The 2020 American Academy of Orthopaedic Surgeons Virtual Education Experience

The originally scheduled annual meeting of the American Academy of Orthopaedic Surgeons was canceled this year due to the COVID-19 pandemic. As a substitute, the academy offered a virtual education experience, featuring medical, clinical, and scientific research spanning all orthopedic subspecialties. The virtual experience highlighted recent advances in the diagnosis and management of musculoskeletal conditions, with content focused on joint fractures, osteoarthritis, and other musculoskeletal injuries as well as factors impacting joint replacement procedure outcomes.

In one study, Wellington K. Hsu, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues found that the incidence of concussions among high school athletes has increased despite efforts to improve awareness and traumatic brain injury laws.

“We previously showed that girls soccer can present an even greater risk for concussion than boys football, and the more recent data continue to support this. Participation rates for boys football has also declined over the past three years,” Hsu said. “What was surprising with the more recent data is that other sports have seen a significant increase over the past three years such as girls volleyball. Our data suggest that while we expected the incidence of concussions in young adolescent athletes to level off over this period of time, we are still seeing increases with certain sports.”

According to Hsu, the data suggest that awareness of this problem is important for all players, even in traditionally low-risk sports such as girls volleyball.

“Athletic trainers, team physicians, and coaching staff of all sports should be aware of the incidence, diagnosis, and management of sports-related concussions,” Hsu added.

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In another study, Timothy Leroux, M.D., of the University of Toronto, and colleagues found that patients with chronic musculoskeletal (MSK) pain are commonly using cannabis to manage these symptoms, and among those who are not, many have an interest in doing so.

The investigators found that 23 percent of patients with chronic MSK pain presenting to an orthopedic surgeon have used or are currently using cannabis with the specific intent to manage their pain.

“Moreover, we found the self-reported efficacy of cannabis to approach 90 percent among those patients,” Leroux said. “However, we need to balance these findings with proper science, specifically studies that use standardized doses of cannabinoids and use a placebo-control group. The intent of this study was to set the stage for such a study and understand the current behaviors of our patients in a postlegalization society.”

The investigators found that upwards of 40 percent of patients reported a decrease in other pain medicine use while consuming cannabis.

“There appears to be a strong correlation between previous recreational cannabis use and odds of using cannabis to manage chronic MSK pain (odds ratio of 12),” Leroux said.

In addition, the researchers observed an association between the likelihood that patients are using cannabis to manage chronic MSK pain and the duration of MSK pain, number of painful areas of the body, other pain medication use, past pain clinic visits, and mental health.

“In counseling patients regarding cannabis, clinicians should caution them that despite the favorable results of this study, our understanding of the role cannabis plays in managing chronic MSK pain is limited. We don’t fully understand risks, drug interactions (including surgical risk or management of cannabis at the time of surgery and immediately after it), or what formulation is best for their symptoms (e.g., all cannabidiol, all tetrahydrocannabinol, or some balance; and what dose and route of administration),” Leroux said. “The current marketplace for cannabis products remains quite variable, whereby studies have shown that even the same product ordered at two different times may contain variable doses of cannabinoids, so there is much we need to learn and improve upon before we make this the standard for care for patients with chronic MSK pain.”

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Michael Tanzer, M.D., of the McGill University Health Center in Montreal, and colleagues evaluated the benefits of hip and knee arthroplasty surgery experienced by a patient’s spouse.

“The spouses reported that the main advantage of the patient’s arthroplasty surgery was the ability to carry on with social and leisure activities with their partner (70 percent). The other benefits of arthroplasty endorsed by spouses, in order of importance, were that they no longer witnessed the patient suffering (61 percent), a diminished caregiver burden (54 percent) and a sense of independence (54 percent), an improved marital relationship (54 percent), an improved social and family life (27 percent), and the freedom to travel (27 percent),” Tanzer said. “The improvements in mobility and pain allow patients to partake in activities such as walking, traveling, and sporting activities with their spouse, which is reported in this study to have a positive effect on their quality of life.”

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AAOS: QR Codes on Children’s Casts May Be Useful for Care Info

THURSDAY, May 28, 2020 (HealthDay News) — Quick response codes on casts of pediatric patients with fractures may be a convenient and useful way to connect children and their caregivers to cast care instructions, according to a study released as part of the American Academy of Orthopaedic Surgeons Virtual Education Experience.

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AAOS: Opioid Prescribing Down for Minor Ortho Injuries in Youth

THURSDAY, May 28, 2020 (HealthDay News) — From 2004 to 2017, there was a decrease in the proportion of pediatric patients with a minor injury prescribed opioids, according to research released as part of the American Academy of Orthopaedic Surgeons Virtual Education Experience.

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