Study: PROMIS Physical Function Scores Correlate with Lumbar Decompression Outcomes
A study published online in the Journal of the AAOS ® found that the Patient-reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) instrument is strongly correlated with pain, disability, and PF up to two years after lumbar decompression surgery. Ninety-two patients treated at a single center were assessed. All PROMIS measures demonstrated significant improvement from baseline at all assessment timepoints. PROMIS PF measures were associated with Visual Analog Scores (VAS) for the back and leg, Oswestry Disability Index scores, and SF-12 (12-item Short Form) Physical Composite Scores.
Meta-analysis Finds Limited Benefit from Platelet Rich Plasma in ACL Reconstruction
A meta-analysis published online in Knee Surgery, Sports Traumatology, Arthroscopy found that platelet rich plasma (PRP) does not significantly improve functional or patient-reported outcomes in ACL reconstruction. Nine studies (n = 525) were evaluated by two independent reviewers. PRP use was not associated with improved graft “ligamentization,” reduced tunnel widening, or reduced knee laxity. PRP was associated with “limited” but statistically significant improvements in VAS and Lysholm scores.
Study: Longer Joint Arthroplasty Procedures Are Frequently Undervalued by RUC
A study published online in The Journal of Arthroplasty found that total joint arthroplasty procedures with longer intraoperative time are frequently undervalued according to the Relative Value Update Committee’s (RUC) estimated intensity per unit time values (wRVU/hr). Thirteen procedure types were evaluated from a national database. The RUC overestimated intraoperative time by an average of 35.24 percent. The wRVU/hr values differed significantly between “long” (>110 min) versus “short” procedures. The undervaluation of intensity for longer procedures was an average of 3.47 wRVU/hr.
Study: Long-term Complications after Anterior Shoulder Instability Treated Conservatively
A study published online in the Journal of Shoulder and Elbow Surgery found a high rate of complications at ≥10 years after nonoperative management for anterior shoulder instability. In total, 254 patients aged <40 years with a median of 17 years of follow-up were assessed. Overall, 58.4 percent reported recurrent shoulder pain, 37.5 percent had recurrent instability, and 12.2 percent developed symptomatic osteoarthritis. Patients presenting with higher pain or recurrent instability were at increased risk of poor outcomes. Having a seizure disorder and smoking were risk factors for adverse outcomes.
New CPG and AUC Offer Guidance on More than 24 Perioperative Pain Management Interventions
In July, the AAOS Board of Directors approved a Clinical Practice Guideline (CPG) and an accompanying set of Appropriate Use Criteria (AUC) on Pharmacologic, Physical, and Cognitive Pain Alleviation for Musculoskeletal Extremity/Pelvis Surgery. The CPG covers 29 therapeutic interventions for perioperative pain alleviation, improved function, and opioid reduction after musculoskeletal injury or orthopaedic surgery. This article reviews the evidence supporting each intervention, with insight from David Ring, MD, FAAOS, cochair of the guideline development group.
AAOS is seeking volunteers to review their CPG on the Prevention of Surgical Site Infections in Major Extremity Trauma. Applications will be reviewed and approved on a first come, first served basis. Deadline to submit applications is September 24th.
