May 4, 2023 | Today’s News

Study Investigates the Effect of Patient Comorbidities and Demographics on Costs after TSA

A study in the Journal of the AAOS^® found that comorbidities such as history of stroke, dementia, and chronic pulmonary disease were associated with an increase in total costs following total shoulder arthroplasty (TSA). To assess how patient demographics, medical comorbidities, and surgical variables affect episode-of-care costs, 1,402 Medicare and 50 private payer patients were identified for analysis. The 90-day costs for Medicare and private payers were $25,822 and $31,055, respectively. Private payers with hyperlipidemia and advanced age were associated with increased total costs. Among Medicare patients, anemia and heart disease were associated with significantly increased costs.

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Study: High Rate of Complications in Femoral Neck Fracture Fixation without Sagittal Malalignment

The Journal of Orthopaedic Trauma published a retrospective case series evaluating the rate of reoperation in patients who underwent percutaneous screw fixation of a valgus impacted femoral neck fracture. Overall, 270 patients without sagittal plane malalignment were included in the analysis. The outcome measures were reoperation and major complications. Fifteen percent of patients required reoperation. The rate of major complications was 173 percent. There was a higher risk of reoperation with constructs consisting of all partially threaded screws compared with use of at least one fully threaded screw (17 percent versus 7.5 percent) when an inverted triangle configuration was used.

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According to a retrospective study in Arthroscopy, Sports Medicine, and Rehabilitation, older age, female sex, and opioid familiarity were identified as risk factors for prolonged opioid use after medial patellofemoral ligament reconstruction. Utilizing the M151Ortho PearlDiver database, 23,249 patients were included in the study. Of these patients, 23.9 percent had preoperative opioid use. Three months postsurgery, patients with pre-existing anxiety, substance use disorder, knee osteoarthritis, and concomitant tibial tubercle osteotomy were at a significantly increased risk of postoperative opioid usage.

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A study in the Journal of Orthopaedic Surgery and Research detailed the midterm outcomes following a new outside-in arthroscopic Broström procedure to treat patients with chronic lateral ankle instability. Thirty-nine patients were evaluated pre- and postoperatively via the American Orthopedic Foot and Ankle Society Ankle Hindfoot Scale system (AOFAS) and Karlsson–Peterson scores. Mean AOFAS scores increased from 48 preoperatively to 91 at the final follow-up. Additionally, Karlsson–Peterson scores also significantly improved. Two patients reported superficial peroneal nerve irritation symptoms postoperatively, and three patients complained of mild pain anteroinferior to the lateral ankle.

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Compared against peripherally inserted central catheters (PICC), implantable venous access devices (TIVADs) can prolong catheter indwelling time and reduce catheter-related complications in patients with malignant bone or soft-tissue tumors of the lower extremities, according to a study in BMC Musculoskeletal Disorders. Sixty-five cases of PICC were compared with 65 cases of TIVAD. After six months, those in the TIVADs group reported less displacement of the catheter end position after 180-degree abduction of the catheterization-side shoulder joint. The TIVADs group also reported better Constant-Murley scores for the catheterization-side shoulder joint than those in the PICC group.

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BoD Proposes Amendment to AAOS SOPs

The AAOS Board of Directors (BoD) has proposed an amendment to the AAOS Standard of Professionalism (SOP) regarding Professional Relationships. Fellows will vote on a proposal related to the AAOS SOP aimed at allegations of harassment, bullying, or discrimination. In the May issue of AAOS Now, Editor-in-chief Robert M. Orfaly, MD, MBA, FAAOS, introduced the topic and the proposed change, including a review of current SOPs and AAOS Professional Compliance Program Grievance. The May issue also features a letter to the editor advocating against the amendment and a response to that letter advocating for the amendment.

Read Dr. Orfaly’s introduction…

Read the letter to the editor…

Read the response to the letter…

AAOS Recognizes Excellence in Musculoskeletal Healthcare Journalism with 2023 MORE Awards

AAOS is pleased to announce the recipients of the 2023 Media Orthopaedic Reporting Excellence (MORE) Awards. Presented annually to U.S.-based journalists, the MORE Awards acknowledge accurate reporting of musculoskeletal health news topics and celebrate the role media play in accurately educating and informing patients about musculoskeletal health issues, innovative bone and joint treatments, preventative care, and patient recovery.

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This brand-new, single-day virtual course on Oct. 13, presented by AAOS, the Musculoskeletal Infection Society (MSIS), and the International Consensus Meeting of Infections (ICMI), brings you up to speed on current knowledge in periprosthetic infection following total hip and total knee arthroplasty. Tune in live for interactive lectures led by Jason M. Jennings, MD, FAAOS; Javad Parvizi, MD, FAAOS, FRCS; and other renowned faculty, plus Q&As and case presentations that will help you evaluate diagnostic dilemmas, formulate treatment plans, and gain strategies for medical and social management in the preoperative period. Registration includes access to recorded sessions for 60 days after the course.

Learn more…