Study: PROMs after TKA Revision for Unexplained Pain versus Aseptic Loosening
According to a study published in The Journal of Arthroplasty, patients undergoing total knee arthroplasty (TKA) revision for unexplained pain had worse patient-reported outcome measures (PROMs) than those undergoing revision for aseptic loosening. Eighty-four unexplained pain patients and 303 aseptic loosening patients were retrospectively reviewed. PROMs were measured using the Oxford Knee Score (OKS), EQ-5D-5L, and Forgotten Joint Score (FJS). The median OKS was 25 in unexplained pain patients versus 31 in aseptic loosening patients. The median EQ-5D-5L was 0.6 and 0.8, respectively. For both groups, the median FJS was 50.
Study Investigates the Influence of Social Determinants of Health in RCR Patients
A systematic review published online in the Journal of Shoulder and Elbow Surgery investigated the influences of social determinants of health on patient access to appropriate orthopaedic treatment and its effect on patient-reported outcomes after rotator cuff repair (RCR). Thirty-two studies consisting of 102,372 patients, 669 physical therapy clinics, and 71 orthopaedic surgery practices met inclusion criteria. Multivariate analysis found that female gender, labor-intensive occupation, tobacco use, lower education level, racial minority status, low income, unemployment, and preoperative narcotic use contributed to delays in access to healthcare. Black and Hispanic patients were more likely to present at low-volume facilities.
Study Evaluates Outcomes of a Novel Surgical Technique to Treat Incomplete Diaphyseal Atypical Femoral Fractures
The Journal of Bone & Joint Surgery published a retrospective study evaluating a novel surgical technique of intramedullary nailing with augmented plate fixation for incomplete atypical femoral fractures associated with increased anterolateral bowing. Pre- and postoperative radiographs were compared in 20 femora. The main outcomes were primary bone union and complications. Primary bone union was achieved in 19 femora at a mean 24.9 weeks postsurgery. Two delayed unions occurred and were healed at 36 and 40 weeks, respectively. The lateral bowing angle and anterior bowing angle significantly improved (12.0 degrees to 3.3 degrees and 17.3 degrees to 11.5 degrees, respectively).
Study: Association between Digit Survival Rate and Intravenous Heparin after Digital Replantation
In a retrospective study published online in The Journal of Hand Surgery, postoperative therapeutic dose intravenous heparin (POTDIVH) in digit replantation and revascularization was associated with higher rates of complications following digit replantation. Digit survival and complication rates were compared between patients who received POTDIVH (group A, n = 374 digits) and those who did not (group B, n = 781 digits). Overall, the revascularization and replantation success rates were 79.9 percent in group A and 92.8 percent in group B. Group A showed increased odds of failure and was associated with increased bleeding-related complications.
Study: Return to Activity and Patient-reported Outcomes after Tarsal Coalition Resection
The Journal of Orthopaedic Surgery and Research published a retrospective analysis of the time to return to activity and outcomes after tarsal coalition resection. Overall, 78 patients undergoing 97 tarsal coalition resections were included in the study. The main outcome measures were the Roles and Maudsley score (RM) and return to activity and/or sport. The average time to return to activity was 18.3 weeks after surgery. The mean preoperative RM score was 4 compared with a mean of 1.3 postsurgery.
Tranexamic Acid: A Paradigm Shift in Total Joint Care
There has been a dramatic decrease in transfusion rates in total joint arthroplasty cases over the past decade. The adoption of tranexamic acid (TXA) by orthopaedic surgeons has played a key role in this ongoing reduction and has contributed to a collective paradigm shift in total joint arthroplasty (TJA) care toward outpatient surgical management. As TXA use is becoming more uniformly adopted in TJA and other bone-cutting procedures, it is important to reflect on its origins, chemistry, and evolving role in orthopaedic surgery, along with its limitations.
Do you have timely research or an interesting story to tell? AAOS Now is seeking editorial submissions from orthopaedic surgeons and orthopaedic- and practice-related product and service providers that qualify as subject matter experts. The magazine features various formats and opportunities to highlight your information or topic. AAOS Now encourages interested authors to contact staff prior to writing in order to review suggestions and provide feedback. Submit an article suggestion online or email AAOS Now Publisher Dennis Coyle at coyle@aaos.org.
