Today’s Top Story
Study: Propensity toward muscle inflammation might predict muscle recovery after THA.
Data from a study published online in the American Journal of Physiology—Endocrinology and Metabolism suggest that muscle inflammation susceptibility (MuIS) status assessed at the time of surgery may serve as a prognostic index for muscle recovery potential after elective total hip arthroplasty (THA). The authors conducted two studies. In the first, they compared muscle inflammation and protein metabolism signaling in elective THA (n = 15) against hip fracture/trauma patients (n = 11) and a group of nonsurgical control participants (n = 19). In the second study, the authors compared two subgroups of THA patients dichotomized into MuIS(+) (n = 7) or MuIS(-) (n = 7) based on muscle expression of TNF-like weak inducer of apoptosis receptor (Fn14). They found that hip fracture patients demonstrated overt systemic and local muscle inflammation and hypermetabolism. However, they detected no systemic inflammation among elective THA patients. The authors noted that local muscle inflammation in the perioperative limb was profound in MuIS(+) patients and was accompanied by suppressed muscle protein synthesis compared with MuIS(-) patients. In addition, muscle from the contralateral limb of MuIS(+) was unaffected. Read the abstract…

Other News

Study: Younger patients who undergo ACL repair may be at increased risk of further knee surgery.
According to findings presented at the annual meeting of the Pediatric Orthopaedic Society of North America, younger patients who undergo surgery for a torn anterior cruciate ligament (ACL) may be at increased risk of further knee surgery. The research team identified 23,912 primary pediatric ACL reconstructions from a statewide database, and found that of those, 1,955 patients (8.2 percent) had a subsequent ACL reconstruction, while 3,341 patients (14 percent) had subsequent non-ACL knee surgery. Overall, the median time between first and second ACL procedures was 1.6 years. Median time between first ACL reconstruction and non-ACL knee surgery was 1.4 years. The research team noted that factors linked with undergoing a second ACL repair were younger age at time of first ACL repair, male sex, white race, private insurance, higher hospital ACL volume, and higher surgeon ACL volume. Factors associated with a second non-ACL knee surgery were younger age, female sex, white race, private insurance, and higher hospital ACL volume. Read more…

Study: Use of vancomycin powder may reduce risk of SSI in open spine surgery.
Data presented at the annual scientific meeting of the American Association of Neurological Surgeons suggest that the use of vancomycin powder may be protective against surgical site infection (SSI) in open spinal surgery. The researchers conducted a meta-analysis of eight retrospective cohort studies and one randomized controlled trial, covering 2,424 cases and 95 infections in the control group (3.9 percent) and 2,368 cases and 28 infections (1.1 percent) in the treatment group. They found that the use of vancomycin powder was associated with a reduced risk of SSI. In addition, a subgroup analysis found that patients who had implants had a reduced risk of SSI with vancomycin powder, compared to those who had non-instrumented spinal operations. Read more (PDF)…

Does confusion between metric and English measurements impact patient safety?
An article in Modern Healthcare discusses how continued use of the English system of measurements may negatively impact patient safety. The writer notes that the transition to electronic health records (EHRs) may be exacerbating the problem, as most EHR systems may contain default values or rely on use of both the metric system and English units of measurements, making it easier for mistakes to occur. A list of safety concerns issued recently by the non-profit ECRI Institute listed confusion between English and metric systems as one of the organization’s top safety concerns for 2015. Read more…(registration may be required)

Study: Steroid use may not be linked to improvements in athletic performance.
Findings from an Australian study published in the March issue of the Journal of Human Sport and Exercise suggest that the use of performance enhancing drugs may not be associated with improvements in athletic performance. The authors reviewed 1,560 records of male and female athletes among 22 disciplines of summer and four winter sports, from pre- and post-1932 (when steroids became available) and pre- and post-1967 (when widespread doping was acknowledged). They found that records in a number of disciplines did not improve as predicted by extrapolation of pre-doping years’ results. In addition, averaged best life records for ‘doped’ top athletes did not differ significantly from those considered ‘non-doped’. “Even assuming that not all cases of doping were discovered,” the authors write, “the practice did not alter sporting records as commonly believed.” Read more…
Read the abstract…

Court rules that Infuse suit cannot proceed.
The Minneapolis Star Tribune reports that a three-judge panel in the 10th Circuit Court of Appeals has ruled that a suit over the off-label use of Medtronic’s Infuse product will not be allowed to proceed. The newspaper states that under federal law, plaintiffs are required to explain how a device maker’s actions specifically contributed to a plaintiff’s individual injuries. The plaintiff is also required to demonstrate that the device maker’s actions violated federal law, or approach the case via state personal injury laws that do not usurp federal power. Observers say the ruling could influence trial court judges in other device cases. In May 2014, Medtronic settled 950 Infuse cases for $22 million, and set aside additional funds to address 3,800 other damage claims over the use of Infuse. Read more…

NOLC participants meet with legislators to support orthopaedic initiatives.
On Thursday, April 30, 2015, more than 400 orthopaedic surgeons from around the country took to Capitol Hill to meet with their congressional representatives as part of the AAOS National Orthopaedic Leadership Conference (NOLC). Attendees expressed their thanks for repeal of the Medicare Sustainable Growth Rate formula and reauthorization of the Children’s Health Insurance Program, and discussed with members of Congress other issues important to the orthopaedic community, including repeal of the Independent Payment Advisory Board, which was created by the Affordable Care Act, and a bill to protect traveling sports medicine professionals. Read more…

Call for volunteers: Central Evaluation Committee.
July 15 is the last day to submit your application for a position on the Central Evaluation Committee. Members of this committee write questions for the Orthopaedic In-Training Examination. Currently, two openings are available:

  • Hand (one member opening)
  • Spine (one member opening)

Applicants for these positions must be active or emeritus fellows with a practice emphasis in the relevant topic. Learn more and submit your application…(member login required)