Outpatient THA Associated with Increased Complications versus Same-day Discharge THA
The Journal of Arthroplasty published a study that compared the outcomes after total hip arthroplasty (THA) in 2,003 patients who underwent an outpatient procedure (as designated by the hospital) versus 4,069 same-day discharge (SDD, length of stay [LOS] = 0 days) patients. Patient demographics, LOS, discharge destinations, and complications were compared between groups. Outpatient THA patients were more likely to be women and have diabetes mellitus, general anesthesia, and operative times ≥95 minutes. The outpatient group was more likely to have a nonhome discharge (6.3 percent versus 2.8 percent) and experience complications (5.5 percent versus 3.9 percent) than the SDD group.
Study: 10-year Outcomes of Arthroscopic Repair for Upper Third Subscapularis Tendon Tears with Open Subpectoral Biceps Tenodesis
A case series published in the Journal of Shoulder and Elbow Surgery examined the minimum 10-year outcomes of primary arthroscopic repair of isolated partial or full-thickness tears of the upper third of the subscapularis (SSC) tendon. A total of 14 patients with isolated upper third SSC repairs were analyzed. The main outcome scores were the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). ASES scores improved from 52.9 to 92.2 on average. Mean postoperative SANE and QuickDASH scores were 90.27 and 14.6, respectively.
Study Investigates Efficacy of Hematoma Block after Intramedullary Rod Fixation of Femoral Shaft Fractures
According to a randomized controlled trial in the Journal of Orthopaedic Trauma, intraoperative, postfixation fracture hematoma block was associated with reduced postoperative pain and opioid consumption compared with saline in patients undergoing intramedullary rod fixation. Eighty-two patients received a standardized multimodal pain regimen that included opioids and either 20 mL of normal saline or 0.5 percent ropivacaine. Patients in the control group had higher visual analog scale scores 24 hours postsurgery (6.7 versus 5.0). Patients in the treatment group consumed significantly fewer opioids (morphine milligram equivalents [MMEs]) within 24 hours of surgery (43.6 MMEs vs. 65.9 MMEs).
Study: Biologic Augmentation after Meniscus Repair Associated with Lower Revision Rates
The Orthopaedic Journal of Sports Medicine published a retrospective study investigating the association of platelet-rich plasma (PRP) or bone marrow aspirate concentrate (BMAC) augmentation with revision surgery after isolated meniscus repair and meniscus repair performed concomitantly with ACL reconstruction (ACLR). A total of 570 BMAC/PRP augmentation patients were matched with 2,850 controls. Patients who underwent BMAC/PRP-augmented meniscus repair with concomitant ACLR were significantly less likely to require revision surgery than matched controls (5.2 percent versus 7.9 percent, respectively).
Study Examines Outcomes of Pseudoarthrosis after Anterior Cervical Diskectomy and Fusion
BMC Musculoskeletal Disorders published a retrospective study that analyzed the outcomes of 10 patients who underwent anterior revision surgery for pseudoarthrosis after anterior cervical diskectomy and fusion (ACDF) The clinical outcome measurements included Neck Disability Index (NDI) and the visual analog scale (VAS) for neck and arm pain, and radiological outcomes were assessed via CT scans one-year postoperatively. Eighty percent of patients achieved fusion, and 40 percent of patients experienced occult infection. The mean NDI was the same pre- and postoperatively (both 23.5). VAS-neck pain scores decreased from 8 to 6.5 postoperatively.
Are Steroid Injections a Safe Treatment for CTS during Pregnancy?
Several studies have demonstrated a high prevalence of carpal tunnel syndrome (CTS) during pregnancy, with reports of incidence rates ranging from 31 to 62 percent. Studies have demonstrated that CTS most commonly presents in the third trimester and frequently occurs bilaterally, with one study reporting 70 percent bilateral incidence among cases of pregnancy-induced CTS. This edition of the Patient Safety Corner series reviews evidence regarding the management of CTS in pregnant patients and important considerations for orthopaedic surgeons.
Time is Running Out to Register for an Upcoming Practice Management Virtual Course
Due to popular demand, AAOS, the American Alliance of Orthopaedic Executives, and the Illinois Association of Orthopedic Surgeons present a virtual course covering practice management topics, including how to understand the flow of patients and cash as you work your way through an orthopaedic practice, the different ways physicians can be compensated, how to negotiate contracts, and more. This two-part course, “Understanding the Business of Orthopaedics: Today’s Realities and Preparing for the Future,” takes place on Sept. 30 and Oct. 14 and provides the opportunity to engage with renowned faculty and hear firsthand experiences. Unable to attend those dates live? You can register for the course to receive a recording
Call for Action in Orthopaedic Surgery: Safe Pain Control After Surgery Patient Education Risk Reduction Program
The American College of Surgeons’ (ACS’) Patient Education Safe Pain Control After Surgery program is being sent to all patients undergoing hip and knee replacements and/or spine surgeries as part of their Blue Cross Blue Shield preapproval letter in Illinois, Montana, New Mexico, Oklahoma, and Texas. Visit the link below to view and utilize the program’s resources. To learn more and access patient and professional education, register and take a five-minute survey via the link below.
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