Study: How Does Distal Tibial Tuberosity High Tibial Osteotomy Affect Patella Height and Patellofemoral Joint Congruity?
A study published online in the Journal of Orthopaedic Surgery and Research assessed the clinical and radiographical effects of distal tibial tuberosity high tibial osteotomy (DTT-HTO) on the patellofemoral joint. Between January 2018 and May 2020, 29 patients (33 knees) underwent DTT-HTO and second-look arthroscopy upon implant removal and were followed for 18 to 24 months. The Caton-Deschamps index, congruence angle, and lateral patellar tilt did not significantly change postoperatively. The weight-bearing line ratio significantly increased postoperatively. International Cartilage Repair Society grades showed no significant progression of the cartilage lesions in the patella and femoral trochlea from the first- to second-look arthroscopy.
Study Evaluates Outcomes of Arthroscopic Treatment of Iliopsoas Impingement Following THA
A study published online in Archives of Orthopaedic and Trauma Surgery analyzed midterm outcomes after arthroscopic release of the iliopsoas tendon following total hip arthroplasty (THA). Twenty patients were assessed. The average time from THA to arthroscopy was 6.3 years. The modified Harris Hip Score significantly improved from pre- to postoperatively. Pain per the numerical analog scale significantly decreased. Activity measured by the University of California, Los Angeles activity score improved.
Study Compares Safety, Financial Outcomes in Minor Hand Surgeries by Setting
A study published online in JAMA Network Open found that performing minor hand procedures in the office setting may reduce patient costs without compromising safety. Claims data from private employer-sponsored health insurance for 468,365 patients undergoing minor hand procedures were retrospectively reviewed. Procedures were performed in office, ambulatory surgery center (ASC), and hospital outpatient department (HOPD) operative settings. In controlled analyses, procedures performed outside the office had higher odds for complications. HOPD procedures, compared to office procedures, incurred an extra $1,216 in total payments and $115 out of pocket; ASC procedures incurred an additional $709 in costs and $140 out of pocket.
Study: Surgical Simulation in Orthopaedic Trainings’ Implications on Spine Surgery
A study published online in Clinical Spine Surgery reviewed available data on surgical simulation in orthopaedics and how this can be applied to spine surgery. A PubMed search yielded 23 relevant studies that analyzed orthopaedic simulation and objectively evaluated trainee performance. Most data focused on trauma and arthroscopy. The studies were inconsistent in terms of the measurements the simulators made and the skills they assessed. Only one study was identified that analyzed the relationship between surgical simulation and spine surgery.
Study: Telemedicine Usage, No-show Visits for a Trauma Clinic During COVID-19
A study published in the October issue of Clinical Orthopaedics and Related Research ® compared telemedicine usage before versus during the COVID-19 pandemic, as well as no-show visits before and after telemedicine was implemented. Clinic schedules and patient charts for a single level 1 orthopaedic trauma center were analyzed for data spanning March 16 through April 10 (COVID-19) and the four weeks preceding March 16 (pre-COVID-19). The percentage of office visits conducted via telemedicine increased from the pre-COVID-19 (0 percent) to COVID-19 period (37 percent). No-show rates did not largely differ during the pre- versus COVID-19 periods.
In its code of medical ethics, the American Medical Association defines the behavior of disruptive physicians as “personal conduct, whether verbal or physical, that negatively affects or that potentially may affect patient care.” Episodes of poor personal conduct are easily recognized in the form of aggressive physical behaviors and personality traits, but when poor conduct takes the form of passive-aggressive behaviors, it may be harder to pinpoint. This article discusses aggressive and passive-aggressive examples, as well as possible fallout of such conduct and how to optimize personal conduct.
