Study: Utility of Low-dose RT as Heterotopic Ossification Prophylaxis in THA with Porous Implants
Low-dose preoperative radiotherapy (RT) without shielding as heterotopic ossification (HO) prophylaxis in total hip arthroplasty (THA) did not increase the risk of aseptic loosening of porous implants or nonunion of extended trochanteric osteotomies in high-risk patients, according to a retrospective study published in the March 1 issue of the Journal of the AAOS ®. Thirty-nine patients with a follow-up of 24 to 144 months were included. HO prophylaxis was successful in 85 percent of patients. All femoral implants and 91 percent of acetabular implants were “well fixed” at follow-up.
Study Reports Minimal Clinical Improvement between One and Two-year PROMs after TKA
Patient-reported outcome measure (PROM) scores at one year after total knee arthroplasty (TKA) demonstrated similar clinical reliability and utility as two-year PROMs, according to a retrospective study published in The Journal of Arthroplasty. PROMs from 1,093 patients were compared at four months, one year, and two years post-TKA. Scores significantly improved from preoperative levels at four months postoperatively, and from four-month levels at one year postoperatively. Improvements from one to two years were small and did not meet a minimal clinically important difference for pain, function, activity level, and satisfaction.
Survey of Shoulder, Trauma Surgeons on Rehabilitation Preferences after Proximal Humerus Fracture
A survey of orthopaedic surgeons, published online in the Journal of Shoulder and Elbow Surgery, reported different rehabilitation preferences after surgery for proximal humerus fractures. In total, 172 shoulder surgeons and 78 trauma surgeons participated. Forty-five percent of trauma surgeons preferred immediate weight-bearing status after shoulder arthroplasty, compared with 19 percent of shoulder surgeons. Trauma surgeons also had a stronger preference for home exercise therapy than shoulder surgeons (21 percent versus 2 percent). There were differences between specialties for preferred timing of passive range of motion after two-part fractures. Shoulder surgery fellowship training was associated with preferences for non–weight-bearing duration.
Study: Delayed Surgery for Severe Ankle Fracture Is Associated with Poor Outcomes
Delays of more than seven days before surgery for severe ankle fractures with posterior malleolar fragments was associated with poor clinical outcomes and increased pain, according to a study published online in Foot & Ankle International. In total, 130 patients with low-energy fractures were included. Mean follow up was 26 months. Self-reported Foot and Ankle Scores were significantly lower for patients treated more than one week from injury than patients treated within one week (34 versus 38) Pain-reported pain was higher and satisfaction was lower for patients in the delayed surgery group.
Systematic Review Evaluates Use of Arthroscopic Subspine Decompression with Concomitant Procedures
A systematic review published online in Arthroscopy investigated trends in the use of arthroscopic subspine decompression in conjunction with concomitant procedures. Ten studies (n = 438) were included. The most common maneuver was the subspine impingement test, used in nine studies. Most arthroscopic subspine decompressions occurred in addition to procedures for femoroacetabular impingement syndrome One study reported isolated subspine osteoplasty. Average modified Harris Hip Scores improved from pre- to postoperative levels, and five surgical complications were reported overall.
‘When in Doubt, Refer’ to Avoid Unplanned Resections of Soft-tissue Masses
Despite standard educational grounding about initial evaluation and management of soft-tissue masses, orthopaedic surgeons continue to make what may turn out to be the mistake of an unplanned resection, according to a study by Ana C. Belzarena, MD, and colleagues. Based on these findings, Dr. Belzarena suggests that “knowing how to avoid an unplanned resection for sarcoma should be paramount in orthopaedic oncology training education.”
AAOS, OTA, POSNA, and SOMOS Team up to Provide Hands-on Disaster Response Training
On Tuesday, March 22, AAOS, in conjunction with the Society of Military Orthopaedic Surgeons (SOMOS), the Orthopaedic Trauma Association (OTA), and the Pediatric Orthopaedic Surgeons of North American (POSNA), will present a full-day course at the AAOS 2022 Annual Meeting in Chicago. The course includes a four-hour cadaver skills lab for treating disaster-inflicted injuries instructed by expert faculty who are surgeons with military and disaster response experience. Learn how this course can prepare you to make a difference in desperate situations.
