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June AAOS Now Available Now!

Read the full issue here.

‘Tap Test’ May Offer Simple Method for Detecting Intraoperative Syndesmotic Instability

Terry Stanton
A study that evaluated a novel intraoperative test for syndesmotic instability of the ankle involving use of a 3.5 mm blunt cortical tap found the technique served as a “simple, reliable, and accurate tool for diagnosis of coronal syndesmotic instability.”

Experts Offer Suggestions to Manage Transition to Value-based Care

Maureen Leahy
As health care shifts from volume to value, some orthopaedic surgeons may be concerned about how to effectively manage the transition. During a symposium held at the AAOS 2018 Annual Meeting, moderator Kevin J. Bozic, MD, MBA, of the Dell Medical School at the University of Texas at Austin, and other experts explored a variety of different principles and pathways for implementing value-based care.

Study: Foot and Ankle Surgical Patients Are Overprescribed Opioids

Terry Stanton
A study presented at the AAOS 2018 Annual Meeting reported that patients who undergo orthopaedic foot and ankle procedures are prescribed narcotic medication by nearly twice the amount that is actually consumed, leading to a significant surplus of narcotics available for potential diversion.

Study: Mixing of Some Surgical Antiseptics May Produce Toxic Products

Terry Stanton
A study observing the reactions that occur when commonly used surgical antiseptics are mixed found that at least two of the reactions tested—chlorhexidine + Dakin’s solution (sodium hypochlorite) and Dakin’s solution + hydrogen peroxide—yielded byproducts that are potentially toxic to human beings.

Considerations for Maternal and Fetal Outcomes in Pregnant Orthopaedic Trauma Patients

Kelly L. Hill, MD; Karen M. Sutton, MD; and Mary K. Mulcahey, MD
Trauma affects nearly one in 12 pregnancies, with motor vehicle collisions and intimate partner violence being the most common causes. Aside from pregnancy-related issues, trauma is the leading cause of maternal death. Studies suggest that multidisciplinary care for a pregnant orthopaedic trauma patient should include an obstetrician, perinatologist, orthopaedic surgeon, general trauma surgeon, critical care specialist, emergency medicine specialist, anesthesiologist, and a radiologist.

Clinical Trials for Cervical Disk Replacement

S. Raymond Golish, MD, PHD, MBA; Steven M. Kurtz, PHD; and Richard D. Guyer, MD
Each of the seven cervical total disk replacements (cTDR) currently available in the United States has undergone a clinical trial providing evidence of safety and efficacy that supports U.S. Food and Drug Administration (FDA) premarket approval. Sufficient similarity exists among the trials to constitute a de facto consensus regarding the basic trial structure for cTDR—a two-arm, noninferiority, randomized, controlled trial (RCT) with anterior cervical discectomy and fusion (ACDF) as the active control. Given a decade of clinical experience in the United States with these devices and the absence of recalls, the question now is whether cTDR clinical trials should still be structured in this fashion.