AAOS Now, January 2019
Lumbar Spinal Stenosis Study Associates Surgical Decompression with Improved Low Back Pain
A study examining the effect of surgical lumbar decompression on low back pain (LBP) in patients with lumbar spinal stenosis (LSS) found that the surgical intervention significantly improved pain at three months, which was maintained 12 and 24 months after surgery in most patients.
Study: Higher Cost of IV Acetaminophen Balanced by Reduction in Opioid Usage and Other Indirect Costs
Intravenous (IV) acetaminophen has been demonstrated to be safe and effective, but because of its comparatively high cost, it is prescribed far less to patients after spine surgery than oral (PO) formulations.* During a Best Paper session at the North American Spine Society Annual Meeting, researchers reported that IV acetaminophen may be a better value for use in circumferential lumbar spine surgery due to the reduction in indirect costs and avoidance of potential opioid dependence.
Common Misconceptions Continue to Plague Implant-related Hypersensitivity Responses and Testing
The terms metal hypersensitivity and metal allergy have been used interchangeably to refer to metal delayed-type hypersensitivity (DTH) responses. DTH, or adaptive, immune responses differ dramatically from normal physiologic responses to metal debris. A normal physiologic response to metal implant debris may be adverse (toxic and/or immunogenic) and increase in proportion to exposure.
Antimicrobial Stewardship in Orthopaedics
Antimicrobial resistance (AMR) is responsible for two million infections and 23,000 deaths annually in the United States alone. Globally, more than 700,000 people die each year of antibiotic-resistant infections. By the year 2050, AMR infections are predicted to be a larger killer than cancer and heart disease. The primary drivers for resistance are overuse and inappropriate use of antimicrobials. As much as half of all antibiotic use may be misuse.
Outcome Instrument Tracks Care in Young Throwing Athletes
More than 2.6 million emergency department visits annually are due to sports-related injuries in the five- to 24-year-old age group. As more young athletes play organized sports, the rate of pediatric sports injuries continues to rise. Clinical outcome instruments specific to both this patient group and constellation of injuries are needed to objectively evaluate the effect of interventions on recovery from injuries.
AAOS Develops and Approves Position Statement on Development of Musculoskeletal-based PRO-PMs
The AAOS Performance Measurement Committee (PMC) has observed that a dizzying array of patient-reported outcome performance measures (PRO-PMs) related to hip and knee joint replacement care were being developed by other stakeholders.