Today’s Top Story

Study: Preoperative Radiological Patellofemoral Disease May Not Affect Long-term UKA Outcomes

The results of a prospective study published online in Knee Surgery, Sports Traumatology, Arthroscopy found that the presence of patellofemoral disease at the time of unicompartmental knee arthroplasty (UKA) did not affect long-term implant survival 10 years postoperatively. Researchers followed 216 patients (263 knees) who underwent UKA between 2003 and 2005. Patellofemoral disease was present in 41 knees (15.6 percent), and 222 knees (84.4 percent) had normal patellofemoral joint state. After 10 years, the normal and patellofemoral groups had similar Oxford Knee Scores (20 versus 20, respectively) and Knee Society Scores (79 versus 81, respectively). The normal group had 12 revisions, half of which were performed for contralateral compartment osteoarthritis (OA), and the patellofemoral group had one revision for contralateral compartment OA. When labeling all secondary surgeries as failures, the 10-year survival rate was 95.1 percent.

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Other News

Study Compares Factors Predictive of Perioperative Adverse Outcomes in THA

A retrospective cohort study published in the Oct. 15 issue of the Journal of the AAOS found that a patient’s American Society of Anesthesiologists (ASA) class and age were the most predictive factors of adverse outcomes after total hip arthroplasty (THA). Researchers identified 64,792 THA patients (mean age, 64.8 years; 55.2 percent female) and compared their ASA class, modified Charlson Comorbidity Index, modified Frailty Index, and demographic characteristics. Perioperative outcomes consisted of any adverse event (AE), severe AEs, minor AEs, extended hospital stay, and discharge to higher-level care. ASA was the most predictive comorbidity index, and age was the most predictive demographic factor. Between the two, age was the best indicator in four of the five adverse outcomes.

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Study: Effects of Closed Suction Drain in Multilevel Posterior Spinal Surgery

According to a prospective study published online in the European Spine Journal, not using closed surgical drains after multilevel posterior spinal surgery may limit postoperative blood loss but could increase wound soakage and the need for postoperative wound aspirations. Data were analyzed for 155 posterior spinal surgery patients who were divided into two groups: drain (n = 80) and no drain (n = 75). The drain group experienced much more perioperative blood loss than the no drain group (716 mL versus 377.9 mL, respectively) and had more transfusion requirements. The no drain group had a greater number and volume of postoperative aspirations. Each group had one case of superficial wound inflammation but no other complications.

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Surgeons May Receive Stats for Hip, Knee Replacement Patients via Smart Watch

Hip and knee replacement patients may soon be able to communicate data to their surgeons using their Apple Watch. A new app, mymobility, is in the works by Apple and Zimmer Biomet. The mymobility Clinical Study will evaluate its efficacy in pre- and postoperative care. Patients will be able to share heart rate, steps taken, and standing hours with their caregiver. Surgeons will have access to a dashboard providing threshold values that allows them to analyze their patient’s progress.

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Learn more about the clinical study…

In The States

Medicaid Access Hindered for Low-income Adults in States Without Expanded Eligibility

According to a report from the Government Accountability Office, low-income adults in states that have not expanded Medicaid are more likely to forego medical care than those who live where coverage has been expanded. In nonexpansion states, 40 percent of low-income adults said they had unmet medical needs compared to 26 percent of low-income residents in expansion states. Twenty percent of low-income adults living in nonexpansion states reported financial barriers to necessary medical care compared to 9 percent of low-income adults residing in expansion states. Low-income individuals in expansion states were more likely than those in nonexpansion states to report having a usual place of care when they are sick or in need of medical advice (82 percent versus 68 percent, respectively).

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Pediatric SHFs with Vascular Injuries Are Complex

Supracondylar humerus fractures (SHFs) are the most common pediatric fractures and are associated with vascular complications in about 20 percent of cases. How to optimally manage the “perfused but pulseless limb,” which presents when the radial pulse is absent to palpitation following pediatric SHF, has been the subject of much debate. A recent survey found that only 50 percent of pediatric hospitals currently have a protocol in place to manage type III pediatric SHFs and a threatened limb. AAOS developed an Appropriate Use Criteria dedicated to managing pediatric SHFs with vascular injury, which evaluates treatment options and acknowledges subtleties that exist in clinical decision-making.

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Avoid Spooky Injuries This Halloween

Halloween is quickly approaching. As trick-or-treaters plan their candy routes, and jack-o’-lanterns appear on porches in neighborhoods across the country, AAOS wants to ensure people are prepared with safety tips to get them through the day without injury. According to the Consumer Product Safety Commission, in 2017, 16,706 patients were treated for Halloween-related injuries in emergency departments, doctors’ offices, and clinics, 3,158 of whom were treated for pumpkin-carving injuries alone. AAOS provides safety tips for adults and children to reduce their risk of injury this October.

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