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| Today’s Top Story
Retrospective Study: How Do Activity Levels after TKA and UKA Affect the Risk of Aseptic Revision?
Archives of Orthopaedic and Trauma Surgery published a retrospective cohort study investigating the association between high levels of activity following total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) and the risk of aseptic revision. At the two-year follow-up, the lower extremity activity scale (LEAS) was utilized to assess activity level and univariate logistic regression was conducted to test for association in 1,745 TKAs and 161 UKAs. TKA patients with higher LEAS scores had lower revision rates compared with those with low and moderate LEAS scores, and a higher LEAS two years after surgery was associated with a lower risk for future revision.
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| In Other News
Study Finds Increased Female Representation in Leadership and Resident Positions in Orthopaedic Residency Programs
According to a study in the Journal of Bone and Joint Surgery, the percentage of female residents in orthopaedic residency programs has increased by almost 6 percent over the past five years. Utilizing the American Medical Association Fellowship and Residency Electronic Interactive Database, the number of female residents, interns, faculty, professors, and associate professors from the 2021 to 2022 academic year were compared with data from the 2016 to 2017 academic year. Compared with 2016 to 2017, there were significant increases in female faculty per program (2.77 to 4.54) as well as female full professors (0274 to 0.694) in 2021 to 2022.
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| Study Investigates the Association between Preoperative Opioid Use and Complications after TSA
A study analyzing the effect of persistent preoperative opioid use on outcomes following total shoulder arthroplasty (TSA) found an increased risk of early postoperative complications. The study, published in Shoulder & Elbow, assessed the 90-day complications, readmissions, and rates of revision surgery in 9,933 opioid-naïve patients, 3,016 sporadic opioid users, and 5,842 persistent opioid users. Persistent opioid users had significantly more complications than opioid-naïve patients and sporadic users (9.1 percents versus 6.0 percent versus 6.1 percent), as well as higher rates of readmissions (12.6 percent versus 7.6 percent versus 8.2 percent) and revision (2.3 percent versus 1.1 percent versus 1.1 percent).
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| Study Compares Two Minimally Invasive Approaches to Locating Radial Nerve
BMC Musculoskeletal Disorders published a biomechanical study comparing the clinical value between locating the radial nerve (RN) guided by ultrasonography and the posterior antebrachial cutaneous nerve (PACN) in the posterior humeral approach. The methods were compared by measuring the operation time and the length of incision in 10 arms. Statistical analyses were conducted using paired t-tests. The length of incision was smaller in the ultrasound group. The operation time was longer in the ultrasound group; however, after accounting for the time of ultrasound location, operation time in the ultrasound group was shorter than the PACN group.
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| Systematic Review: Comparison of Clinical Features of Primary versus Secondary Spinal Arachnoid Cysts
A systematic review of 80 studies in the Spine Journal investigated clinical features and optimal treatment modalities of secondary spinal arachnoid cysts compared against primary spinal arachnoid cysts. Specifically, the condition of symptom relief and duration of treatment response were the main outcome measurements. The most reported etiologies were iatrogenic factors, trauma, and subarachnoid hemorrhage. For intradural cysts, recurrence risk was lower following surgical resection than after fenestration/marsupialization (21.43 percent versus 50.72 percent). For unresectable cysts, the authors suggested that shunting procedures, particularly shunting into a body away from the subarachnoid space, could be an effective therapeutic alternative besides fenestration/marsupialization.
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| AAOS Now
Learn How Different NGO Models Deliver Orthopaedic Care in Low- and Middle-income Countries
Many medical non-government organizations (NGOs) provide orthopaedic services in low- and middle-income countries (LMICs). With the increased availability of information and interest in this topic, this article sets out to define and, when possible, compare the predominant models used by NGOs delivering orthopaedic care in LMICs, to inform the conversation on the best ways to bring orthopaedic care to patients in LMICs and be a resource for anyone interested in participating.
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