Biologics: Hope, Market Pressures, Evidence, Guidelines, and Equipoise

Ronald A. Navarro, MD, FAAOS, FAOA; Gary E. Friedlaender, MD, FAAOS, FAOA, FORS

Through the application of rigorous scientific methodology, evidence-based practice, and advances in safe and effective technology, many important new solutions to serious health issues are being addressed with orthobiologic products.

AAOS Biologics Initiative Focuses on Advancing Orthobiologics for Better Outcomes

Ryan Pezold, MA, MBa

In the evolving landscape of patient care, biologics are gaining attention as tools that may improve patient outcomes.

AAOS Biologics Symposium Investigates the Present and Future of Orthobiologic Therapies

Terry Stanton

At AAOS’ third annual Biologics Symposium, titled “The Next Generation of Biologics,” hosted on July 12 in collaboration with the Biologic Association, attendees were able to get a “first look” at the next generation of biologics expected to be available and used in orthopaedics over the next several years.

Understanding Regulatory Pathways for Osteobiologic Use in Orthopaedic Surgery

John Cherf, MD, MPH, MBA, FAAOS

Osteobiologics are a subset of biologics that focus on bone regeneration. An estimated 500,000 bone-grafting procedures are performed in the United States annually, and bone is the second most transplanted tissue, second only to blood transfusions.

AAOS Book on Orthobiologics Provides In-depth Insights into an Emerging Field

AAOS recently released a book on orthobiologics, a fast-growing field that uses biologic materials to enhance tissue repair and regeneration.

Exploring Skeletal Stem Cells: Insights and Challenges in Cartilage Regeneration

Cailin Conner

The third annual Biologics Symposium, titled “The Next Generation of Biologics,” took place on July 12 in Washington, D.C., and featured four sessions on regulatory clarity, autologous tissue processing, personalized blood products, and future biologics trends.

An Opportunity Exists to Better Understand Patient Pain through Patient-reported Outcome Measures

Richard Seiden

As a patient with severe arthritis who has undergone six major joint replacements and recently lumbar spine surgery, I believe that patients need to understand how their own outcomes can be used to further educate other patients, physicians, surgeons, and others in the healthcare-delivery system.

Study Finds Increased Risk of Periprosthetic Fracture in THA Patients following Bisphosphonate Use

Cailin Conner

A study analyzing the effects that bisphosphonates have on osteoporotic patients undergoing total hip arthroplasty (THA) found that bisphosphonate use prior to THA was an independent risk factor for periprosthetic fracture.

Lower Rates of Revision Associated with All-polyethylene Tibial Components in TKA

Rebecca Araujo

An analysis of primary total knee arthroplasty (TKA) cases in patients aged >65 years found a lower all-cause and infection-related revision risk associated with the use of all-polyethylene tibial components (APTCs).

Attending Orthopaedic Surgeons on Call at Night Have Reduced Sleep Quality and Heart-rate Variability

Rebecca Araujo

A study presented at the AAOS 2023 Annual Meeting investigated how orthopaedic call impacted sleep patterns among attending orthopaedic surgeons.

Type of Deep Wound Closure Used in PJI Treatment Does Not Impact Likelihood of Treatment Success

Rebecca Araujo

The demand for total joint arthroplasty procedures in the United States is only rising, making it critical to advance and optimize the treatment of prosthetic joint infection when it occurs.

Poor Understanding of Over-the-counter Medications Puts Orthopaedic Patients at Risk

Cailin Conner

A study presented at the 2023 AAOS Annual Meeting found that most patients have a poor understanding of the different classes of OTC medications and their major side effects.

Study Reports on Long-term Outcomes of Total Hip Arthroplasty in Patients Younger than 30 Years

Cailin Conner

A study presented at the AAOS 2023 Annual Meeting by Ena Colo, MD, described long-term patient-reported outcomes of total hip arthroplasty (THA) in younger adults.

Use of Beta Blockers May Be Associated with Increased Risk of Fracture Nonunion

Terry Stanton

A recent study of patients with a fracture of the humerus, forearm, tibia/fibula, or femur found that exposure to selective and nonselective beta blockers was associated with an increase in nonunion, even after controlling for age and comorbidity index.

Second Dexamethasone Dose after Primary TKA Is Associated with Reduced Opioid Use and Pain

Rebecca Araujo

A retrospective study presented at the AAOS 2023 Annual Meeting sought to investigate the safety, analgesic effect, and opioid-sparing potential of the administration of a second postoperative dose of dexamethasone in patients undergoing total knee arthroplasty.

Study of AJRR Data Investigates Trends in TKA Technology Use at Safety-net Hospitals

Rebecca Araujo

An analysis of data from the AAOS American Joint Replacement Registry identified disparities in the use of premium total knee arthroplasty technologies among safety-net hospitals.

Increased Risk of Periprosthetic Femur Fracture with Cementless Femoral Fixation for THA

Cailin Conner

Postoperative periprosthetic femur fractures, severe complications following total hip arthroplasty, present both a significant clinical and economic burden.

Dual Mobility Articulation in Revision THA: An Analysis of Outcomes from the AAOS American Joint Replacement Registry

Cailin Conner

The utilization of dual mobility articulations during revision total hip arthroplasty to prevent postoperative hip instability has increased in recent years.

Imageless Navigation during THA Is Not Associated with Improved Outcomes

Cailin Conner

Given the increasing use of computer navigation during total hip arthroplasty (THA), the degree of its effectiveness compared with traditional navigational methods has become increasingly important.

Study Evaluates the Efficacy of Serum and Synovial Diagnostic Markers to Diagnosis PJI following Hemiarthroplasty

Cailin Conner

For elderly patients who have sustained a femoral neck fracture, hemiarthroplasty is the recommended surgical management, as frail and low-mobility patients have demonstrated better functional outcomes with this method when compared with patients undergoing total hip arthroplasty.