Today’s Top Story

Study: Liposomal Bupivacaine versus Interscalene Block in Arthroscopic RCR

A randomized study published online in the Journal of Shoulder and Elbow Surgery reported acceptable pain control after arthroscopic rotator cuff repair (RCR) with either periarticular liposomal bupivacaine injection (n = 41) or single-shot interscalene nerve block (ISB; n = 36). Compared to liposomal bupivacaine injection on the day of surgery, ISB demonstrated superior Visual Analog Scale (VAS) pain scores (0.69 versus 4.65) and oral morphine equivalent (OME) use (18.66 versus 34.39). By week six, VAS and OME use were comparable between groups. Liposomal bupivacaine was found to be approximately $300 less per use than ISB.

Read the abstract…

In Other News

Study: Colonoscopy Is Associated with PJI in Patients with Total Prosthetic Knee Joints

A study published online in The Journal of Arthroplasty found that colonoscopy in patients with previous total knee arthroplasty (TKA) is associated with an increased risk of periprosthetic joint infection (PJI). The researchers conducted a matched cohort study of TKA patients using a nationwide claims database (colonoscopy, n = 45,612; control, n = 211,841). Colonoscopy was associated with a greater PJI risk at nine months and one year after colonoscopy compared to matched controls. Invasive colonoscopic procedures did not increase PJI risk. Posttraumatic arthritis was the only significant risk factor for PJI.

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Study: Cortical Button versus Suture Anchor in Lateral Ulnar Collateral Ligament Repair

A biomechanical study published online in the Journal of Hand Surgery found that cortical button fixation for lateral ulnar collateral ligament repair with ligament bracing is noninferior to suture anchors. Sixteen elbows were randomized to either treatment and then tested for elbow flexion ranging between 120 degrees and 30 degrees. Laxity after bracing and load to failure were comparable between groups. Overall laxity was significantly reduced compared to the native ligament with either technique. In all cases, the failure mode was slippage of the suture tape through the humeral anchor. Capitellum damage occurred in nine cases.

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Study: Single Position Lumbar Surgery versus Supine ALIF

A retrospective study published online in The Spine Journal found that single position lateral decubitus anterior lumbar interbody fusion (ALIF) with percutaneous posterior fixation led to fewer complications compared to supine ALIF with prone percutaneous pedicle screws. In total, 321 patients were evaluated, including 248 propensity-matched patients (single-position surgery, n = 124; supine ALIF, n = 197). The single-position group demonstrated reduced operative time, blood loss, length of stay, and perioperative ileus compared to the supine group. Between-group differences were comparable for radiation dose, perioperative complications, and 90-day reoperation.

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Applications for COVID-19 Provider Relief Funding Are Now Open

The Department of Health and Human Services (HHS) announced that the applications for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments are now open. PRF Phase 4 is available to a broad range of providers who were financially impacted by the COVID-19 pandemic. ARP Rural is available to providers serving rural Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) beneficiaries. Providers can apply for both programs in a single application until the deadline on Oct. 26 at 11:59 p.m. ET. There are a series of validation checks required before the application is accepted, so HHS recommends beginning the application as soon as possible.

Apply through the PRF Application and Attestation Portal…


It’s Time for Physicians to Talk about Our Mental Health

In this article, Julie Balch Samora, MD, PhD, MPH, FAAOS, FAOA, talks about her experiences with “Second Victim Syndrome” after one of her patients had a poor outcome, as well as the importance of supporting the mental wellness of healthcare providers at risk for experiencing burnout. “Physicians report that organizational responses to medical errors can be hostile, threatening, isolating, and fundamentally flawed,” wrote Dr. Samora. “Changing the culture should include fostering a nurturing, blame-free environment for openly discussing errors, promoting constructive discussions, and addressing the false notions of perfectionism.”

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Webinar: How Virtual Reality Is Improving Total Joint Arthroplasty

Tune in on Wednesday, Oct. 13 for a discussion on the advancements in robotic technology and their influence on how surgeons are performing knee and hip joint arthroplasty. This webinar, hosted by Cory Calendine, MD, Yogesh Mittal, MD, and Justin Barad, MD, from OssoVR, will explore how virtual reality (VR) technology is providing an immersive virtual environment for learning the Mako Total Knee arthroplasty surgical workflows, describe the role of Mako SmartRobotics™ in making informed surgical decision-making, examine the challenges that remote training can potentially solve, and discuss the future of VR as an alternate route of surgical education.

Register for the webinar…