Tag Archive | Hip

Functional Outcomes of Patients with Schizophrenia After Hip Fracture Surgery

Thirty-eight patients with schizophrenia were compared with 170 geriatric patients without schizophrenia who underwent a surgical procedure for a hip fracture.

Read the full article here.

What’s New in Sports Medicine 2021

Every month, JBJS publishes a review of the most pertinent and impactful studies published in the orthopaedic literature during the previous year in 14 subspecialties. Click here for a collection of all such OrthoBuzz Guest Editorial summaries.

This month, co-author Rachel M. Frank, MD summarizes the 5 most compelling findings from the >30 studies highlighted in the April 21, 2021 “What’s New in Sports Medicine.”

Anterior Cruciate Ligament (ACL)

–Two-year results from the STABILITY randomized controlled trial (RCT)1 comparing single-bundle, hamstring-autograft ACL reconstruction with or without lateral extra-articular tenodesis demonstrated a

4% graft failure in the tenodesis group versus 11% in the non-tenodesis group. Both groups had similar levels of sports activity at 2 years.

Meniscus

–A matched cohort comparison of 45 posterior medial meniscal root tears2 treated either nonoperatively, with partial meniscectomy, or with root repair found the following at a mean of 74 months:

  • No significant between-group differences in patient-reported outcomes (IKDC and Tegner scores)
  • Progression to arthroplasty in 60% of those who underwent partial meniscectomy, 27% of those treated nonoperatively, and 0% of those who underwent root repair
  • Less arthritic progression on radiographs in the root-repair group relative to the other 2 groups

Rotator Cuff

A multicenter Level-II study compared 96 patients with a rotator cuff tear who underwent nonoperative treatment with 73 similar patients who underwent a surgical procedure. At approximately 3 months, patients in the nonoperative group had significantly better outcomes, but after 1 to 2 years, surgical patients did better in terms of ASES and SPADI scores.

Hip Preservation

–A meta-analysis of 3 RCTs (n=650 patients)3 comparing physical therapy with hip arthroscopy for treating femoroacetabular impingement found the following:

  • Greater improvement in the arthroscopy group (as measured with the International Hip Outcome Tool-33) at 10 months
  • No between-group differences in 1 of the 3 RCTs at 1 or 2 years when the Hip Outcome Score-ADL and -Sports scales were used

The authors concluded that “hip arthroscopy had significantly superior short-term outcomes.”

Long Head of the Biceps Tendon

–A prospective RCT4 compared biceps tenodesis with biceps tenotomy in >100 patients with pathology of the long head of the biceps tendon. At the 2-year follow-up, the authors found no between-group differences in cramping, elbow flexion strength, or supination strength. The only significant difference was the incidence of a cosmetic Popeye deformity, which was associated with a 3.5 times higher risk after tenotomy.

References

  1. Getgood AMJ, et al. for the STABILITY Study Group. Lateral extra-articular tenodesis reduces failure of hamstring tendon autograft anterior cruciate ligament reconstruction: 2-year outcomes from the STABILITY study randomized clinical trial. Am J Sports Med.2020 Feb;48(2):285-97. Epub 2020 Jan 15.
  2. Bernard CD, Kennedy NI, Tagliero AJ, Camp CL, Saris DBF, Levy BA, Stuart MJ, Krych AJ. Medial meniscus posterior root tear treatment: a matched cohort comparison of nonoperative management, partial meniscectomy, and repair. Am J Sports Med.2020 Jan;48(1):128-32. Epub 2019 Nov 25.
  3. Dwyer T, Whelan D, Shah PS, Ajrawat P, Hoit G, Chahal J. Operative versus nonoperative treatment of femoroacetabular impingement syndrome: a meta-analysis of short-term outcomes. 2020 Jan;36(1):263-73.
  4. MacDonald P, Verhulst F, McRae S, Old J, Stranges G, Dubberley J, Mascarenhas R, Koenig J, Leiter J, Nassar M, Lapner P. Biceps tenodesis versus tenotomy in the treatment of lesions of the long head of the biceps tendon in patients undergoing arthroscopic shoulder surgery: a prospective double-blinded randomized controlled trial. Am J Sports Med.2020 May;48(6):1439-49. Epub 2020 Mar 30.

Routine Diagnostic Tests for Periprosthetic Joint Infection Demonstrate a High False-Negative Rate

 
Background:
Current guidelines recommend serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as the first-line testing for evaluation of suspected periprosthetic joint infection, in addition to synovial white blood-cell (WBC) count and polymorphonuclear percentage. However, the sensitivity and other diagnostic measures of these tests and the influence of organisms on these inflammatory markers remain inadequately investigated.

Perioperative Tranexamic Acid Treatment and Risk of Cardiovascular Events or Death After Total Hip Arthroplasty

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There have been concerns that the antifibrinolytic drug tranexamic acid (TXA) might increase the postoperative risk of cardiovascular events. Our objective was to determine whether perioperative TXA use is associated with cardiovascular events and death within 30 days after primary total hip arthroplasty (THA).

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Osteosynthesis with Parallel Implants in the Treatment of Femoral Neck Fractures

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The purpose of this study was to estimate the incidence of reoperation and the effect of implant position on the risk of reoperation within 12 months following osteosynthesis with use of parallel implants for femoral neck fractures.

Full Article >

Cross-Linked Polyethylene for Total Hip Arthroplasty Markedly Reduces Revision Surgery at 16 Years

Total hip arthroplasty (THA) is an effective operation for the management of end-stage hip osteoarthritis, but long-term success can be limited by wear of the polyethylene bearing surface.

Full article: https://bit.ly/2nlQxoL

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Preop Opioid Use Associated with Higher Readmission and Revision Rates after TJA

Prescription opioid use is epidemic in the U.S. Recently, an association was demonstrated between preoperative opioid use and increased health-care utilization following abdominal surgeries. #JBJSInfographics #visualabstract #JBJS

Full article: https://bit.ly/2uVhwfl

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Minimum Five-Year Outcomes of Hip Arthroscopy for the Treatment of Femoroacetabular Impingement and Labral Tears in Patients with Obesity

Obesity is a negative prognostic factor for various surgical procedures. https://bit.ly/2JKUj4C #JBJSInfographics #VisualAbstract

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Inability of Older Adult Patients with Hip Fracture to Maintain Postoperative Weight-Bearing Restrictions

For elderly trauma patients, a basic goal is early mobilization, as immobilization can trigger various complications, such as venous thromboembolism, pneumonia, urinary tract infections, and pressure ulcers. https://bit.ly/2JIILyU #JBJSInfographics #JBJSVideoSummaries #VisualAbstract

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Risk Reduction Compared with Access to Care: The Trade-Off of Enforcing a BMI Eligibility Criterion for Joint Replacement

Morbidly obese patients with severe osteoarthritis benefit from successful total joint arthroplasty. However, morbid obesity increases the risk of complications. https://bit.ly/2qpfj8w #JBJS

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