Today’s Top Story

Study: Hospital and Surgeon Volume Are Associated with Rates of Revision THA and TKA

A study published in the June 1 issue of the Journal of the AAOS ® found a greater number of complications after total hip arthroplasties (THAs) and total knee arthroplasties (TKAs) in low-volume hospitals with low-volume surgeons compared with high-volume centers and surgeons. The researchers identified Medicare-eligible total joint arthroplasties from 2012 to 2017 via the American Joint Replacement Registry database. Across surgeon/hospital volume groupings, low surgeon/low hospital volume had the highest association with all-cause THA revision and early septic THA and TKA revisions.

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In Other News

Correction

The abstract “Fracture Dislocations of the Proximal Humerus Treated with Open Reduction and Internal Fixation: A Systematic Review” published in Monday’s issue of Headline News Now (HNN) included an incorrect statistic. According to the study, the total reoperation rate after ORIF (open reduction–internal fixation) of proximal humerus fractures was 35.6 percent, not 95.6 percent. HNN regrets the error.

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Study: High Survival Rates with Navigation-assisted and Conventional TKA in Patients with Severe Varus Knee

A study published online in The Journal of Arthroplasty found similar long-term clinical outcomes and survival rates (>96 percent) between navigation-assisted and conventional total knee arthroplasty (TKA) in patients with severe preoperative varus deformity. In total, 152 conventional and 62 navigation-assisted TKAs were included. Mean follow-up was 135.7 months. Postoperative hip-knee-ankle (HKA) angles were statistically similar between TKA methods, but navigation-assisted procedures led to fewer outliers in postoperative HKA angles (8.1 percent versus 18.4 percent for conventional TKA).

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Study: Heel-rise Endurance and Gait Biomechanics in Patients with Chronic Achilles Rupture

Greater heel-rise endurance was correlated with better biomechanics during walking in patients surgically treated for chronic Achilles tendon rupture, according to a study published online in Knee Surgery, Sports Traumatology, Arthroscopy. Twenty-one patients underwent a heel-rise endurance test, the Achilles Tendon Resting Angle (ATRA) measurement, ultrasound measurement of tendon length, and 3D gait analysis. Better performance in the heel-rise endurance test was moderately correlated with faster walking speed, greater peak ankle power, shorter stance phase, and lower peak ankle dorsiflexion angle. Higher ATRA was correlated with longer stance time, greater peak ankle dorsiflexion angle, less heel-rise repetitions, and lower heel-rise total work limb symmetry index (LSI)

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Study: Nerve Transfer with Phrenic Nerve as Donor to Restore Shoulder Abduction in Patients with Brachial Plexus

Compared to the spinal accessory nerve (XI), use of the phrenic nerve (Ph) as the donor in nerve transfers to restore shoulder abduction in acute brachial plexus injuries led to similar outcomes at ≥2 years follow-up, according to a retrospective study published online in The Journal of Hand Surgery. Ninety-four patients underwent nerve transfer using a Ph donor nerve and 42 using a XI donor nerve. Maximum shoulder abduction at follow-up was 61.9 degrees and 51.1 degrees, respectively Sixty-seven percent of the Ph group and 59 percent of the XI group achieved more than M3 shoulder abduction. Age was correlated with functional outcomes over time, but donor nerve was not.

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AAOS Now

Reconstructive Microsurgery Pioneer L. Scott Levin, MD, Receives Kappa Delta Elizabeth Winston Lanier Award for Advancing the Field of Orthoplastic Extremity Reconstruction

L. Scott Levin, MD, FAAOS, FACS, FAOA, was hooked on microvascular surgery even before medical school, finding every opportunity to study and learn from pioneers in the field. More than 40 years later, Dr. Levin has popularized the use of microsurgery in orthopaedics. He remains committed to educating residents and fellows on the full spectrum of reconstructive microsurgery, including revascularization, replantation, composite free tissue transfers, and most recently, vascularized composite allotransplantation. These techniques are vitally important to optimize limb salvage and functional outcomes for a variety of upper- and lower-extremity conditions.

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Your AAOS

Virtual Course: MOC and General Orthopaedic Review—July 2022

For those preparing for the Maintenance of Certification (MOC) exam or simply looking for a general review, the AAOS MOC and General Orthopaedic Review online course provides the latest orthopaedic advances across 11 specialty areas. Course content is focused on the most current evidence-based updates on testable materials to refresh your knowledge. Content is available beginning July 1 and offers more than 30 CME credits.

Learn more and register…