Researchers urge collaboration to control TJR costs

Jennie McKee

Physician selection of implants has significant effect on hospitals’ financial bottom lines Finding ways to reduce the costs of total joint replacement (TJR) is important to hospitals as well as orthopaedists, given their limited ability to influence reimbursement rates from Medicare or private insurers. In a study funded by the Kaiser Family Foundation, Kevin J.

“Shocking” incidence of dental pathology found in TJA patients

Jennie McKee

Preoperative dental screening and treatment may help avoid periprosthetic joint infection “Bacteremia associated with dental pathology is a rare but serious causative agent of infections in total joint arthroplasty (TJA) patients,” said John W. Barrington, MD. “Deep infections often necessitate additional care and extensive revision procedures that can cost approximately three to four times more than primary TJA.”

Bad bearings

Stephen S. Tower, MD

Lessons learned from failures of this generation of MoM hip implants I believe that we, as orthopaedic surgeons, are obligated to stop implanting metal-on-metal (MoM) hip implants. I also believe that, whenever possible, patients already implanted should be monitored for the complications of arthroprosthetic cobaltism. The development, regulation, marketing, and dissemination of the current MoM hip implants bear study and should be thoroughly reviewed. I am biased on this topic.

Surgery better for nightstick fractures

Maureen Leahy

Study shows earlier return of function, fewer complications In adults, isolated ulnar shaft fractures (IUSF) associated with a direct blow—also known as “nightstick fractures”—are uncommon, and opinions on treatment regimens vary widely. “The majority of ulnar nightstick fractures are treated nonsurgically,” said Clifford B. Jones, MD. “Historically, benign neglect or nonsurgical treatment produced good results with early return to function and high healing rates.”

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 Michael R. Murray, MD, and Michael F. Schafer, MD, from Northwestern University in Chicago.

Isolated pediatric tibial shaft fractures can be treated effectively with below-knee cast

Maureen Leahy

Study finds no significant increase in the risk of malunion or refracture Historically, an above-knee cast (AKC) has been the gold standard for isolated fractures of the tibia in children. Although these fractures routinely heal, they have a tendency to displace into varus angulation.

Distinguishing Lyme arthritis from septic arthritis in children

Maureen Leahy

Knowing the difference has significant impact on treatment Caused by the Borrelia burgdorferi spirochete, Lyme disease is transmitted to humans through the bite of infected ticks. Clinical manifestations can range from an initial skin rash at the site of the bite to neurologic and cardiac complications. A common late-stage manifestation of the disease is Lyme arthritis, which can mimic bacterial septic arthritis, especially in children.

Meetings and Course Listings

Listed below are upcoming continuing medical education (CME) courses and orthopaedic meetings (April through July). For more information about AAOS-sponsored courses, contact the AAOS customer service department at (800) 626-6726 or visit the CME course section of the AAOS Web site at www.aaos.org/courses For more information about other CME courses or orthopaedic meetings listed, contact the source provided.