A study published in the September/October issue of the Journal of Orthopaedics compared tourniquet time, operative time, and manipulation between cemented versus cementless total knee arthroplasty (TKA). Cementless (n = 127) and cemented (n = 127) TKAs performed by a single surgeon were age- and BMI-matched. Average follow-up time was two years. Tourniquet time was significantly shorter in the cementless group than the cemented group (45.7 minutes versus 54.8 minutes), with no significant differences in blood loss (179.5 mL versus 196.0 mL, respectively) or postoperative outcomes. The manipulation rate was 0 percent in the cementless group and 3.1 percent in the cemented group.
Study: How Useful Is the Standardized Letter of Recommendation Form in Residency Applications?
A study published in the Oct. 1 issue of the Journal of the AAOS ® assessed the usefulness of the standardized letter of recommendation (SLOR) form in the orthopaedic surgery residency program selection process. Researchers evaluated 1,137 SLOR forms submitted to their institution for 513 applicants during a single application cycle. Rank inflation with the SLOR form was significant, with 92 percent of applicants deemed either ranked to match or in the top one-third of their rank list. Grades and Step 1 scores had little to no association with summative rank.
Study Evaluates Routine Postoperative Laboratory Tests After THA
A retrospective study published in the October issue of The Journal of Arthroplasty found that postoperative laboratory tests after primary total hip arthroplasty (THA) may not be necessary for most patients, except those with certain risk factors. Among 395 consecutive primary THA patients, 349 had abnormal postoperative laboratory test results, most of which were anemia and hypoalbuminemia. Clinical intervention was required in 27 patients. Seven patients out of the 307 with postoperative anemia underwent blood transfusion, and 16 out of the 149 with postoperative hypoalbuminemia received hypoalbuminemia supplementation.
Study: Do Methamphetamines Increase Complication Risks in Trauma Patients?
A retrospective study published in the October issue of the Journal of Orthopaedic Trauma assessed the relationship between methamphetamine use and complications in orthopaedic trauma patients. Methamphetamine users (n = 189) were compared to matched controls (n = 378). The methamphetamine group, compared to the control group, had higher rates of deep vein thrombosis, ICU admission, leaving the hospital against medical advice, nonadherence to weight-bearing precautions, and loss of follow-up. Surgical treatment for orthopaedic injuries was less common among methamphetamine users. Rates of infection and nonunion did not largely differ between the groups.
Study Assesses Role of Health Literacy in Hand Surgery Decision-making Preferences
Most hand surgery patients want to be involved in surgical decision making, regardless of their level of health literacy, according to a study published online in The Journal of Hand Surgery. Health literacy and preferred decision-making role were determined for 226 first-time hand surgery patients. Overall, 78 percent of patients opted for an active or collaborative role in decision making, as opposed to a passive role; 61 percent of patients believed they attained their desired role. There was no correlation between preferred role and attaining it and health literacy.
Infection Most Common Culprit of Revision TKA Failure
Revision TKA is becoming increasingly more common, but data regarding failed procedures are not as robust as those pertaining to primary TKA failures In a new study, researchers explored the most common reasons for revision TKA failures and concluded that the most likely culprit is infection. Michael B. Geary, MD, presented the findings as part of the AAOS Annual Meeting Virtual Experience. The work was a collaboration between the Atrium Health Musculoskeletal Institute, OrthoCarolina, and the OrthoCarolina Research Institute.
AAOS Submits Comments on CMS’ Proposed 2021 Payment Policy Changes
AAOS submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its proposed payment policy changes for calendar year (CY) 2021. On the Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center (OPPS/ASC) Payment System Proposed Rule, AAOS focused on the proposal to eliminate the inpatient-only (IPO) list starting with all 266 musculoskeletal procedures. It urged the agency to consider the associated safety concerns and increased out-of-pocket costs for patients. On the Medicare Physician Fee Schedule (PFS) Proposed Rule, AAOS expressed strong disagreement with recommendations that would significantly cut physician payment.
