August 22, 2018 | Today’s News

Study: Delaying surgery on fractured hip may be costly, increase hospital LOS

A population-based, propensity-matched cohort study published in the Aug. 15 issue of The Journal of Bone & Joint Surgery found that delaying hip fracture surgery for more than 24 hours after arrival at the emergency department increased medical costs and hospital length of stay (LOS). Data were collected for 42,230 patients who underwent hip fracture surgery performed by 522 different surgeons at 72 hospitals in Ontario, Canada between 2009 and 2014. The mean cost for patients was $39,497. Among those who did not receive immediate surgery, one-year medical costs were $2,638 higher, on average, and patients spent an average 0.610 days longer in the hospital, compared to patients who underwent surgery within 24 hours. Researchers said this information may provide a financial incentive to mitigate delays in hip fracture surgery.

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Study appears to show correlation between IDU and septic knee arthritis

A study published in the August issue of Clinical Orthopaedics and Related Research found that opioid and injected drug use (IDU) may cause septic arthritis of the knee and is associated with higher rates of mortality, reoperation, resource utilization, and leaving the hospital against medical advice. Researchers used the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample database to identify patients aged 15–64 years with a principal discharge diagnosis of native septic arthritis of the lower leg between 2000 and 2013. The proportion of patients with IDU-related septic arthritis increased from 5 percent in 2000 to 11 percent in 2013. Patients with IDU-related septic arthritis were more likely to die at the hospital, undergo repeat arthroscopic or open irrigation and débridement, leave against medical advice, and spend, on average, five days longer in the hospital than patients with septic arthritis unrelated to IDU. The researchers said orthopaedic surgeons should screen for IDU in patients with septic arthritis and monitor them closely.

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Researchers advised against overtensioning during calcaneofibular ligament (CFL) reconstruction to best mimic a normal ankle in a controlled laboratory, according to a study published online in The American Journal of Sports Medicine. The study tested 12 cadaveric ankles using a six degrees of freedom robotic system that applied passive plantarflexion-dorsiflexion motion and multidirectional loads. Researchers found that the greater the initial graft tension at the time of the procedure, the more abnormal ankle kinematic problems and laxity became following the surgery. The calcanea with an initial tension of 10, 30, 50, and 70 N had mean eversion translations of 1.2, 3.0, 5.0, and 6.2 mm, respectively.

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A retrospective study published in the July issue of The Spine Journal measured the kinematic change of the intervertebral disk and space available for the spinal cord (SAC) of the thoracic spine. The study included 105 patients who underwent a kinematic MRI of the thoracic spine. Researchers found kinematic changes from flexion to extension in the thoracic disks and SAC from T4–T5 to T11–T12. The thoracic intervertebral disk area’s mean value was larger in flexion than extension in these areas. Prominent disk bulging was found at T8–T9 between flexion and extension, T9–T10 between neutral and flexion, and T9–T10 between flexion and extension. Researchers concluded that for patients with thoracic myelopathy, one etiology for neurogenic deterioration may be kyphotic deformities.

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The Yale School of Management and the Commonwealth Fund partnered to create the Commonwealth Fund Fellowship in Minority Health Leadership at Yale University. The program will pay for three fellows to complete the MBA for Executives degree program each year. Experts will mentor the selected participants and educate them on healthcare inequities. The fellows will be health practitioners who seek to improve healthcare access for minority and socioeconomically disadvantaged populations. The 22-month program will start in July 2019; applications will be accepted beginning this fall.

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Board of Directors’ thoughtful, strategic approach bolsters member value proposition

In the past 12 months, the AAOS Board of Directors embraced a much more rigorous approach toward strategic planning, taking a fresh look at how it evaluates programming, how it functions (i.e., governance), and what benefits it provides members. The board’s goal is to maximize the potential of the Academy’s overall value and portfolio of member benefits. These efforts will ultimately enable the Academy to become a hub where members from all career stages and specialties can engage for their lifelong learning needs.

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Last call: Apply for Shoulder & Elbow Evaluation Committee chair position

The Shoulder & Elbow Evaluation Committee has an open position for chair, a three-year term that runs from March 18, 2019 through March 25, 2022. The committee prepares the Shoulder and Elbow Self-Assessment Examination triennially and acts as a resource for providing examination questions for other AAOS educational programs. The deadline to apply is Aug. 24.

Learn more and submit your application…(member login required)