Today’s Top Story

Study: Frequency of Articular Impaction in Geriatric Olecranon Fractures

Articular impaction is common in geriatric olecranon fractures, according to a study published in the Sept. 15 issue of the Journal of the AAOS ®. Of 63 patients whose fractures were managed via ORIF (open reduction internal fixation), 31 (49.2 percent) demonstrated associated intra-articular impaction. Articular impaction was not associated with significant differences in postoperative complications (35.5 percent versus 32.3 percent) or revision (32.3 percent versus 25.8 percent) compared to patients without impaction.

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In Other News

Systematic Review: Improvements in Sleep after Surgical RCT Management

A systematic review published online in Arthroscopy found that surgery for rotator cuff tear (RCT) and glenohumeral osteoarthritis was associated with significant sleep improvements Sixteen studies were evaluated. Interventions included arthroscopic rotator cuff repair (RCR; n = 2,198); arthroscopic capsular release (n = 131); total shoulder arthroplasty (TSA; n = 372); sternoclavicular joint procedures (n = 29); and comprehensive arthroscopic management (n = 18). All techniques led to improvements in self-reported sleep quality versus preoperative levels. RCR and TSA led to improvements in Pittsburgh Sleep Quality Index scores within six to 24 months.

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Study: Economic Justifiability of Prophylactic Intrawound Antibiotic Powder in Trauma Surgery

A single-center study published online in Injury found that intrawound vancomycin and tobramycin powder is economically justifiable as infection prophylaxis in orthopaedic trauma surgery. The institutional pricing was $20.64 and $75.80 for vancomycin 1 g and tobramycin 1.2 g, respectively. To be economically justifiable, vancomycin and tobramycin needed to achieve an absolute risk reduction (ARR) of 0.02 percent and 0.07 percent, respectively. The ARR for both powders in combination was 0.09 percent, with a cost of $90.66. Varying the infection rate between one to 25.0 percent did not impact ARR.

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Study: Limb Symmetry at Long-term ACLR Follow-up Varies by Measurement Device

A study published online in Knee Surgery, Sports Traumatology, Arthroscopy found that knee strength and symmetry after ACL reconstruction (ACLR) with hamstring grafts vary at long-term follow-up according to assessment method and body position. Thirty-one patients were evaluated after a median of 14 years postoperatively. Assessments included seated knee extension/flexion, supine knee flexion, and eccentric Nordic Hamstring Curl. Limb symmetry varied by methodology, with reduced symmetry in supine knee flexion torque at 60 and 75 degrees versus other measures. Knee extensor peak and Nordic curl torque were predictors of ACL Quality of Life scores.

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Study: Enhanced Recovery Pathway after Adolescent Idiopathic Scoliosis Surgery

A systematic review published online in the European Spine Journal found that enhanced recovery after spine surgery (ERAS) for adolescent idiopathic scoliosis is safe and effective compared to traditional discharge pathways. Fourteen studies (n = 2,456) were included. In total, 1,375 patients underwent ERAS and 1,081 underwent traditional recovery. Compared to controls, patients in the ERAS group had shorter average operative time, less blood loss, earlier ambulation and catheter discontinuation, reduced length of stay, and lower pain ratings within the first two postoperative days. Complications and readmissions were comparable between pathways.

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AAOS Now

African-American Patients More Likely to Undergo Inpatient TKA

A study involving nearly 55,000 patients undergoing total knee arthroplasty (TKA) found that African-American patients were more likely to undergo the procedure in an inpatient setting, whereas Caucasian and Asian patients were more likely to undergo outpatient TKA. The trends were primarily driven by patients’ comorbidity burden, not race alone. African-American patients had the lowest rate (18.3 percent) of outpatient TKA and the highest mean surgical time (102.7 minutes), postoperative transfusion (1.8 percent), and discharge to acute rehabilitation (8.4 percent).

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Your AAOS

AAOS Articular Cartilage Surgical Skills Course—Reduced Rates for a Limited Time!

The AAOS Articular Cartilage Restoration course, directed by Kevin D. Plancher, MD, MPH, FAAOS, and Nicholas A. Sgaglione, MD, FAAOS, will take place Oct. 7–9 at the OLC Education & Conference Center in Rosemont, Ill. This hands-on surgical skills course will feature two and a half days of cutting-edge education, covering the latest in arthroscopic knee cartilage restoration, meniscus repair and transplantation, ACL advancements, medial patellofemoral ligament, tibial and femoral osteotomy, unicompartmental knee replacement, and more. AAOS and the OLC prioritize continue your health and safety with stringent protocol and proof of vaccination required. Take advantage of reduced registration rates through Friday, Sept. 24!

Learn more and register…