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| Today’s Top Story
Review: Management of Incidental Durotomy in Lumbar Spine Surgery
A review published in the March 15 issue of the Journal of the AAOS ® described risk factors, complications, and perioperative management of incidental durotomy (ID) during lumbar spinal surgery. ID can occur in up to 14 percent of lumbar spine surgeries, with an increased risk among elderly patients with advanced spinal pathology and in patients receiving revision surgery or other invasive procedures. When unrepaired, IDs can increase meningitis risk and lead to the formation of cerebrospinal fluid fistulas and pseudomeningoceles. Primary suture repair is the “benchmark” technique for ID management, although comparable outcomes have been found for indirect repair alone.
Read the abstract… |
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| In Other News
Senate Confirms Vivek Murthy, MD, as Surgeon General
On March 23, the Senate confirmed Vivek Murthy, MD, as U.S. Surgeon General under President Joe Biden by a vote of 57–43. Dr. Murthy previously served as the Surgeon General under President Barack Obama between 2014 and 2017 and cochaired President-elect Biden’s COVID-19 Advisory Board from November 2020 to January. According to Dr. Murthy, his priorities in office will focus on the ongoing COVID-19 pandemic, as well as mental health and substance abuse disorders.
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| Study: Incidence and Risk Factors of Stress Fractures after RTSA
A study published online in the Journal of Shoulder and Elbow Surgery determined incidence and risk factors of acromial (ASF) and scapular spine stress fractures (SSF) following reverse total shoulder arthroplasty (RTSA). In total, 6,755 RTSAs from 2013 to 2019 were included. Mean follow-up was 19.8 months. Total fracture incidence was 3.9 percent (n = 264; ASF, 3.0 percent; SSF, 0.9 percent), occurring after a mean 8.2 months postoperatively. Risk factors associated with both ASF and SSF were osteoporosis, arthritis, female sex, and rotator cuff arthropathy. Factors associated with ASF only were chronic dislocation, rotator cuff tear, and older age.
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| Study: Impact of Discoid Lateral Menisci on Meniscal Allograft Transplantation Outcomes
A study published online in Knee Surgery, Sports Traumatology, Arthroscopy compared meniscal allograft transplantation (MAT) outcomes between patients with or without discoid lateral menisci (DLM). A total of 106 patients who underwent unilateral MAT between 2005 and 2017 were followed for at least two years (DLM, n = 59; non-DLM, n = 47). Both groups achieved improved knee function postoperatively. Postoperative International Knee Documentation Committee, Lysholm, and visual analog scale scores were higher among the non-DLM group compared to the DLM group. Tegner scores were not higher among non-DLM patients.
Read the abstract… |
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| Study Measures Impact of Insurance on Ankle Fracture Care and Complications
A retrospective study published in the March issue of the Journal of Orthopaedic Trauma evaluated how insurance status impacts treatment of closed unstable ankle fractures. A total of 489 patients (uninsured, 70.5 percent; insured, 29.5 percent) who underwent ORIF between 2014 and 2016 were included. Uninsured patients more frequently presented to an outside hospital, had longer average time from injury to presentation (4.5 ± 7.6 days versus 2.3 ± 5.5 days), and had longer time to surgery compared to insured patients (9.4 ± 8.5 days versus 7.3 ± 9.1 days). Delaying surgery was directly associated with increased infection risk.
Read the abstract… |
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| AAOS Now
Build a Strong Foundation for Your Practice’s COVID-19 Recovery by Focusing on Your Biggest Asset: Your People
Following Washington’s statewide stay-at-home orders enacted in March 2020 in response to the COVID-19 pandemic, the office of Olympia Orthopaedic Associates (OOA) had to act quickly. The OOA Executive Committee worked to triage and notify patients, plan for staff support, and establish urgent and continued care for their patients. In this case study review, Lourie Roberts, chief operating officer of OOA, describes how this practice handled the early wave of COVID-19 and provides some helpful tips, advice, and lessons learned.
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| Your AAOS
Register Now to Watch the First Resident Rumble of 2021
Show support for your residency program and watch them compete with others from across the country by signing up to watch the AAOS 2021 Virtual Resident Rumble, sponsored by DePuy Synthes. The first AAOS orthopaedics-based trivia event of 2021 will take place on April 7 from 8 p.m. to 9 p.m. CT. Zachary D. Post, MD, FAAOS, from Rothman Orthopaedic Institute, will cohost the event.
Learn more…
Register for the event… |
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