Today’s Top Story

Systematic Review Finds Surgical Approach Is Not Associated with Instability after THA

Surgical approach (direct anterior or posterolateral) in total hip arthroplasty (THA) was not associated with postoperative dislocation rates (risk difference, -0.00; P = 0.92), according to a systematic review of 25 studies published in the Nov. 15 issue of the Journal of the AAOS ®. In total, 7,172 THA cases were assessed. Neither cup positioning nor surgical factors were associated with increased rates of dislocation. The acetabular implant was better positioned within the safe zone in the direct anterior approach group ( P = 0.01).

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In Other News

Study Compares Efficacy of DAIR for PJI in Patients with or without a Sinus Tract

The presence of a sinus tract does not significantly impact the success of debridement, antibiotics, and implant retention (DAIR) for periprosthetic joint infection (PJI) after joint arthroplasty, according to a study of 107 patients published online in BMC Musculoskeletal Disorders. At a median of 4.4 years, the failure rate was 36.5 percent in the sinus tract group, compared with 27.3 percent in the non-sinus tract group. Cumulative success rates at one and five years were similar between groups. Modular component exchange in DAIR was associated with a higher success rate among patients with a sinus tract (75.8 versus 47.4 percent with no modular component exchange).

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Study: High Union Rates in Autograft for Talar Neck Fracture, but Complications Are Common

In a case series of 12 patients, published online in Foot & Ankle International, tibial autograft in osteosynthesis of comminuted talar neck fractures with substantial bone defects was associated with favorable union rates (92 percent) and low incidence of malunion (8 percent) at an average of 26 months follow-up. However, the authors noted that avascular necrosis with or without collapse and post-traumatic arthritis were common. Relatively low scores on the 36-item Short Form Survey, Foot Function Index, and Foot and Ankle Ability Measure sports subscale were also common.

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Study: Does Academic Influence Impact Industry Payments for Orthopaedic Sports Medicine Surgeons?

For academic orthopaedic sports medicine surgeons, academic influence (defined as h-index value) is not strongly associated with industry research and non-research payments, according to a study published online in Arthroscopy. Payments were determined via the Open Payments Database (industry payments) and National Institutes of Health (NIH) website (NIH funding). Surgeons receiving industry and NIH funding had significantly higher mean h-index and number of publications than surgeons who did not receiving funding. However, there were no significant differences in h-index/publications between surgeons who did or did not receive industry funding ( P >0.1).

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Study Compares Rate of AEs and Complications after One-, Two-, Three-, and Four-level ACDF

A large retrospective study of patients who underwent one- to four-level anterior cervical diskectomy and fusion (ACDF) reported that four-level procedures had significantly greater odds of 90-day readmission, dysphagia, and prolonged length of stay, as well as greater five-year reoperation rates. The researchers identified 97,081 patients from the PearlDiver database (2010–2020) and then compared adverse events (AEs) and reoperation between one- and two-level (43.7 and 24.8 percent, respectively) versus three- and four-level procedures (29.1 and 2.4 percent). Differences in 90-day AEs were statistically significant in favor of the one- and two-level subgroup (all <2.5 percent). Three-level ACDF was not associated with increased odds of any 90-day AEs.

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How the ABOS Creates Written Examinations

The American Board of Orthopaedic Surgery (ABOS) proudly administers the ABOS Part I Examination, 10 different Computer-based Recertification Examinations, and two Subspecialty Examinations. ABOS staff and many orthopaedic surgeon volunteers work hard to make the examinations successful, from writing questions to reporting scores. In this article, April D. Armstrong, MD, FAAOS, provides a behind-the-scenes look at how the system works.

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The AAOS Annual Meeting Is Back and Better than Ever, March 22–26 in Chicago

Be part of the most influential global forum for orthopaedic surgery. Register for the AAOS 2022 Annual Meeting today and get ready to reach new heights by learning, innovating, and collaborating with colleagues in Chicago. New for 2022, the AAOS Member registration fee now includes three complimentary Instructional Course Lectures—a $210 value.

Learn more and reserve your spot…