Today’s Top Story

Study: Risk Factors for Clostridium difficile-associated Diarrhea after Revision TKA

A study published online in The Journal of Arthroplasty assessed the incidence of and perioperative risk factors for Clostridium difficile-associated diarrhea (CDAD) following revision total knee arthroplasty (rTKA). A total of 6,023 rTKAs performed between 2015 and 2016 were identified using the American College of Surgeons (ACS) National Surgical Quality Improvement Program. CDAD incidence within 30 days of rTKA was 0.4 percent; the rate of CDAD after aseptic revision was 0.2 percent and the rate after septic revision was 1.1 percent. The following risk factors were significantly correlated with CDAD after rTKA: preoperative functional dependence, septic revision, and cancer.

Read the abstract…

 
 
 
 
In Other News

Study Compares THA Outcomes Based on Insurance Status

Patients with government-sponsored insurance or no insurance may have a greater risk of complications following total hip arthroplasty (THA), according to a study published in the July 1 issue of the Journal of the AAOS. Data were gathered from the Nationwide Inpatient Sample on all primary elective THA patients from 1998 to 2011. Final analysis included about 515,037 patients; more than half (53.7 percent) had Medicare, 40.1 percent had private insurance, 3.9 percent had Medicaid or were uninsured, and 2.2 percent were classified as “other.” Patients with private insurance were less likely to sustain complications than those with Medicare. There were no significant differences in complications between Medicare patients and those with Medicaid or no insurance. Patients with private insurance also had lower mortality rates and were more likely to undergo THA at a higher volume hospital compared to Medicare patients.

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Study: Hypoalbuminemia Predicts Complications in Lower-extremity Fracture Patients

According to a study published in the June issue of the Journal of Orthopaedic Trauma, hypoalbuminemia may be a reliable predictor of postoperative complications and mortality in lower-extremity orthopaedic trauma patients. Of 5,673 patients aged < 65 years from the ACS National Surgical Quality Improvement Program database, 29.6 percent had hypoalbuminemia. Compared to those without hypoalbuminemia, patients with hypoalbuminemia had higher rates of postoperative complications (2.6 percent versus 9.3 percent), mortality (0.4 percent versus 3.2 percent), sepsis (05 percent versus 1.5 percent), and reintubation (0.4 percent versus 2.3 percent). Hypoalbuminemic patients also had higher rates of reoperation (2.6 percent versus 5.5 percent) and readmission (4.1 percent versus 11 percent)

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Study: Arthroscopic Rotator Cuff Repair Revision Risk Higher Among Osteoporosis Patients

Patients with osteoporosis who undergo arthroscopic rotator cuff repair may be more likely to require revision surgery, according to a study published online in Arthroscopy. Patients were stratified into three groups: those with osteoporosis who used bisphosphonates (study group, n = 451), those with osteoporosis with no bisphosphonate use (no-bisphosphonate control group, n = 902), and those without osteoporosis (nonosteoporosis control group, n = 1,353). The study group and no-bisphosphonate control group both had higher rates of revision compared to the nonosteoporosis control group. Revision rates did not largely differ between the study group and no-bisphosphonate control group.

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Financial Impact of the Community Health Center Fund

According to a report from the Government Accountability Office, the Community Health Center Fund (CHCF) provided health centers an estimated $15.8 billion in the form of federal grants from fiscal years 2011 through 2017. Nearly 80 percent of this revenue was allocated to maintenance of existing operations. CHCF grants help bridge the gap between what it costs a health center to operate and how much revenue it generates.

Read the report…

 
 
 
AAOS Now

Nurse Leadership at University of Maryland Shore Regional Health Drives PRO Program Efforts

The University of Maryland Shore Regional Health (UMSRH), part of the University of Maryland Medical System, recently shared its patient-reported outcomes (PROs) journey at the National Association of Orthopaedic Nurses 39th Annual Congress, which took place May 18–21 in Atlanta. The UMSRH story demonstrates how physician and nurse leadership can successfully collaborate to implement a PRO program both locally and in conjunction with a national arthroplasty registry.

Read more…

 
 
 
Your AAOS

Apply for the Committee on Evidence-based Quality and Value Open Positions

The Committee on Evidence-based Quality and Value (EBQV) has three open positions: EBQV chair, EBQV clinical practice guideline (CPG) section leader, and EBQV resident member. These three positions are all two-year terms that run from March 30, 2020, through March 25, 2022. Committee members plan, organize, direct, and evaluate evidence-based initiatives, including CPGs, appropriate use criteria, systematic reviews, and performance measures, as well as oversee related education, dissemination, validation, and implementation activities. Applicants should have experience with evidence-based practice principles. The application deadline is Aug. 8.

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

 

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