November 15, 2019
Today’s Top Story

Study Assesses Value of Tool to Measure Functional Workspace in Shoulder Arthroplasty and OA Patients

A study published in the November issue of the Journal of Shoulder and Elbow Surgery observed that a low-cost motion analysis system (LCMAS) could be a valuable tool to measure functional workspace (FWS) in total shoulder arthroplasty (TSA), reverse TSA (RTSA), and shoulder osteoarthritis (OA). The LCMAS used to measure FWS in this study was the Kinect2 gaming camera; the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form and Patient-reported Outcomes Measurement Information System (PROMIS) scores were also used. Overall, 70 TSA patients, 50 OA patients, and 34 RTSA patients were included in the study; both arthroplasty groups were evaluated at six, 12, and 24 months postoperatively. At almost every measured timepoint, TSA and RTSA patients had a significantly higher FWS compared to OA patients. At 24 months, the TSA group had a significantly higher FWS compared to the RTSA group. PROMIS and ASES scores were significantly correlated with FWS in TSA and RTSA patients.

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In Other News

Study: Impact of Time to Discharge One Year After THA

One-year outcomes for total hip arthroplasty (THA) did not largely differ regardless of time to discharge, according to a study published online in The Journal of Arthroplasty. The Humana insurance database was queried using the PearlDiver Patient Records Database from 2007 to 2017. THA patients were stratified into three groups: discharge within a day (hospital length of stay [LOS] < 24 hours, n = 754), rapid discharge (hospital LOS one to two days, n = 13,670), and traditional discharge (hospital LOS three to four days, n = 25,614). One-year outcomes included all-cause revision surgery, periprosthetic joint infection (PJI), prosthetic loosening, prosthetic dislocation, and periprosthetic fracture. Multivariate analysis yielded no significant differences among the three groups. Compared to traditional discharge, the rapid discharge group had a lower risk of PJI and readmission.

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Study: Rate of Remote PROMIS Questionnaire Completion Ahead of Clinic Visits

A study published in the October issue of the Journal of the AAOS Global Research & Reviews measured remote completion rates of PROMIS questionnaires prior to clinic visits. Patients received PROMIS forms via email. Among 740 appointments included in the study, 67 percent included a completed previsit form. Completion rates were high across visit types, with the highest rate among new visits (74 percent), followed by return (67 percent) and postoperative (64 percent) visits. The completion rate was higher among women (71 percent) than men (64 percent) White patients had the highest completion rate (71 percent) compared to other racial groups, as did patients in the third median household income quartile ($53,725 to $83,088) (72 percent) compared to other household income groups.

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Study: Which Procedures Are Safest to Treat Lumbar Disk Herniation?

A study published in the November issue of the European Spine Journal assessed complication rates associated with different treatment techniques for lumbar disk herniation. A meta-analysis of three databases was conducted to identify randomized, controlled trials (RCTs) evaluating complications associated with diskectomy/microdiskectomy, percutaneous laser disk decompression (PLDD), percutaneous endoscopic lumbar diskectomy (PELD), microendoscopic diskectomy (MED), and tubular diskectomy. The surface under cumulative ranking curve (SUCRA) was used to determine each technique’s rank based on its complication rates. Final analysis included 18 RCTs with 2,273 total patients. None of the pairwise comparisons yielded significant differences. PELD (SUCRA = 0.856) ranked the lowest for overall and postoperative complication rates; diskectomy/microdiscectomy (SUCRA = 0.599) ranked the lowest for intraoperative complication rates. Per the modified Clavien–Dindo classification scheme, PELD (SUCRA = 0.803) ranked the lowest for the occurrence of type one complications, while MED (SUCRA = 0.730) and PLDD (SUCRA = 0.605) ranked the lowest for type two and three complications, respectively. Tubular diskectomy (SUCRA = 0.699) ranked the lowest for rates of reoperation.

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CMS Announces Two New Rules to Increase Transparency

Today, the Centers for Medicare & Medicaid Services (CMS) unveiled two rules. The Calendar Year 2020 Outpatient Prospective Payment System & Ambulatory Surgical Center Price Transparency Requirements for Hospitals to Make Standard Charges Public Final Rule requires that health systems publicize their standard fees online. The Transparency in Coverage Proposed Rule would require all health plans to share their negotiated rates on a public website. These long-awaited changes target transparency in order to increase competition and reduce healthcare costs.

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AAOE Survey Supplements OPUS with Financial Benchmarking Data

This article is the final installment of a four-part series that discusses results from the 2018 AAOS Census Survey and examines orthopaedic financial data in the United States. This article discusses the results from the 20th American Alliance of Orthopaedic Executives (AAOE) Benchmarking Survey for orthopaedic practices. Highlights include changes in physician compensation, work relative value units per physician, overhead expenses, and more.

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Read part three…


Hundreds of Surgical Techniques Modules Available Free to AAOS Members

Build your surgical and clinical decision-making skills with unique educational experiences available on the AAOS online learning platform. Explore the surgical instruction interactive learning modules that assess your knowledge, patient management, and clinical decision making. Available free to AAOS members, these microlearning experiences provide quick and exciting lessons for hundreds of procedural techniques. Topics include advanced reconstruction, foot and ankle, hand and wrist, shoulder and elbow, hip and knee, spine, and sports medicine.

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