COVID-19 Updates

AAOS, in Partnership with DOCSF, to Host “COVID-19: The Orthopaedic Response” Virtual Summit, April 2–3

DOCSF–The Digital Orthopaedics Conference San Francisco, in partnership with the Academy and the Department of Orthopaedic Surgery at the University of California San Francisco (UCSF), will host a special, two-day virtual summit on the specific impact of COVID-19 on orthopaedics. Thought leaders will share state-of-the-art, real-time learnings and outline the technology resources available to guide you through this unprecedented crisis. Programming aims to spark the creativity and ingenuity that runs deep in the orthopaedic community to redesign orthopaedic care in real-time, to protect our colleagues, our health systems, our patients, and our communities. Registration is free, and sessions will be recorded and made available on demand after the event.

Learn more and register today…

In Other News

Study Compares Predictive Models for Complications, Mortality in Older Acetabular Surgery Patients

A study published in the March/April issue of Current Orthopaedic Practice compared the Elixhauser Comorbidity Measure (ECM), Charlson Comorbidity Index (CCI), and Combined Comorbidity Score (CCS) for predicting outcomes and mortality in operative acetabular fracture patients. The National Inpatient Sample was queried for patients aged older than 65 years who underwent surgery between 2002 and 2014. The researchers employed logistic regression models of basic demographic variables and the ECM, CCI, or CCS to compare their ability to predict inpatient mortality, complications, extended length of stay, and discharge disposition. Final analysis included 2,497 patients. The demographic variables and CCS model were superior to the ECM and CCI models. The area under the curve (AUC) for mortality was 0.829 for CCS, 0.791 for ECM, and 0.689 for CCI; the AUCs for cardiac complications were 0.791, 0.694, and 0.704, respectively; for renal complications, 0.789, 0.787, and 0.683, respectively; and for pulmonary complications, 0.760, 0.750, and 0.662, respectively.

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Study Evaluates Preoperative Warming in TJA for Hypothermia Prevention

A retrospective study published in the March 15 issue of the Journal of the AAOS ® found that forced-air preoperative warming reduced the rate of perioperative hypothermia in total joint arthroplasty (TJA) patients. Between April 1, 2017, and Oct. 31, 2017, 672 TJA patients at a single institution received warmed intravenous fluids and forced-air warming gowns in the preoperative holding area; they were compared to 383 patients treated with the previous protocol. Fewer patients were hypothermic at incision with the new protocol compared to the old protocol (26 percent versus 37 percent). Core body temperature decreased the most between preoperative holding and anesthesia induction. Normothermic patients had less time from operating room entry to incision than hypothermic patients. Hypothermia duration was similar between the groups, although with the new protocol, total hip arthroplasty patients were significantly less likely to remain hypothermic for the whole operation.

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Study Assesses Load Distribution, Contact Area Size of Palmar Surface of Hand During Frequently Used Grip Types

A study published in the March issue of The Journal of Hand Surgery measured the load distribution (LD) and contact area (CA) size of the palmar surface of the hand during four commonly used grip types in activities of daily living: standard, lateral, pinch, and tripod grips. A total of 80 right-handed patients wore sensor-equipped gloves and grasped different items; LD and CA size were recorded for each grip type. CA and LD varied for each grip. For standard grip, the largest CA was observed at the metacarpophalangeal joint level, while the largest LD was over the middle finger pulp. The index, middle, and ring fingers seemed to be loaded with close to the same frequency as the thumb. CA on the thumb was maximum in the pinch, lateral, and tripod grip types, but the LD on the thumb was not.

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Study: Does Delayed Achilles Tendon Rupture Repair Adversely Impact Outcomes?

Delaying minimally invasive repair of Achilles tendon ruptures by 14 to 30 days resulted in similar outcomes as patients treated less than 14 days after injury, according to a study published online in The American Journal of Sports Medicine. Patients who presented between 14 and 30 days after the index injury (n = 21) were matched by sex, age (plus or minus two years), and level of activity. Patients underwent a core suture repair consisting of a modified Bunnell suture in the proximal stump and a modified Kessler suture in the distal stump. The median Achilles tendon rupture score was 91 for both patients with delayed treatment and the acutely treated (median time of presentation after injury, 2.4 days). Mean Achilles tendon resting angle did not largely differ between the delayed repair group (–3.9 degrees) and the acute repair group (–3.7 degrees). Wound infection did not present in either group, and one patient in the acute treatment group presented an iatrogenic sural nerve injury.

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Study: Operative versus Nonoperative Treatment for Sciatica

A randomized trial published online in The New England Journal of Medicine compared outcomes between diskectomy versus conservative management in patients with sciatica that has persisted for four to 12 months. Patients with persistent sciatica and lumbar disk herniation at the L4–L5 or L5–S1 level were randomized 1:1 to receive either microdiskectomy or six months of standardized nonoperative care; conservative patients underwent surgery if necessary. Final analysis included 64 patients in each group; 22 patients in the conservative group (34 percent) were converted to surgery at a median 11 months after enrollment. The mean leg-pain intensity score at baseline was 7.7 in the surgical group and 8.0 in the nonsurgical group. At six months, the leg-pain intensity score was 2.8 in the surgical group and 5.2 in the nonsurgical group. At 12 months, the operative group had greater improvements in pain and on the Oswestry Disability Index. Nine operative patients sustained adverse events, and one patient required reoperation for recurrent disk herniation

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AAOS Announces New Leadership Team, Celebrates Award Winners

AAOS is pleased to announce its new leadership team and celebrate the 2020 orthopaedic award winners. A comprehensive online newsroom was created to house the materials and package news originally planned for the AAOS 2020 Annual Meeting. The kit includes links to the 2019 Year in Review as well as the scientific ePosters and ePapers.

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