November 11, 2019
 
Today’s Top Story

Study: How Do Carpal Tunnel Syndrome Patients Prefer to Make Decisions?

A study published in the November issue of The Journal of Hand Surgery evaluated carpal tunnel syndrome (CTS) patient preferences on shared decision making (SDM) during different times of CTS treatment. Three hypotheses were investigated: (1) there is no correlation between younger age and a preference for greater involvement in decisions; (2) there is no independent association between demographic and socioeconomic factors and preferences for decision-making (stratified by preoperative, operative, postoperative, and the full SDM scale) and the Control Preference Scale; and (3) there is no correlation between the SDM scale and Control Preference Scale. A total of 113 new and postoperative CTS patients were asked to take part in the study and complete the SDM scale and Control Preference Scale. Per the full SDM scale and all subsets, patients preferred sharing treatment decisions with the surgeon, with a moderate tendency toward desiring the surgeon to be more involved in making decisions. Multivariable analysis observed an independent association between having commercial insurance (versus Medicare) and preferring less surgeon involvement in decision-making.

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In Other News

Study Assesses Impact of TXA on PJI Risk in TJA

A study published online in The Journal of Arthroplasty observed a reduced risk of periprosthetic joint infection (PJI) in total joint arthroplasty (TJA) cases that used tranexamic acid (TXA). Researchers queried an institutional database to identify 6,340 primary TJA patients with at least one year of follow-up. Patients were stratified into groups based on whether they did (n = 3,683, 581 percent) or did not (n = 2,657, 41.9 percent) receive intravenous TXA. In the total cohort, 16 percent of patients had preoperative anemia, 1.8 percent required postoperative blood transfusion, and 2.4 percent sustained PJI. In bivariate analysis, patients in the TXA cohort were significantly less likely to sustain PJI. When adjusting for confounders, TXA was correlated with reduced PJI risk following primary TJA.

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Study: Predictors of Poor Outcomes in Reversed L-shaped Osteotomy for Hallux Valgus Deformity

According to a study published online in BMC Musculoskeletal Disorders, obesity was not associated with poor outcomes after reversed L-shaped osteotomy (ReveL) to treat hallux valgus deformity; however, male sex may be a risk factor for unfavorable outcomes Adult patients treated with ReveL for hallux valgus deformity at a single institution were retrospectively evaluated. The primary and secondary exposures were body mass index (BMI) at the time of surgery and sex, respectively; the main outcome measure was radiological relapse of hallux valgus deformity (hallux valgus angle > 15 degrees) at final follow-up. Other outcomes included patient improvable satisfaction, complication, revision surgery, and optional hardware removal. The median BMI was 24 kg/m 2. Upon logistic regression analysis, no relationship was observed between relapse and BMI, independent of age, sex, additional technique, and preoperative hallux valgus angle. Male patients were 91 percent more likely to relapse, 79 percent more likely to have improvable satisfaction, and 47 percent less likely to have hardware removal.

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Study Evaluates Outcomes for Posterior-only Spinal Fusion to Treat Thoracic and Thoracolumbar Kyphosis

A retrospective cohort study published in the November issue of the European Spine Journal reported five-year outcomes on patients with thoracic and thoracolumbar kyphosis (TK/TLK) who underwent posterior-only spinal fusion. Between 1999 and 2009, 43 patients (average age, 33 years) diagnosed with TK/TLK with more than five years of follow-up after posterior-only spinal fusion were treated. Full-length standing radiographs were used to report preoperative, postoperative, and final measurements. Average follow-up was 5.6 years. The most prevalent diagnosis was Scheuermann’s disease, identified in 15 patients (35 percent); other diagnoses included idiopathic (n = 10, 23 percent), pseudarthrosis (n = 6, 14 percent), iatrogenic (n = 4, 9 percent), degenerative (n = 3, 7 percent), post-traumatic (n = 3, 7 percent), and congenital kyphosis (n = 2, 5 percent). Posterior-only surgery yielded an average 44.3-degree correction. At final follow-up, the average loss of correction in the instrumented segments was 1 degree. Overall, 11 patients sustained a complication, the most common of which was proximal junctional kyphosis (n = 3, 7 percent). One patient each lost intraoperative monitoring and had postoperative temporary neurological deterioration but no permanent deficit. There were no pseudarthroses. Oswestry Disability Index score improved an average of 17.2 points.

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HIPAA Violation Costs University of Rochester Medical Center $3 Million after Unencrypted Data Leaked

The University of Rochester Medical Center will be required to pay $3 million to the Department of Health and Human Services Office for Civil Rights. The health system violated the Health Insurance Portability and Accountability Act (HIPAA) when it failed to encrypt health information on a lost flash drive and stolen laptop.

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AAOS Now

Subspecialty Certification: What Does It Mean?

Have you completed an Accreditation Council for Graduate Medical Education-accredited one-year fellowship in Orthopaedic Sports Medicine or Surgery of the Hand? If so, you may be eligible to apply for American Board of Orthopaedic Surgery (ABOS) Subspecialty Certification. Approximately 2,500 orthopaedic surgeons hold an ABOS Subspecialty Certificate in Orthopaedic Sports Medicine. Another 1,900 have a Surgery of the Hand Subspecialty Certificate. There are even 37 ABOS Diplomates who have both Subspecialty Certificates. With approximately 29,000 total ABOS Diplomates, only a small percentage can claim Subspecialty Certification. Subspecialty Certification improves education and highlights the bodies of knowledge unique to the practices of Orthopaedic Sports Medicine and Surgery of the Hand.

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Your AAOS

Honor a Veteran Through AAOS-ACP’s Veteran Mentorship Program

In honor of Veterans Day, AAOS is encouraging members to participate in a veteran mentorship program through American Corporate Partners (ACP). The national nonprofit organization has supported more than 15,000 post-9/11 veterans transitioning into the private sector. Through one-on-one counseling, AAOS mentors have a unique opportunity to provide veterans—in particular, those interested in health care or business—with important tools and knowledge for long-term career development. It’s also a chance to help them create a better life post-service through the gift of your time. The AAOS member-exclusive program is a one-year commitment with mentorship discussions once a month.

Sign up to mentor a veteran…(use access code: AAOSACP)

 

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