May 7, 2018 | Today’s News

Study: Medicare reimbursement for most common orthopaedic procedures fell from 2000 to 2016

According to a study published online in the journal Orthopedics, Medicare reimbursement for many orthopaedic procedures has decreased over time. Members of the research team reviewed Medicare Physician Fee Schedule Current Procedural Terminology code values for common orthopaedic and nonorthopaedic procedures between 2000 and 2016. After adjustment for inflation, they found that annual reimbursements decreased over the study period for all orthopaedic procedures examined except for removal of orthopaedic implant. Orthopaedic procedures with the greatest mean annual decreases in reimbursement were shoulder arthroscopy/decompression, total knee arthroplasty (TKA), and total hip arthroplasty. Orthopaedic procedures with the least annual reimbursement decreases were carpal tunnel release and repair of ankle fracture. The researchers noted that the rate of reimbursement change varied across orthopaedic specialties, with trauma receiving the smallest reductions and adult reconstruction seeing the greatest.

Read the abstract…

Study: One-quarter of TKA patients may retain knee instability one year later

A study published online in the Journal of Orthopaedic Research suggests that one-quarter of TKA patients with knee instability prior to surgery may still have knee instability after surgery. The researchers surveyed 908 patients regarding knee instability prior to TKA and at one-year follow-up. They found that 649 (71 percent) reported instability prior to TKA, and 187 (21 percent) reported knee instability one year after TKA. Among patients with preoperative knee instability, 165 (25 percent) reported instability at final follow-up. The researchers state that knee instability was associated with pain, activity limitations, and reduced quality of life both preoperatively and postoperatively.

Read the abstract…

Findings from a study published in the May/June issue of the Journal of Pediatric Orthopaedics suggest that a severity classification system that differentiates patients based on total infection burden and degree of dissemination may help identify pediatric patients at increased risk of musculoskeletal infection (MSKI). The authors developed a classification system with operational definitions for MSKI severity based on degree of dissemination and retrospectively applied the definitions to a cohort of 202 pediatric patients with MSKI from a tertiary care children’s hospital over a 5-year period. They found that patients with greater infection dissemination were more likely to have worse hospital outcomes based on length of stay (LOS), number of surgeries performed, number of positive blood cultures, duration of antibiotics, intensive care unit LOS, number of days with fever, and number of imaging studies performed. In addition, they note that peak C-reactive protein, erythrocyte sedimentation rate, white blood cell count, and temperature were higher in patients with more disseminated infection.

Read the abstract…

A survey conducted by the National Association of ACOs suggests that many Medicare Shared Savings Program (MSSP) Track 1 accountable care organizations (ACOs) may exit the program if they are required to assume risk. The organization surveyed 82 ACOs that began the MSSP in 2012 or 2013 and remain in Track 1 in 2018. They are required to move to a two-sided ACO model in their third agreement period that begins in 2019. Overall, 71.4 percent of respondents said they were likely to leave the MSSP as a result of having to assume risk, 22.9 percent said they were not at all likely to leave, and 5.7 percent said they were unsure.

Read more…

The Hill reports that, in a letter to the head of the U.S. Food and Drug Administration (FDA), three U.S. senators are urging the agency to remove from the market opioids that exceed 90 milligrams of morphine equivalent dose due to concerns regarding “accidental ingestion, borrowed medication, and recreational use.” Supporters of the proposal say that the pain needs of patients who are prescribed high doses of opioids for cancer and other conditions could be addressed with multiple pills, patches, or other formulations. Critics respond that in some cases, patient safety could be compromised due to the need for some patients to have a greater number of pills on hand to meet their needs.

Read more…

Read the letter (PDF)…

Nominate a colleague for the AAOS Diversity, Humanitarian, or Tipton Leadership Awards

Nominations are now being accepted for the 2019 Diversity and Humanitarian Awards and the William W. Tipton Jr, MD, Orthopaedic Leadership Award. These awards are presented annually at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession. The last day to submit nominations for the Humanitarian Award is May 15, 2018; the last day to submit nominations for the Diversity and Tipton Awards is June 15, 2018.

Learn more and submit nominations…

Call for volunteers: SSI AUC voting panel

AAOS seeks fellows to participate on the voting panel for the Management of Postoperative Surgical Site Infections (SSIs) appropriate use criteria (AUC). The panel will participate in two rounds of voting, during which they will rate the appropriateness of various treatments related to SSI. Voting panel members will be required to complete the AAOS conflict of interest enhanced disclosure form online and attend a one-day, in-person meeting in Rosemont, Ill. To participate on the voting panel for this AUC topic, please contact Mary DeMars by Monday, May 21, at:

demars@aaos.org