February 25, 2019
Today’s Top Story

Study Evaluates Efficacy of Modified Robert Jones Bandage in TKA

A meta-analysis published online in the March issue of the International Journal of Surgery found that use of a modified Robert Jones bandage after primary total knee arthroplasty (TKA) may not be necessary. Researchers queried EMBASE, PubMed, Web of Science, and Cochrane Library for relevant English-language randomized, controlled trials (RCTs) published through November 2018. Outcomes included total blood loss, hemoglobin decline, transfusion rates, pain score, range of motion (ROM), length of hospitalization, knee circumference difference, and adverse events. Among the five RCTs included in the study, no significant differences in outcomes were found among primary TKA patients, whether or not a modified Robert Jones bandage was used.

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Other News

Study Assesses Orthopaedic Surgeons’ Opioid Prescribing Habits

A study published in the Feb. 15 issue of the Journal of the AAOS evaluated how orthopaedic surgeons prescribe opioids. A total of 555 orthopaedic surgeons practicing in 37 states completed an anonymous online survey. Most respondents reported prescribing hydrocodone/acetaminophen for teenagers and adults. About two-fifths (42.3 percent) of surgeons said one of their patients developed an opioid dependency; 35.3 percent said they do not have concerns about opioid use in their practice. Nearly a third (30.3 percent) of surgeons said they prescribed refills. More years in practice and practicing in a suburban rather than urban or rural setting were predictors of refill prescribing.

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Study Determines Predictors of Post-discharge Physical Function after LBF

A study published online in Therapeutics and Clinical Risk Management identified risk factors for decreased physical function and strength among older adults hospitalized for lower body fracture (LBF). Researchers independently tested four variables in 89 LBF patients: age, sex, type of fracture, and use of a walking aid before fracture. They evaluated mobility using the Timed Up and Go (TUG) test and strength with the handgrip strength (HGS) test. Mean TUG test time was 26.11 seconds, and mean HGS was 19.02 kg. The following factors were associated with worse TUG and HGS results: older age, female sex, hip fracture, and prefracture use of a walking aid.

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Study Compares Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures

A comparison of minimally invasive chevron-Akin (MICA) surgery and open scarf-Akin surgery for hallux valgus found neither procedure was significantly advantageous to the other, according to a study published online in Foot & Ankle International. The study involved 50 scarf patents and 48 MICA patients who underwent treatment between January 2014 and December 2015 and were followed for a minimum of two years. Primary endpoints included American Orthopaedic Foot & Ankle Society (AOFAS) score, ROM, visual analog scale for pain, scar length, and subjective foot value. Three patients in each group experienced moderate stiffness. MICA patients experienced a 10-degree extension increase, while scarf patients had no change. AOFAS score, pain, and subjective foot value improved at similar rates in both groups. MICA patients had a 3 mm-increased shortening of the first metatarsal. MICA patients had smaller scars than scarf patients (1.2 cm versus 5 cm). Delayed healing occurred in 10 percent of scarf patients, and 4 percent of MICA patients had wound infections. MICA patients had higher reoperation rates (27 percent, primarily for protruding screws) than scarf patients (8 percent, primarily for stiffness). In the MICA cohort, 14 percent of patients were intraoperatively converted to open surgery.

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Study Finds Similar Complications for Direct Anterior and Anterolateral Approaches in THA

A retrospective study published online in BMC Musculoskeletal Disorders found that the direct anterior approach (DAA) and anterolateral approach for total hip arthroplasty (THA) yielded comparable short-term surgical complications. Elective THA patients were stratified into two groups with 396 patients each. Both groups were similar with respect to age, sex, body mass index, American Society of Anesthesiologists score, and surgeon experience. DAA and anterolateral patients had similar amounts of blood loss, fracture, and early infection rates. The DAA group had lower rates of transfusion and overall complications but higher rates of dislocation.

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Don’t Let Going Out of Network Get Out of Control

According to a recent report from the Kaiser Family Foundation, almost 18 percent of hospital stays for large employer health plan members left patients with out-of-network (OoN) balance bills; for emergency department patients, this increased to 27 percent. Physicians are contemplating OoN strategies to relieve current practice stresses, such as dropping Medicare, Medicaid, and/or commercial insurance contracts. Physicians need to consider, however, how these potential changes could affect their practice’s revenue and reputation.

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Apply for the Practice Management/Rehabilitation Program Subcommittee Chair Position

The Practice Management/Rehabilitation Program Subcommittee has an open chair position. Over the course of a three-year term, the chair will grade symposium in May and abstracts in June or July. The chair may serve as a moderator for a paper session at the Annual Meeting. The application deadline is April 22.

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


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