Today’s Top Story

Study: Should All Meniscal Tear Patients Undergo Operative Treatment?

According to a systematic review and meta-analysis published online in the British Journal of Sports Medicine, arthroscopic partial meniscectomy (APM) may not be the best option for all patients with knee pain and meniscal tear. Researchers queried MEDLINE, Embase, CENTRAL, Scopus, Web of Science, Clinicaltrials.gov, and ISRCTN for randomized, controlled trials (RCTs) comprising patients with meniscal tears that compared APM to nonsurgical intervention, pharmacological intervention, surgical intervention, and no intervention. A total of 10 RCTs were included, but the findings were limited by a small sample size, small number of trials, and crossover of participants to APM from comparator interventions. At six to 12 months, APM patients had a slight improvement in knee pain, knee-specific quality of life, and knee function compared to physiotherapy patients. When excluding osteoarthritis (OA) patients, the aforementioned outcomes exhibited small to moderate improvement. Knee pain, function, and quality of life did not improve for APM patients compared to placebo surgery patients at six to 12 months regardless of OA status.

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Other News

Study Evaluates Metacarpophalangeal Arthroplasty Outcomes

A study published in the March 15 issue of the Journal of the AAOS assessed survival and complication rates associated with metacarpophalangeal (MCP) arthroplasty. The researchers reviewed 128 revision MCP arthroplasties in 64 patients (mean age at surgery, 62 years); 50 nonconstrained (31 pyrocarbon, 19 surface-replacing arthroplasty) and 78 constrained silicone implants were used. At a median six years of follow-up, 16 percent of implants required another revision surgery. Five- and 10-year survival rates were 81 percent and 79 percent, respectively, and 13 percent of MCP joints had postoperative dislocation. When comparing surface-replacing arthroplasties to pyrocarbon and silicone implants, the five-year survival rates were 67 percent and 83 percent, respectively.

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Study: Impact of Certificate-of-need Laws on THA

State certificate-of-need (CON) laws may not impact total hip arthroplasty (THA) incidence growth or improved quality of care or outcomes, according to a study published in the March issue of The Journal of Arthroplasty. CON programs require governmental approval to open or expand healthcare services, with the goal of limiting cost and coordinating utilization of healthcare resources. Researchers used the 100 percent Medicare Standard Analytic Files from 2005 to 2014 to compare THA procedure volumes, charges, reimbursements, and distribution of procedures based on facility volumes. Overall and during each time period evaluated, per capita THA incidence was higher in non-CON states than CON states; however, the rate of change in THA incidence during the study was higher in CON states, although this was not statistically significant. CON states had longer lengths of stay and higher rates of patients receiving care in high-volume hospitals. Postoperative complication rates did not significantly differ between CON and non-CON states.

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Study: What Causes Low Back Pain in Female High School Students?

A prospective, cross-sectional study published in the March 15 issue of Spine identified risk factors for low back pain in adolescent females. Researchers considered age, body mass index, weight, mode of backpack use, history of low back pain among first-degree family members, and passive smoking status, as well as the patient’s history of low back pain. They also assessed joint hypermobility, anthropometric measurements, spinal flexion, and hip joint range of motion. Mean age among the 372 high school students was 15.8 years. Lifetime, more than three months, and last month history of low back pain was 46.2 percent, 11.6 percent, and 31.2 percent, respectively. Students whose first-degree relatives had a history of low back pain were more likely to also experience it. Passive smoking was associated with one-month history of low back pain. Joint hypermobility was associated with lifetime and one-month low back pain.

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Executives Believe Shared-risk Value-based Health Care Is Still Years Away

According to a survey conducted by the HealthCare Executive Group and Change Healthcare, 90 percent of medical leaders believe shared-risk value-based health care is still at least one year away. More than a third of respondents (39.8 percent) said it will take three to five years, and just over a quarter (26.7 percent) believe it will take one to two years. Less than 10 percent of respondents said changes will be implemented in less than a year. According to the survey, barriers to shared-risk value-based health care include limited data sharing, a lack of consensus on outcome measures, and no incentives for payer-provider collaboration.

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AAOS Now

Natural Language Processing Provides Foundation for AI in Medical Diagnoses

In the third installment of an ongoing series about artificial intelligence (AI), AAOS Now provides an overview of several approaches to the use of language in understanding medical conditions, charting, conducting research, and making diagnoses. The article also discusses natural language processing tools, including stemming, rare token analysis, edit distance, and mathematical word representation vectors, as they apply to orthopaedics.

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Your AAOS

New OrthoInfo Basics Printable PDFs Now Available

Meet the learning needs of all your patients with OrthoInfo Basics. These printable PDF handouts address some of the most common musculoskeletal conditions and treatments in plain, straightforward language written to maximize reading comprehension. Now available as a benefit of AAOS membership, the handouts can be printed, as well as easily customized with your practice logo and contact information.

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