Today’s Top Story

Study: High Postoperative Complications with Multiligamentous Knee Reconstruction

An analysis of 15 years of data on multiligamentous knee surgery performed at a single academic institution found a high rate of early postoperative and low intraoperative complications, according to a retrospective study published online in Arthroscopy. In total, 301 knees (n = 296 patients) treated between 2005 and 2019 were assessed. Eleven intraoperative complications occurred in nine knees (3.0 percent) and 136 complications occurred within 90-days postoperatively in 90 knees (30.0 percent). Factors associated with increased risk of complications included procedure times >300 minutes, inside-out meniscal repair, posterolateral corner (PLC) reconstruction, tibial-based PLC reconstruction, and shorter time from injury to surgery.

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In Other News

Study Assesses Incidence of DVT in Elective Surgery for Degenerative Musculoskeletal Disorders

A retrospective study published online in BMC Musculoskeletal Disorders found older age, surgery type, American Society of Anesthesiologists (ASA) physical status, and malignancy were associated with deep vein thrombosis (DVT) in patients having elective surgery for musculoskeletal disorders. The researchers evaluated 1,236 consecutive patients aged ≥30 years who underwent elective surgery, including total joint arthroplasty and spine surgery. Preoperative D-dimer levels were measured and 431 and 805 patients had levels ≥1 and <1 µg/mL, respectively. Preoperative DVT prevalence was 7.4 percent (proximal, n = 7; distal, n = 85). No postoperative symptomatic venous thromboembolism occurred. Age ≥80 years, knee surgery, ASA grade ≥2, and malignancy were significantly associated with DVT incidence.

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Study: Predictors of Poor Outcomes in Open Reduction of Radial Neck Fractures in Children

A study published online in the Journal of Shoulder and Elbow Surgery found injury severity and soft tissue stripping or radial head comminution during open reduction of radial neck fractures in children were associated with poor outcomes. Twenty-two patients treated between 2009 and 2018 were assessed over a mean follow-up of 15.8 months. Twelve patients (55 percent) had a fair or poor outcome and 10 reoperations occurred. Intraoperative findings of soft tissue stripping and radial head comminution were predictors of fair/poor outcomes and radiographic changes, including radial head fragmentation or collapse and arthritic changes. Injury severity was significantly associated with outcomes, but reduction quality and hardware choice were not.

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Study: Influences on Continued Immobilization of a Nondisplaced Scaphoid Waist Fracture

Inadequate radiographic healing and depression are associated with continued cast or splint immobilization of a nondisplaced scaphoid waist fracture, according to a study published online in the Journal of Hand Surgery. Researchers assessed outcomes of 46 patients treated nonoperatively and immobilized with a cast. Patients reported pain, function, and symptoms of depression after an average of six weeks, and scores were compared to radiographic healing. Inadequate radiographic healing and greater symptoms of depression were independently associated with continued cast immobilization, while pain was not. Shorter immobilization duration was associated with surgeon perception of inadequate radiographic consolidation.

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Study: Outcomes of Ankle Joint Preservation Surgery in Posterior Ankle Arthritis

A study published online in Foot & Ankle International identified a possible relationship between posterior ankle arthritis and plantarflexion of the talus. Ten ankles treated with flatfoot reconstruction with hindfoot arthrodesis for posterior ankle arthritis between 2017 and 2018 were assessed and followed for a minimum of two years. Posterior arthritis was associated with lower preoperative medial longitudinal arch, forefoot abduction, and valgus hindfoot alignment. Sagittal tibiotalar alignment, measured via lateral talar center migration, showed postoperative restoration (−3.3 to −0.3 mm). Seven patients (70 percent) had radiographic arthritis stage improvement Overall median pain scores also decreased significantly postoperatively. No patients underwent conversion to joint-sacrificing procedures at last follow-up.

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AAOS 2021 Annual Meeting: Instructional Courses Are Your Ticket to the Latest in Orthopaedic Advancements

The upcoming AAOS Annual Meeting, Aug. 31–Sept. 3 in San Diego, is the premier educational event in the profession, featuring distinguished faculty sharing the latest findings to use in your practice. Among the many stimulating educational events offered, the centerpiece for many attendees is a comprehensive slate of Instructional Course Lectures that provide master-level, experience-based knowledge and techniques from world-renowned surgeons. This year’s meeting offers an exceptional lineup, including 121 new sessions—more than half of the total—and the option to customize your learning experience by selecting from advanced or moderate tracks.

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Hundreds of Surgical Techniques Modules Available Free to AAOS Members

Build your surgical and clinical decision-making skills with unique educational experiences available on the AAOS online learning platform. Explore the surgical instruction interactive learning modules that assess your knowledge, patient management, and clinical decision making. Available free to AAOS members, these microlearning experiences provide quick and exciting lessons for hundreds of procedural techniques. Topics include advanced reconstruction, foot and ankle, hand and wrist, shoulder and elbow, hip and knee, spine, and sports medicine.

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