Study Measures Risk Factors of Ogilvie Syndrome After TJA
A retrospective study published in the Feb. 15 issue of the Journal of the AAOS ® determined incidence and risk factors of acute colonic pseudo-obstruction, or Ogilvie syndrome (OS), following total joint arthroplasty (TJA). A total of 12,541,169 patients who underwent primary and/or revision TJA between 2001 and 2014 were included, of which 0.03 percent developed postoperative OS. Revision surgery was associated with higher odds of OS compared to primary TJA. Fluid and electrolyte disorders were identified as OS risk factors. Patients with OS had increased risk of complications, length of stay, and costs compared to those without OS.
Study: Higher Rates of ACL Reconstruction Failure in Patients with Generalized Joint Laxity
A systematic review published online in Arthroscopy evaluated the effect of generalized joint laxity (GJL) on primary ACL reconstruction (ACLR) outcomes. Nine studies were included, comprising 1,869 patients who underwent either bone-patellar tendon-bone (BPTB, n = 1,062) or hamstring autograft (n = 696) ACLR. Patients with GJL had higher graft failure rates (6.0–30.0 percent versus 0–12.3 percent) and inferior patient-reported outcomes and postoperative knee stability compared to those without GJL. BPTB autografts were more successful than hamstring autografts in patients with GJL (failure rates, 6.0–21.0 percent versus 17.6–30.0 percent).
Study: Osteoporosis Is Underdiagnosed in Elderly Patients Receiving THA
A retrospective study published online in Osteoporosis International analyzed bone mineral density (BMD) and incidence of osteoporosis in 268 patients aged older than 70 years who received total hip arthroplasty (THA). Patients underwent dual-energy X-ray absorptiometry within three months of primary THA. Forty-nine patients (18 percent) were diagnosed with osteoporosis, of whom 73 percent were not diagnosed prior to their preoperative radiograph. Osteopenia was diagnosed in 110 patients (41 percent). Female sex and BMI were negatively associated with BMD.
Study: Continuous Spinal Distraction Impacts Vertebral Body Depth in Scoliotic Children
A study published online in the European Spine Journal evaluated the impact of growth-friendly spinal implants (GFSI) with continuous distraction on vertebral outcomes in children with spinal muscular atrophy treated for scoliosis. The study included two treatment groups: 19 patients without prior scoliosis treatment and 24 patients treated with GFSI for an average 4.5 years. Based on pre- and post-implant radiography, prior GFSI was associated with decreased vertebral body depth and volume compared to no GFSI, with significant differences for lower thoracic and entire lumbar spine. Vertebral height was unchanged between groups.
Commentary: Provider Bias Can Result in Patient Death
In an op-ed published online on MedPage Today, Mary I. O’Connor, MD, FAAOS, explains how failure to understand the medical risks and disparities faced by women and racial or ethnic minorities could result in a higher likelihood of adverse outcomes. A recent survey of orthopaedic surgeons asked whether they feel pressure to avoid or restrict access to patients with limited social support. The survey found that surgeons do feel such pressure. As minorities are more likely to require costly post-surgical support, value-based payment models may increase existing disparities for minorities who are perceived to be less profitable in such models.
Rare Disease Research Paves the Way for Registry Studies of the Most Common Orthopaedic Ailments
The 2019 launch of the AAOS Musculoskeletal Tumor Registry (MsTR) was a major achievement for the orthopaedic oncology community, as surgeons from the smallest orthopaedic subspecialty collaborated with the AAOS Registry Program to create the Academy’s first diagnosis-based registry. Having met the 2020 goals for the registry rollout, the MsTR Steering Committee is optimistic that the majority of orthopaedic oncologists will be entering patient information within the next few years. It is entirely possible that the MsTR may progress from a concept to collecting data on most of the new sarcoma patients in the United States within a decade.
Webinar: AAOS Kicks Off Innovation Series with Virtual Reality OR Experience
The new AAOS Innovation Series invites members and residents to discover what is current or evolving in the field of medicine and see how it integrates with orthopaedic surgery and outcomes. From innovative augmented reality technologies to new virtual reality techniques, this series is designed to help members stay at the forefront of orthopaedic solutions through a virtual training environment with some of today’s leading names in orthopaedics. The series’ first webinar “Learn How Virtual Reality is Transforming Orthopaedic Education Through the Immersive Persona® Revision Knee Module” will take place March 18 at 7:15 p.m. CT.
