RCT Reports Similar Migration/Displacement with Gap Balancing versus Measured Resection in Bicruciate Stabilized TKA
Findings from a randomized controlled trial (RCT), published online in The Journal of Arthroplasty, demonstrated comparable implant migration or displacement with gap balancing (GB) versus measured resection (MR) surgical techniques in bicruciate stabilized total knee arthroplasty (TKA). Fifty-six patients were enrolled (GB, n = 31; MR, n = 25). No differences were found between groups in tibial or femoral migration or inducible displacement. Overall tibial migration was below 0.5 mm from baseline through two years follow-up.
Study: Single-dose TXA Safely Reduces Blood Loss in Geriatric Hip Fracture Surgery
A meta-analysis published online in Injury reported that a single preoperative dose of tranexamic acid (TXA) effectively reduces perioperative blood loss and transfusion, without increased risk of postoperative thromboembolic events, in hip fracture surgery in elderly patients. Ten RCTs were evaluated. TXA significantly reduced total blood loss by 229.45 ml and transfusion rates by 40 percent compared with placebo. Subanalysis found no significant benefit associated with multiple doses in terms of blood loss reduction. Fewer complications occurred in patients receiving a single dose of ≤15 mg/kg compared with multiple or higher doses.
Study: Complications in Arthroscopic and Open Latarjet Shoulder Stabilization
A systematic review published online in the American Journal of Sports Medicine identified complication rates of arthroscopic and open Latarjet procedures for anterior shoulder instability across 35 studies, comprising 2,560 procedures. The overall complication rate was 16.1 percent, including 3.4 percent intraoperative complications and 6.5 percent postoperative complications. Nonunion was the most common postoperative complication, and 2.6 percent of patients required unplanned reoperation. Arthroscopy was associated with greater intraoperative complications (5.0 percent versus 2.9 percent) and fewer instability-related complications (3.1 percent versus 7.2 percent) compared with open surgery.
RCT Finds Minimal Benefit of PRP Injections for Treating Ankle OA
An RCT published online in JAMA did not find a significant benefit of intra-articular platelet-rich plasma (PRP) injections for improving symptoms and function in patients with ankle osteoarthritis (OA). One hundred patients received either two PRP injections (n = 48) or saline placebo (n = 52). At 26 weeks, mean American Orthopaedic Foot and Ankle Society scores improved by 10 points in the PRP group and 11 points in the placebo group. Thirteen adverse events occurred in the PRP group and eight in the placebo group.
Interview Study Documents Women’s Experiences after a Second ACL Injury
Among women with a history of ACL reconstruction (ACLR), sustaining a second ACL rupture (in either knee) and the rehabilitation that follows may significantly challenge patients’ coping skills, according to a qualitative study published online in Knee Surgery, Sports Traumatology, Arthroscopy. Eight women with previous ACLR and a subsequent rerupture were interviewed. The researchers noted that the overarching theme of the interviews was the “lifelong adaptive coping process” associated with second ACL injury, including adapting to altered activity levels and coping with fear of reinjury.
Initiative to Decrease Time to Initial Emergency Department Antibiotic Administration for Open Fractures Sustained after Two Years
Consensus generally holds that in patients with open fractures, simple antibiotic prophylaxis can effectively decrease the time to antibiotic administration. A study in the Journal of the AAOS ® sought to determine whether adherence to protocol decreased over time without active input from the orthopaedic trauma team and found that implementing an educational initiative reduced the time from presentation to antibiotic administration after two years and that adherence to the protocol was durable.
Never View Patient Images on a CD Again with mymedicalimages
A new and better way to get images from patients in advance of appointments is now available to AAOS members. The AAOS Member Advantage Program has partnered with mymedicalimages, which offers cloud-based sharing and viewing of medical images. For telemedicine, second opinions, consults with colleagues, or importing to a Picture Archiving and Communication System, mymedicalimages eliminates the need for patients to mail or drop off CDs, avoiding frustration and delays. This service is free to physicians, and patients can upload their images by clicking a simple “Uploader Button” on a practice’s own webpage or by sending a secure email request. Plus, see how mymedicalimages is changing the future of case studies with its Virtual Grand Rounds program.
