Today’s Top Story

Study: Malpositioning of FT in patients undergoing MPFL reconstruction may be associated with complications

A study published online in The Journal of Arthroscopic and Related Surgery found that malpositioning of the femoral tunnel (FT) during medial patellofemoral ligament (MPFL) reconstruction may be associated with postoperative complications but may not result in unsatisfactory subjective or objective clinical outcomes. Researchers assessed 63 knees from 60 patients who underwent MPFL reconstruction between 1998 and 2012. The FT showed an average distance of 13.3 mm to the Schoettle point, and 45 knees (71.4 percent) were deemed malpositioned. The postoperative Kujala score of malpositioned FT was not significantly inferior to an FT within 10 mm (75.9 points versus 80.5 points).

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Other News

Study evaluates TAA outcomes in patients with varus and valgus malalignment versus neutral alignment

A study published in the May 16 issue of The Journal of Bone and Joint Surgery indicates that varus and valgus malalignments of up to 20 degrees may not lead to worse outcomes compared to neural alignment (less than five degrees) in patients undergoing mobile-bearing total ankle arthroplasty (TAA). Researchers enrolled 144 consecutive ankles (140 patients) undergoing primary TAA using a mobile-bearing HINTEGRA prosthesis with a minimum follow-up of four years. Outcomes for the mean Ankle Osteoarthritis Scale pain and disability score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, Short Form-36 Physical Component Summary score, visual analog scale pain score, and ankle range of motion did not significantly differ, nor did the prevalence of major complications. At mean 7.3-year follow-up, the overall probability of implant survivorship was 91.1 percent: 97.7 percent in the varus group, 81.1 percent in the valgus group, and 90.9 percent in the neutral group.

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Study: Certain risk factors associated with short-term complications in arthroplasty patients at safety net hospitals

Substance abuse, mental illness, and infections may be risk factors for short-term complications following primary hip and knee arthroplasty at safety net hospitals, according to a study published online in The Journal of Arthroplasty. The retrospective cohort study included 486 consecutive patients who underwent primary hip or knee arthroplasty, of whom 103 had a history of substance abuse and completed a one-year sobriety pathway preoperatively. Substance abuse alone was not an independent risk factor for complications, but infections such as HIV and hepatitis C virus, which are common in those with substance abuse problems, were most closely associated with adverse outcomes.

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Study: Elixhauser Comorbidity Measure outperforms Charlson Comorbidity Index for predicting shoulder arthroplasty outcomes

The Elixhauser Comorbidity Measure (ECM) appeared to outperform the Charlson Comorbidity Index in anticipating resource utilization after total shoulder arthroplasty (TSA), according to a study published online in the Journal of Shoulder and Elbow Surgery. Researchers assessed the National Inpatient Sample to identify 90,491 patients who underwent TSA between 2002 and 2014. They assessed the models’ ability to predict inpatient death, complications, extended length of stay, and discharge disposition. The model incorporating basic demographic variables and the complete set of ECM comorbidity variables was most predictive, with a C-statistic of 0.867 for death, 0.752 for extended length of stay, and 0.81 for nonroutine discharge.

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In the States

Report examines implications if final 19 states expand Medicaid coverage

A report from the Urban Institute examined what would happen if the 19 remaining states that have not expanded Medicaid under the Affordable Care Act did so. Highlights of their findings include the following:

  • 4.5 million more people would have health coverage in 2019.
  • The uninsured rate in those 19 states would drop from 16.9 percent to 12.6 percent.
  • Demand for uncompensated care would decrease by $8 billion.

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Read the full report…


What Factors Are Linked to Prolonged Opioid Use after Knee Arthroscopy?

Information from a paper presented at the AAOS 2018 Annual Meeting may help identify patients who would benefit from multimodal pain management strategies to minimize opioid use.

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Last call – 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 5 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)