Today’s Top Story

Study Compares Rotator Cuff Repair Outcomes Based on Brace Type

According to a study published online in Arthroscopy, pain and clinical outcomes may not significantly differ among arthroscopic rotator cuff repair patients immobilized by an abduction brace compared to an antirotation brace. The study included 120 patients with symptomatic degenerative complete tear of the supraspinatus or infraspinatus tendons. The Constant-Murley score (CMS) was measured preoperatively, at three and six months, and at one year postoperatively. Visual analog scale (VAS) scores were obtained on the day of surgery and postoperatively at one, three, and six weeks and three months. One-year postoperative isokinetic muscle strength was evaluated for the shoulder external rotator. Mean VAS score on the day of surgery was 75.6 for the abduction brace cohort and 74.9 for the antirotation sling group; three months postoperatively, mean VAS scores were 17.7 and 18.5, respectively. Preoperatively, the mean CMS level was 40.9 for the abduction brace group and 41.2 for the antirotation sling group; one year postoperatively, mean CMS levels were 84.7 and 84.5, respectively. Isokinetic muscle strength did not significantly differ between the groups.

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Study Determines LOS Predictors Among Older Hip Fracture Patients

In a retrospective analysis published in the March 15 issue of the Journal of the AAOS, researchers developed a predictive model of length of stay (LOS) for geriatric hip fracture patients. The researchers considered patient- and system-specific variables using a multivariate linear regression analysis. Average LOS was 5.95 days, and reduced LOS was associated with avoidance of delirium and reduced time to surgery. American Society of Anesthesiologists score was a reliable predictor of LOS, while Charlson Comorbidity Index was not. The model was accurate for 63 percent of patients tested, and among those for whom it did not work well, 80 percent had postoperative complications.

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Study: Posterior Débridement, Decompression, and Transpedicular Screw Fixation in T12-L1 Tuberculosis Patients

A retrospective, multicenter study published online in BMC Musculoskeletal Disorders found that single-stage posterior débridement, decompression, and transpedicular screw fixation is safe and effective in treating thoracolumbar junction (T12-L1) tuberculosis patients with neurological deficit. Between January 2005 and January 2015, 69 patients underwent treatment. All patients received antituberculosis therapy before and after surgery. Measured outcomes included patient blood loss and change in VAS pain score, kyphotic angle, Oswestry disability index (ODI) score, and American Spinal Injury Association (ASIA) grade preoperatively, immediate postoperatively, and at final follow-up. The average blood loss was 354 mL. The average kyphosis angle improved from 21 degrees preoperatively to 9 degrees postoperatively. Mean VAS pain and ODI scores decreased by 3.4 and 16, respectively. Postoperative ASIA grades were grade A for five patients, grade C for 15 patients, and grade D for 49 patients. At final follow-up, these grades improved to grade C for four patients, grade D for three patients, and grade E for 62 patients. No patients experienced worsening neurological deficit.

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Study Compares Payments and Readmission Rates for Medicare Beneficiaries Discharged to Home Versus Facility

According to a retrospective cohort study published online in JAMA Internal Medicine, Medicare beneficiaries face lower bills but greater risk for readmission if they are discharged to home health care compared to a skilled nursing facility. Between Jan. 1, 2010, and Dec. 31, 2016, 17,235,854 hospitalized patients (62.2 percent female) were discharged to home health care (38.8 percent) or a skilled nursing facility (612 percent). The discharge-to-home cohort had a 5.6-percentage point higher 30-day readmission rate compared to the skilled nursing facility group. Postacute Medicare payment and total Medicare payment within the first 60 days following admission were significantly lower among the home health care patients compared to the skilled nursing facility patients.

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ACA Exchanges on the Rise

More Americans have access to Affordable Care Act (ACA) exchanges this year compared to previous years, according to a new report from the Urban Institute. Today, 37.5 percent of Americans live in a rating region with one or two insurers compared to 33.8 percent in 2017. In 2018, 45.1 percent of Americans lived in areas with almost no marketplace insurer competition. Marketplace competition largely differs based on region: In 2019, no Northeast rating region had fewer than two marketplace insurers, and 40.7 percent of the Northeast population lives in rating regions with at least five marketplace insurers, while the South is reportedly almost the opposite.

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Do Your Cybersecurity Policies Need a Checkup?

Cybersecurity policies are critical to protect patient and other sensitive data in your network and reduce the risk of breaches, which could result in reputational harm, costly recovery, and patient disclosure activities. Michael J. Sacopulos, JD, founder and chief executive officer of the Medical Risk Institute, discusses important cybersecurity policy considerations and why orthopaedic surgeons should take them seriously.

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Apply for the Committee on Evidence-based Quality and Value Member Position

The Committee on Evidence-based Quality and Value has an open member position. During this two-year term, the committee member will plan, organize, direct, and evaluate evidence-based initiatives, including clinical practice guidelines and appropriate use criteria, systematic reviews, and performance measures. Applicants should have experience with evidence-based practice principles. The application deadline is April 6.

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


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