March 27, 2020 | Today’s News

President Trump Signs $2 Trillion Stimulus Package, Invokes Defense Production Act

President Donald J. Trump signed the newly passed $2 trillion stimulus package to aid in the economic consequences of the COVID-19 outbreak. It is the largest emergency relief package in the nation’s history. President Trump also invoked the Defense Production Act to require General Motors to manufacture more ventilators.

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A Few Words to the AAOS New Member Class from Denis R. Clohisy, MD, FAAOS

Denis R. Clohisy, MD, FAAOS, was scheduled to address attendees at the New Member Luncheon during the AAOS 2020 Annual Meeting in Orlando, Fla. After the meeting was canceled, Dr. Clohisy wrote the following message, which is inspiring for both new and long-time members of the Academy.

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In 2019, AAOS broke barriers in nearly every aspect of its business. President Kristy L. Weber, MD, FAAOS, served as the Academy’s first female president in its 87-year history. She introduced new initiatives such as the five-year Strategic Plan and Core Values and enriched educational products such as the Orthopaedic Video Theater and live-streaming courses. AAOS entered into partnerships with the American Joint Replacement Registry and American Association of Neurological Surgeons to expand the family of registries. From people to performance, experience to quality, and culture to strategy, 2019 was a barrier-breaking year.

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Study: Is UKA a Good Option for Morbidly Obese Patients?

Two-year unicompartmental knee arthroplasty (UKA) failure rates are significantly greater in morbidly obese patients compared to the general population, according to a retrospective study published in the April issue of The Journal of Arthroplasty. Mobile-bearing medial UKAs performed at a single facility between January 2012 and May 2015 with at least two years of follow-up were examined. Patients were stratified into two groups: those with morbid obesity (body mass index [BMI] ≥ 40 kg/m ²) and those without (BMI < 40 kg/m ²). Outcomes included major revision procedures, minor secondary procedures, infection procedures, and recommendations for revision. Final analysis included 152 patients (190 knees) who were followed for a mean 3.4 years. The morbidly obese UKA group was more than five times as likely as the nonmorbidly obese group to undergo major revision surgery (15.7 percent versus 3.0 percent). No significant between-group differences were observed in rates of minor secondary surgery and infection. In the morbidly obese group, 85.7 percent of failures were attributed to disease progression involving other compartments or mobile-bearing instability.

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A study published online in the Journal of Shoulder and Elbow Surgery observed a high rate of complications in proximal humerus fracture (PHF) patients aged older than 60 years treated with open reduction internal fixation (ORIF) with locking plate fixation. This was a single-center study of 173 PHFs performed between 2005 and 2015. The overall complication and failure rates were 44 percent and 34 percent, respectively. Failure was associated with fracture type: two-part fractures, 26 percent; three-part fractures, 39 percent; and four-part fractures, 45 percent. Failure rate did not differ with and without fibular allograft (33 percent versus 34 percent). The majority of patients who presented radiographic or clinical failure did not require reoperation. The overall reoperation rate was 11 percent, with higher rates based on fracture type: two-part fractures, 7 percent; three-part fractures, 14 percent; and four-part fractures, 18 percent.

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A study published online in JAMA Pediatrics evaluated the association between proton pump inhibitor (PPI) use and fracture risk among children. Patients aged younger than 18 years who initiated PPI use were propensity score- and age-matched to children without PPI use. Final analysis included 115,933 pairs of children; mean follow-up was 2.2 years. A total of 5,354 fractures in the PPI group and 4,568 fractures in the non-PPI group were recorded. PPI patients had a greater risk for upper-limb, lower-limb, and other fractures, but not head or spine fractures.

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A study published online in The Journal of Hand Surgery assessed the reliability and interpretability of sonographic palmar nodules measurements. Two observers assessed 50 patients with nodules characteristic for early Dupuytren disease via ultrasound. Four disease nodule aspects were measured in the transversal and sagittal planes: width, depth, circumference, and area. Intraobserver reliability was good in all areas, except width in the sagittal direction. Interobserver reliability was moderate.

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