November 13, 2019
Today’s Top Story

Study Measures Impact of Kidney Disease on Hemiarthroplasty Outcomes

Patients with predialysis chronic kidney disease (CKD) or end-stage renal disease (ESRD) had poorer outcomes than patients without kidney disease after hemiarthroplasty to treat femoral neck fracture, according to a study published in the November issue of the Journal of Orthopaedic Trauma. This retrospective review included data from the Nationwide Readmissions Database. Between 2010 and 2014, 214,399 patients underwent hemiarthroplasty after femoral neck fracture; patients were stratified into three groups: no kidney disease (n = 176,300, 82 percent), predialysis CKD (n = 34,400, 16 percent), and ESRD (n = 3,698, 2 percent). Compared to those without kidney disease, both predialysis CKD and ESRD patients had higher risks of mortality, blood transfusion, and postoperative complications during the index hospitalization, as well as a greater likelihood for 90-day hospital readmission.

Read the abstract…

In Other News

Study: Does Low-level Laser Therapy Affect Knee OA?

A study published online in BMJ Open analyzed the effect of low-level laser therapy (LLLT) on osteoarthritis (OA) of the knee in terms of pain and disability outcomes. Researchers conducted a systematic review and meta-analysis of randomized, controlled trials (RCTs) from PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, and Cochrane Central Register of Controlled Trials; reference lists; a book; citations; and field experts. Eligible RCTs were placebo-controlled and included knee OA patients who met the American College of Rheumatology and/or Kellgren/Lawrence criteria. A total of 22 trials comprising 1,063 patients were included. LLLT was significantly associated with reduced pain compared to placebo at the end of therapy (visual analog scale [VAS] score 14.23 mm) and at follow-up between one and 12 weeks later (VAS score 15.92 mm). Subgroup analyses also found significant pain reductions associated with the recommended LLLT doses compared to placebo at the end of therapy (VAS score 18.71 mm) and during follow-up between two and 12 weeks after the end of therapy (VAS score 23.23 mm). LLLT significantly reduced disability. No adverse events were observed.

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Study Determines Availability of Spanish Language Proficiency and Resources in Pediatric Orthopaedic Centers

Despite the growing population of Spanish-speaking patients, there are limited professionals in pediatric orthopaedic centers who are proficient in Spanish, according to a study published online in the Journal of Pediatric Orthopaedics. Researchers referred to websites for U.S. medical centers with orthopaedic surgery fellowships recognized by the Pediatric Orthopaedic Society of North America for a health library and interpreter services availability. Attending surgeon profiles were assessed for educational qualifications and evidence of Spanish proficiency. Availability of Spanish proficiency resources was confirmed via telephone calls. Final analysis included 46 centers with 44 fellowship programs. Of 334 surgeon profiles evaluated, 12 (3.6 percent) indicated Spanish proficiency After phone calls, 17 Spanish-proficient physicians (5.1 percent) were identified. While 38 pediatric orthopaedic centers (82.6 percent) indicated online that they had interpreter services available, the type of availability varied from around-the-clock live interpreters to interpreter phones. Nearly all (n = 45, 97.8 percent) of the centers contacted by phone said they offer interpreter service in inpatient and outpatient settings; 16 (34.8 percent) provided orthopaedic condition or surgical care information translated into Spanish online. Automated Spanish phone messages or live operators who spoke Spanish were unavailable at 20 centers (43.5 percent).

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Study: Do Prereferral Advanced Diagnostic Tests Affect Wait Times for Hand Surgeons?

According to a study published online in The Journal of Hand Surgery, prereferral advanced diagnostic testing may be associated with longer wait times to see a hand surgeon for common hand conditions. Data for a single academic tertiary care center from 2006 to 2015 were assessed to identify adult patients referred to a hand surgeon for carpal tunnel syndrome (CTS), soft tissue masses (STM), and joint pain (JP). Patient characteristics, use and timing of diagnostic tests, and wait time for the initial hand surgeon evaluation were all recorded. Among patients who underwent advanced diagnostic tests prior to surgeon evaluation, CTS patients were the most likely to receive prereferral advanced testing (53.4 percent), followed by JP (10.6 percent) and STM patients (5.8 percent). CTS patients were the most likely to undergo repeat testing (19.5 percent), followed by JP (1.4 percent); no STM patients received repeat testing. Regardless of the condition, patients with prereferral advanced testing had to wait an additional 19 to 94 days to see a surgeon compared to those who only received post-referral testing or no testing.

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Google Health Data Deal ‘Project Nightingale’ Under Federal Investigation

A deal between Google and Ascension, code-named “Project Nightingale,” will provide the tech giant with medical data on millions of patients that includes diagnoses, lab results, and hospitalization records, according to a report from The Wall Street Journal (WSJ). The deal is now the subject of a federal investigation to be led by the Department of Health and Human Services Office of Civil Rights.

Read the WSJ report…(login may be required)

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November AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the November 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 highlights include ballistic trauma basics for orthopaedic surgeons, the impact of medical student debt on specialty choice, the use of social media to increase awareness of surprise medical billing, and more.

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