September 17, 2018 | Today’s News

Study Compares Cost of ACL Reconstruction with Meniscal Repair and Partial Meniscectomy

Anterior cruciate ligament (ACL) reconstruction patients may save money by undergoing meniscal repair as opposed to partial meniscectomy, according to a study published in the September issue of Arthroscopy. Researchers simulated outcomes after meniscal repair and partial meniscectomy at the time of ACL reconstruction using a decision-analytic disease progression model with a 40-year horizon. The estimated total direct cost of ACL reconstruction with meniscus repair was $17,898 compared to $24,768 for partial meniscectomy. ACL reconstruction with meniscus repair resulted in an estimated gain of 18 quality-adjusted life years (QALYs) compared to 17.16 QALYs for ACL reconstruction with partial meniscectomy. Researchers calculated an incremental cost-effective ratio of $8,178.57 per QALY.

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Study: Outcomes of Primary THA for Charcot Arthropathy

A study published in the September issue of The Journal of Arthroplasty found that primary total hip arthroplasty (THA) to treat Charcot arthropathy may have positive clinical outcomes but could pose a high risk for complications and revisions. Researchers retrospectively reviewed 12 primary THAs for Charcot arthroplasty. At two- and five-year follow-up, 75 percent of THAs were free of any revision. Two THAs required revision for recurrent instability and one for femoral component loosening. Sixty-seven percent of THAs were free of any reoperation. The total complication rate (including revisions and reoperations) was 58 percent: three recurrent dislocations, two periprosthetic fractures, one femoral component loosening, and one delayed wound healing. Mean Harris Hip Scores improved from 43 preoperatively to 81 postoperatively.

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A study published online in the Journal of Shoulder and Elbow Surgery found an association between static posterior translation of the humeral head and glenohumeral osteoarthritis. Researchers measured glenoid version, humeral torsion, posterior acromial slope, and critical shoulder angle in 99 patients with glenohumeral joint degeneration scheduled to undergo anatomic or reverse total shoulder replacement. Compared to type A or B1 glenoid patients, type B2 and C patients had a median of 4 degrees more glenoid retroversion, a 5 degree less steep acromion, and a higher combined score. Osteoarthritic changes were less significant in patients with a torn rotator cuff.

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An interim analysis of a five-year study published online in JAMA found that Comprehensive Care for Joint Replacement (CJR) bundled payments may reduce institutional postacute care in Medicare beneficiaries who undergo lower extremity joint replacement (LEJR). The study included 75 metropolitan statistical areas (MSAs) using the bundled payment model and 121 control MSAs not assigned to the bundle. During the study period, 131,285 eligible LEJR procedures were performed on 130,343 patients. In the control group, the mean percentage of LEJR admissions discharged to institutional postacute care was 33.7 percent; the mean was 2.9 percentage points lower among the CJR group. Mean Medicare spending was also lower in the CJR cohort. Differences in overall Medicare spending per LEJR episode and other secondary outcomes were not significantly different between the two groups.

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Depression and anxiety in orthopaedic trauma patients may need further treatment during acute care to improve overall recovery, according to a study published in the September issue of the Journal of Orthopaedic Trauma. The secondary observational analysis from a randomized controlled study followed 101 patients with orthopaedic trauma from acute care to week 12 postdischarge. All patients reported greater satisfaction and physical outcomes by week 12. However, moderate-to-severe depression and anxiety, which were present in 20.9 percent and 35.3 percent of patients, respectively, were associated with negative physical and mental patient-reported outcomes. Depression indicated greater lengths of stay, complex injuries, and more readmissions. Anxiety was associated with weaker physical improvements. Depression and anxiety were also correlated with lower Psychosocial Illness Impact–Positive scores by week 12.

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First Female African-American Surgeon Shapes Orthopaedics

When individuals achieve unlikely and near-impossible feats, it is often done with the help of mentors and others who motivate them to never give up. Claudia Lynn Thomas, MD, had the unwavering support of her parents, Charles, who taught her carpentry and the importance of a strong work ethic, and Daisy, who taught her the alphabet and how to sew. Those skills and foundational building blocks, coupled with an exceptional education and a loving, supportive family, helped propel Dr. Thomas to become the first female African-American orthopaedic surgeon.

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Register for the 2018 AAOS Fall Meeting

The 2018 AAOS Fall Meeting will be held Oct. 25–27 at the JW Marriott San Antonio Hill Country Resort in San Antonio, Texas. You must have a current disclosure to register for and attend the meeting.

Learn more and register now…