The annual meeting of the American Academy of Orthopaedic Surgeons was held from March 24 to 28 in Las Vegas and attracted approximately 30,000 participants from around the world. The conference highlighted recent advances in the diagnosis and management of musculoskeletal conditions, with presentations focusing on joint fractures and other musculoskeletal injuries, osteoarthritis, and factors impacting joint replacement procedure outcomes.
In one study, Michael G. Zywiel, M.D., of the University of Toronto, and colleagues evaluated the economic consequences of perioperative delirium in older orthopedic patients by reviewing hip fracture records of 242 patients between January 2011 and December 2012. The investigators found that 116 patients (48 percent) experienced delirium during hospital admission.
“Perioperative delirium in this group was associated with significant incremental length of stay and episode-of-care costs from the hospital perspective,” Zywiel said. “Even when adjusted for potential confounding, experiencing delirium was associated with a 1.65 times longer length of acute care hospital stay, and a 1.46 times higher cost to the hospital for the episode of care.”
The investigators also found that the incremental cost of delirium was responsible for 26 percent of the total cost of care for these patients, from the acute care hospital perspective.
“Perioperative delirium represents a significant incremental health resource burden from the hospital perspective in terms of both length of stay and episode-of-care costs,” Zywiel added. “Given this and the large number of patients who experience a fragility hip fracture every year (over 300,000 in the United States), delirium is a promising target for reducing acute care hospitalization costs for these patients.”
In another study, Diego Villacis, M.D., of the University of Southern California in Los Angeles, and colleagues found vitamin D insufficiency to be prevalent among elite level athletes, with 33.6 percent of the 223 National Collegiate Athletic Association Division I athletes having abnormal levels. In addition, the investigators also found that dark skin tone was a risk factor for abnormal vitamin D levels.
“Vitamin D supplementation may be safe and cost-effective. However, further research will be necessary to determine intake guidelines and normal ranges for athletes,” Villacis said. “A large-scale investigation of the relationship between vitamin D levels and injury would be highly beneficial.”
In a study of 51,843 patients who received total joint arthroplasty (TJA) between 2008 and 2012, Robert H. Aseltine Jr., Ph.D., of the University of Connecticut in Farmington, and colleagues found that black and Hispanic patients were 60 and 50 percent more likely, respectively, to be readmitted within 30 days of discharge following TJA, compared with Caucasian patients.
“These differences were reduced but not completely explained by controlling for patient socioeconomic status and patient comorbidities,” Aseltine said. “Racial and ethnic minorities are at increased risk for complications and hospital readmission after TJA, representing increased patient morbidity and cost of care.”
Patrick Horst, M.D., of the University of California in San Francisco, and colleagues found that surgery for degenerative spine disease not only improves low back pain but a patient’s sex life as well.
“The fact that sex life is relevant to 70 percent of patients in our study with degenerative spine disease is interesting and has never been reported in this large a series,” Horst said. “We also found it interesting that over 40 percent of patients report some level of pain related to their sex life at baseline.”
The investigators found that through four years of follow up, only 15 to 20 percent of patients who underwent surgery reported pain with their sexual activity, while around 40 percent of patients treated non-operatively reported having pain.
“This study sheds light on the fact that sex life is an important consideration for patients with degenerative spine disease,” Horst added. “It provides the surgeon with some evidence that low back pain is relevant to sexual function and that questions regarding improvement of sexual dysfunction can be addressed.”
AAOS: Just Home Rehab May Be Enough Post Knee Surgery
THURSDAY, March 26, 2015 (HealthDay News) — Patients who choose at-home physical therapy instead of in-patient rehabilitation after knee replacement surgery do just as well when it comes to complications, long-term pain management, and movement recovery, new research indicates. The findings were presented this week at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 24 to 28 in Las Vegas.
AAOS: Driving Two Weeks Post Hip Replacement May Be OK
WEDNESDAY, March 25, 2015 (HealthDay News) — Many people who’ve had hip replacement surgery might safely be able to drive as soon as two weeks after the procedure, a new small study finds. The findings were scheduled for presentation Tuesday at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), held from March 24 to 28 in Las Vegas. The study was also published online November 2014 in The Journal of Arthroplasty.
AAOS: Many Parents Unaware of Youth Pitching Guidelines
TUESDAY, March 24, 2015 (HealthDay News) — Young baseball players often feel pressure from parents or coaches to continue playing despite arm pain, and many parents are unaware of guidelines to reduce injury risk, a pair of recent studies found. The studies are scheduled for presentation March 24 at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 24 to 28 in Las Vegas.
AAOS: Minimalist Running Shoes May Need Longer Transition
TUESDAY, March 24, 2015 (HealthDay News) — A new study suggests that runners over the age of 30 who transition from traditional running shoes to minimalist shoes should do so cautiously to avoid injury. The findings are scheduled to be presented this week at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 24 to 28 in Las Vegas.
AAOS: Hip Replacement Surgery Up in Younger Americans
TUESDAY, March 24, 2015 (HealthDay News) — Between 2002 and 2011, the rate of hip replacement surgery nearly doubled among Americans ages 45 to 64. By 2011, those middle-aged patients accounted for over 42 percent of all hip replacements nationally — up from 34 percent in 2002, according to research findings scheduled to be presented on Thursday at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 24 to 28 in Las Vegas.
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