Study Evaluates THA in Young Patients with Osteonecrosis and Hematological Disease
A study published online in The Journal of Arthroplasty assessed long-term outcomes for young patients who underwent total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH) following allogeneic bone marrow transplantation (BMT) for hematological disease. Seventy-five THAs performed in 45 patients for osteonecrosis after BMT were matched to 75 THAs performed in 58 patients with idiopathic ONFH without hematological disease. Outcomes did not largely differ between the groups after a mean 10.6 years. Survivorship for all-cause revision after 13 years was 93.4 percent in the BMT group and 95.0 percent in the control group.
Study: Current Practices for VTE Prophylaxis Following Pelvic and Acetabular Fractures
A study published in the Sept. 15 issue of the Journal of the AAOS ® reviewed current practices among orthopaedic surgeons regarding venous thromboembolism (VTE) prophylaxis for pelvic and acetabular (P&A) fractures. A web-based survey was posted on the Members of the Orthopaedic Trauma Association (OTA) website and made available to OTA members; 103 people completed the questionnaire. The participants regarded effectiveness as the most important factor when choosing a VTE regimen and cost as the least important. The preferred agent for VTE prophylaxis following P&A trauma was low-molecular-weight heparin.
Study: Does Vancomycin Powder Reduce SSI Risk After Fracture Fixation?
According to a study published online in the Journal of Orthopaedic Trauma, vancomycin powder may reduce the risk of surgical site infections (SSIs) following ORIF in bicondylar tibial plateau, tibial pilon, and calcaneus fractures. Of 583 high-risk fractures treated operatively between 2011 and 2015, 35 received topical vancomycin powder. The infection rate with vancomycin powder, compared to the control group, was significantly lower (0.0 percent [n = 0/35] versus 10.6 percent [n = 58/548]).
Study Compares Outcomes in Athletes Undergoing Classic Latarjet Versus Congruent Arc Latarjet Surgery
A study published in the September issue of Arthroscopy observed comparable return to sport, recurrence, and healing rates between athletes with recurrent glenohumeral instability and a failed stabilization who underwent “classic Latarjet” versus “congruent arc Latarjet” surgery. Between May 2009 and April 2017, 135 athletes (mean age, 26.5 years) were treated (classic, n = 55; congruent arc, n = 80). Most athletes returned to sports (87 percent) at the same level (92 percent), with no significant between-group differences. Shoulder range of motion, functional outcomes, and recurrence rate did not largely differ between the groups. Six recurrences (4 percent) occurred in the entire cohort.
Study Analyzes Center of Pressure Position Under the Foot in Ankle OA Patients Undergoing Arthroplasty
A study published online in the Journal of Orthopaedic Research examined the pathway of the center of pressure (COP) under the foot in symptomatic ankle osteoarthritis (OA) patients before and after total ankle arthroplasty (TAA) and compared the COP between the affected and nonaffected sides. Ninety-three patients were analyzed. Preoperative COP position asymmetry was minimal and was reduced postoperatively. Preoperative walking speed was slower, and COP path was shorter. After TAA, the proximodistal distance the COP traveled under the affected and unaffected sides increased; this change was still present two years after surgery. Age and sex did not largely affect outcomes.
Suspected COVID-19 Case Complicates Fracture Treatment for Elderly Patient
In the age of COVID-19, how long can physicians afford to entertain previously common differential diagnoses when the cost of missing a COVID-19 diagnosis and consequences of exposure are so high? This article highlights an example encounter with a fracture patient who initially tested negative for COVID-19 but clinically presented as COVID-19-suspected, potentially increasing the risk of transmission to the healthcare team.
AAOS Board of Directors Approved AUC for Rotator Cuff Pathology
The AAOS Board of Directors has approved a new Appropriate Use Criteria (AUC) for the Management of Rotator Cuff Pathology. This AUC is presented via an online diagnostic tool and includes recommendations to determine appropriateness of various treatments for the management of rotator cuff pathology. This new AUC supports an existing AAOS Clinical Practice Guideline for the Management of Rotator Cuff Injuries.
