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| Today’s Top Story
Study: Intraoperatively Administered Liposomal Bupivacaine Decreases IV Opioid Use in Patients with Hip Fractures
According to a retrospective review in the Journal of the AAOS ®, intraoperative administration of liposomal bupivacaine resulted in notable decreases in IV opioid requirements postsurgery in patients with hip fractures. Eighty-two of the 109 patients included in the study received intraoperative liposomal bupivacaine. Opioid requirements, delirium, and visual analog scale pain scores were measured at one, two, and three days following surgery. Pain scores were not statistically different between groups at any time point after surgery. Compared with patients who did not receive liposomal bupivacaine, those who did tended to have lower rates of delirium (23.9 percent versus 32.8 percent).
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| In Other News
AJRR Analysis Compares Outcomes following Resurfaced versus Unresurfaced Patellae TKA
A study in the Journal of Arthroplasty examined the rates and outcomes of patellar resurfacing during total knee arthroplasty (TKA) for osteoarthritis. The researchers utilized the American Joint Replacement Registry (AJRR) to identify primary TKAs and classified them according to a resurfaced patella (RP) and unresurfaced patella (URP). The main outcomes included trends in patellar resurfacing, factors influencing rate of resurfacing, and revision rates. The rates of patellar resurfacing decreased while the rates of URP TKA increased significantly in ambulatory surgery centers and among high-volume surgeons. URP patients were significantly more likely to require revision surgery compared with RP patients.
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| Study Examines Risk Factors of PJI in Patients with Multiple Arthroplasties
The Bone & Joint Journal published a retrospective study analyzing the risk factors of metachronous periprosthetic joint infections (PJIs) in patients who had undergone multiple arthroplasties. Patients’ sex, age, BMI, and pre-existing comorbidities were examined. Eleven percent of 661 total cases of PJI developed a metachronous PJI. Patients with diabetes mellitus were more likely to have metachronous infections. In addition to diabetic patients, female patients and those with a polymicrobial index PJI were more likely to experience metachronous PJI.
Read the abstract… |
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| Study: Proximal Row Carpectomy of the Wrist with Interposition Associated with Higher Costs and Longer Operative Times
Proximal row carpectomy (PRC) with capitate resurfacing trended towards longer operative times compared with PRC with interposition, according to a study in Current Orthopaedic Practice. Ten patients underwent PRC with interposition, and six underwent PCR with resurfacing. Patient demographics, pre- and postoperative range of motion (ROM), operative time, costs, and postoperative complications were collected via retrospective chart review. In addition to longer operative times, PCR with resurfacing was associated with higher costs ($29,116 versus $15,290). There were no significant differences observed regarding ROM and overall survivorship.
Read the abstract… |
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| Study: What Factors Can Predict Outcomes after Symptomatic Spinal Cavernous Malformation Surgery?
A study investigated potential factors that predict one-year neurological status in postoperative patients with spinal cavernous malformation (SCM) was published in the European Spine Journal. Conducting a prospective observational study, 268 eligible patients with SCM were identified for analysis. The main outcome was the American Spinal Injury Association Impairment Scale (AIS) grade measured pre- and one-year postsurgery. In 51 patients, neurological outcomes were worse at one year from preoperative baseline measurements. Following multivariable logistic regression, strong outcome predictors included: admission size of the lesion, morphology, symptom duration, AIS grade, and the presence of subarachnoid hemorrhage.
Read the abstract… |
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| AAOS Now
Board Approves CPGs for Surgical Management of Knee Osteoarthritis and Treatment of Clavicle Fractures
The AAOS Board of Directors approved an update to the 2015 AAOS Clinical Practice Guideline (CPG) for the Surgical Management of Osteoarthritis of the Knee (SMOAK) and a new CPG for the Treatment of Clavicle Fractures. The 2022 CPG for SMOAK updated 19 of the 38 evidence-based recommendations included in the 2015 CPG. The clavicle fracture guideline focuses on the treatment of isolated fractures in both skeletally mature and immature patients and features three moderate-strength recommendations and one strong recommendation.
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| Your AAOS
Access AAOS Quality Resources
After more than a decade of developing Clinical Practice Guidelines (CPGs), AAOS has expanded its reach into the quality space. With the transition to value-based care, AAOS sought to produce quality products that provide the most benefit to the membership. AAOS continues to develop CPGs, with 20 currently available, but the Academy now uses them to create Appropriate Use Criteria (AUC), care pathways, and other derivative materials. These tools help members answer the question, “What does quality care look like?” All AAOS quality resources are free to members.
View CPGs and AUC…
View all quality resources… |
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