Today’s Top Story

Study: Delaying fracture fixation till after abdominal wall closure may increase risk of SSI in trauma patients

Data from a study published in the December issue of the Journal of Orthopaedic Trauma ( JOT) suggest that definitive fracture fixation may safely be performed in the presence of an open abdomen. Members of the research team conducted a retrospective, observational, cohort study of 81 adult polytrauma patients with an open abdomen after “damage control” laparotomy and associated major fractures that required surgical repair. Overall, 32 patients received fracture fixation concurrent with an open abdomen, while 49 underwent abdominal wall closure prior to fracture fixation. The researchers found that incidence of surgical site infection (SSI) was 3.1 percent among concurrent fixation patients and 30.6 percent among later fixation patients.

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Other News

Study: How effective is arthroscopic subacromial decompression for shoulder pain at 6 months?

Findings from a study conducted in the United Kingdom and published online in the journal The Lancet suggest little difference in outcomes for patients with subacromial shoulder pain treated with various options. The authors conducted a multicenter, randomized, pragmatic, parallel group, placebo-controlled trial of 274 patients treated with arthroscopic subacromial decompression (n = 90), investigational arthroscopy only (n = 94), or no intervention (n = 90). At 6-month follow-up, they found no significant difference in mean Oxford Shoulder Score across cohorts. The authors note that both surgical groups displayed a small benefit over no treatment, but write that the differences were not clinically important. Two patients in each cohort experienced frozen shoulders.

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Study: Which synovial fluid markers offer greatest diagnostic utility for PJI among revision arthroplasty patients?

A study published in the November issue of the Journal of the AAOS seeks to identify synovial fluid markers with high diagnostic utility for diagnosis of periprosthetic joint infection (PJI). The researchers conducted a meta-analysis of 23 cross-sectional and longitudinal studies of patients who underwent revision hip and knee arthroplasty. They found that the most common markers were interleukin-17 (area under the curve [AUC] 0.974), leukocyte esterase (AUC 0.968), α-defensin (AUC 0.958), interleukin-6 (AUC 0.956), interleukin-1β (AUC 0.948), and C-reactive protein (AUC 0.927), all of which had high diagnostic utility. Among those markers, α-defensin displayed the highest diagnostic odds ratio, but the difference was not statistically significant.

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Study: Chitosan sponge in conjunction with NPWT may help reduce risk of infection of open fracture wounds

Findings from a study published in the December issue of JOT suggest that antibiotic delivery to a wound via chitosan sponge may be more effective than polymethylmethacrylate (PMMA) beads for patients treated with negative pressure wound therapy (NPWT). The authors conducted a prospective study of contaminated musculoskeletal wounds in goats that were treated with either PMMA bead pouch, PMMA bead pouch with NPWT, chitosan sponge, or chitosan sponge with NPWT. After treatment, they found significantly fewer bacteria in wounds treated with antibiotic chitosan sponge compared to antibiotic PMMA bead depot, and that NPWT was not associated with a reduction in effectiveness of the chitosan sponge.

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Study: Patient satisfaction often linked to provider communication and responsiveness

According to a study published online in the journal Orthopedics, provider communication and responsiveness may affect satisfaction assessments of patients who undergo total joint arthroplasty (TJA). Members of the research team reviewed information on 1,454 TJA patients with a mean age of 63 years. They found that overall hospital ratings were most significantly influenced by communication with nurses, followed by responsiveness of hospital staff, communication with physicians, and hospital environment. The researchers found no significant association between Press Ganey survey scores and presence of complications.

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Call for abstracts: AAOS/ORS research symposium

AAOS is sponsoring 15 young investigators to attend and present their research at the upcoming AAOS/Orthopaedic Research Society (ORS) symposium. The Physis: Fundamental Knowledge to a Fantastic Future through Research Symposium will be held Feb. 7-9, 2018, in Rosemont, Ill. AAOS is seeking abstracts on research addressing growth plate function, regulation, or novel treatments for physeal disorders. Selected young investigators will present a poster during a dedicated poster session and have the opportunity to learn from experienced mentors in the field. In addition, authors of five selected abstracts will be invited to give a podium presentation. Selected young investigators will receive airfare, lodging, and meals at the event. The submission deadline is Dec. 1, 2017.

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Submit your application…

Call for volunteers: Instructional Course Committees

Jan. 12, 2018, is the last day to submit your application for a position on an Instructional Course Committee. Members of Instructional Course Committees grade Instructional Course Lecture applications in May and evaluate courses at the AAOS Annual Meeting in March.

  • Adult Reconstruction Knee (one member opening)
  • Foot and Ankle (chair)
  • Hand and Wrist (chair)
  • Pediatrics (chair)
  • Practice Management (chair)
  • Shoulder and Elbow (chair, one member)
  • Spine (chair)
  • Sports Medicine and Arthroscopy (chair)
  • Tumor (chair)

Applicants for this position must be active fellows with a practice emphasis in the relevant topic.

Learn more and submit your application…  (member login required)

Note: AAOS Headline News Now will not be published on Friday, Nov. 24. Publication will resume on Monday, Nov. 27.