Today’s Top Story

Study Examines Factors Associated with Stroke After THA and TKA

A study published online in PLOS ONE examined stroke incidence following elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). The National Surgical Quality Improvement database was queried to identify 333,117 patients; 286 (0.09 percent) had a stroke. Neither procedure appeared to increase stroke risk, so THAs and TKAs were analyzed together. Two-thirds of strokes happened before discharge. A quarter occurred by postoperative day (POD) one, half by POD two, and three-quarters by POD nine. Independent risk factors for stroke were age 60 years or older, American Society of Anesthesiologists score of three or greater, and smoking.

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In Other News

Study Assesses Anatomic and Reverse Shoulder Arthroplasty in Older Patients

A study published online in the Journal of Shoulder and Elbow Surgery compared anatomic total shoulder arthroplasty (TSA) versus reverse shoulder arthroplasty (RSA) in younger (50 to 69 years) versus older (70 to 89 years) patients. Patients were stratified into four groups: TSA younger (n = 274), TSA older (n = 208), RSA younger (n = 81), and RSA older (n = 104). Minimum follow-up was two years. Pain and American Shoulder and Elbow Surgeons score improved similarly in all groups. Older RSA patients, compared to younger ones, reported better function during activities of daily living. Revision was higher in RSA patients.

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Study: How Do Surgeons Treat Radial Longitudinal Deficiency?

A study published online in The Journal of Hand Surgery questioned how pediatric hand surgeons treat radial longitudinal deficiency (RLD) patients with anomalies of the thumb and forearm. Seventy-four pediatric hand surgeons filled out a survey. The flexor digitorum superficialis transfer was the preferred technique for type 2 hypoplastic thumb reconstruction (81 percent); pollicization was the number one answer for both type 3B (94 percent) and type 4 (100 percent) hypoplastic thumb. Most surgeons (88 percent) aimed for tip-to-tip pinch in pollicization; half preferred 100-degree rotation, and 38 percent preferred greater than 120-degree rotation. Only 12 percent preferred tip-to-side pinch.

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Study Compares Deltoid Ligament Repair Outcomes by Suture Anchor Location

A retrospective study published online in Foot & Ankle International assessed outcomes in patients who underwent deltoid ligament repair with rotational ankle fracture fixation by suture anchor placement. Suture anchors were placed either on the medial malleolus (n = 114) or talus (n = 17). Radiological outcomes were determined per medial clear space oblique, medial clear space perpendicular, tibiofibular clear space, and tibiofibular overlap; clinical outcomes were determined via the Olerud-Molander Ankle Score and visual analog scale score for pain. Follow-up was about 17 months in both groups. Radiological outcomes did not differ three months postoperatively nor at final follow-up. Clinical outcomes did not differ at final follow-up.

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Study Analyzes Effect of 24/7 Trauma Surgeon Presence on Process-related Decisions, In-hospital Transport Times

A study published online in Injury found that polytrauma patients benefited from 24/7 physical presence of trauma surgeons. The study consisted of 391 polytrauma patients aged 15 years or older admitted to a level 1 trauma center ICU with 24/7 in-house trauma surgeons. Forty-four patients went directly from the ED to OR for urgent surgery; the median transport time was 28 minutes. Patients who required CT scan first had a median transport time of 31 minutes. There were 74 deaths (19 percent), 70 percent of which were due to traumatic brain injury. Death was preventable in one patient, who died due to hemorrhage but underwent CT scan before urgent surgery.

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Osteoporosis and Hip Fracture: Research Directions Based on Sex, Race, and Socioeconomic Status

Fractures due to osteoporosis are a global and national health burden, taxing the economy and society at large. The results of osteoporosis and hip fractures can include long-term pain, physical disability, psychosocial consequences involving the family unit, and increased utilization of healthcare services, in any geographical location. Personal and societal burdens are vast, affecting men and women and all races and socioeconomic classes. This article reviews some notable recent publications on the increasing inclusion of the differences in those various subgroups.

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JAAOS Global Accepted into Medline Indexing

The Journal of the AAOS Global Research & Reviews ® (JAAOS Global) was recently accepted into the prestigious Medline for indexing as of July. First accepted into PubMed Central in September 2018, JAAOS Global has worked to refine its selection of articles and has seen a strong growth of submissions by 39 percent from 2019 to 2020 and an impressive 130 percent since 2018. To date, JAAOS Global has received more than 200 submissions and projects in 2020, anticipating close to 300 by year’s end. Additionally, JAAOS Global now features a content carousel that highlights select articles per each issue to enhance readers’ experiences.

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