AAOS Now, May 2017
Study Compares Clinical Effects of Hyperosmolar, Isotonic Irrigation Solutions in Shoulder Arthroscopy
Excessive fluid extravasation has been associated with technical difficulties and complications during arthroscopic procedures. According to research presented at the AAOS Annual Meeting, hyperosmolar irrigation solution is a safe and effective method for decreasing periarticular fluid retention associated with arthroscopic rotator cuff surgery.
Quality of Recovery Following Anterior THA Not Influenced by Anesthesia Technique
A study presented at the AAOS Annual Meeting compared three different types of commonly used anesthesia techniques in direct anterior approach during total hip arthroplasty (THA). The researchers found that although anesthesia technique did not affect patients' quality of recovery, it did affect several short-term outcomes.
Second Look – Clinical News and Views
These items originally appeared in AAOS Headline News Now, a thrice-weekly e-newsletter that keeps AAOS members up to date on clinical, socioeconomic, and political issues, with links to more detailed information. Subscribe at www.aaos.org/news/news.asp (member login required).
Investigators Compare Outcomes of ORIF Versus THA for Femoral Neck Fractures
A study comparing outcomes with open reduction and internal fixation (ORIF) versus total hip arthroplasty (THA) for femoral neck fractures in patients younger than age 65 years found that THA was a cost-effective option for healthy patients older than 54 years. THA was also a cost-effective option for patients with mild comorbidity older than 47 years and for patients with multiple comorbidities older than 44 years.
Identifying Risk Factors for Unplanned Readmissions Following TJA
A study that sought to identify trends and risk factors for unplanned readmission following total joint arthroplasty (TJA) found that increasing body mass index (BMI), an American Society of Anesthesiologists (ASA) score of ³3, and discharge to an inpatient rehabilitation facility were independent risk factors for early unplanned readmissions.
Issues of Appropriateness in Patient Safety
A "Safety Now" article by Robert J. MacArthur, MD, in the January 2017 issue of AAOS Now ("Wrong-Side Procedure in the Modern Era") provided members of the Patient Safety Committee with considerable food for thought. At a recent meeting of the committee, chair David Ring, MD, PhD, facilitated a discussion among committee members Dwight Burney, MD; Michael Pinzur, MD; Alan Reznik, MD; Andrew Grose, MD; Chris Gaunder, MD; Ramon Jimenez, MD; Michael R.
Study Demonstrates Rapid Method for Detecting P Acnes
A study presented at the AAOS Annual Meeting reported on an assay and technique for detecting Propionibacterium acnes (P acnes). This technique was shown to identify the organism in tissue obtained from a shoulder biopsy within 24 hours.
Study Examines Risk Stratification for Adult Spine Deformity Surgery
A program of risk stratification to more judiciously select candidates for adult spinal deformity surgery more selectively can yield reduced complications and increased cost effectiveness, according to Dr. Sethi presented the results of such a program during a 2017 Scoliosis Research Society Specialty Day session. "The number of operative adult scoliosis cases has increased significantly, and we have to find a better way to care for these patients at lower cost," he said.
Synovial Sarcoma Treatment Strategies
Synovial sarcoma is a rare soft-tissue cancer that most often affects children and young adults. Synovial sarcoma is aggressive and difficult to treat, and it presents a significant risk of metastasis, particularly to the lungs. Treatment generally employs multimodal therapies that include surgery, chemotherapy, and radiation.
New CPG Addresses Hip Osteoarthritis and THA
At the 2017 AAOS Annual Meeting in San Diego, the AAOS approved the release of a Clinical Practice Guideline (CPG) on Management of Osteoarthritis (OA) of the Hip. The guideline includes four recommendations classified as "strong," being derived from evidence from two or more "high-quality" studies with consistent findings for recommending for or against an intervention, and eight classified as "moderate."