Study: Increased Length of Stay and TJA Complications in Patients with Cannabis Use Disorder
A study published in the April 1 issue of the Journal of the AAOS ® reported that total joint arthroplasty (TJA) patients with cannabis use disorder (CUD) had longer in-hospital length of stay (3.61 days versus 2.07 days) and increased complications compared with patients without CUD. In total, 9,260 patients with CUD were matched 1:5 to 46,293 patients without CUD. Patients with CUD had higher frequency and odds of medical and prostheses-related complications, as well as significantly higher episode-of-care costs ($29,025.34 versus $24,258.17), than the non-CUD population.
Study Finds Serum D-lactate Is a Promising Biomarker for Diagnosing PJI
Serum D-lactate demonstrated similar efficacy to fibrinogen (FIB) and erythrocyte sedimentation rate (ESR) for the diagnosis of periprosthetic joint infection (PJI), according to a study published online in BMC Musculoskeletal Disorders. The researchers compared serological results from 26 patients with PJI and 26 patients with aseptic implant failure. Serum d-lactate demonstrated a sensitivity of 88.46 percent at the optimal threshold of 1.14 mmol/L, compared with 80.77 percent and 73.08 percent for FIB and ESR, respectively. Specificity was similar between the three biomarkers.
Study: Low Post-ACLR Infection Rates in Pediatric Patients
A study published online in the Journal of Pediatric Orthopaedics reported that pediatric patients who underwent arthroscopic ACL reconstruction (ACLR) had low postoperative infection rates, which were similar to rates in young adults. Administrative claims data from 44,501 pediatric patients (aged <18 years) and 63,495 patients aged 18 to 30 years were included. Infection rates were 0.52 percent and 0.46 percent, respectively. In the pediatric group, patients aged younger than 15 years had a significantly lower infection rate than patients aged 15 to 17 years (0.37 percent versus 0.55 percent).
Study: Return to Sport after Biceps Tenodesis for SLAP Tears
In a retrospective study published online in The American Journal of Sports Medicine, overhead sports athletes requiring biceps tenodesis for an isolated superior labrum anterior to posterior (SLAP) tear had high rates of successful outcomes and return to play with low revision rates. Forty-four overhead athletes aged between 16 and 46 years were followed for a mean of 49 months. Overall, 81.8 percent of athletes returned to sport at an average of 8.7 months postoperatively, with 59.1 percent returning to the same or higher levels of play. No patients within the study required revision.
Study: Rib Fixation Lowers Mortality but Not Vent-free Days after Flail Chest Injury
A study investigating surgical fixation of unstable chest wall and flail chest injury found no improvement in ventilator-free days or other outcomes compared to nonsurgical treatment across the entire patient population. However, the study did record a lower rate of mortality with surgical treatment. Lead author Niloofar Dehghan, MD, notes that appropriate patient selection is important in this setting. “If the patient has minimal displacement of ribs or is comfortable, able to take deep breaths, and able to cough, then surgery will probably not be beneficial,” Dr. Dehghan said.
AAOS Board of Directors Approves CPG/AUC on the Prevention of Surgical Site Infections after Major Extremity Trauma
The AAOS Board of Directors approved a new clinical practiced guideline (CPG) and an Appropriate Use Criteria (AUC) for the Prevention of Surgical Site Infections after Major Extremity Trauma. This CPG and AUC are one of six developed in collaboration with the Major Extremity Trauma Research Consortium and funded by a Department of Defense Grant. This CPG contains recommendations to assist in the prevention of surgical site infections in adults who have experienced major extremity trauma. The AUC offers clinicians guidance to appropriate interventions for patients presenting with high-energy extremity trauma who are being considered for surgical intervention.
