Today’s Top Story

Study: Injection drug use may be linked to an increase in septic knee admissions

A study published online in Clinical Orthopaedics and Related Research reports that injection drug use may be related to septic knee admissions and is associated with higher rates of mortality, reoperations, resource utilization, and leaving the hospital against medical advice. The researchers used the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample database to identify patients aged 15 to 64 years with a principal discharge diagnosis of native septic arthritis of the lower leg between 2000 and 2013. The proportion of patients with injection drug use-related septic arthritis increased from 5 percent in 2000 to 11 percent in 2013. The authors write that orthopaedic surgeons should screen for injection drug use among patients with septic arthritis.

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Other News

Study: Navigation system may increase accuracy of cuts, independent of surgeon experience

Data from a study published in the May 16 issue of The Journal of Bone & Joint Surgery suggest that use of a cone-beam computed tomography (CBCT)-guided navigation system designed for osteotomies with joint-sparing bone cuts may be associated with an increase in cut accuracy, regardless of surgeon experience. The authors compared 126 navigated cuts and 126 non-navigated cuts performed by 18 orthopaedic oncologists of varying experience levels. They found that, even in expert hands, navigated cuts were significantly more accurate than non-navigated cuts. In addition, when the osteotomies were aided by navigation, their accuracy did not differ according to the level of professional experience.

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Study: Compared to screw, helical blade may increase risk of failure of cephalomedullary fixation

According to a study published online in the Journal of Orthopaedic Trauma, use of a helical blade may be linked to increased risk of failure compared to screw fixation for the treatment of hip fracture with cephalomedullary nail fixation. The researchers retrospectively reviewed data on 126 patients treated with cephalomedullary fixation for low energy hip fracture at a single center. They found that seven failures of fixation (5.6 percent) occurred, all of which used a helical blade. Overall, five failures resulted from medial migration of the helical blade through the femoral head, while two resulted from typical superolateral cutout and varus collapse.

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Study: Protein-rich diet may be beneficial for adult bone health

Protein-rich diets—even those with protein levels above the current recommended dietary allowance—may help reduce bone loss and hip fracture risk, provided there is also adequate calcium intake, according to an expert consensus published online in Osteoporosis International. Among other things, the researchers state that:

  • bone mineral density (BMD) may be positively associated with dietary intake
  • protein and calcium combined in dairy products have beneficial effects on calciotropic hormones, bone turnover markers, and BMD
  • there appears to be no direct evidence of osteoporosis progression, fragility fractures, or altered bone strength with the acid load originating from a balanced diet

The European Society for Clinical and Economical Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases, and the International Osteoporosis Foundation both endorse this expert consensus.

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Study: Why do patients return to the ED?

A study published online in the Journal of Health Psychology seeks to identify the reasons patients return to the emergency department (ED) after initial discharge. Members of the research team used direct patient input and listening sessions to develop the “Uncertainty Scale.” Based on preliminary scale reliability and validity testing of the scale, they identified a number of recurring themes for patient return to ED, including:

  • concern over treatment quality
  • concern about lack of a diagnosis
  • lack of clarity regarding self-management
  • psychosocial factors, including concerns about home and work commitments

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CMS redesigns drug dashboard to provide new information on pricing

The U.S. Centers for Medicare & Medicaid Services (CMS) unveiled a new version of the Drug Spending Dashboards, which now show year-over-year information on drug pricing and indicate manufactures that have increased prices. Available to the public, these dashboards are interactive, online tools that demonstrate trends in Medicare and Medicaid drug spending. The updated version shows the change in percentage of drug spending per dosage unit and includes an expanded list of drugs.

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Vote now: AAOS 2019 Nominating Committee, ten resolutions, and three bylaw amendments

Electronic voting is now open for active, emeritus, and inactive fellows to elect the five members of the 2019 Nominating Committee, and to determine action on 10 AAOS resolutions and three AAOS bylaw amendments. Online voting is quick, secure, and confidential. For the resolutions and bylaw amendments, at least five percent of the total fellowship must cast ballots for the voting to be valid. Ballots must be submitted by Wednesday, May 30, 2018. An AAOS member ID is required to vote. For more information, please contact Donna Malert, at:

Learn more and cast your ballot…  (member login required)