AAOS Now, November 2015
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Topical Vancomycin May Alter Bacteriology of SSI
Research presented at the Orthopaedic Trauma Association 2015 annual meeting provides "provocative evidence" that topical vancomycin powder may alter the bacteriology of surgical site infections (SSIs), and may thus play an important role in preventing infection after fracture fixation surgery, according to Robert V. O'Toole, MD, the study's senior author. "SSI remains a big problem in orthopaedic trauma," said Dr. O'Toole.
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AAHKS Going Strong at 25
As it marks its 25th anniversary, the American Association of Hip and Knee Surgeons (AAHKS) is thriving, with a membership of more than 2,600 and growing. The organization offers an ever-expanding portfolio of programs, initiatives, and membership services. But like many a success story, its origins were humbler. At the time of its founding, surgeons focusing on the knee and hip had two organizations to call their own: The Knee Society and The Hip Society.
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Study Finds Benefit to Early Weight Bearing
Study data presented at the Orthopaedic Trauma Association annual meeting indicate that immediate weight bearing as tolerated (WBAT) following intramedullary (IM) fixation of subtrochanteric femur fractures decreases hospital length of stay (LOS) and does not appear to increase the risk of implant failure or nonunion.
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Second Look – Clinical News and Views
These items originally appeared in AAOS Headline News Now, a thrice-weekly enewsletter 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) The U.S. Food and Drug Administration (FDA) is investigating the use of tramadol in children aged 17 years and younger, due to a rare but serious risk of slowed or difficult breathing.
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Study: Nearly All Trauma Patients Show Low Vitamin D Levels
A study of patients in an urban trauma population found that more than 98 percent of those who had not already been taking vitamin D supplements exhibited hypovitaminosis D. In a subsequent group of trauma patients who were provided with vitamin D supplements, all patients who were adherent with them achieved normal vitamin D levels at 7 weeks.
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Making an Intrepid Move
"Wounded warriors" is a phrase often applied to service members who return to the United States after serving in battle zones such as Iraq and Afghanistan. Many come home with devastating injuries, including major extremity trauma and amputated limbs. To meet their needs for rehabilitative services, the Center for the Intrepid (CFI) opened its doors in 2007. (See "Center for the Intrepid Offers State-of-the-Art Healing," AAOS Now, December 2007.
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Hand Hygiene: Are We Doing Enough to Ensure Adherence to Guidelines
Hand hygiene is recognized as the best method to prevent transmission of pathogens in the healthcare setting. The use of alcohol-based hand sanitation is preferred in most situations, although soap and water must be used in cases of direct contamination with body fluids, visibly soiled hands, or contact with patients with Clostridium difficile. It is useful to divide the areas of potential cross contamination into the "patient zone" and the "healthcare zone."
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LLRS Celebrates 25th Anniversary
Although one of the smallest orthopaedic specialty societies, the Limb Lengthening and Reconstruction Society (LLRS) is a vibrant organization dedicated to stimulating scientific exchange and fostering research and clinical excellence in limb lengthening, limb reconstruction, extremity deformity correction, and complex fracture treatment. A limb length difference may simply be a mild variation between the two sides of the body, which is not unusual in the general population.
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Nanotechnology for the Delivery of Biologics in Orthopaedic Surgery
According to the U.S. Food and Drug Administration (FDA), biologics are usually considered living entities (eg, cells or tissues) but can also be nonviable compounds such as growth factors. Biologics have been used for the treatment of a variety of musculoskeletal conditions in orthopaedics, with target sites including bone, cartilage, and soft tissues (ligaments, tendons, and muscle).
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The Big Three Autografts—and the Allograft Alternatives
In reconstructive surgery of the anterior cruciate ligament (ACL), debates over autograft versus allograft are ongoing. (See "Allograft versus Autograft in ACL Reconstruction," AAOS Now, October 2015.) But that's not the only decision that surgeons must make. They can also choose from three primary autograft tendons (patellar, hamstring, and quadriceps) and five primary allograft tendons (patellar, hamstring, tibialis, Achilles, and quadriceps).
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Curbing Opioid Consumption: No Easy Task
A comprehensive effort is necessary to help address the growing opioid epidemic in the United States, according to the AAOS Information Statement on Opioid Use, Misuse, and Abuse in Orthopaedic Practice.