Rothman Orthopaedic Institute

Click here to read the Cover Story, “Responsible musculoskeletal pain management is up to the orthopedist.”

Opioids are a main class of pain management drugs that started to be used more often in the U.S. and Canada about 20 years ago, with the HHS now reporting more than 650,000 opioid prescriptions on average dispensed per day in the U.S. However, prescribing opioids and informing patients about opioid misuse issues is just one part of the orthopedic surgeon’s role in pain management. In this Cover Story, orthopedic surgery, trauma, anesthesiology and pain medicine experts discuss responsible pain management and how orthopedic surgeons should approach pain management and better collaborate with other specialties to achieve optimal resolution of their patients’ pain.

Management of periprosthetic joint infection is challenging on many accounts. Fungal periprosthetic joint infections are particularly difficult to treat. The problem is the incidence of fungal infections has increased globally in the last few decades. Fungal periprosthetic infections, although rare, are similarly increasing in prevalence. Most case series of patients with fungal periprosthetic joint infections report a disastrous outcome for surgical management of these patients with treatment failure rates of up to 50% at 2-year follow-up. Part of the problem relates to the complex biofilm that fungi can form. Furthermore, patients with fungal periprosthetic joint infection are often immunocompromised with impaired cellular immunity.

Among professional players in Major and Minor League Baseball, results showed elbow injuries were most common among pitchers.

SAN FRANCISCO — At the American Society for Surgery of the Hand Annual Meeting, Asif Ilyas, MD, discussed ways in which physicians can manage the opioid crisis specifically for patients who underwent carpal tunnel release. He said formal preoperative counseling was associated with decreased opioid consumption in patients after surgery.

Professional baseball pitchers who required a revision ulnar collateral ligament reconstruction and those who did not had no statistically significant differences in the length of time to return to sport, according to results.

Patients continued to experienced sleep disturbance at 24 months after arthroscopic rotator cuff repair, especially patients who used narcotic pain medication, according to results.

SAN DIEGO — When its use is considered in addition to the traditional test results for periprosthetic joint infection, the alpha-defensin test improved the ability to predict positive cultures both when the traditional tests were equivocal or when they were all aligned toward one diagnosis, according to Gregory S. Kazarian, BA.

Recently published results showed fever and an elevated serum white blood cell count were associated with the diagnosis of septic arthritis of the wrist.

Main Line Health and Jefferson Health have partnered with Rothman Institute and NueHealth in the ownership of the Physicians Care Surgical Hospital in Royersford, Pa., according to a recent press release.