High BMI Increases Risk of Complication for Lumbar Surgery Patients

Peter Pollack

Patients with high body mass index (BMI) who undergo lumbar spinal surgery have more postoperative complications than non-obese individuals,” said Rafael A. Buerba, a researcher and MD/MHS candidate at Yale University School of Medicine. Speaking to members of the North American Spine Society during their 2013 annual meeting, he continued, “Complication rates appear to increase substantially for patients who have a BMI greater than 40 kg/m2 (obesity class III).”

Second Look—Clinical News and Views

Pediatric sports- and recreation-related injuries Data in the Journal of Pediatric Orthopaedics (December) suggest that, contrary to current perception, the incidence of pediatric sports- and recreation-related (SRR) injuries may not have increased in the United States during the last 10 years. Based on data from 2000, 2005, and 2010 on patients 8 to 14 years of age from the National Electronic Injury Surveillance System, musculoskeletal injuries decreased by 10.8 percent in 2005 and by 12.

Face Off: Intertrochanteric Hip Fracture Treatment

PRO: Why I use compression hip screws Douglas W. Lundy, MD, FACS As orthopaedic surgeons, we are fascinated by the “new and improved.” We are drawn to the newest ideas like moths to a flame. This characteristic pervades the orthopaedic community, and those who wish to sell us things know it all too well.

Concussions: Doing the Right Thing

Kay Daugherty

“The perfect storm of high-profile cases in youth and professional sports, military actions in Iraq and Afghanistan, media attention, and public fascination with the National Football League (NFL)”—that’s how Richard Ellenborgen, MD, chair of the department of neurological surgery at the University of Washington and co-director of the Seattle Sports Concussion Program, described the evolution of concussion from an “invisible injury” to the focus of much scientific and nonscientific attention.

Concussion in the News

Recently, AAOS Headline News Now has reported on several stories in the media dealing with concussions. Following are summaries of these stories: Hiding symptoms “Don’t Tell Coach: Playing Through Concussions” by Jan Hoffman for The New York Times looks at what the Institute of Medicine (IOM) identified as a “culture of resistance” among high school and college athletes, who may eschew examination by coaches and trainers in order to more quickly return to playing.

AAOS Sponsors Team STEPPS “Train the Trainers”

The AAOS will conduct a 2-day “Train the Trainer” session on Team STEPPS (Strategies and Tools to Enhance Performance and Patient Safety) for orthopaedic surgeons, Feb. 20–22, in Rosemont, Ill. The session is being offered at no charge to AAOS fellows and other members, but will be limited to 20 attendees to optimize the learning experience.

BMP-2 Treatment Results in Different Complication Trends in ASD Patients

Peter Pollack

Patients with adult spinal deformity (ASD) who are treated with recombinant human bone morphogenetic protein-2 (BMP-2) are likely to see a different—but not necessarily more beneficial—pattern of complications than those treated without BMP-2, according to research presented at the 2013 annual meeting of the North American Spine Society (NASS).

Improving 30-day Readmission Models for TJR

Thomas K. Fehring, MD; David C. Ayers, MD; Patricia D. Franklin, MD, MPH, MBA; the FORCE-TJR investigators

The latest findings from a collaboration between the American Association of Hip & Knee Surgeons (AAHKS) and FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement) were presented at the 2013 AAHKS Annual Meeting in Dallas.

Former CMS Administrator: Obamacare Part of a Better Future

Terry Stanton

As keynote speaker during the 2013 annual meeting of the American Association of Hip & Knee Surgeons, Donald M. Berwick, MD, once the administrator of the Centers for Medicaid & Medicare Services (CMS) in the Obama administration, tried to sell the audience a bridge. To be precise, he sought to convince them by using the metaphor of building a bridge to a new model of delivering and paying for health care in the United States.

Study: Barbed Sutures Show Advantages in TKA

Terry Stanton

“As orthopaedic surgeons, we are all aware of the need for improved operating room efficiency, better resource allocation, and increased patient and surgeon safety,” said Jeremy M. Gililland, MD, in introducing his study on the use of barbed sutures in total knee arthroplasty (TKA) during the 2013 annual meeting of the American Association of Hip and Knee Surgeons.

What's Your Diagnosis?

In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. The images for this month’s challenge were submitted by Marc Biggers, MD, a resident member at the University of Tennessee–Campbell Clinic. Dr. Biggers writes that a 15-year-old high-school football player was seen with a 1-week history of anterior knee pain. The youth states that the pain began after he sustained a hit to his knee during a game.

Using Biomarkers to Diagnose Periprosthetic Joint Infection

Terry Stanton

The diagnosis of periprosthetic joint infection (PJI) remains a clinical challenge. It currently requires an algorithmic approach using a varied assortment of clinical and laboratory considerations.

Is Immediate Weight Bearing Safe for Tibial Shaft Fractures Treated with IM Nails?

Maureen Leahy

Tibial shaft fractures that require surgery are typically treated with intramedullary (IM) nails, yet no standard postoperative rehabilitation protocol currently exists. “As a general principle, mechanical loading of injured bone is conducive to its healing,” according to Steven C. Gross, MD. “However, clinical decision making must balance the advantages of weight bearing on fracture healing against the risks of placing excessive loads across the fixation construct.”

Predicting Displacement After Closed Treatment of Distal Radius Fractures

Maureen Leahy

The majority of displacement in distal radius fractures treated with closed reduction and casting occurs within the first 6 weeks of treatment and loss of reduction continues—although at a slower rate—for many months, according to data presented at the Orthopaedic Trauma Association annual meeting. “Most surgeons immobilize these fractures for 4 to 6 weeks until the fracture is stable enough for a removable splint and range of motion.