Source : Healio
Judicious risk-stratified usage of antibiotic cement during primary total knee arthroplasty may not decrease infection at 1 year, according to study results. Researchers retrospectively reviewed data for 3,292 patients who underwent primary total knee arthroplasty (TKA). Patients were grouped into cohorts based on whether their surgery involved plain or antibiotic cement, or if they were high-risk patients who received antibiotic cement, and infection rates were compared between the cohorts.
Study results showed a 30-day infection rate of 0.29% in cohort 1, 0.2% in cohort 2 and 0.13% in cohort 3.
Infection rates in all cohorts increased at all time points, with 6-month rates at 0.39% in cohort 1, 0.54% in cohort 2 and 0.38% in cohort 3, and 1-year rates at 0.78% in cohort 1, 0.61% in cohort 2 and 0.64% in cohort 3. However, no statistically significant between-group differences in infection rates were seen at any of the time intervals studied, according to the researchers.
Source : Healio
Recently published study data indicated short-stem and straight-stem implants for total hip arthroplasty exhibited no significant differences in functional outcome measures.
Researchers conducted a randomized, double-blinded study of 80 patients who underwent total hip arthroplasty (THA). Patients were grouped by whether their THA utilized a short-stem or conventional straight-stem implant. Radiological and functional outcomes were evaluated at 6 weeks postoperatively, and quality of life was quantified via Harris Hip Score, SF-36 and WOMAC scores.
No significant changes in offset differences were observed in either group from before surgery to after surgery. At final follow-up, no significant differences between groups were found in Harris Hip Score, SF-36 or WOMAC values, according to the researchers.
Comparison of long-term survival rates among both cohorts will help determine whether short stems are a viable alternative THA solution, the researchers concluded.
Source : MedicalXpress
Over the past decade, a greater number of patients, age 80 and older, are having elective orthopaedic surgery. A new study appearing in the Journal of Bone and Joint Surgery (JBJS) found that these surgeries are generally safe with mortality rates decreasing for total hip (THR) and total knee (TKR) replacement and spinal fusion surgeries, and complication rates decreasing for total knee replacement and spinal fusion in patients with few or no comorbidities (other conditions or diseases).
Among patients with atraumatic rotator cuff tears, shoulder activity was not associated with severity of the tear, but was affected by patients’ age, sex and occupation, according to study results.
Researchers prospectively enrolled patients with an atraumatic rotator cuff tear on MRI in the Multicenter Orthopaedic Outcomes Network shoulder study of nonoperative treatment. Patients were asked to complete a previously validated shoulder activity scale; 434 patients completed the scale and were included in the analysis. Mean patient age was 62.7 years.
The researchers performed a regression analysis to assess the association of shoulder activity level to rotator cuff tear characteristics, including tendon involvement and traction, as well as patient factors such as age, sex, smoking and occupation.
Shoulder activity was not associated with severity of the rotator cuff tear, according to the researchers. However, shoulder activity was negatively associated with age and female sex. According to the regression model, 69-year-old patients with rotator cuff tears were 1.5 points less active on the 20-point scale vs. identical 56-year-old patients; female patients were 1.6 points less active vs. similar male patients. Occupation was also a significant predictor of shoulder activity level, with unemployed patients predicted to be 4.8 points less active compared with employed patients.
Although arthroscopic capsular release is a known treatment for shoulder stiffness, posterior extended capsular release might not be necessary in arthroscopic surgery, according to study results.
Researchers enrolled 75 patients who underwent arthroscopic capsular release for shoulder stiffness. The patients were randomly assigned to one of two groups: those in whom capsular release, including release of the rotator interval and anterior and inferior capsule, was performed (n = 37), and those in whom capsular release was extended to the posterior capsule (n = 38).
The researchers used American Shoulder and Elbow Surgeons scores, Simple Shoulder Test, VAS pain scores and range of motion (ROM) for evaluation before surgery, at 3, 6 and 12 months postoperatively, and at the last follow-up. Mean follow-up was 18.4 months.
ROM increased significantly among both groups at the last follow-up compared with preoperative scores (P < .05). However, there were no statistical differences between the two groups in American Shoulder and Elbow Surgeons scores, Simple Shoulder Test and VAS pain scores at the last follow-up (P > .05), according to the researchers.
Anatomic features associated with the severity of atraumatic rotator cuff tears are not associated with pain level, according to a study published in the May 21 issue of The Journal of Bone & Joint Surgery.
The impact of being overweight has far reaching health implications — implications that may be taking a toll at an earlier age.
In a new study, researchers found that packing on the pounds may be setting the stage for total knee or hip replacement at increasingly younger ages.
Further, the scientists found that being overweight or obese had a greater impact on the knee than the hip.
Shoulder instability is a common injury in football players but the rate of return to play has not been regularly determined following surgery. A new study, discussed at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting, details that return rates for NFL players is approximately 90 percent no matter what the stabilization procedure (open vs. arthroscopic).
As cases of Little League Shoulder (LLS) occur more frequently, the need for additional information about the causes and outcomes of the condition has become clear. Researchers presenting at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting shared new data identifying associated risk factors, common treatment options and return to play.
Concurrent meniscal and ACL repair has shown high rates of success, according to a presenter here.
Researchers evaluated 235 patients from the Multicenter Orthopaedic Outcomes Network (MOON) who underwent both unilateral primary ACL reconstructions and concurrent meniscal repair between 2002 and 2004. Of the meniscal repairs, 154 were medial, 72 were lateral and nine underwent both.
Validated patient-oriented outcome data (KOOS, WOMAC) scores, Marx activity scores and IKDC scores were recorded at 2 and 6 years follow-up. Failure of meniscal repairs was determined by subsequent ipsilateral repair.
“This represents the largest cohort combining meniscus repair and ACL reconstruction follow-up for a minimum of 6 years,” Robert W. Westermann, MD, said during the American Orthopaedic Society for Sports Medicine Annual Meeting.
Overall, 86% of meniscal repairs were successful at 6-year follow-up; of these, 86.4% were medial meniscal repair, 86.1% were lateral meniscal repairs and 77.8% were in cases where both were repaired, according to Westermann.
Of the 33 repair failures, nine (27.3%) were related to revision ACL surgery. On average, medial meniscal repairs failed sooner than lateral repairs (2.1 years vs. 3.7 years).
KOOS Symptoms, KOOS Pain, KOOS KRQOL, WOMAC Pain, and IKDC values all improved significantly when comparing baseline scores to 6-year follow-up, according to Westermann. Marx Activity levels gradually declined from time of injury to 6-year follow-up. — by Christian Ingram
Westermann RW. Paper #44.Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.
Disclosure:Westermann has no relevant financial disclosures.