The Impact of Injections

Sophia A. Traven, MD; Daniel Brinton, MHA, MAR; Kit N. Simpson, DrPH; Zachary Adkins, MD; Alyssa Althoff, BS; John Palsis, MD; William Ashford, MD; Harris S. Slone, MD

Corticosteroid injections (CSI) are frequently used in the nonsurgical management of rotator cuff tears. According to the authors of Scientific Paper 838 displayed at the AAOS 2018 Annual Meeting, however, individuals who undergo rotator cuff repair (RCR) surgery within a year of receiving a CSI are at much higher risk of needing a revision RCR than those who had not been treated with CSI.

Study: Foot and Ankle Surgical Patients Are Overprescribed Opioids

Terry Stanton

A study presented at the AAOS 2018 Annual Meeting reported that patients who undergo orthopaedic foot and ankle procedures are prescribed narcotic medication by nearly twice the amount that is actually consumed, leading to a significant surplus of narcotics available for potential diversion. The study involved 1,009 patients undergoing outpatient procedures, primary investigator Joseph Daniel, DO, reported.

Preventing Fractures in High-risk Women

Peter Pollack

Dr. Bukata presented her findings in two scientific posters displayed at the AAOS 2018 Annual Meeting. “Abaloparatide is a parathyroid hormone-related protein similar to teriparatide,” Dr. Bukata continued. “One of the notable things about our study is that it directly compares abaloparatide not only to placebo, but to teriparatide as well. There aren’t many osteoporosis studies that offer direct comparison of two treatment options.”

Study: Mixing of Some Surgical Antiseptics May Produce Toxic Products

Terry Stanton

A study observing the reactions that occur when commonly used surgical antiseptics are mixed found that at least two of the reactions tested—chlorhexidine + Dakin’s solution (sodium hypochlorite) and Dakin’s solution + hydrogen peroxide—yielded byproducts that are potentially toxic to human beings. The findings were presented in Scientific Poster 696 at the AAOS 2018 Annual Meeting.

Trends in Carpal Tunnel Syndrome Management Continue to Evolve

Anil Akoon, MD, MBA; C. Liam Dwyer, MD

Carpal tunnel syndrome (CTS) remains the most common compressive neuropathy. The following reviews recent trends in the preoperative evaluation, anesthesia, surgical approaches, and opioid prescribing patterns for patients with CTS. The diagnosis of CTS is made primarily by a physical exam and the patient’s medical history.

Considerations for Maternal and Fetal Outcomes in Pregnant Orthopaedic Trauma Patients

Kelly L. Hill, MD; Karen M. Sutton, MD; Mary K. Mulcahey, MD

Trauma affects nearly one in 12 pregnancies, with motor vehicle collisions and intimate partner violence being the most common causes. Aside from pregnancy-related issues, trauma is the leading cause of maternal death. Fetal death secondary to maternal trauma affects 2.3 per 100,000 live births, often stemming from placental abruption.

Second Look - Clinical News and Views

BMI criteria—A study in The Journal of Bone & Joint Surgery (JBJS; Apr. 4) attempts to assess various body mass index (BMI) criteria for total joint arthroplasty (TJA).

‘Tap Test’ May Offer Simple Method for Detecting Intraoperative Syndesmotic Instability

Terry Stanton

Astudy that evaluated a novel intraoperative test for syndesmotic instability of the ankle involving use of a 3.5 mm blunt cortical tap found the technique served as a “simple, reliable, and accurate tool for diagnosis of coronal syndesmotic instability.” Cesar de Cesar Netto, MD, PhD, offered that characterization as he presented the results of a cadaveric investigation during the American Orthopaedic Foot & Ankle Society 2018 Specialty Day.

Sexual Dimorphism in Sacroiliac Joint Dysfunction

Laura M. Bruse, MD

The presentation of any patient with sacroiliac (SI) joint pain is complex. The unique nature of the anatomy of the junction of the sacrum and the ilium and surrounding soft-tissue layers, which are attached by strong ligaments, contributes to highly variable symptoms. In addition, SI joint pain may manifest differently in males and females.