Study: High Treatment Failure Rate in PJI with Corynebacterium striatum
A study published online in The Journal of Arthroplasty found a high rate of treatment failure among patients treated for periprosthetic joint infection (PJI) caused by Corynebacterium striatum. From two facilities, 741 consecutive PJI cases were retrospectively assessed and 15 patients with a positive Corynebacterium striatum culture were evaluated (nine hips and six knees). Two of five patients who received irrigation-debridement-polyexchange had to be reoperated due to persistent infection. Six patients were explanted, cleared infection, and were reimplanted. Among these patients, 67.0 percent experienced subsequent failure.
Study: Dual-mobility THA versus Hemiarthroplasty in Active Elderly Patients
A randomized controlled study published in Current Orthopaedic Practice found that dual-mobility cup total hip arthroplasty (DMTHA) outperformed bipolar hemiarthroplasty (BA) for femoral neck fractures in active elderly patients. Thirty-three patients were randomized to DMTHA or BA. Demographics and preoperative parameters were comparable between groups. Postoperatively, there were significant between-group differences in Harris Hip Scores and Visual Analog Scale groin pain in favor of DMTHA. Postoperative dislocation rates were comparable between methods.
Study: Long-term Outcomes of Open Modified Inferior Capsular Shift for Traumatic Shoulder Instability
A study published online in the Journal of Shoulder and Elbow Surgery found favorable long-term outcomes with open modified inferior capsular shift fixation for traumatic anterior shoulder instability. However, the authors noted that recurrent instability may result from new trauma after surgery. Eighty-four patients were included and followed for an average of 28.0 years. Nine shoulders (10.5 percent) displayed recurrent instability, but no revisions were required. At follow-up, 97.7 percent of patients reported their shoulders were “much better,” and 88.4 percent of athletes returned to sports activity at >70 percent preoperative levels.
Meta-analysis of Locking versus Nonlocking Plates for Lateral Malleolus Fractures
A meta-analysis published online in Foot & Ankle International did not find a significant benefit of locking versus nonlocking plates in lateral malleolus fracture fixation. Eleven studies were included. American Orthopaedic Foot & Ankle Society scores were comparable between techniques. There were no between-group differences in complication rates or hardware removals. Subgroup analyses of older patients and patients who received anatomical locking plates also did not yield a clear benefit for locking versus nonlocking plates.
Study Identifies Rates of Dysphagia after ACDF with rhBMP-2
In a single-center study, researchers found that adding rhBMP-2 (recombinant human bone morphogenetic protein-2) during anterior cervical diskectomy and fusion (ACDF) increased dysphagia at seven days postoperatively. However, patients recovered similarly to controls by six weeks postoperatively. These findings were published in The Spine Journal. In total, 114 patients were prospectively assessed, including 39 who received ACDF with rhBMP-2. Swallowing Quality of Life questionnaire scores were significantly different at seven days between rhBMP-2 versus controls, but mean scores at six weeks, six months, and one year were similar overall.
AAOS President Daniel K. Guy, MD, FAAOS, reflects on the AAOS 2021 Annual Meeting, which featured a strong focus on advocating to advance access to and quality of musculoskeletal care. He also outlines the programming for the 2021 Combined National Orthopaedic Leadership Conference/Fall Meeting, where members engaged with members of Congress in Washington, D.C. “We cannot ignore issues that impact the care we provide to patients. At AAOS, we meet these issues head on,” Dr. Guy writes. “Advocacy never sleeps.”
AAOS is seeking volunteers to review their Clinical Practice Guideline on the Management of Anterior Cruciate Ligament Injuries. Applications will be reviewed and approved on a first come, first served basis.
