Medical Device Network lists the top five terms tweeted on orthopaedic in Q1 2021, based on data from GlobalData’s Influencer Platform. The top tweeted terms are the trending industry discussions happening on Twitter by key individuals (influencers) as tracked by the platform.
1. Knee Replacement – 191 mentions
The increasing incidence of total knee arthroplasty (TKA), the factors involved in determining whether one should opt for partial knee replacement surgery, and robot assisted knee replacement were the most popular topics of discussion in the first quarter of 2021.
Yelena Bogdan, an orthopaedic trauma surgeon, tweeted a study on how TKA and periprosthetic supracondylar femoral fractures are becoming more common. The treatment for these conditions is complicated and may include the use of an intramedullary femoral nail retrograde.
The study notes that it is important to ensure that the nail can fit through the femoral prosthesis and into the intramedullary canal. Certain measurements, such as the minimum intercondylar distance and the location of the notch on the femoral component in relation to the intramedullary canal, are, essential for such procedures.
This information will be helpful in preparing the surgical treatment of periprosthetic supracondylar femoral fractures, according to the study.
Nicholas Frisch, a board-certified orthopaedic surgeon, further tweeted about how the knee joint is made of three main components and arthritis can occur in any one of these components. Minimally invasive partial knee surgery involves replacement of only the damaged part of the knee.
The potential merits of this surgery are minimal blood loss, less scars, minimal injury to the healthy tissues, rapid recovery, improved motion range, more natural feel to the knee and less post-surgical pain, the video detailed.
Discussions on knee replacement also included a video shared by Neil Bradbury, a specialist knee surgeon, on robot assisted knee replacement surgery. Robot assisted surgeries can improve the accuracy of a surgery and can enable surgeons to plan and execute their surgeries. Neil added that robots can also be used for other surgeries such as hips, knees and other joints.
The knee replacement basically determines your starting point… The posterior start point is a known issue with doing a retrograde through a total knee. If you tell me the type of knee that is, there’s a paper that tells you how posterior the hole is
— Yelena Bogdan, MD, FACS, FAAOS (@InvictaOrtho) January 15, 2021
2. Tendon – 145 mentions
The incidence of Achilles tendon ruptures among National Football League (NFL) players, some shoulder injuries being missed after a fall, and the effectiveness of Achilles tendon tear surgeries were popularly discussed in Q1 2021.
According to an article shared by Matthew DiPaola, an orthopaedic surgeon, X-rays can discover most of the shoulder fractures that occur during a fall or slip but not a rotator cuff tendon tear. The rotator cuff tears rarely turn up on X-ray, but a negative x-ray does not mean the shoulder is fine.
X-rays mainly expose bone while an MRI and a detailed physical examination are required to better diagnose a rotator cuff tear. Such tears can lead to permanent loss of strength and motion and need to be checked within few months to fix them, the article highlighted.
Tim Hewett, a PhD consultant, further shared a study on monitoring Achilles tendon (AT) ruptures during an NFL season to determine whether the player position, time of injury and playing surface had any impact on rupture rates.
Published information on injuries and AT ruptures during a regular season and post-season was reviewed in the study. The study revealed that AT ruptures mostly occurred in defensive players and in the first and second four game segments of a regular season. Playing surface did not have any impact on the AT rupture rates, the study found.
The term tendon was also discussed in a video tweeted by Steve A. Mora, an ortho surgeon, that depicts the surgical repair of the Achilles tendon tear. The video details how the tendon’s torn ends are joined together.
Mora states that sutures can be used to properly secure the Achilles tendon in the heels. The resting length should be properly calculated otherwise the leg will remain weak if it is sewn too loosely. After the surgery, final examinations, such as leg stiffness and calf muscle squeezing need to be performed. Further, the Thompson test can be used to verify if the Achilles repair is accurate.
ACHILLES TENDON RUPTURE … Here’s the Human Biomechanics of it all! https://t.co/cPdzJVYqk7 @TimothyHewett1 @TimHewett5 @Hewett1Tim #NFL @NFL @NFLResearch @DrAdamBitterman @Seth0Neill https://t.co/68iCr0gMwj https://t.co/zKRI4tU9t4 https://t.co/NOcXaBPQwo https://t.co/DQ4lcemMcM https://t.co/OhmYAD6d3E
— Tim Hewett (@Hewett1Tim) February 4, 2021
3. Arthroplasty – 110 mentions
Performing hip or knee arthroplasty during the Covid-19 pandemic, high cost of post arthroplasty care for patients and the use of highly porous cones in revision knee arthroplasty were widely discussed in the first quarter of this year.
Chloe Scott, a hip and knee surgeon, shared a study on how the number of patients waiting for hip, or knee arthroplasty almost doubled during the Covid-19 pandemic.
The study evaluated the quality of life of patients who are on the waiting list for these surgeries based on EuroQol quality of life scores (2020 group) compared to a control group. Results of the study showed that more than 80% of the 2020 group felt that the quality of life had deteriorated while waiting for the surgeries.
Ugo Ihekweazu, a hip and knee replacement surgeon, further discussed arthroplasty with regards to a study on post-operative barriers for minorities in bundled payments programmes.
African American patients have higher episode-of-care costs after total hip and knee arthroplasty, when compared to Caucasian patients, due to higher rates of home health and recovery use. The study added that other social variables need to be identified to minimise post-acute care resources and ensure access to arthroplasty care in bundled payment models.
Another discussion on arthroplasty was shared by Brian Chalmers, an adult reconstructive surgeon, of a study on the use of highly porous cones in revision knee arthroplasty.
Metaphyseal cones have long-term fixation in revision TKA. The new strongly porous tibial cone ensures 100% survival without re-revision for aseptic loosening for at least two years although long-term follow-up is required, the study concluded.
— Chloe EH Scott (@EdinburghKnee) March 24, 2021
4. Arthritis – 102 mentions
Artificial intelligence helping in reducing racial disparities in healthcare, an illustrated guide to arthritis and the causes of anterior knee pain were popular topics discussed in the first quarter of 2021.
According to an article shared by Jonathan Braman, a shoulder surgeon, new algorithms can reduce racial inequalities in health care. The article detailed a study on how algorithms were better at reading knee X-rays of arthritis patients than radiologists. The algorithms can interpret disease evidence that radiologists cannot.
Machine learning programmes trained on patients’ reports are able to identify the pain experienced by patients, especially black patients, by discovering patterns in the disease that are missed by doctors. By revealing information that doctors usually miss, these algorithms can make healthcare more equitable, the article noted.
Stefano Sinicropi, an orthopaedic spine surgeon, further shared a guide to arthritis and how it is a group of disorders characterised by inflammation and swelling of one or more joints.
The article detailed the various types of arthritis including osteoarthritis, psoriatic, rheumatoid, fingers and hands, neck and shoulders, knee, hip, back and spine. Osteoarthritis, also known as degenerative joint disease, affects more than 30 million Americans, the article added.
Other discussions around arthritis was shared by Robert LaPrade, a knee surgeon, on the causes of anterior knee pain, which occurs in the front section of the knee.
Squatting and lunging can cause discomfort in the front part of the knee by increasing the tension around the kneecap joint.
The anterior knee pain can be treated by a well-developed rehabilitation programme including low-impact exercises such as using a stationary bike, an elliptical machine, cycling, or swimming, the article added.
I found it interesting that imaging in this setting reportedly correlates with symptoms.
Even more interesting that a machine learning algorithm reportedly reduced bias that underreported arthritis symptom severity in Black patients. https://t.co/4b3B8xSjI1
— Jonathan P. Braman, MD, FAOA (@shouldergeek) January 25, 2021
5. Meniscus – 92 mentions
Arthroscopic intervention for treatment of meniscus tears, use of cortisone injection for meniscus tear, and better outcomes in meniscus transplants were the most widely discussed topics in Q1 2021.
According to a study shared by David Hunter, an osteoarthritis scientist and clinician, patients with meniscal tears experience meniscal symptoms such as catching or locking after undergoing arthroscopy.
The study investigated whether patients with meniscal tears who reported meniscal symptoms will benefit more from arthroscopic partial meniscectomy (APM) than physical therapy (PT). Meniscal symptoms are often used to explain arthroscopic surgery in patients with meniscal tears and osteoarthritis and these symptoms are not related to improved pain relief. The study revealed that clinical decisions such as APM and PT should not be based on meniscal symptoms.
Meniscus was also discussed by Jervis Yau, a meniscus surgeon, on how a meniscus tear may occur because of a traumatic injury or because of degeneration.
A cortisone injection can help reduce the inflammation and discomfort caused by a torn meniscus. A cortisone injection, however, is not recommended if a meniscus is repairable because it can affect meniscus healing, he added.
The term also trended in discussions with regards to meniscus transplants in a video shared by Brian Cole, an orthopaedic sports medicine surgeon. The video details that meniscal transplant surgery is a form of surgery that substitutes a missing or injured meniscus with a cadaver donor meniscus.
Meniscal transplant can slow the degeneration caused by damaged or partially removed meniscus. The patient can eventually experience knee pain and joint arthritis without a meniscus. Meniscus transplant surgery can address these issues and provide pain relief, the video detailed.
The presence of meniscal symptoms is often used to justify arthroscopic intervention in persons with meniscal tears and #osteoarthritis. Yet it does not appear to be associated with improved pain relief. 🤔 @OrACORe_BWH https://t.co/wIyIu7bVvu
— David Hunter (@ProfDavidHunter) March 9, 2021