Orthopedics This Week

Injections prior to TKR or THR could mean an increased risk of infection, according to two new studies. Research from Rush indicates that those who are malnourished before surgery are at a higher risk of infection. And new work has found that a full 65% of patient satisfaction was attributed to physician empathy!

A survey of orthopedic programs reveals that most do not feel ready for the bundled payment initiative. Academic hospitals have lower total cost per procedure, and community hospitals have a shorter LOS, says a Cleveland Clinic study. How to save $2.5 and $4 billion in healthcare costs? Go to a high volume center for knee replacement.

The FDA approved nearly every PMA submitted to it in 2015 (98%). And shortened time to decision for both PMA and 510(k) significantly. The trends are clearly favorable. Where does the FDA go from here? Even faster approvals, they say. Here’s the data.

TranS1 and AxiaLIF?  Back from the dead? Yes and behind it is an up and coming player in orthopedics—Jeffrey Schell. Michigan born and bred, Schell has made formerly bankrupt TranS1 profitable and AxiaLIF steadily gaining new users and champions. It’s a remarkable story.

Anterior hip arthroplasty. Is it really better, faster and cheaper or is that mere marketing hype? This week’s debate pits William J. Hozack, M.D. against Fares Haddad, M.B., F.R.C.S. with Paul Lachiewicz moderating on this hot topic. Who wins this most entertaining debate? You be the judge.

How disabling is scoliosis. A new study finds that it can be more disabling than such other conditions as blindness or amputation. Brigham and Women finds art sharpens observational skills. Former AAOS president—Dr. Terry Canale—honored with the William W. Tipton Leadership Award.

Johns Hopkins researchers are making it possible for patients to control fingers of a prosthetic limb in a way never before possible! Turns out that patients already taking opioids for pain fare better if non-opioid methods are used as well. And a team from the University of Missouri has found that a new biologic method of resurfacing a joint results in improved outcomes.

It’s been a tough March so far for Alphatec. Former CEO and longtime board member, John Foster, resigned mere days before the release of the 2015 financial report. That report revealed that sales fell 10% in 2015 and, after write-offs, losses were $179 million. Putting it nicely, the company is in a transition.

Did Tom Sculco get the short straw in this dual mobility THA debate against Steven MacDonald?   At one point Moderator Thornhill offered to shield Dr. Sculco from MacDonald’s expected onslaught of data.  What really happened?  Here’s a clue:  Australian Registry!  And not much blood on the floor.

What is the #1 debated issue in TKA? USC’s Orthopedics Department Chair will tackle that and more at the upcoming Great Debates at AAOS. A new study shows that pain and function are improved when you freeze nerves prior to TKA. And alarming research finds that African-Americans with RA twice as likely to have atherosclerotic blood vessels (increasing the chances of heart attack, stroke or death).

Donald Trump wants to repeal and replace Obamacare. “We have to take care of the people in our country. We can’t let them die on the sidewalks of New York or the sidewalks of Iowa or anywhere else.” Sounds good. Except his plan costs the public purse almost $500 billion over ten years and removes over 20 million people from insurance coverage. What’s in the plan? Read it here.

EXPAREL is a widely used post-operative pain treatment for large joint arthroplasty. But not for spine. Have two Chicago doctors created the alternative to EXPAREL for spine surgery…and possibly large joints and other surgeries as well?

The FDA’s panel of spine orthopedic experts roundly voted against recommending approval for Medtronic’s DIAM Spinal Stabilization System. But Medtronic is not giving up. Read what happened at the panel meeting and how Medtronic is responding.

Corrosion, adverse tissue reaction, fracture and Australian Registry data. Jacobs and Murphy stir all those concepts up into a hot gumbo of data and case studies. This debate serves up the facts behind distal neck modularity. Bottom line, these guys were for it before they were against it.

Work from the University of Liverpool: genes point toward stress fracture susceptibility. Should surgeons avoid arthroscopic partial meniscectomy for patients with degenerative knee disease and mechanical symptoms? UCSF researchers say that to avoid knee buckling and possible falls, it’s necessary to target specific exercises to patients in need.

When Breg was a division of Orthofix, it grew 32% in eight years. Since spinning off, Breg has doubled in three years. What happened and where is this, the second largest bracing company in the world, heading? The answer is both interesting and highly strategic.

A new study shows that wrong-site surgery is still with us. New research from HSS shows that bariatric surgery before TKR could be cost-effective for morbidly obese patients with end-stage arthritis. And the chief of Sports Medicine at MGH is on to new vistas out West.

Natural orifice surgery. Now that’s a concept. The human body has a fair number of such entry points. But, for spine surgery? On the shoulders of the GI surgeon community, a strong argument in the form of two patents and a YouTube video say “Yes”.

Forty-six tons of rigging, truss and hoists. 28,000 square feet of usable floor space. Zimmer Biomet’s AAOS booth was a theatrical live event experience. How did they do it? We peek behind the curtain to show you. So put up those tray tables and make sure your seat belt is buckled. It’s not a booth, it’s a spaceship.

Metal on Metal Hip Resurfacing—YES! It is an option for the right patient and surgeon. De Smet v. Dunbar dive into this very interesting, CCJR debate.