Today’s Top Story

Study: PRP, but not PRF, linked to improved outcomes for rotator cuff repair

Findings published online in The American Journal of Sports Medicine suggest that treatment with platelet-rich plasma (PRP) may be linked to improved outcomes for rotator cuff repair. The researchers conducted a meta-analysis of 18 randomized, controlled trials covering 1,147 patients. Compared to controls, they found that use of PRP was associated with significantly decreased rates of incomplete tendon healing for all tears combined, incomplete tendon healing in small-medium tears, and incomplete tendon healing in medium-large tears. In addition, at 30-day follow-up, the researchers found that PRP was linked to significant improvements in Constant score and visual analog scale score for pain compared to controls. However, the researchers write that use of platelet-rich fibrin (PRF) was not linked to similar improvements, and was associated with significantly longer surgical times.

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Other News

Study: Joint laxity may be a risk factor for poorer outcomes after ACL reconstruction

According to a study published in the Feb. 21 issue of The Journal of Bone & Joint Surgery, generalized joint laxity may have an adverse effect on stability and functional outcomes for patients undergoing anterior cruciate ligament (ACL) reconstruction. Members of the research team conducted a retrospective review of 163 patients who underwent unilateral ACL reconstruction. They found an increased likelihood of meniscectomy, graft rupture, and contralateral ACL rupture among a cohort of patients with generalized joint laxity, although differences in proportions and cumulative rupture rates did not reach significance. However, at 8-year follow-up, the researchers found that patients with generalized joint laxity displayed less stability and poorer functional outcomes. “Generalized joint laxity should be considered a risk factor for poor outcomes after ACL reconstruction,” the researchers write.

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Study: Smoking linked to increased risk of infection after primary TJA

A study published online in The Journal of Arthroplasty suggests that smoking may be linked to increased risk of infection following primary hip or knee total joint arthroplasty (TJA). The authors conducted a prospective, cohort study of 8,559 primary TJAs (mean patient age: 69.5 years). Overall, 5,722 reported having never smoked, 1,315 had quit smoking, and 1,522 were current smokers. The authors found that incidence rates of infection within the first year for never, former, and current smokers were 4.7, 10.1, and 10.9 cases/1,000 person-years, respectively. Beyond the first year, the authors report that infection risk was similar across cohorts.

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Study: Dementia may increase risk of hospital readmission

According to a study conducted in Japan and published online in the Journal of the American Geriatrics Society, dementia may increase risk of hospital readmission. The researchers conducted a retrospective, cohort study of 1,834,378 individuals aged 65 years or older who were diagnosed with one of 30 common diagnoses. They found that the overall prevalence of dementia was 14.7 percent, and 8.3 percent of patients with dementia were readmitted within 30 days, compared to 4.1 percent of patients without dementia. The researchers note that diagnostic category substantially modified the relationship between dementia and hospital readmission. The risk of readmission for hip fracture patients was 11.5 percent for patients with dementia, compared to 7.9 percent for those without.

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Opioid reduction initiative sees strong results in Colorado EDs

An article in Kaiser Health News profiles efforts by a group of hospitals in Colorado to reduce opioid use in the emergency department (ED). Ten hospitals participated in a 6-month pilot project designed to encourage the use of nonopioid alternatives such as ketamine and lidocaine. The goal of the project was to reduce opioid prescribing by 15 percent, but the hospitals achieved an overall reduction rate of 36 percent.

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Physicians should be prepared for in-flight emergencies

An article in the Canadian Medical Association Journal ( CMAJ) offers some practical recommendations for healthcare professionals who may be called upon to manage in-flight medical emergencies. Among other things, the writers note that:

  • The cabin environment will affect patients’ vital signs as well as how to measure them reliably.
  • The working environment should be optimized by creating space, turning on the cabin lights, and recruiting additional help.
  • An in-flight medical kit may be available, and providers should contact ground-based telemedicine support early.
  • Open, two-way communication with airline staff should be maintained to ensure the pilots can make the safest decisions for all of the passengers.

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Read the CMAJ article…


Call for volunteers: MACRA Episode-Based Cost Measures Clinical Subcommittee

AAOS seeks to nominate members to the MACRA Episode-Based Cost Measures Clinical Subcommittee, which will help develop care episode and patient condition groups for use in cost measures to meet the requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biography, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by March 12, 2018, at 11:59 p.m. CT, at:

Learn more and submit your application…