the burden on healthcare facility resources and personnel. However, the authors of this article observed, once the current pandemic subsides, the orthopaedic profession should seek to identify any disparities and inequities that may have occurred in the provision of orthopaedic care in the face of COVID-19 to better inform future responses.
Two Million and Counting: American Joint Replacement Registry Reaches Major Milestone
The American Joint Replacement Registry, the cornerstone of AAOS’ Registry Program, reached and surpassed its two millionth hip and knee procedure with the input of data from Mayo Clinic in Rochester, Minn. Having tracked an additional one million procedures since 2017, the Registry Program gives orthopaedic surgeons and providers the most comprehensive picture to date of trends of hip and knee arthroplasty practice and outcomes in the United States.
