Today’s Top Story

Study Measures In-hospital Harm Associated with Low-value Care

The use of seven procedures in patients who should not receive them may result in added patient harm, increased hospital resources, and delayed care for other patients, according to a cohort study published online in JAMA Internal Medicine. Researchers assessed admission data from 225 Australian public hospitals for 9,330 total episodes, including endoscopy for dyspepsia in people younger than 55 years (3,689 episodes); knee arthroscopy for osteoarthritis or meniscal tears (3,963 episodes); colonoscopy for constipation in people younger than 50 years (665 episodes); endovascular repair of abdominal aortic aneurysm in asymptomatic, high-risk patients (508 episodes); carotid endarterectomy in asymptomatic, high-risk patients (273 episodes); renal artery angioplasty (176 episodes); and spinal fusion for uncomplicated low back pain (56 episodes). Harm associated with low-value care was measured by 16 different hospital-acquired complications (HACs) The most common HAC for the majority of procedures was healthcare–associated infection, the rate of which was highest in renal artery angioplasty patients (8.4 percent). Median length of stay (LOS) for patients with an HAC was at least twice the median LOS for patients without an HAC across all procedures.

Read the abstract…

Other News

AAOS 2019 Annual Meeting Coverage

This week, AAOS Headline News Now (HNN) will be reporting on the AAOS 2019 Annual Meeting, taking place in Las Vegas from March 12–16. Research presented at the meeting will include predictors of complications in lower extremity factors, the efficacy of intravenous acetaminophen after total hip replacement, an update on American Joint Replacement Registry data findings, and more. HNN will also present highlights from symposia, Your Academy 2019, Instructional Course Lectures, and more.

Learn more about the Annual Meeting…

Study: Does FICB Impact Pain Control in THA Patients?

In a meta-analysis published online in the International Journal of Surgery, fascia iliaca compartment block (FICB) significantly reduced pain intensity in total hip arthroplasty (THA) patients. Researchers queried PubMed, Embase, and Cochrane Library for randomized, controlled trials that included THA patients who received FICB versus placebo for pain. They included seven studies comprising 326 THA patients. Compared to placebo, FICB was significantly associated with lower visual analog scale (VAS) scores at postoperative hours one to eight and at hour 12, but VAS scores did not largely differ after 24 and 48 hours.

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Study Compares MPFLR Techniques to Treat Patellar Dislocation

A study published in the March issue of Arthroscopy found that adults with recurrent lateral patellar dislocation may have good outcomes with two medial patellofemoral ligament reconstruction (MPFLR) techniques. A total of 91 recurrent patellar dislocation patients were randomized to undergo the traditional single-bundle transpatellar tunnel technique (group A) or the double-anchor anatomic reconstruction technique (group B). Pre- and postoperative CT evaluated the congruence angle, lateral patellar angle, patellar tilt angle, and lateral patellar translation. Patients were followed for a mean 41.11 months. Four patients in group A with instability symptoms had recurrent patellar dislocations, but there were no other significant differences between the groups. CT results showed similar improvements in both groups, but group B had a lesser patellar tilt angle. Subjective and functional outcomes all significantly improved in both groups, except for International Knee Documentation Committee and Kujala scores in group B.

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Study: Time to Surgery for Lower Extremity Fracture Does Not Impact Complications

Time to surgery may not lead to increased wound complication risks in patients who undergo operation to treat lower extremity fracture, according to a study published online in Foot & Ankle International. Among 93 total lower extremity fracture patients, 75 had an ankle fracture. Researchers followed patients for three months and documented wound complications. A total of 18.3 percent of patients experienced wound complication, but there appeared to be no correlation between complication and time to surgery. An independent association was observed between wound complication and a heel-pad edema index > 1.4. In a subgroup analysis of ankle fracture patients, increased heel-pad edema index, tobacco history, and body mass index > 25 mg/kg 2 independently predicted wound complication. Patients who had none of the three aforementioned risk factors had a 3 percent change of wound complication; patients with one, two, and three of the risk factors had a 12 percent to 36 percent, 60 percent to 86 percent, and 96 percent probability of wound complication, respectively.

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March AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the March issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue includes information on the prevention and early treatment of frostbite injuries, the removal of total knee arthroplasty from the Medicare inpatient-only list, the treatment of female combat amputations, and more.

Read more…


Apply for the Adult Reconstruction Knee Instructional Course Committee Member Position

The Adult Reconstruction Knee Instructional Course Committee has an open member position. Over the course of a two-year term, the member will be responsible for reviewing and grading all existing Instructional Courses and new applications. Applicants must be active AAOS fellows who specialize in the knee. The application deadline is April 22.

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


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