March 31, 2021 | Today’s News

Study: Simulated Practice of Distal Locking Screw Placement Improves Speed and Success

A randomized, controlled trial published in the March 15 issue of the Journal of the AAOS ® determined how simulated practice of placing a distal locking screw impacted completion time, radiation use, success, and overall quality. Twenty-eight medical and premedical students used the TraumaVision Virtual Reality Simulator to perform locking screw placement using the “perfect circle” technique and were assessed pre- and post-simulation. Simulated practice improved total post-test completion time compared to pretest figures (251.2 minutes versus 497.3 minutes) and success rates (100.0 percent versus 64.3 percent). Simulated practice did not impact radiation use or overall quality.

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Study: Long-term Survival and Outcomes after Shoulder Replacement

A study published online in the Journal of Shoulder and Elbow Surgery assessed survival and clinical outcomes of 44 shoulder replacements after a minimum 20 years of follow-up. Forty patients implanted at a single center between 1996 and 2000 were included. Survival at 20 years was 84.1 percent, with glenoid loosening reported in all surviving patients. Of the patients who died, 72 percent died with the prosthesis in situ. Twenty-year survival of rotator cuff integrity was 16.8 percent. Visual analog scale pain scores showed improvement at 10 years but not at 20 years postoperatively.

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A randomized study published online in BMC Musculoskeletal Disorders evaluated task-oriented rehabilitation after proximal humeral fracture repair. Seventy patients received a regimen of exercises based on the patient’s job (n = 35) or general physiotherapy (n = 35). After 12 weeks, Disabilities of the Arm, Shoulder, and Hand (DASH) and DASH work subscale scores were higher among the experimental compared to the control group (difference, 16.0 points and 19.7 points). There was a 2.9-point difference in pain intensity Numerical Rating Scale scores and a difference ranging from 17.9 to 37.0 points in Short-form Health Survey scores, both in favor of the experimental group.

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A systematic review published online in the European Spine Journal compared outcomes of a combined anterior posterior versus posterior only approach in hemivertebrectomy for correction of congenital scoliosis. In total, 37 studies published between 2000 and 2020 were included, comprising data on hemivertebrectomy of the thoracolumbar (51.3 percent), thoracic (26.2 percent), lumbar/lumbosacral (21.6 percent), and cervical spine (0.7 percent). There was a significant reduction in operative time for posterior only compared to the combined approach (227 minutes versus 316 minutes), as well as in blood loss (522 mL versus 888 mL). There was no difference in correction rate between approaches.

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A study published online in Injury measured safety and efficacy of magnesium-based alloy implants in children and adolescents. In total, 89 patients treated with implants were included (osteosynthesis, n = 38; osteotomy, n = 18; osteochondral refixation, n = 33) and followed for a mean 8.2 months. All patients had good to very good clinical outcomes. Radiolucent zones were identified in all patients postoperatively but decreased during follow-up. One patient required revision surgery due to unstable osteochondritis dissecans lesions of the knee. No implants were removed.

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RJOS Announces 2021 ‘He For She’ Nominees and Winner

In 2020, the Ruth Jackson Orthopaedic Society (RJOS) instituted the annual “He For She” Award, which recognizes a male orthopaedic surgeon who serves as a strong mentor and sponsor for women in orthopaedics, supporting and empowering females at all stages of their careers to achieve their professional goals. This article spotlights the 2021 award winner William Levine, MD, FAAOS, as well as highlights the other 18 nominees.

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New Podcast Episode: Threats to Orthopaedics in 2021

Prior authorization paperwork, insurance battles over setting of care, and electronic health record documentation challenges are just a few of the many ways that government policies can stand in the way of patient care. In the latest episode of “The Bone Beat” podcast, the new AAOS Advocacy Council Chair Douglas W. Lundy, MD, MBA, FAAOS, discusses the threats orthopaedic surgeons are fighting in 2021 and how these rules and regulations impact orthopaedic surgery from Capitol Hill to the OR.

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