Today’s Top Story

Study Examines Factors That Influence Opioid Prescribing Patterns in Fracture Patients

A retrospective study published in the March/April issue of Current Orthopaedic Practice assessed patient, prescriber, and injury factors associated with opioid prescribing patterns in orthopaedic trauma patients. Malleolar, diaphyseal tibia, plateau, proximal femur, and forearm fracture patients from a single level 1 trauma center were evaluated for data including how many opioid pills were prescribed at discharge, demographics, and prescriber (physician versus advanced practice practitioner [APP]). Final analysis included 101 patients. At discharge, patients were prescribed a mean 60 oxycodone 5 mg pill equivalents. Younger patients received more opioids than older ones, and tibial plateau fracture patients received more opioids than patients with other fractures. Physicians were more likely than APPs to prescribe low numbers of narcotics.

Read the abstract…

In Other News

Study: Do Arthroscopic Partial Meniscectomy Simulator Skills Transfer to Real Patients?

A study published in the March 1 issue of the Journal of the AAOS ® assessed the transferability of a simulated arthroscopic partial meniscectomy (APM) training program to real patients. The study included 11 junior orthopaedic residents and three expert knee surgeons. At baseline, trainees completed APM on a supervised real patient and the simulator, measured per the Arthroscopic Surgical Skill Evaluation Tool. Trainees then completed an APM training program and were evaluated again on the simulator and in real patients. From baseline to final follow-up, trainees improved from 14 points to 39 points on the real patients and from 10 points to 36 points on the simulator. The trainees’ final simulator score did not largely differ from that of experts on the simulator.

Read the abstract…

Study: How Do Older Patients Fare after Rotator Cuff Repair?

According to a study published online in the Journal of Shoulder and Elbow Surgery, rotator cuff repair patients aged 75 years and older had good pain and functional outcomes. Patients were retrospectively reviewed for outcomes including range of motion (ROM), as well as visual analog scale (VAS) pain, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), Single Assessment Numeric Evaluation (SANE), and Short Form Health Survey (SF-12) scores. They also assessed reoperation and reverse shoulder arthroplasty (RSA) conversion rates. Final analysis included 83 patients (average follow-up, 56.9 months). Additional surgery was required in six patients (7.2 percent), including revision rotator cuff repair for retear (n = 3), RSA conversion (n = 2), and capsular release and loose anchor removal (n = 1). Shoulder ROM and ASES, SANE, VAS, and SF-12 scores all significantly improved.

Read the abstract…

Study Analyzes Vertebral CT Hounsfield Units in Older Vertebral Fragility Fracture Patients

According to a retrospective study published online in the European Spine Journal, older patients with acute vertebral fragility fractures have lower Hounsfield units (HU) than patients without fracture. Of 299 total acute vertebral fragility fracture patients aged 65 years and older, 77 were age- and sex-matched to nonfracture controls. Patients were assessed for vertebral HU value of L1 (L1-HU); in the event of L1 fracture, T12 and L2 were used. A total of 460 thoracic and lumbar vertebral fractures were identified, of which 349 were acute vertebral fragility fractures and 111 were chronic fractures. The average L1-HU value was 66 HU. This varied significantly based on a patient’s number of vertebral fractures: one, 73.3 HU; two, 58.7 HU; and three or more, 40.7 HU. In the comparison between nonfracture controls, fracture patients had significantly lower HU (70.6 HU versus 101.5 HU).

Read the abstract…

Nearly a Quarter of Doctors Report Canceled or Deferred Procedures Amid COVID-19

According to a small survey conducted by Jefferies investment bank, 23 percent of orthopaedic surgeons, anesthesiologists, and interventional cardiologists have observed an increase in canceled or deferred surgical procedures amid the COVID-19 pandemic. More than half of those surveyed believe cancelations and deferments will increase.

Read more…(login may be required)

Read the report…


The Modern Need (or Not) for Tetanus Prophylaxis with Open Fractures in the United States

Does tetanus prophylaxis remain relevant to standardized open fracture care and its crucial components to prevent infection, including prophylactic broad-spectrum antibiotics and timely, effective surgical débridement? Although there are good historical and scientific reasons for its initial use in traumatic wound care, the low modern incidence and prevalence of tetanus make the question worth investigation.

Read more…


ASA, AAOS Launch Toolkit to Help Physicians Safely, Effectively Alleviate Patients’ Postoperative Pain with Reduced Opioid Use

AAOS partnered with the American Society Anesthesiologists (ASA) to develop a Pain Alleviation Toolkit that provides clinicians with resources to support patient communication and decision-making to help patients get as comfortable as possible, as safely as possible.

Learn more…