COVID-19 Presidential Update from Joseph A. Bosco III, MD, FAAOS

In his latest COVID-19 update, AAOS President Joseph A. Bosco III, MD, FAAOS, shared progress on new flexibilities for the Paycheck Protection Program, Provider Relief Fund, and the Centers for Medicare & Medicaid Services’ (CMS) alternative payment model programs during the public health emergency. AAOS has been advocating for these changes since March; this has resulted in CMS making COVID-19-related adjustments to its Bundled Payments for Care Improvement Advanced and Comprehensive Care for Joint Replacement models. Dr. Bosco also noted that AAOS’ In-district Advocacy Event this August will be a nationwide effort, and all members will be receiving details soon on how to participate.

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In Other News

Study: Anteromedial Versus Transtibial Femoral Tunnel Drilling in ACL Reconstruction

A study published online in BMC Musculoskeletal Disorders compared clinical outcomes between anterior cruciate ligament (ACL) reconstruction femoral tunnel drilling performed using the anteromedial (AM) versus transtibial (TT) techniques. Three hundred ACL injury patients were stratified by AM (n = 150) and TT (n = 150) drilling techniques. Outcomes were assessed using clinical examination; Lysholm, Tegner, and International Knee Documentation Committee scores; and instrumented laxity measurements (KT-2000 TM). Sixty AM patients and 58 TT patients were available for two-year follow-up. No significant between-group differences were observed for any of the outcomes.

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Study: Arthroscopy for Borderline Developmental Dysplasia of the Hip

A systematic review published online in Arthroscopy assessed hip arthroscopy in patients with borderline developmental dysplasia of the hip (BDDH). The PubMed, Embase, and Cochrane Library databases were queried for studies involving BDDH. Final analysis included 28 studies, none of which had a high bias risk; the studies included 1,502 total hips. Most studies defined BDDH as a lateral center-edge angle of 20 degrees to 25 degrees. Hip arthroscopy was associated with improved modified Harris Hip Score, a high rate of acquisition of minimal clinically important difference, and a low complication rate.

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Study: Lessons Learned in Setting Up a Registry

A study published in the June issue of Archives of Orthopaedic and Trauma Surgery described the development and challenges of setting up an international bone infection registry. Data collection included essential patient, clinical, and surgical data with a one-year follow-up period for patients with confirmed Staphylococcus aureus long bone infection. Negotiating contracts with a high number of study sites was difficult. Ethics approvals took a long time to obtain but were straightforward. Patient recruitment was slow in the beginning, leading the researchers to reduce the target patient number from 400 to 300; ultimately, 292 patients were recruited by 18 study sites in 10 countries spanning four continents.

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Study: PROMIS Measures in Legg-Calvé-Perthes Disease

A study published in the May/June issue of the Journal of Pediatric Orthopaedics validated the Patient-reported Outcomes Measurement Information System (PROMIS) to evaluate health-related quality of life for different stages of pediatric Legg-Calvé-Perthes disease (LCPD). The study stratified 190 patients (mean age, 10.4 years) into groups based on disease stage: early, late, or healed. PROMIS domains collected included pain interference, fatigue, mobility, depression, anger, anxiety, and peer relationships. Early-stage patients had the worst scores in all seven domains. Patients with more anxiety, depression, and anger had decreased mobility and increased fatigue and pain.

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Study: Targeted Muscle Reinnervation in Limb Amputee Patients

A study published online in Clinical Orthopaedics and Related Research observed improvements in residual limb and phantom limb pain parameters in major limb amputees (n = 33) who underwent targeted muscle reinnervation. The main outcome was residual limb and phantom limb pain preoperatively and one-year postoperatively, assessed by an 11-point numerical rating scale (NRS); other outcomes included changes in PROMIS pain measures and limb function. After one year, NRS scores for residual limb pain improved from 6.4 to 3.6; phantom limb pain improved from 6.0 to 3.6. PROMIS pain intensity and pain interference scores with respect to residual limb and phantom limb pain both improved.

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Dave M. Atkin, MD, FAAOS, Honored as 2020 Humanitarian Award Runner-up

Dave M. Atkin, MD, FAAOS, has devoted nearly three decades of his life to providing orthopaedic care to underserved populations. His continued dedication to giving back to others both in the United States as well as abroad is why he was selected as a runner-up for the Academy’s 2020 Humanitarian Award.

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