June 7, 2021 | Today’s News

Study Assesses Reporting and Analysis of Race and Ethnicity in Orthopaedic Clinical Trials

Race and ethnicity are underreported in orthopaedic clinical trials, according to a study published in the May issue of the Journal of the AAOS: Global Research & Reviews ®. Researchers assessed 482 randomized controlled trials from 2015 and 2019. Most studies reported age (95.4 percent) and sex (94.6 percent), and 7.3 percent reported race and 3.1 percent reported ethnicity. Age and sex were analyzed in 16.4 percent and 14.9 percent of studies, respectively. Race and ethnicity were analyzed in 1.2 percent and 0.2 percent, respectively. Spine was the subspeciality with highest reported race and ethnicity (23.5 percent and 17.6 percent, respectively). Sports medicine had the lowest reporting (2.0 percent).

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Study: CKD Increases One-year Mortality Risk after Intertrochanteric Fracture Surgery

A study published online in Injury found a higher mortality rate after surgery for intertrochanteric fracture in patients with chronic kidney disease (CKD). Forty-nine patients with CKD treated between 2011 and 2019 were followed for an average of 8.6 months (range, 1-82 months). Sixteen patients died within one year postoperatively, and 21 patients died overall. Pneumonia was the most common postoperative complication (n = 11). The researchers found significant differences in gender and grade of CKD associated with risk of one-year mortality. CKD grade, postoperative septic shock, and acute kidney injury were risk factors of one-year mortality.

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A study published online in Arthroscopy found a decrease in the rate of arthroscopic subacromial decompression (aSAD) without rotator cuff repair (RCR) in the U.S. between 2010 and 2018. The researchers used the PearlDiver Mariner database to identify 186,932 patients who underwent aSAD and 9,263 patients who underwent open SAD (oSAD), both with and without RCR. Between 2010 and 2018, there was a 61.5 percent decrease in aSAD without RCR, while aSAD with RCR remained stable. There was an overall decrease in oSAD of 68.1 percent.

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A study published online in Foot & Ankle International found comparable outcomes between conventional and accelerated rehabilitation after suture bridge Achilles tendon reattachment in 49 patients (conventional, n = 18; accelerated, n = 41). Patients who received conventional rehabilitation had better three-month scores for Visual Analog Scale (4 vs. 3), Foot and Ankle Ability Measure (53 vs. 68), and 36-item Short Form Health Survey scores (57 versus 67), compared to accelerated protocols. Six- and 12-month outcomes also were comparable between groups. All patients could perform the single heel raise test at six months, and no complications occurred.

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A study published online in BMC Musculoskeletal Disorders found poor sagittal alignment and decreased quality of life among patients with vertebral compression fractures (VCF). In total, 142 patients aged >60 years with VCF were compared to 108 age-matched asymptomatic controls. Compared to controls, patients with VCF had significantly greater thoracic kyphosis, pelvic tilt, pelvic incidence, sagittal vertical axis, and T1-pelvic angle. VCF was associated with significantly higher knee-flex and ankle-flex angles compared to controls. The number of VCFs significantly correlated with lower limb alignment and global sagittal balance. Patients with VCFs reported lower 12-item Short Form Health Survey, Oswestry Disability Index, and VAS scores.

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Off-label Use of Medications, Biologics, and Devices in Orthopaedic Trauma Creates a Bevy of Risks and Challenges

In the United States, the FDA oversees the formal approval of medications, biologics, and devices (MBD). Use of MBD for any indication or manner that is different than what has been approved by the FDA constitutes “off-label” use. Orthopaedic surgeons need to be uniquely aware of off-label use guidelines for medications, biologics, and surgical implants. Treating surgeons must also be aware of on-label use of MBD they plan to use in off-label ways. This article highlights considerations and resources for off-label MBD use in orthopaedic trauma care.

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Get Published Faster with OVT Now

Did you know that now you can share your videos and get published faster with OVT Now? OVT Now features an expedited peer-review process and fast publication online. Once uploaded, a video is submitted to AAOS committee members in the given orthopaedic specialty and is quickly reviewed and published. With this option, you can showcase your skills and help advance orthopaedic education more than ever. This growing collection offers OVT viewers the chance to discover relevant content, and access to the very latest in orthopaedic surgical techniques. Log in to submit a video and discover all OVT has to offer.

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