Today’s Top Story

Study: Comparison of Nursing versus Physical Therapy Evaluations and 90-day Outcome Predictions in TJA Patients

A retrospective study published online in the Journal of the AAOS ® investigated whether the use of the Activity Measure for Post-acute Care (AM-PAC) scoring system by nurses could substitute scoring by physical therapists (PTs) or predict 90-day outcomes after total joint arthroplasty (TJA). AM-PAC evaluations were administered by nurses and PTs within 24 hours of surgery in 1,119 patients. Agreement testing scores between nurses and PTs had a weak correlation. PT and nurse scores were not predictors for 90-day complications or readmissions. Higher PT and nurse scores were predictors of hospitalization of ≤2 days and fewer nonhome discharges.

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In Other News

Study: Ten-year Survival and Complications with Hybrid Total Hip Replacement for Prior Failed Proximal Femoral Nail Antirotation

In a study published in BMC Musculoskeletal Disorders, patients aged >75 years with prior failed proximal femoral nail antirotations achieved satisfactory 10-year outcomes with hybrid total hip replacement (THR). Overall, 118 THRs were reviewed. Primary outcomes were implant survivorship, functional measurements, and the incidence of surgical complications. The most common indication for revision was aseptic loosening and periprosthetic fracture, at 70 percent and 30 percent of revisions, respectively. Sixteen patients experienced implant-related complications; however, 10-year survivorship was 0.914.

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Study Identifies Predictors of Adherence to a Step Count Intervention after Total Knee Replacement

In a study published in the September issue of the Journal of Orthopaedic & Sports Physical Therapy, 51 patients who had recently undergone total knee replacement were randomized to receive a wearable tracker to monitor the number of steps taken per day, up to three months. Of the participants, 47 percent demonstrated 100 percent adherence to the program. In univariate analysis, the prospective cohort study found younger age, higher patient activation, and higher technology self-efficacy were associated with higher adherence to a step count intervention following total knee replacement.

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Study: Recovery of Forearm Bone Strength after Plate Removal

According to a study published online in The Journal of Hand Surgery, patients with forearm diaphyseal fractures showed complete bone strength recovery six months postsurgery. CT scans of the bilateral forearms of 31 patients were taken before plate removal and at one, three, and six months after surgery. On average, the time between plate fixation and removal was 27.5 months. Bone strength of the distal ulna showed delayed recovery. Bone strength at one month after removal was estimated to be 66 percent. Bone strength at three and six months was estimated to be 85 percent and 97 percent, respectively.

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Study Finds Lumbar Facet Joint Osteoarthritis as Underlying Reason for Persistent Low Back Pain after Minimally Invasive Diskectomy

The Archives of Orthopaedic and Trauma Surgery published a randomized controlled study online examining the reasons why patients suffer persistent low back pain (LBP) after surgery. Patients who were diagnosed with lumbar disk herniation (LDH) and underwent either endoscopic or microendoscopic diskectomy were analyzed. Patient demographics, clinical outcomes, and radiological parameters were assessed. Eighteen patients reported persistent LBP at the two-year follow-up. Significantly higher rates of preoperative lumbar facet joint osteoarthritis (LFJOA) were found in patients with persistent LBP. Additionally, LFJOA was associated with more adjacent segment degeneration and lateral recess stenosis in patients with LBP.

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AAOS Now

September Issue of AAOS Now Is Now Available Online

The electronic edition of the September issue of AAOS Now is available on the AAOS Now website. This month’s issue highlights the new AAOS Device Recall Dashboard, which provides orthopaedic surgeons with critical recall information, AAOS members’ efforts to advocate for key healthcare policy issues during the second annual Orthopaedic Advocacy Week, upcoming educational programming, and more.

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Your AAOS

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