May 4, 2020 | Today’s News

COVID-19 Presidential Update from Joseph A. Bosco III, MD, FAAOS

In his latest COVID-19 update, AAOS President Joseph A. Bosco III, MD, FAAOS, discussed considerations for returning to elective surgery as some states begin to relax surgery restrictions. AAOS’ guidelines for returning to elective surgery, published two weeks ago, “stress that the decision to perform elective surgery should be based on the local availability of resources and the local prevalence of COVID-19,” Dr. Bosco reiterated. He also announced that the Ortho-pinion Blog on orthoinfo.org has been reignited to help frame conversations patients will raise regarding elective surgery. AAOS Second Vice President Felix Savoie III, MD, FAAOS, is creating a frequently asked questions guide to help surgeons answer what’s on patients’ minds. Finally, Dr. Bosco called on members to vote on the bylaws amendments and resolutions. “Your vote counts as much as mine. I know that you will vote based on facts and what you feel is best for the Academy,” Dr. Bosco said. “After the vote, regardless of the outcome, I will harness the passion on both sides of this issue and work with all parties involved to move the Academy forward and execute on our Strategic Plan.”

Read Dr. Bosco’s message…

Study: Reasons for 30-day Readmission After Outpatient TKA

A study published online in The Journal of Arthroplasty evaluated reasons and risk factors associated with 30-day readmission following outpatient total knee arthroplasty (TKA). Primary TKA patients with a hospital length of stay (LOS) of zero days (n = 3,015) were identified. The main outcome was readmission during the first 30 days postoperatively. Reasons for and timing of readmission were assessed, as were risk factors for and effect of overnight hospital stay on 30-day readmission. The 30-day readmission rate was 2.59 percent. Most readmissions were attributed to nonsurgical site related issues (64 percent), including thromboembolic and gastrointestinal complications. Risk factors included preoperative dependent functional status, hypertension, chronic obstructive pulmonary disease, and operative time of 91 minutes or more. Patients who had some of the risk factors were significantly less likely to require 30-day readmission if they had LOS at least one night.

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A study published online in Arthroscopy compared two-year outcomes between staged bilateral hip arthroscopy versus unilateral hip arthroscopy. Patients treated between January 2007 and December 2017 for femoroacetabular impingement were assessed. There were 84 matched patients (84 hips) each in the bilateral and unilateral groups. The modified Harris Hip Score (mHHS) and Non-arthritic Hip Score (NAHS) both significantly improved from pre- to postoperatively in both groups. In the bilateral group, 57 hips (68 percent) achieved the patient-acceptable symptomatic state compared to 62 hips (74 percent) in the unilateral group. Bilateral hip arthroscopy patients with less than 17 months between the index procedure and contralateral hip arthroscopy had significantly better mHHS and NAHS.

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A randomized, controlled trial published in the May issue of the Journal of Shoulder and Elbow Surgery assessed the impact of tranexamic acid (TXA) on postoperative swelling, hematoma formation, pain, and opioid use in patients undergoing the Latarjet procedure. A single surgeon performed open Latarjet surgery on 100 patients with anterior shoulder instability. Patients intravenously received either 1 g TXA or placebo preoperatively. Intraoperative blood loss did not largely differ between the TXA and placebo groups (60.9 mL versus 68.9 mL), but TXA patients had significantly lower postoperative blood loss (29.6 mL versus 64.9 mL), painful postoperative swelling (4 percent versus 32 percent), visual analog scale pain score (1.7 versus 3.0), and postoperative opioid use (9.4 mg versus 22.0 mg). Correlations were observed between postoperative swelling and increased pain and opioid use.

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The Orthopaedic Research and Education Foundation announced its endorsement of the “For Such A Time As This – OrthoChallenge.” This innovative program, conceived by NovApproach Spine Chief Executive Officer Raymond J. Cloutier, along with cosponsors Joseph D. Zuckerman, MD, and Dawn A. Lissy, MS, encourages the development of new product, software, and services that address the needs of orthopaedic patients whose surgeries and therapies have been delayed as a result of the COVID-19 pandemic. Submissions are due May 10.

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‘He For She’ Award Goes to Mark E. Baratz, MD, FAAOS

The newly implemented, annual “He For She” Award, given by the Ruth Jackson Orthopaedic Society, recognizes a male orthopaedic surgeon who serves as a strong mentor and sponsor for women in orthopaedics, supporting and empowering females at all stages of their careers to achieve their professional goals. The criteria for award selection include being an open advocate for women in orthopaedics; demonstrating continued support, mentorship, and sponsorship for various women; and being a forward-minded, inclusive thinker. This year’s winner is Mark E. Baratz, MD, FAAOS.

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Follow the Office of Government Relations on Twitter

Looking for AAOS advocacy updates on Twitter? Follow the Office of Government Relations for timely news and information. The Association arm of the Academy identifies, analyzes, and directs all health policy activities and initiatives to position AAOS as the trusted leader in advancing musculoskeletal health. Members are encouraged to follow this handle and engage with tweets to help promote the viewpoint of the orthopaedic community.

Follow @AAOSAdvocacy…