Clinical News Alert from the American Academy of Orthopaedic Surgeons Journal of Bone and Joint Surgery Hot Topics

ROSEMONT, Ill, March 21, 2012 /PRNewswire-USNewswire/ -- Below are highlights of orthopaedic research studies appearing in the March 21, 2012 issue of the Journal of Bone and Joint Surgery (JBJS), as well as the issues' full Table of Contents. For more information on these full articles, please contact Lauren Pearson Riley at [email protected] 847-384-4031 or Kayee Ip at [email protected] or 847-384-4035.

Thromboembolic Events are Uncommon Following Ankle Fracture Surgery

Thromboembolic events – such as deep vein thrombosis (DVT), blood clots developing in the extremities; or pulmonary embolism (PE), a complication that causes a blood clot to move to the lungs – can occur following musculoskeletal injury and related surgery, and are potentially life threatening. In "The Incidence of Thromboembolic Events in Surgically Treated Ankle Fracture," a study appearing in the March 21, 2012 issue of the JBJS, researchers sought to determine the frequency of, and potential risk factors for, thromboembolic events following surgical treatment of an ankle fracture.

• Investigators reviewed the records of 1,540 patients who underwent ankle fracture surgery at one of three university hospitals between 1997 and 2005.
• The incidence of thromboembolic events was 2.99 percent, total: 2.66 percent of patients had a DVT, and 0.32 percent a non-fatal PE. Approximately 16 percent of patients received thromboprophylaxis preventative treatment, such as an anticoagulation (blood thinning) drug. Investigators found that thromboembolic events following ankle fracture surgery were uncommon.
• Patients with risk factors, such as hormone use, pregnancy, cancer, smoking and obesity, did have higher a higher incidence of DVT or PE (3.59 percent versus 2.38 percent). However, the use of a thromboprophylaxis did not impact the occurrence of DVT or PE in patients, including those at risk.  There was no link between the occurrence of thromboembolic events and fracture types, age or sex.

A Structured, Independent Exercise Regimen Can Reduce the Need for Therapy Following Meniscus Surgery
The treatment of meniscus tears in injured workers is associated with less favorable outcomes and higher utilization of clinical services.  "Disability, Impairment, and Physical Therapy Utilization in Workers' Compensation Patients after Arthroscopic Partial Meniscectomy," is a study appearing in the March 21, 2012 issue of the JBJS, which investigates the effects of a recommended, self-regulated exercise program on the number of physical therapy visits and patient outcomes.

• The study reviewed the success of 164 primary arthroscopic meniscectomies (the surgical procedure to remove torn areas of the two, wedge-shaped pieces of cartilage that acts as shock absorbers in the knee joint) on 155 injured workers. The patients in a "control group" receiving traditional supervised physical therapy , were compared to  a separate "study group" that received a written referral specifying the exact number of approved physical therapy visits, a kit containing equipment with a booklet illustrating 25 exercises, and the prescribed rehabilitation protocol outlining the philosophy, expected subjective and functional outcomes, and specific weekly goals.
• One year following surgery, there was a 40 percent reduction in the median number of physical therapy visits in the study group, compared to the control group.  There was no difference between the two groups in the time before workers were released to light duty, full duty, or claim closure; and no difference in impairment or complication rates.
• The author of the study believes that the results support the implementation of a structured, independent exercise protocol as a way to reduce physical therapy costs without negatively affecting strength, knee motion, or disability rates in workers' compensation patients undergoing arthroscopic meniscectomy.

March 21, 2012 JBJS Full Table of Contents
Randomized Clinical Trial of Rotating Platform and Fixed Bearing Total Knee Arthroplasty: No Clinically Detectable Differences at Five Years

Efficacy of Surgical Preparation Solutions in Lumbar Spine Surgery

Short-Term Complications of the Laterjet Procedure

Comparative Effect of Orthosis Design on Functional Performance

Revision Posterior Cruciate Ligament Reconstruction Using a Modified Tibial-Inlay Double-Bundle Technique

Outcome of Lower-Limb Preservation with an Expandable Endoprosthesis After Bone Tumor Resection in Children

Outcomes Following Distal Humeral Fracture Fixation with an Extensor Mechanism-on Approach

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The Journal of Bone & Joint Surgery has been the most valued source of information for orthopaedic surgeons and researchers for over 100 years and is the gold standard in peer-reviewed scientific information in the field.  JBJS is published twice a month online and in print. Abstracts are available online at (http://www.jbjs.org).  Contact Michelle Hache for general information on JBJS at [email protected]

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SOURCE American Academy of Orthopaedic Surgeons