June 8, 2023 | Today’s News

Study: Does Anticoagulant Use after ACLR Affect Rate of MUA?

Arthrofibrosis following ACL reconstruction (ACLR) was associated with the use of pre- or postoperative thromboprophylaxis, according to a study in the Journal of the AAOS^®. In order to determine whether anticoagulant use had an effect on the incidence of manipulation under anesthesia (MUA) for treatment of arthrofibrosis after ACLR, 216,147 patients were identified and stratified by MUA within two years of ACLR. Overall, 162 percent of patients underwent MUA within two years, and patients who were on anticoagulants after ACLR were more likely to require MUA. Specific relationships between thromboprophylaxis and MUA were identified for low-molecular-weight heparin, warfarin, and direct factor Xa inhibitors.

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Study Identifies Risk Factors for Acute Kidney Injury in Patients with PJI

A study in the Journal of Arthroplasty compared the incidence of and risk factors for acute kidney injury (AKI) in patients with periprosthetic joint infections (PJI) who were either treated with antibiotic-loaded bone cement (ALBC) or debridement and implant retention (DAIR) without the use of ALBC. Overall, 162 PJI patients treated with ALBC and 115 PJI patients treated with DAIR were included in the analysis. Twenty-nine patients in the ALBC group and 17 in the DAIR group developed AKI. Independent risk factors for AKI included chronic kidney disease, systemic vancomycin, and diuretic use.

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A meta-analysis in Archives of Orthopaedic and Trauma Surgery assessed the incidence and risk factors for complex regional pain (CRP) in radius fractures. Nine studies which focused on patients with conservative or surgically treated radius fractures leading to CRP as well as a control group of patients with radius fractures and no CRP were included. The incidence of CRP ranged from 0.19 to 13.63 percent. Fractures with greater complexity or greater associated tissue damage, female sex, high BMI, and psychiatric disorders were found to be risk factors for CRP.

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Current Orthopaedic Practice published a retrospective analysis that compared the rate and character of transfers for hand surgery evaluation during the initial three months of state-mandated restrictions due to the COVID-19 pandemic (March to June 2020) with a temporally matched prepandemic period (2018 to 2019). Transfer frequency was the primary outcome, and the secondary outcomes included treatment rendered and type of disposition. There were no significant differences observed between prepandemic and COVID-19 transfer rates. Moreover, there were no significant differences in admission patterns (prepandemic = 71.4 percent versus COVID-19 = 52 percent).

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According to a case-control study in BMC Musculoskeletal Disorders, placing the tracer on the spinous process instead of the iliac spine during robot-assisted posterior spine surgery could lead to a lengthier procedure but improved satisfaction in screw placement. Overall, 525 pedicle screws placed during 92 robot-assisted surgeries were analyzed. After being grouped based on the location of tracers, the spinous group had significantly better screw accuracy compared with the iliac group.

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MIS Hip Surgery Improves Return-to-sports Timelines

“Orthopaedic sports medicine surgical techniques are largely driven by the desire to return all levels of athletes to sport and pain-free, high-level function, ideally through smaller incisions with less soft-tissue disruption and morbidity,” writes Andrea Herzka, MD, FAAOS, co-chair of the combined AAOS Board of Councilors/Board of Specialty Societies Professionalism Committee. In this article, Dr. Herzka discusses how advancements in minimally invasive hip arthroscopy techniques have allowed for improved surgical outcomes and expanded treatment options for various hip conditions, such as femoroacetabular impingement, labral reconstruction, capsular management, and deep gluteal pain.

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Register by July 24 to Save: Surgical Skills in Total Hip and Total Knee Arthroplasty

Elevate your surgical skills in total hip and total knee arthroplasty by attending this hands-on course, taking place Sept. 22 to 24 in Rosemont, Ill Expert faculty will deliver contemporary strategies for preoperative planning, surgical execution, and postoperative management for primary and revision total hip and total knee arthroplasty. Spend most of the course in the cadaver lab practicing current techniques for a variety of procedures with direct guidance from course instructors, including directors Nicholas J. Giori, MD, PhD, FAAOS; Charles L. Nelson, MD, FAAOS; Hany S. Bedair, MD, FAAOS; and David W. Manning, MD, FAAOS.

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