American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting Daily Hot Topics and News Summaries

SAN FRANCISCO, Feb. 9, 2012 /PRNewswire-USNewswire/ -- The 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) takes place this week at the Moscone Convention Center in San Francisco. Each day, the public relations department will send the most newsworthy components of the meeting.  To schedule an interview about any of the topics below, contact AAOS public relations.

Media Highlights

Ultrasound Can Reliably Diagnose Hip Dysplasia at Age 6 Months

• Radiation no longer required to detect common congenital birth defect

Developmental dislocation (dysplasia) of the hip (DDH) is a common congenital condition in which a child's upper thighbone is dislocated from the hip socket. The condition can be present at birth or develop during a child's first year of life. Plain radiography (X-rays) has long been the gold standard screening modality for this condition in 6-month-old children, despite concerns over exposing very young children to ionizing radiation. Thirty-five, 5 to 7 month-old children at high risk for DDH were screened with the standard pelvis X-ray, as well as a bilateral non-stress hip ultrasounds. Blinded orthopaedic surgeons then evaluated the X-rays and ultrasounds for standard measure of hip dysplasia. Of the 35 children involved in the study, only one was diagnosed with dysplasia, and the diagnosis was made on both the ultrasound and X-ray.  Ultrasound provided good quality images with 100 percent diagnostic correlation to the X-rays in all patients. Ultrasound is a reliable alternative imaging method to X-rays for DDH screening in 5-to-7 month old children.

Undiagnosed Neurological Disorders May Cause Falls and Hip Fractures in the Elderly

• Hip fracture patients should be screened for cervical myelopathy

Hip fractures are a common cause of morbidity and mortality in elderly patients. Cervical myelopathy is a common neurological condition that can diminish balance and coordination. Investigators screened 28 hip fracture patients and 35 hip replacement patients (all cognitively healthy) for cervical myelopathy. Eighteen percent (five) of the hip fracture patients did indeed have cervical myelopathy. None of the hip replacement patients tested positive for the condition. Undiagnosed neurological disorders may predispose patients to falls and fractures. Screening for cervical myelopathy should be standard care for all hip fracture patients, to reduce the risk for additional falls and fractures.

Shorter Hospital Stay for Total Knee Replacement Linked with Greater Revision and Mortality Risks

• Any TKR short-stay hospital protocol should be implemented gradually to ensure capacity, avoid complications

No previous research has quantified and compared the costs and outcomes between total knee replacement (TKR) patients who have differing lengths of hospital stay following surgery. Investigators identified Medicare patients who had undergone TKR between 1997 and 2009.  The patients were separated into the following groups: outpatient, 1-day inpatient, 2-day inpatient, 3- or 4-day inpatient (standard of care), and 5 plus day inpatient. Investigators reviewed outcomes for the patient groups including annual payments, mortality, readmission, revision and common complications. After adjusting for various factors, the results were compared at 90 days, one year, and two years after surgery.  Compared to patients who had the standard of care 3-4 day hospital stay, the incremental payments for osteoarthritis costs at 2 years were - $6,964 (lower) for the outpatient group, - $3,327 for patients hospitalized for one day, -$1,681 for two days, and +$1,159 for five plus days. At 90 days, the outpatient group had less pain and stiffness compared to the standard care (3-4 day) group, but had a higher risk for mortality, readmission and dislocation. Investigators recommend that hospitals that choose to implement shorter stay protocols for TKR patients, should do so gradually and only with appropriate and sufficient capabilities.

About the AAOS
With more than 37,000 members, the American Academy of Orthopaedic Surgeons, (www.aaos.org) or (www.orthoinfo.org) is the premier not-for-profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality of musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues. An advocate for improved care, the Academy is participating in the Bone and Joint Initiative (www.usbjd.org), the global initiative to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life.  The Academy's 2012 Annual Meeting is being held February 7 - 11, 2012 at the San Francisco Moscone Center in San Francisco.

SOURCE American Academy of Orthopaedic Surgeons