Second Look – Clinical News And Views

These items originally appeared in AAOS Headline News Now, a thrice-weekly enewsletter that keeps AAOS members up to date on clinical, socioeconomic, and political issues, with links to more detailed information.

Foot and Ankle
Adjunct therapy with PRP and HA for arthroscopic talar OCL treatment

Data from a Turkish
study in Foot & Ankle International (August) suggest that treatment with platelet-rich plasma (PRP) or intra-articular hyaluronic acid (HA) may improve clinical outcomes for patients who undergo arthroscopic surgery for talar osteochondral lesions (OCLs). The prospective, randomized, blinded study involved 40 patients with talar OCLs in their ankle joints who were treated with arthroscopic débridement and microfracture. Patients also received PRP (n = 13) or HA (n = 14); the control group received a saline injection (n = 13). At mean 15.3-month follow-up, the two treatment cohorts had significant improvement in average AOFAS score and visual analog pain scale (VAS) score compared to the control group. Patients in the PRP group saw additional significant improvement in AOFAS and VAS scores compared to those in the HA group.

Hip and Knee
Study examines early data on recalled hip system

An online
study in Clinical Orthopaedics and Related Research (CORR) attempts to evaluate early data from a follow-up study of the recalled Articular Surface Replacement (ASR) hip system. The prospective study involved 288 patients (333 hips) who received DePuy Orthopaedics ASR and ASR XL hip systems and who had a metal artifact reduction sequence magnetic resonance imaging (MIR) scan of the hip performed at a mean time of 6 years after surgery. Moderate or severe adverse local tissue reactions (ALTRs) were identified in 79 hips. The direct lateral approach was used in 41 hips and the posterior approach in 38 hips. In patients in whom the lateral approach was used, 83 percent had an anterior ALTR, while 71 percent of patients in the posterior approach group had posterior ALTRs. The researchers noted no differences in patient-reported outcome measures between patients with moderate-to-severe ALTRs and those with no ALTR findings on MRI. In addition, use of ASR XL was an independent risk factor for moderate-to-severe ALTRs, and patients with ASR XL also had a thicker synovium and larger maximal ALTR diameter compared to patients treated with ASR.

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