Orthopaedic Trauma Association Annual Meetings Research Articles

Distal femur fractures: basic science and international perspectives.

Distal femur fractures are challenging injuries to manage, and complication rates remain high. This article summarizes the international and basic science perspectives regarding distal femoral fractures that were presented at the 2022 Orthopaedic Trauma Association Annual Meeting. We review a number of critical concepts that can be considered to optimize the treatment of these difficult fractures. These include biomechanical considerations for distal femur fixation constructs, emerging treatments to prevent post-traumatic arthritis, both systemic and local biologic treatments to optimize nonunion management, the relative advantages and disadvantages of plate versus nail versus dual-implant constructs, and finally important factors which determine outcomes. A robust understanding of these principles can significantly improve success rates and minimize complications in the treatment of these challenging injuries.

What's New in Orthopaedic Trauma.

What's New in Orthopaedic Trauma.

Are we missing the mark? Relationships of psychosocial issues to outcomes after injury: A review of OTA annual meeting presentations.

Objectives:To observe the availability of information about social, emotional, and psychological factors in abstracts presented at the Orthopaedic Trauma Association (OTA) annual meeting.Data source:OTA website (https://ota.org/education/meetings-and-courses/meeting-archive/)Study Selection:All abstracts selected for paper or poster presentation at the 2016 through 2018 OTA annual meetings, as published in the final program. Studies were included if they sought to measure mental illness, substance use or abuse, pain, or other psychosocial issues. If studies utilized 1 or more patient-reported outcome measures (PROMs), they were also included.Data extraction:For each abstract meeting inclusion criterion, studies were assessed for interventions intended to improve outcomes in any of the listed psychosocial domains.Data synthesis/Results:Nine hundred forty-two abstracts were evaluated over a 3-year period. Of these, 294 (31.2%) met inclusion criteria. Twenty-five abstracts (8.5% of 294) reported mental illness, with depression (n = 14), anxiety (n = 9), and posttraumatic stress disorder (n = 5) being the most common. Eighty-eight abstracts (29.9% of 294) reported substance-use of tobacco, alcohol, narcotics, and/or recreational drugs. Tobacco-use was most prevalent (n = 59), followed by opioid-use (n = 31). Ten abstracts reported substance abuse. Pain was measured in 95 abstracts, and 203 abstracts utilized PROMs. Thirty-five abstracts found that these psychosocial elements significantly impacted outcomes or complications. Many abstracts did not assess the influence of these factors on clinical outcomes (n = 99). Sixteen studies described an intervention aimed at mitigating these features.Conclusions:This study illustrates limited attention to the impact of psychological, social, and environmental factors on outcomes after orthopaedic trauma. Substance-abuse problems and mental health concerns are not only predictors of poor clinical and PROMs of pain and quality of life after injury, but have also been implicated in subsequent recidivism. Only 3% of 942 abstracts observed mental health and 1% reported substance-abuse. Moving forward, greater understanding of psychosocial issues may enhance interventions to impact long-term outcomes.

Publication Rates of Posters From the Orthopaedic Trauma Association Annual Meeting 2011-2016: Posters Are Not Second Rate.

To determine the publication rate of posters presented at the OTA annual meeting from 2011 to 2016. All posters presented at the OTA annual meetings from 2011 to 2016 were identified from the OTA's official website and confirmed through review of the OTA official programs. This information was then used to direct a search, and if the presentation was associated with a publication, publishing information was entered into the database. From 2011 to 2016, there were a total of 875 posters with 473 associated publications (54%). The highest rate of publication was 64.1% of posters published in 2012. The posters were published at an average of 19.4 months after presentation. One hundred sixty posters were published in the Journal of Orthopaedic Trauma (35%). Our research demonstrated a 54% publication rate over a 6-year period of posters presented at the OTA annual meetings. This rate is higher than other publication rates for podium presentations in other societies (eg, American Academy of Orthopaedic Surgeons and American Academy for Surgery of the Hand). This validates the quality of research presented in poster format at the OTA annual meeting.

What’s New in Orthopaedic Trauma

What’s New in Orthopaedic Trauma

Orthopaedic Trauma Association Annual Meeting Program Committee: Analysis of Impact of Committee Size and Review Process on Abstract Acceptance

To evaluate whether scientific abstracts selected for podium presentation at the Orthopaedic Trauma Association (OTA) Annual Meeting differ based on the program committee size and/or the proportion of abstracts each committee member evaluates. Abstract scores from the Orthopaedic Trauma Association program committee from 2010 through 2016 were obtained. All members (range, 8-9) reviewed each clinical abstract (range, 506-778) each year in a blinded fashion. The 90 top-scoring abstracts were considered "accepted" for this study. To determine the effect of reducing the committee size, all possible combinations of reviewers for each possible committee size were modeled. To determine the effect of reducing the number of abstracts each member reviewed, we used Monte Carlo simulation with 100 cycles to generate possible combinations of 1-9 reviewers for each abstract. Mean percent agreement with the actual selection was the primary outcome. The mean percent agreement progressively declined from 90.2% with 1 less committee member to 56.7% with only a single reviewer. For each reduction in the number of committee members, 4.4% agreement was lost. If all committee members were retained but the number of reviewers per abstract was reduced from 8 to 1, the mean percent agreement declined from 88.8% to 43.0%. Each reduction in reviewers per abstract reduced the mean percent agreement 6.3%. The findings inform program committees striving to balance the trade-off between an acceptable reduction in agreement, given a reduction in the program committee size or the proportion of abstracts each committee member evaluates.

Publication of Podium Presentations at the Orthopaedic Trauma Association Annual Meetings: 2008-2012.

To determine journal publication rates of podium presentations from the OTA Annual Meetings between 2008 and 2012. Podium presentations from the 2008 to 2012 OTA annual meeting were compiled from the Annual Meeting archives. During December 2016, and Google Scholar were performed using individual keywords in the abstract title and content. The results were reviewed for matches to the meeting abstracts with regard to the title, authors, and abstract content. Yearly publication rates were calculated, along with time to publication and common journals for publication. The publication rate for the 357 podium abstracts presented at the OTA between 2008 and 2012 was 72.8%. Eighty-one percent of abstracts were from the US institutions. The mean time to publication from podium presentation was 23.4 months, and the most common journals of publication were Journal of Orthopaedic Trauma (45.4%) and The Journal of Bone & Joint Surgery (15.3%). The publication rate of the podium presentations at the OTA Annual Meeting from 2008 to 2012 has increased since previous years. Compared with other orthopaedic subspecialty and nonorthopaedic specialty meetings, the OTA publication rate is among the highest in the medical field. OTA annual meetings are an opportunity for early access to high-quality research in the area of orthopaedic trauma.

Current Publication Rates of Abstracts Presented at the Orthopaedic Trauma Association Annual Meetings: 2005-2010.

To evaluate the publication rate of abstracts presented at the 2005-2010 Orthopaedic Trauma Association (OTA) Annual Meetings. All abstracts from the 2005 to 2010 OTA meetings were identified through the OTA's official website. Each abstract was searched across PubMed and Google to determine its publication status. The overall publication rate of abstracts was determined, along with the first authors' sex, number of authors, time and journal of publication, and analyzed with statistical testing. Of the 392 abstracts presented at the 2005-2010 OTA meetings, the overall publication rate was 66.3%, with an overall mean time to publication of 28.3 months. The Journal of Orthopaedic Trauma published 38.5% of published OTA abstracts, the most of any journal. The proportions of published OTA abstracts with female first authors exhibit increasing trends within the time period. The quality of research presented at OTA meetings is relatively high compared with other orthopaedic meetings, with 66.3% of OTA abstracts progressing to peer-reviewed publication. The publication rate of 2005-2010 OTA abstracts was greater than that of the 1990-1995 abstracts. The Journal of Orthopaedic Trauma remains the most frequent publisher of manuscripts presented as abstracts at OTA meetings. Although most abstracts are eventually published, the information presented at these meetings, like all scholarly work, should be critically evaluated as they have undergone a less robust peer-review process and may be modified in the future in preparation for publication.

Variability in conflict of interest disclosures by physicians presenting trauma research.

AIMTo quantify the variability of financial disclosures by authors presenting orthopaedic trauma research.METHODSSelf-reported authorship disclosure information published for the 2012 American Academy of Orthopaedic Surgeons (AAOS) and Orthopaedic Trauma Association (OTA) meetings was compiled from meeting programs. Both the AAOS and OTA required global disclosures for participants. Data collected included: (1) total number of presenters; (2) number of presenters with financial disclosures; (3) number of disclosures per author; (4) total number of companies supporting each author; and (5) specific type of disclosure. Disclosures made by authors presenting at more than one meeting were then compared for discrepancies.RESULTSOf the 5002 and 1168 authors presenting at the AAOS and OTA annual meetings, respectively, 1649 (33%) and 246 (21.9%) reported a financial disclosure (P < 0.0001). At the AAOS conference, the mean number of disclosures among presenters with disclosures was 4.01 with a range from 1 to 44. The majority of authors with disclosures reported three or more disclosures (n = 876, 53.1%). The most common cited disclosure was as a paid consultant (51.5%) followed by research support (43.0%) and paid speaker (34.8%). Among the 256 physicians with financial disclosures presenting at the OTA conference, the mean number of disclosures was 4.03 with a range from 1 to 22. Similar to the AAOS conference, the majority of authors with any disclosures at the OTA conference reported three or more disclosures (n = 140, 54.7%). Most authors with a disclosure had three or more disclosures and the most common type of disclosure was paid consulting. At the OTA conference, the most commonly cited form of disclosure was paid consultant (54.3%) followed by research support (46.1%) and paid speaker (42.6%). Of the 346 researchers who presented at both meetings, 112 (32.4%) authors were found to have at least one disclosure discrepancy. Among authors with a discrepancy, 36 (32.1%) had three or more discrepancies.CONCLUSIONThere were variability and inconsistencies in financial disclosures by researchers presenting orthopaedic trauma research. Improved transparency of conflict of interest disclosures is warranted among trauma researchers presenting at national meetings.

Introduction.

Welcome to the inaugural Orthopaedic Trauma Association (OTA)/Journal of Orthopaedic Trauma Video Supplement. This issue provides 21 videos that demonstrate state-of-the-art techniques for managing various orthopaedic trauma scenarios. These videos are all narrated to enhance the educational impact; are approximately 8–10 minutes in length; generally include preoperative considerations, intraoperative footage, and postoperative care and results. Each video was peer-reviewed to assure quality and lack of bias, and each is accompanied by a supporting abstract. Anatomic regions covered in this issue include knee (patella and tibial plateau fractures and extensor mechanism disruption), shoulder (proximal humerus fracture and AC separation), pelvis, elbow, tibia, and ankle (subtalar fusion and ankle fracture). Other general topics include biomechanics, split thickness skin graft, and making antibiotic intramedullary nails for osteomyelitis. These 21 videos represent the highest quality and most up-to-date techniques that are available. They also represent the beginning of what will be a comprehensive library covering a wide variety of techniques and approaches used for fractures in all anatomic locations. These videos were all presented at the 2015 OTA Annual Meeting Video Theater in San Diego. All viewers and readers are encouraged to submit their videos to the 2016 OTA Annual Meeting Video Theater. Published videos with accompanying abstracts are included in PubMed so that authors receive appropriate academic recognition. It is our goal to provide educational content that is valuable to you and hope that you might consider contributing in the future.

Has the Level of Evidence of Podium Presentations at the Musculoskeletal Tumor Society Annual Meeting Changed Over Time?

Level of evidence (LOE) framework is a tool with which to categorize clinical studies based on their likelihood to be influenced by bias. Improvements in LOE have been demonstrated throughout orthopaedics, prompting our evaluation of orthopaedic oncology research LOE to determine if it has changed in kind. (1) Has the LOE presented at the Musculoskeletal Tumor Society (MSTS) annual meeting improved over time? (2) Over the past decade, how do the MSTS and Orthopaedic Trauma Association (OTA) annual meetings compare regarding LOE overall and for the subset of therapeutic studies? We reviewed abstracts from MSTS and OTA annual meeting podium presentations from 2005 to 2014. Three independent reviewers evaluated a total of 1222 abstracts for study type and LOE; there were 577 abstracts from MSTS and 645 from OTA. Changes in the distributions of study type and LOE over time were evaluated by Pearson chi-square test. There was no change over time in MSTS LOE for all study types (p = 0.13) and therapeutic (p = 0.36) study types during the reviewed decade. In contrast, OTA LOE increased over this time for all study types (p < 0.01). The proportion of Level I therapeutic studies was higher at the OTA than the MSTS (3% [14 of 413] versus 0.5% [two of 387], respectively), whereas the proportion of Level IV studies was lower at the OTA than the MSTS (32% [134 of 413] versus 75% [292 of 387], respectively) during the reviewed decade. The proportion of controlled therapeutic studies (LOE I through III) versus uncontrolled studies (LOE IV) increased over time at OTA (p < 0.021), but not at MSTS (p = 0.10). Uncontrolled case series continue to dominate the MSTS scientific program, limiting progress in evidence-based clinical care. Techniques used by the OTA to improve LOE may be emulated by the MSTS. These techniques focus on broad participation in multicenter collaborations that are designed in a comprehensive manner and answer a pragmatic clinical question.

OTA Annual Meeting Roundup

The annual meeting of the Orthopaedic Trauma Association (OTA) continues to stand out as the foremost global meeting focussed on the practice and science of orthopaedic trauma surgery. All of the global opinion leaders in orthopaedic trauma regularly present their work, alongside instructional elements, and it remains the meeting at which one will find most of the United Kingdom’s leading trauma surgeons. The UK Orthopaedic Trauma Society (OTS) is steadily bringing practice-changing meetings of this kind to the UK and, given time, it seems likely that the OTS meetings should be part of UK trauma and orthopaedic (T&O) surgeons’ calendars. The 30th anniversary 2014 OTA Annual Meeting was held between 15 and 18 October 2014 in Tampa, Florida, hosted by the irrepressible Roy Sanders, of the calcaneal fracture classification. Nearby, the white sands of Clearwater Beach and the turquoise warm water of the Gulf of Mexico posed stiff competition for the extensive educational programme which offered a combination of a large collection of instructional course lectures, symposia, and scientific exhibits representing a wide range of trauma subspecialties. The programme committee presented 150 podium presentations from over 800 submitted, along with 170 posters, for the 1340 attendees. Prior to the annual meeting, on the Wednesday afternoon and Thursday morning there was a number of pre-meeting events, which cater for the variety of trauma surgeons attending. There is a guest nation each year, which this year was Brazil; 2016 will be the UK’s turn as guest nation in Vancouver, Canada. The extensive OTA meeting includes a number of ‘pre-meeting’ events such as the pelvic surgeons’ forum hosted by Adam Starr each year, and the basic science focus forum. A standout paper from …

Levels of Evidence at the Orthopaedic Trauma Association Annual Meetings

To examine the strength of evidence presented at the Orthopaedic Trauma Association (OTA) annual meetings before and after the level of evidence guidelines became popular in the literature. 10 years of abstracts from OTA podium presentations, preguidelines (1998-2002), and postguidelines (2007-2011). All abstracts were blinded and randomized for review. Only therapeutic, diagnostic, prognostic, and economic study types were included. Study type and level of evidence were determined for each abstract. Five hundred thirteen abstracts were included, primarily consisting of therapeutic studies (63%). The distribution of study types between the pre- and postguideline periods was similar (P = 0.37). The levels of evidence for podium presentations in the preguideline period were as follows: level I, 10%; level II, 16%; level III, 14%; and level IV, 60%. The distribution in the postguideline period was as follows: level I, 13%; level II, 2%; level III, 29%; and level IV, 36%. The differences between the pre- and postguideline presentations were significant (P < 0.0001), indicating an improvement in the strength of evidence presented at the annual meetings. The majority of podium presentations at the OTA annual meetings are level IV studies; however, there has been a measurable decrease in the number of uncontrolled case series presented at more recent meetings. Encouraging reporting of levels of evidence at future annual meetings has the potential to positively influence the orthopaedic trauma community by improving readers' understanding of the strength of evidence presented, the study design hierarchy, and encouraging investigators to conduct controlled study designs when possible.

Orthopaedic Trauma Association Annual Meeting - October 2012

This year’s annual gathering of the Orthopaedic Trauma Association took place in Minneapolis, USA set against the backdrop of the Mississippi, and the first few days of the perishing Minnesota winter. Quite a contrast for the 3000 or so orthopaedic traumatologists to the previous year’s meeting in San Antonio, USA This year, delegates faced the mid-west cold in place of the intense Texan heat. The four days of the main meeting were prefaced by symposia on basic science, a residents’ trauma ‘boot camp’ and short instructional courses on grant writing, a young practitioners’ forum and a comprehensive course on trauma coding. The Basic Science Focus forum was full of high quality research. Much of it was grant-funded and well conducted basic science or clinical research. The start of the meeting was a biomechanical symposium chaired by Emil Schemitsch and John Bechtold. This summarised the biomechanical evidence for almost every fracture. In most cases, the message seemed to be fairly clear. Good reduction and accurate placement of a plate or nail has a more profound effect on the stability of the construct than the choice of implant itself. In the free paper session, an interesting paper analysed the biomechnical properties of using a 4.0 cancellous ‘bail-out screw’ after the thread of a 3.5 screw has stripped. The authors effectively demonstrated that the 4.0 cancellous screw provides a biomechanically effective bailout.1 In a lively symposium on venous thromboembolism, the difficulties of defining VTE and effective treatment options were discussed in a session chaired by Steven Olson and William Geerts. Free papers explored the possibility of predicting the risk of venous …