Study: Factors Associated with Lifetime Revision Risk in Unicompartmental Knee Arthroplasty
A retrospective study published online in The Bone & Joint Journal reported a higher lifetime risk of revision unicompartmental knee arthroplasty (UKA) in younger patients, female patients, and patients with American Society of Anesthesiologists grades 3 to 4. The New Zealand Joint Registry was queried and 13,481 UKAs were identified. Revision risk was higher among patients aged 46 to 50 years at the time of surgery (40.4 percent) than patients aged 86 to 90 years (3.7 percent). UKA revision risk was double the risk in total knee arthroplasty across all age groups.
Study: Cost Savings Associated with Routine HbA1c Screening in Diabetic Total Joint Arthroplasty Patients
In patients with diabetes mellitus, routine hemoglobin A1c (HbA1c) screening, with referral of patients with elevated HbA1c for glycemic optimization, may reduce costs in patients scheduled for total hip arthroplasty (THA) but not for total knee arthroplasty (TKA), according to a study published online in Current Orthopaedic Practice. Using a decision tree model, the researchers evaluated short-term costs and periprosthetic joint infections (PJIs) with routine screening versus no screening. Pre-THA screening led to a net savings of $81 per patient, with 286 patients screened to prevent one PJI. For TKA, routing screening incurred $15,810 net additional costs per PJI prevented.
Study Finds Similar Outcomes between Three Fixation Methods for Olecranon Fractures
A retrospective study of 95 patients treated for olecranon fractures reported similar postoperative clinical results and elbow joint function between fixation with tension band wiring, a 3.5 mm locking compression plate (LCP), or a double mini-locking plate. This study was published online in BMC Musculoskeletal Disorders. Thirty-five patients received tension band wiring, 32 received a 3.5 mm LCP, and 28 received the double plate treatment. Follow-up ranged from 12 to 18 months. There were no significant differences in operation or fracture union time, range of motion, or patient-reported outcome scores between fixation methods.
Study: Reductions in Pain after Proximal Interphalangeal Joint Arthroplasty
A study published online in The Journal of Hand Surgery found that only half of patients who underwent proximal interphalangeal joint arthroplasty experienced clinically relevant reductions in pain at one year follow-up. Ninety-eight patients completed the Michigan Hand Outcomes Questionnaire at baseline and then at three and 12 months postoperatively. Pain scores improved significantly, from 42 at baseline to 65 at 12 months postoperatively. Fifty percent of patients achieved a minimal clinically important difference in pain. Range of motion did not improve from baseline, and 13 percent of patients required reoperation.
Diffusion-weighted MRI and Diffusion Kurtosis Imaging to Differentiate Spinal Metastases and Chordoma
A study published online in the European Spine Journal found that monoexponential, biexponential, and stretched-exponential models of diffusion-weighted (DWI) MRI and diffusion kurtosis (DKI) imaging were able to differentiate spinal metastases and chordomas. Imaging was taken of 31 spinal metastases and 13 chordomas. DWI-derived and DKI-derived diffusion coefficients were significantly lower in spinal metastases than chordomas. Mean kurtosis was significantly higher in spinal metastases than chordomas. The true diffusion coefficient for DWI imaging had the highest area under the receiver operating curve in differentiating the two tumors.
AAOS members will soon receive the print edition of the May issue of AAOS Now, but the electronic edition is already available on the AAOS Now website. This month’s issue highlights the launch of the AAOS IDEA Grant Program to foster diversity within orthopaedics, “safe zones” to reduce iatrogenic injury risk to the sural nerve during foot and ankle surgery, and AAOS’ efforts to improve access to quality healthcare.
Take Part in the Development of an Appropriate Use Criteria
AAOS is seeking volunteers to take part on the voting panel for the development of the Management of Glenohumeral Joint Osteoarthritis Appropriate Use Criteria. Voting panelists will be charged with rating appropriateness of included treatments based on patient indications/scenarios via two rounds of voting. Applications will be reviewed and approved on a first come, first served basis.
