A study published online in Archives of Osteoporosis found that moderate to heavy smoking could lead to higher cortical bone porosity in women. The study included 46 female smokers aged 35–64 years and 45 age- and body mass-matched female nonsmokers. Researchers used low-resolution images to determine distal radius macro-scale variables (including bone volume, bone mineral content, and volumetric bone mineral density [vBMD]) and high-resolution peripheral quantitative CT to measure distal radius microstructure. Among the smokers, cortical porosity was 33 percent higher, cortical vBMD was 3 percent lower, and stiffness was 8 percent lower than the nonsmoking group. Macro-scale variables did not differ between cohorts.
Study observes indicators of knee stiffness surgery after tibial plateau fixation
The greatest risk factors for knee stiffness surgery in tibial plateau fixation patients appear to be the number of weeks spent in an external fixator and the presence of bilateral tibial plateau fracture, according to a study published in the September issue of the Journal of Orthopaedic Trauma. The retrospective, observational cohort studied compared 110 patients who underwent surgery (manipulation while under anesthesia, arthroscopic lysis of adhesion, or quadricepsplasty) for knee stiffness and 319 patients with tibial plateau fractures treated with open reduction and internal fixation who did not undergo surgery for knee stiffness (control group). The researchers found that external fixator time and bilateral tibial plateau fractures were significant predictors of surgical intervention for knee stiffness. They recommended that clinicians be aware of these risk factors as indicators of potential subsequent surgery.
A study published online in BMC Musculoskeletal Disorders found patients with mild-to-moderate hip osteoarthritis (OA) may experience significantly lower levels of hip and knee muscle strength than those without hip OA. Researchers compared muscle strength in patients with symptomatic and radiographic hip OA (n = 19; 12 unilateral, seven bilateral) and healthy individuals (n = 23) and measured isometric strength in the hip and knee flexors and extensors and hip abductors and adductors. OA patients had much lower knee flexor and extensor and hip flexor, extensor, and abductor strength than the healthy individuals. The researchers suggested early intervention be used to target these muscle weaknesses.
Study: Risks of osteomyelitis in combat trauma patients
An assessment of U.S. military personnel with combat-related trauma found that those with significant muscle damage had the highest risk for osteomyelitis, according to a study published in the September issue of the Journal of Orthopaedic Trauma. Researchers reviewed 130 tibia osteomyelitis cases and 85 controls. Blast injuries, antibiotic bead utilization, high risk of transtibial amputations on the Gustilo–Andersen scale, and foreign body at the fracture site were all risk factors for the development of osteomyelitis.
Study identifies COPD as a potential risk factor in lower-limb arthroplasty patients
A study published online in the International Journal of Chronic Obstructive Pulmonary Disease found that chronic obstructive pulmonary disease (COPD) may be a risk factor for increased length of hospital stay, pneumonia and wound infection, a need for red blood cell (RBC) transfusion, and other general complications following lower-limb arthroplasty. The single-blind study included a monocentric patient cohort of 2,760 arthroplasties. After controlling for confounding factors, researchers found that C-reactive protein and leukocyte levels were higher among those with COPD. Risks for admission to the intensive care unit and pneumonia were increased in the COPD cohort. Although not significant, COPD patients also had higher rates of infection, more RBC transfusions, and longer hospital stays.
AAOS members will soon receive the print edition of the September issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue includes information on opioid use following foot and ankle procedures, the importance of diagnostic coding in value-based care, and the connection between binge drinking and fracture healing.
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.
