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| Today’s Top Story
Study: Outcomes of TKA for Tibial Plateau Fracture
A systematic review published online in the Journal of Orthopaedics and Traumatology evaluated outcomes and perioperative complication rates of primary total knee arthroplasty (TKA) in tibial plateau fracture treatment. A search of the Medline, Embase, and PubMed databases from inception through March 2018 yielded seven articles encompassing 105 total patients. The all-cause mortality rate was 4.75 percent, and complication rate was 15.2 percent. The most commonly reported outcome was Knee Society scores; average Knee Society Knee Score was 85.6, and Knee Society Function Score was 64.6. At final follow-up, the average range of motion was 107.5 degrees.
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| In Other News
Study: Synovial Bone Sialoprotein in PJI, Aseptic Failure Arthroplasty Patients
A study published online in the Journal of Orthopaedic Surgery and Research analyzed synovial bone sialoprotein (sBSP) in periprosthetic joint infection (PJI) and aseptic failure (AF) arthroplasty patients before revision surgery. Synovial fluid samples were used to determine sBSP and C-reactive protein (CRP) in PJI (n = 13) and AF (n = 25) patients. PJI patients had significantly lower mean sBSP than AF patients (14.8 ng/mL versus 38.2 ng/mL) and much higher mean synovial CRP (8.4 μg/mL versus 1.8 μg/mL, respectively). The area under the receiver operating characteristics curve (AUC) of synovial CRP in PJI patients was 0.71; AUC of sBSP in AF revision arthroplasty patients was 0.83.
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| Study: Should BMI Cutoffs Be Used in THA?
According to a study published in the June issue of The Bone & Joint Journal, using body mass index (BMI) alone to determine eligibility for total hip arthroplasty (THA) did not improve the rate of clinically meaningful improvements. One-year patient-reported outcome measures were assessed in 3,449 primary THAs. A BMI cutoff of 30 kg/m 2 would have denied 21 patients a meaningful improvement in hip injury and osteoarthritis outcome score pain score and prevented one failed improvement. A BMI cutoff of 35 kg/m 2 would have denied 18 patients an improvement; 40 kg/m 2 would have denied 21 patients; and 45 kg/m 2 would have denied 21 patients.
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| Study Compares Pain Control Options for Wrist Surgery
A study published in the June issue of The Journal of Hand Surgery compared pain control using a long-acting local anesthetic, liposomal bupivacaine versus bupivacaine HCl in elective carpometacarpal joint arthroplasty and proximal row carpectomy patients Postoperative pain scores were measured using a numeric rating scale. Final analysis included 52 patients. Pain scores, opioid use, and postoperative outcomes did not largely differ between the groups during postoperative days (PODs) one through four, but opioid use on POD one was slightly lower in the liposomal bupivacaine group.
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| Study: Arthroscopic Ankle Arthrodesis in Mild Versus Severe Deformity
A retrospective study published online in Arthroscopy compared arthroscopic ankle arthrodesis (AAA) outcomes between patients aged ≥ 60 years with mild versus severe deformity Forty-one patients (mean age, 70.6 years) were stratified into two groups: patients with coronal deformity either < 15 degrees (group I; n = 26) or ≥ 15 degrees (group II; n = 15). Both groups achieved near normal tibiotalar alignment postoperatively (group I: 3.4 degrees; group II: 4.7 degrees). All patients achieved union except for two, both in group I.
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| AAOS Now
New AAOS Committee on Devices, Biologics, and Technology Springs to Life
Over the next five years, AAOS will prioritize research and development for a biologics-focused competency addressing issues of unreliable information and patient receipt of substandard care from nonorthopaedists, as well as continuing to be the trustworthy source of information for patients, members, and external providers and payers. This reprioritization is an expansion of previous work of many members on previous committees who also worked in this space. As part of this strategy, the AAOS Board of Directors created the Committee on Devices, Biologics, and Technology.
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| Your AAOS
OrthoInfo Helps Doctors Educate Patients
OrthoInfo, the AAOS patient education website, is a free member resource that provides orthopaedic surgeons and patients with authoritative, in-depth information about musculoskeletal health. The website features more than 400 articles, videos, and animations on common orthopaedic problems, surgical procedures, nonsurgical treatments, injury prevention, and healthy living. All content is developed and peer reviewed by AAOS members. Written in simple language, OrthoInfo articles can help your patients be better informed and participate more fully in their care and recovery.
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