Today’s Top Story

Study Assesses the Impact of Frailty on TJA Complications and Resource Use

An epidemiology and propensity score-weighted analysis in the Journal of the AAOS ® examined the effect of frailty on postoperative inpatient complications and hospital resource utilization following total joint arthroplasty (TJA). The study compared epidemiology, medical comorbidities, and postoperative clinical and economic outcomes between 136,516 TJA patients who met the criteria for frailty and 7,718,374 who were classified as non-frail. Frail patients were more likely to experience any postoperative complication, central nervous system complications, hematoma/seroma, wound dehiscence, infection, and postoperative anemia. Additionally, frail patients had longer lengths of stay, higher rates of discharge to rehabilitation facilities, and greater hospital charges.

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In Other News

Study: Do Racial and Ethnic Differences in the Use of Regional Anesthesia Exist for TKA Patients?

The Journal of Arthroplasty published a retrospective cohort study investigating whether there were racial or ethnic differences in the administration of peripheral nerve blocks for patients undergoing total knee arthroplasty (TKA). After querying a large national database and utilizing multivariable logistic regressions, the researchers found that Black patients had lower odds of receiving regional anesthesia than White patients. Hispanic patients also had lower odds of receiving regional anesthesia when compared with non-Hispanic patients. Native Hawaiian/Pacific Islander patients had increased odds of receiving regional anesthesia.

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Study: High Survivorship in Patients Aged >40 Years Undergoing Arthroscopic Treatment of FAI

According to a study in Knee Surgery, Sports Traumatology, Arthroscopy, patients aged >40 years undergoing arthroscopy for femoroacetabular impingement (FAI) had similar patient-reported outcome measurement (PROM) scores at five years postoperatively compared with younger patients. Ninety-seven older patients were matched with 97 younger patients. Six older hips were converted to total hip replacement. Both cohorts experienced significant improvements in range of motion (ROM), and both groups achieved similar rates of a minimal clinically important difference regarding PROMs and ROM.

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Study Investigates Incidence of Peripheral Nerve Decompression Surgery during Pregnancy

A retrospective, registry-based cohort study found that the highest rates of carpal tunnel release (CTR) for peripheral nerve decompression during pregnancy were observed during the first trimester. The study, published in the Journal of Hand Surgery, observed 308 women undergoing CTR during pregnancy and 675 women undergoing CTR within one year following delivery. Compared to the general population, the incidence rate ratio of CTR during pregnancy was 0.5. Women who were actively smoking prior to becoming pregnant were more likely to undergo CTR during pregnancy.

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Study Assesses the Association between Age, Sex, and Tumor Type with Mortality after Pathological Fractures in Patients with Cancer

The Journal of Orthopaedic Surgery and Research published a study assessing the rates of survival associated with age, sex, primary tumor type, and fracture site in patients with pathological fractures due to cancer. Data were collected from 1,453 patients. Forty-eight percent of patients were female, and the median age was 73 years. The type of cancer with the shortest survival time was lung cancer (78 days), and multiple myeloma had the longest median survival (432 days). The longest survival time was associated with spinal pathological fractures and the shortest survival with fractures of lower extremities pathological fractures (386 versus 187 days).

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AAOS Now

An Inside Look at Resident Unions Shows Pros and Cons

Residents throughout the country have embarked on the path to unionize their residency programs through local Committee of Interns and Residents (CIR) chapters. Approximately 15 percent of U.S. residency programs are already unionized under the CIR. Some prominent examples include the UCLA Health system, Stanford, NYC Health + Hospitals, and Boston Medical Center—where increased compensation, including a housing allowance of $12,000 per year, relocation reimbursements of up to $2,750, childcare benefits such as 12-week parental leave, and educational subsidies, have been achieved due to collective bargaining.

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Your AAOS

The AAOS MOC and General Orthopaedic Review Course Virtual Package

For those preparing for the Maintenance of Certification (MOC) exam or simply looking for a general review, the virtual AAOS MOC and General Orthopaedic Review Course provides the latest orthopaedic advances across 11 specialty areas. Content is focused on the most current, evidence-based updates on the testable material to refresh your knowledge. The virtual package is delivered in three phases, with content available beginning July 1.

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