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| Today’s Top Story
Systematic Literature Review for Truncal, Lower Extremity Injuries in MLB Players
A systematic review published in the August issue of the Journal of the AAOS: Global Research & Reviews ® evaluated current literature regarding truncal and lower-extremity orthopaedic injuries among MLB players. Forty-one studies met inclusion criteria. Research primarily reviewed hip and pelvis (16 percent), thigh (15 percent), truncal (14 percent), knee (13 percent), and ankle injuries (11 percent). Twenty-two percent used data from the MLB Health and Injury Tracking System, compared to 29.8 percent which used publicly available data. Most studies (83.7 percent) were level 3 evidence.
Read the study… |
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| In Other News
Randomized Study Finds IV Dexamethasone at Eight Hours Post-THA Is Beneficial
A randomized study published online in The Journal of Arthroplasty found an additional 8 mg dose of IV dexamethasone at eight hours post-total hip arthroplasty (THA) significantly reduced pain, tramadol consumption, postoperative nausea, time to ambulation, and length of stay. A total of 105 enrolled patients received a single perioperative dose of dexamethasone, and 61 received an additional postoperative dose. Ninety percent of two-dose patients ambulated on postoperative day one, compared to 59 percent of the one-dose group. Discharge on postoperative day one was greater in the two- versus one-dose group (95 percent versus 68 percent, respectively).
Read the abstract… |
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| Study: Similar 10-year Outcomes for Computer-assisted versus Conventional TKA
At 10 years, there was no significant difference in outcomes or revision after total knee arthroplasty (TKA) performed via a computer-assisted (CAS) versus conventional technique, according to a study published online in BMC Musculoskeletal Disorders. Eighty patients were randomized to CAS or conventional TKA (40 patients each). Fifty patients were available for final follow-up (CAS, n = 21; conventional, n = 29). Patient-reported outcomes were comparable overall. Ten-year revision risk was 2.5 percent versus 7.5 percent for conventional versus CAS TKA, respectively.
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| Study: Short Inpatient Stay Post-TSA Does Not Increase 90-day Readmission Risk
Risk factors for unplanned 90-day readmission after total shoulder arthroplasty (TSA) include reverse TSA (RTSA), indications for revision or fracture, and right-sided surgery, according to a study published online in the Journal of Shoulder and Elbow Surgery. In total, 2,805 anatomic TSAs and 2,605 RTSAs were assessed. Three percent of patients (n = 175) had an unplanned readmission within 90 days, frequently due to surgical rather than medical complications (62.9 percent versus 37.1 percent). Discharge to skilled nursing facility or rehab was associated with readmission, but short inpatient stay was not.
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| Study: Opioid Dosing after Ankle Sprain Treatment Predicts New Persistent Use
A study published online in Current Orthopaedic Practice found that a total opioid dose of 150 mg oral morphine equivalents (OMEs) after ankle sprain diagnosis was a significant modifiable risk factor for new persistent opioid use. Researchers queried insurance claims data for opioid prescriptions within one year before and six months after nonoperative ankle sprain management. A total dose of 150 mg OMEs was also associated with refill within 30 days. Other factors associated with new persistent use were tobacco use, medical comorbidity, and certain pain and mental health disorders.
Read the abstract… |
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| AAOS Now
Targeted Muscle Reinnervation in Amputee Care
With advances in targeted muscle reinnervation techniques, amputation is now another reconstructive pathway demanding surgical expertise and a familiarity with neuroanatomy and neuroscience. In this article, Col. Joseph F. Alderete Jr, MD, FAOA, and Thomas P. Smith, MD, review the current state of targeted muscle reinnervation in amputee care. “Amputation should no longer be viewed as just the final solution for biological or technical failures in limb salvage,” the authors wrote. “Patients demand more of their reconstructions, and a thoughtfully created amputation should focus on a quiet host-prosthetic envelope where nerve handling has been carefully orchestrated.”
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| Your AAOS
AAOS Approves Updated Evidence-based CPG for the Management of Osteoarthritis of the Knee (Non-arthroplasty)
The AAOS Board of Directors has approved the Management of Osteoarthritis of the Knee (Non-arthroplasty) 3rd Edition Evidence-based Clinical Practice Guideline (CPG). This CPG includes updates to all 19 evidence-based recommendations included in the 2nd edition of the guideline, with a total of 29 non-surgical treatment recommendations. Additionally, seven of the recommendations deemed inconclusive due to the lack of available evidence from the 2013 CPG were upgraded.
View the new CPG… |
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