Surgery Counteracts Effects of Acute Flaccid Myelitis
Young patients with acute flaccid myelitis (AFM) — a subtype of transverse myelitis — regained arm function after undergoing nerve transfer surgery, according to the Hospital for Special Surgery (HSS).
Most patients with AFM lose muscle function in their arms or legs. Two patients, ages 12 and 14, were part of case studies at New York-based HSS, the findings of which were published in Pediatric Neurology. Both regained arm movement after undergoing the complex procedure, which involves repurposing a functioning but redundant, or less critical, nerve by transferring it to paralyzed muscles.
The nerve transfer surgery should ideally take place six to nine months after the onset of AFM, according to a surgeon at HSS.
AFM appears to be linked to a viral infection, HSS notes in a news release about the surgery, and the condition typically occurs in teenagers and children.
A Tool to Help Predict Hip Replacement Outcomes
Patients who struggle to independently perform normal activities prior to total hip replacement may have worse outcomes after the surgery, according to a study by Johns Hopkins Medicine.
Researchers reviewed the medical records of about 43,000 adults who had undergone primary total hip arthroplasty to treat osteoarthritis. Complications from the surgery were up to three times more likely among those who had been less able to care for themselves prior to the procedure. Those patients’ likelihood of needing care in a rehabilitation or nursing facility before going home was similarly greater, and their hospital stays were nearly 20% longer.
Preoperatively evaluating patients’ ability to engage in activities such as dressing, showering and eating may help predict outcomes, the researchers concluded.
“Our study offers a simple tool to help inform treatment decisions,” Micheal Raad, MD, a postdoctoral research fellow in the Department of Orthopaedic Surgery at the Johns Hopkins University School of Medicine, stated in a news release.
The findings appear in Orthopedics.
Quadricep Weakness Linked to ACL Reinjury
Reinjuring the knee is more likely among young athletes who do not reach a certain threshold of lower-quadricep strength before returning to sports (RTS) after ACL reconstruction, according to findings presented at the 2019 meeting of the American Orthopaedic Society for Sports Medicine.
While surgical patients had reduced likelihood of experiencing an ipsilateral graft failure if they did not reach 90% quadricep strength before RTS, their chance of experiencing a contralateral ACL injury rose threefold, researchers found.
About 40 of 181 patients in the study experienced a second ACL injury within two years after RTS. That included 21 contralateral ACL tears and 18 ipsilateral graft failures.
“Further investigation is needed on the relationship between quad strength and side of future ACL injury and whether other factors may help contribute to a predictive model of future ACL injury specific to limb,” says researcher Mark V. Paterno, PT, PhD, MBA, SCS, ATC, Division of Sports Medicine, Cincinnati Children’s Hospital, in a release about the study.