Today’s Top Story

Study: Patient BMI and gender may increase the risk for sacral fractures after spinal fusion

A study published online in The Spine Journal found that the odds of experiencing a sacral fracture were approximately six times higher for obese patients compared to normal or underweight patients undergoing posterior instrumented fusion at a single academic institution between 2002 and 2016. However, bone mineral density (BMD) was not significantly associated with the odds of experiencing a sacral fracture. The researchers retrospectively identified 21 patients with sacral fractures and compared outcomes to those without fractures. The majority of patients with sacral fractures were female (76.2 percent) and elderly (mean age, 66.4 years). The outcomes suggest that body mass index (BMI) and gender indicate risk for postoperative sacral fractures more than pelvic parameters and BMD.

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Other News

Study: Combination unfractionated heparin and aspirin do not appear to decrease incidence of VTE following TJA

The addition of unfractionated heparin (UH) to aspirin did not decrease the incidence of venous thromboembolism (VTE) following total joint arthroplasty (TJA) compared to aspirin alone, according to a study published in the May 1 issue of Orthopedics. Researchers retrospectively reviewed data from a single hospital system and identified 5,350 patients: 1,024 received aspirin only, 1,695 received aspirin plus one UH dose, and 2,631 received aspirin plus multiple UH doses. Rates of deep vein thrombosis and pulmonary embolism did not significantly vary; however, transfusion rates were significantly greater with one and multiple UH doses compared to aspirin alone.

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Study: Mental health may not impact outcomes for patients undergoing shoulder arthroplasty

Despite previous research indicating mental health can impact other diseases, a study published online in the Journal of Shoulder and Elbow Surgery suggests that the presence of a psychiatric diagnosis does not impact outcomes for patients undergoing total shoulder arthroplasty (TSA). Researchers prospectively collected data, including mental health diagnoses, from 280 patients undergoing TSA or reverse TSA between 2009 and 2015 at a single academic institution, of whom 105 (37.5 percent) had depression, anxiety, schizophrenia, or bipolar disorder. Patients with and without mental health diagnoses had similar shoulder range of motion, pain, and function before shoulder arthroplasty, as well as similar hospital length of stay, discharge destination, and readmissions.

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Study: Resident participation in TKA does not appear to impact key medical and financial metrics

According to a study published online in Clinical Orthopaedics and Related Research, resident participation in total knee arthroplasty (TKA) procedures was not associated with either postoperative physical function score (PCS) or minimum clinically important difference PCS improvement. There were also no associations with length of stay or facility discharge. Longer operative times were associated with all postgraduate year (PGY) levels except for PGY-5. Researchers retrospectively analyzed a longitudinal institutional registry of TKAs at a single tertiary academic institution between April 2011 and July 2016. They included 1,626 patients who underwent primary, elective unilateral TKA. Resident participation was defined as residents being in the operating room and documented in the operative notes.

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The Office of the National Coordinator for Health IT announces EHR reporting challenge

The Office of the National Coordinator for Health IT (ONC) is launching the Easy EHR Issue Reporting Challenge to help electronic health record (EHR) users identify, document, and report any health information technology safety issues in real time, according to a blog post from Andrew Gettinger, MD, chief clinical officer of the ONC. This initiative challenges software developers to produce an application that will integrate with an EHR’s workflow; minimize the time and effort needed to create a report; allow the clinician practice, hospital, or end user to choose the parties to whom it reports; and be EHR platform-agnostic. Submissions are due by Oct. 15, 2018, and $80,000 in prizes will be awarded to individuals or entities who best meet challenge evaluation criteria.

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Nonopioid pain management is effective in TSA patients

An opioid-free, multimodal pain management pathway is a safe and effective option in properly selected patients undergoing TSA, according to data presented at the AAOS 2018 Annual Meeting.

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Call for volunteers: Shoulder & Elbow Evaluation Committee

An open position is available for chair of the Shoulder & Elbow Evaluation Committee, a three-year term that runs from March 2019 through March 2022. This position prepares the Shoulder and Elbow Self-Assessment Examination triennially and acts as a resource for providing examination questions for other AAOS educational programs. The last day to submit an application is July 31, 2018.

Learn more and submit your application… (member login required)