November 27, 2017| Today’s News

Study: What factors affect outcomes after hip arthroscopy for FAI?

A study published online in The American Journal of Sports Medicine examines factors linked to acceptable outcomes following hip arthroscopy for femoroacetabular impingement (FAI). The authors conducted a case-control study of 386 patients who underwent primary hip arthroscopic surgery with routine capsular closure for FAI and who had failed nonsurgical management. At minimum 2-year follow-up, they found that younger age, Tönnis grade 0, and lower preoperative Hip Outcome Score (HOS)–Activities of Daily Living (ADL) score were linked with achieving minimal clinically important difference (MCID) for HOS-ADL, while younger age, larger medial joint space width, and higher preoperative HOS-ADL score were linked with achieving the patient acceptable symptom state (PASS) for the HOS-ADL. Younger age, lower body mass index, non–workers’ compensation status, and lower preoperative HOS—Sport-Specific Subscale (SSS) score were associated with MCID for the HOS-SSS, and younger age, Tönnis grade 0, running, and higher preoperative HOS-SSS score were associated with PASS for the HOS-SSS.

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Study: I&D with component retention linked to high failure rate for TKA patients with PJI

Findings published online in The Journal of Arthroplasty suggest high failure rates for patients with periprosthetic joint infection (PJI) who undergo irrigation and débridement (I&D) with component retention after total knee arthroplasty (TKA). The researchers conducted a multicenter, observational study of 216 cases of I&D with retention of components performed on 206 patients. They found that the estimated failure rate was 57.4 percent at 4 years, with a median survival time of 14.32 months, and a 5-year mortality rate of 19.9 percent. The researchers write that the data suggest that I&D may have a limited ability to control infection in TKA and recommend that it be used selectively under optimum conditions.

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Findings presented at the annual meeting of the Radiological Society of North America suggest that injury patterns, including fractures, may help identify patients who have been victims of intimate partner violence (IPV) and sexual assault (SA). Members of the research team reviewed information on 87 patients referred to domestic abuse programs and 35 patients referred to sexual assault programs. Regarding IPV victims, the researchers found that 95 percent were female and 40 percent were African American, with a mean age of 34.7 (±12.0) years. Common traumatic injuries were extremity fractures (n = 6), nasal bone fractures (n = 4), orbital fractures (n = 2), soft tissue injury (n = 7), and spinal fracture/compression (n = 3). Regarding SA victims, the researchers found that 91 percent were female and 46 percent were African American, with a mean age of 27.3 (±7.7) years. Traumatic injuries included orbital wall deformity (n = 1), soft tissue swelling (n = 2), and spinal compression fracture (n = 1).

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The Washington Post reports that officials in several states are preparing to notify families that the federally funded Children’s Health Insurance Program (CHIP) may run out of money and put coverage for many at risk by the end of the year. CHIP funding officially expired in October, but most states had enough funds available to continue the program for a short time. On Nov. 9, 2017, the U.S. Centers for Medicare & Medicaid Services (CMS) issued guidance to state health officials detailing options if CHIP funding runs out. States that are forced to end the program will determine whether enrolled children are eligible for Medicaid or if families should seek insurance through an Affordable Care Act marketplace.

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A report presented on the Harvard University website suggests that physicians may judge female surgeons more harshly than male surgeons in the wake of a negative outcome. The author reviewed referral data on matched pairs of male and female surgeons from 2008 to 2013. The author found that if a referral was associated with death of the patient within 1 week of a procedure, the number of referrals made by the referring physician to the surgeon fell by 34 percent if the surgeon was female, while male surgeons saw no lasting impact in referrals. The author notes that the referral bias was independent of the sex of the referring physician.

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Call for abstracts: AAOS biologics research symposium

AAOS is sponsoring 15 young investigators to attend and present their research at the upcoming AAOS Optimizing Clinical Use of Biologics in Orthopaedic Surgery Research Symposium, to be held Feb. 15-17, 2018, in Stanford, Calif. In addition, selected young investigators will present a poster during a dedicated poster session. AAOS is seeking abstracts in the area of biologics, including platelet rich plasma, minimally manipulated adult progenitor cells, tendinopathy, or tissue repair. Selected young investigators will receive airfare, lodging, and meals at the event. The application deadline is Dec. 1, 2017.

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Submit your application…

The last day to submit an application for a position on the Orthopaedic Video Theater Committee is Dec. 31, 2017. This committee selects and evaluates electronic media programs featured in the Orthopaedic Video Theater at the AAOS Annual Meeting. The following openings are available:

• Chair
• Member—shoulder and elbow
• Member—spine
• Member—sports medicine and arthroscopy

Applicants for the chair position must be active fellows with a strong interest in video and multimedia as tools for orthopaedic education. Applicants for the member positions must be active fellows, candidate members, candidate member applicants for fellowship, associate members osteopathic, or resident members with a practice emphasis in the relevant topic.

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