The 2023 Annual Meeting of the American Academy of Orthopaedic Surgeons
By Beth Gilbert HealthDay Reporter
The annual meeting of the American Academy of Orthopaedic Surgeons was held from March 7 to 11 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, osteoarthritis, other musculoskeletal injuries, and factors impacting the outcomes of joint replacement procedures.
In one study, David Christopher Ayers, M.D., of the University of Massachusetts Chan Medical School in Boston, and colleagues found that patients of all ages experience significant improvement in knee pain and improved knee function after total knee arthroplasty (TKA), resulting in a dramatic increase in quality of life.
The authors performed a prospective assessment of a cohort of 11,602 patients who underwent a unilateral primary TKA. Comparing four age groups (younger than 55 years, 55 to 64 years, 65 to 74 years, and 75 years and older), the researchers found that the oldest patients experienced significant improvements in knee pain, knee function, and quality of life after TKA. The youngest patients (younger than 55 years) had more pain after TKA compared with the other three age groups. The improvement achieved in pain in the age group younger than 55 years was equal to the other groups, but because they had more pain preoperatively, the final mean pain scores were lower (more pain) than the other cohorts one year after TKA. Those aged younger than 55 years were more likely to be obese before surgery (body mass index >35 kg/m2), more likely to be current smokers, and more likely to have significant pain in their lumbar spine and other joints in their lower extremities than the other three age groups.
“This illustrates that total knee arthroplasty is a life-changing event for patients with advanced arthritis of the knee, regardless of their age,” Ayers said. “Patients less than 55 years of age have more pain following total knee arthroplasty than the other three age groups. Surgeons should ensure that patients less than 55 years of age undergoing TKA have realistic expectations regarding pain, knee function, and quality of life after TKA and undergo preoperative optimization programs prior to elective TKA.”
In another study, Matthew James Hartwell, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues found that an individual’s running-related history is not associated with hip or knee arthritis.
The authors distributed a survey to all 37,917 participants registered for the 2019 or 2021 Chicago marathon. The survey collected data on runner demographics as well as hip/knee pain, osteoarthritis, family history, surgical history, and running-related history. The researchers found a low prevalence of arthritis (7.3 percent) in this cohort of Chicago marathon runners and found that running-related history was not associated with runners who reported having arthritis. Traditional risk factors for arthritis that are known to affect everyone, including increasing age, body mass index, family history of hip and/or knee arthritis, injuries to the hip and/or knee that prevented running, or prior surgery on the hip and/or knee, did have an association with arthritis.
“We also identified that there is continued dogma in the medical community that runners need to reduce their overall amount of running, with nearly one in four runners (24.2 percent) having been told they need to reduce their amount of running,” Hartwell said. “It may not be necessary to recommend marathon runners, or long-distance runners, to limit their amount of running to prevent the development of arthritis.”
Jonathan Chad Levy, M.D., of Paley Orthopedic and Spine Institute in Boca Raton, Florida, and colleagues found that patients can expect to return to golf following both total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA).
The authors performed a retrospective review of a cohort of 69 patients who played golf recreationally prior to TSA or RSA. Patients were allowed to return to golf three months after surgery and were provided with a survey that evaluated their experience returning to golf after RSA or TSA. The researchers found that patients treated with both TSA and RSA can predictably return to golf. Specifically, most patients returned to golf within six months, with 85 to 90 percent by one year. Most patients reported an increase in their driving distance, and pain while golfing was minimal after shoulder arthroplasty. Furthermore, both TSA and RSA patients reported similar golf experiences.
“Clinical practitioners should reassure golfers who are concerned about returning to golf after shoulder arthroplasty and provide guidance as to expectations of improved participation and pain levels while golfing,” Levy said.
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