Study: Complications and Costs for IM Nails versus Sliding-hip Screws for IT Fractures
A retrospective study published in the Sept. 15 issue of the Journal of the AAOS ® found increased medical complications, readmissions, and costs for intramedullary nails (IMN) versus sliding hip screws (SHS) for intertrochanteric (IT) hip fractures. IT fractures from 2007 to 2017 from the American Board of Orthopaedic Surgery database were evaluated. Most cases were managed via IMN (92.4 percent). Compared to IMN, SHS were also associated with lower rates of anemia and mortality. Surgical or anesthetic complications and reoperation were comparable between techniques.
Randomized Study: Liposomal Bupivacaine Is Not Superior to Ropivacaine for ACBs in TKA
A randomized study published online in The Journal of Arthroplasty did not find improved pain relief with liposomal bupivacaine for adductor canal blocks (ACBs) in total knee arthroplasty (TKA) compared to ropivacaine. One hundred patients received liposomal bupivacaine (n = 46) or ropivacaine (n = 54). At 24, 48, and 72 hours postoperatively, there were no significant between-group differences in opioid consumption, length of stay, and numerical rating scale scores for pain, Knee Injury and Osteoarthritis Outcome Scores for Joint Replacement, and Overall Benefit of Analgesia Scores.
Study: Preoperative Corticosteroid Injections Associated with Infection after CTR
A retrospective study published online in the Journal of Hand Surgery found that preoperative corticosteroid injections (CSIs) before carpal tunnel release (CTR) are associated with increased risk of postoperative infection. Thirty-nine patients with postoperative infection after CTR (0.7 percent of all CTR cases) were compared to a matched cohort of 100 control subjects without infection. Preoperative CSIs were more common in the infection versus control cohorts (41.0 percent versus 16.0 percent). Average time from injection to surgery was around 55 days shorter for the infection versus control groups.
Study: Intra-articular Lasso-loop Stitch for Arthroscopic Anterior Talofibular Ligament Repair
A study published online in Foot & Ankle International found favorable outcomes with the fully intra-articular lasso-loop stitch technique for arthroscopic anterior talofibular ligament repair. Forty-three cases with chronic lateral ankle instability were treated with this technique. Average follow-up was around 28 months. At final follow-up, the mean Karlsson-Peterson score, Cumberland Ankle Instability Tool score, and Visual Analog Scale score were 90.3, 88.6, and 0.8, respectively. No nerve injuries occurred. Two patients required augmentation of the inferior extensor retinaculum.
Study: Factors Influencing Online Recommendations of Orthopaedic Surgeons
A study published online in Current Orthopaedic Practice assessed factors affecting online recommendations of orthopaedic surgeons. The investigators queried Healthgrades.com and identified 834 board-certified surgeons in N.J. Fellowship-trained surgeons were more likely to be recommended than those without fellowship training. Higher numbers of reviews and waiting times <10 minutes were associated with greater rating scores. The researchers noted that positive comments tended to discuss surgeon competence and professionalism, while negative comments tended to center on surgeon personality and waiting time.
FDA Ends Enforcement Discretion on Biologics and Regenerative Products
The FDA has formally ended the “enforcement discretion” of its comprehensive policy framework on biologics and regenerative medicine products. The four-year grace period is complete, and only vendors who can scientifically demonstrate the safety and effectiveness of their orthopaedic products will be able to come into regulatory compliance and market and sell legally and ethically. This article discusses the rationale and history behind the regulation of biologics and spotlights the AAOS Biologics Dashboard, which provides surgeons with guidance for what can and should be used in the current regulatory paradigm.
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