Today’s Top Story

Study: Patients with Spinal Cord Injury Undergoing TKA Have Higher Risk of Postoperative Complications

The Journal of the AAOS: Global Research & Reviews® published a study that examined the impact of spinal cord injury (SCI) on postoperative outcomes in patients undergoing total knee arthroplasty (TKA). Using the National Inpatient Sample database, 558,311 TKA patients with no SCI and 60 patients with SCI were identified. Patients with SCI had a 2.3 times greater risk of blood loss and a higher risk of periprosthetic fracture and prosthetic infection following TKA. The length of stay was 2.21 times greater and the mean total incurred charges were 1.58 times higher in the SCI group than the non-SCI group.

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In Other News

Study Examines the Effect of Metabolic Syndrome and Obesity on Perioperative TJA Outcomes

According to a study in Arthroplasty Today, patients with metabolic syndrome (MetS) undergoing total joint arthroplasty (TJA) had an increased incidence of complications and mortality. In total, 529,737 patients from the American College of Surgeons National Surgical Quality Improvement Program were included in the analysis, and patients with and without MetS were compared. Hypertension and diabetes were also associated with increased complications but not mortality. Obese patients also had increased complications; however, there was a significant decrease in mortality.

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Study Identifies Risk Factors for Repeat Procedures after Ream-and-run Arthroplasty

A retrospective review published in the Journal of Bone and Joint Surgery found younger age to be an independent risk factor for repeat procedures to treat postoperative stiffness after ream-and-run arthroplasty. Over a minimum two-year follow-up period, the demographics and preoperative and two-year patient-reported outcome scores were collected from 340 patients. Twenty-six patients underwent open revision for stiffness, and 35 patients underwent manipulation under anesthesia. Following univariate analysis, American Society of Anesthesiologists class 1 compared with class 3 and less passive forward elevation at discharge were also found to be independent risk factors for repeat procedures.

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Study: Comparison of Psychological Readiness to RTS after Primary versus Revision ACLR

Comparing the psychological readiness to return to sport (RTS) in patients undergoing revision ACL reconstruction (ACLR) and those undergoing primary ACLR, a study in the Orthopaedic Journal of Sports Medicine found revision ACLR patients demonstrated lower psychological readiness scores. The ACL–Return to Sport after Injury (ACL-RSI) psychological readiness scale was collected from 184 patients. At RTS, the ACL-RSI scores were 77.4 in the revision ACLR group and 85.3 in the primary ACLR group. Furthermore, the revision ACLR group returned to play significantly later than the primary surgery group (9.4 months versus 8.1 months).

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Study: Risk Factors for Hip Joint Structural Changes in Ankylosing Spondylitis Patients with Thoracolumbar Kyphosis

The European Spine Journal published a retrospective study examining the risk factors of hip joint structural changes in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis who underwent pedicle subtraction osteotomy. Hip involvement was assessed via the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-h). Clinical and surgical data were collected from 52 patients whose BASRI-h scores maintained and 78 patients whose BASRI-h scores increased. Following multivariate logistic regression analysis, earlier onset of AS, longer kyphotic duration, larger preoperative global kyphosis, sacral fixation, and larger anterior pelvic plane angle were independent risk factors for hip joint structural changes.

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Echoes of Sir William Osler

In this month’s Editor’s Message, Robert M. Orfaly, MD, MBA, FAAOS, AAOS Now editor-in-chief, discussed how a holistic approach to patient care goes beyond repairing physical ailments. “Every day in my professional life, I am reminded of the links between one’s thoughts, beliefs, and attitudes and their physical health,” Dr. Orfaly writes. He evoked the famous Canadian physician, Sir William Osler, who famously stated “The good physician treats the disease; the great physician treats the patient who has the disease.”

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Review the AAOS 2022 Annual Report

Have you read the 2022 Annual Report yet? Over the last three years, the world faced unprecedented challenges, which impacted AAOS members and their patients. Working with leadership, volunteers, and staff, AAOS increased its efforts to listen to its membership’s diverse perspectives, advocate for issues that affect the musculoskeletal community, and pave the way for the future of the profession. The 2022 Annual Report details the many achievements of the Academy over the last year and demonstrates the power and dedication of the orthopaedic community when working together. Visit the link below to see more highlights and download the full report today.

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AAOS Item Writer Spotlight Celebrates the Contributions of Norman Y Otsuka, MD

AAOS has many great volunteers who contribute to the Academy’s examination development process. Using their experience and expertise, they offer their time to help build the future of our examination product offerings. Each quarter, AAOS will celebrate these efforts with a featured volunteer in the AAOS Item Writer Spotlight. Norman Y. Otsuka, MD, FAAOS, FAAP, FACS, is our inaugural featured volunteer for the spring 2023 AAOS Item Writer Spotlight. Dr. Otsuka serves as the editor-in-chief of the Orthopaedic In-Training Examination ® and the Examinations and Assessments Education Committee chair. Read his interview via the link below and discover how you can get involved and become an AAOS Item Writer.

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