October 30, 2019
Today’s Top Story

Study Compares Supplements versus Placebo in Fracture Prevention

Vitamin D and calcium supplements may not be effective in fracture prevention, according to a systematic review and network meta-analysis published in the October issue of BMJ Open. PubMed, Cochrane library, and Embase databases were queried for relevant randomized, controlled trials (RCTs) published through Dec 31, 2017. The primary outcome measure was total fracture; secondary outcome measures were hip and vertebral fracture. Final analysis included 25 RCTs with 43,510 total patients. Different concentrations of vitamin D, calcium, or a combination of the two were not associated with a greater reduction in fracture risk compared to placebo or no treatment. There were no correlations between incident hip or vertebral fractures and supplement intake.

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In Other News

Study: Do Perioperative Disposable Jackets Prevent SSIs?

The use of perioperative disposable jackets was not associated with reduced risk for surgical site infections (SSIs), according to a retrospective review of clean surgical procedures published online in JAMA Surgery. SSI data from 12 hospitals in a large, multicenter healthcare organization spanning Jan. 1, 2014, through July 31, 2018, were analyzed for SSI incidence. Patients were stratified into preintervention (n = 29,098) and postintervention (n = 30,911) groups. The preintervention group consisted of patients treated before the mandatory disposable jackets policy was implemented, and the postintervention group consisted of patients treated after the policy was put in place. The mean age across the entire study group was 62.8 years. SSI rate for clean wounds did not largely differ before (0.87 percent) and after (0.83 percent) the policy was implemented. The cost of the 2,010,040 jackets purchased during the postintervention period was $1,709,898.46.

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Study Identifies Predictors of Satisfaction in Reverse Shoulder Arthroplasty

A study published online in the Journal of Shoulder and Elbow Surgery examined which reverse shoulder arthroplasty patients were most likely to be satisfied and unsatisfied after surgery. Researchers examined two-year satisfaction outcomes in pain, work, activities, quality of life, and overall satisfaction. The American Shoulder and Elbow Surgeons (ASES) shoulder; Shoulder Activity Scale (SAS); Short Form 12 (SF-12) mental and physical component summary; and visual analog scale (VAS) pain, fatigue, and general health scores were recorded pre- and postoperatively. Two-year evaluation included 161 patients, who reported being “very satisfied” in an average of 3.3 of the five domains. Indicators of higher satisfaction included improvements in ASES, SAS, VAS pain, and SF-12 physical component summary scores. Higher preoperative ASES score, as well as worse VAS fatigue and SF-12 mental and physical component summary scores, were predictive of lower postoperative satisfaction.

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Study: Calcaneal Avulsion Fractures Outcomes

A study published in the November issue of the Journal of Orthopaedic Trauma characterized the presentation and outcomes of calcaneal avulsion fractures. Researchers gathered data on fracture instances that included soft tissue compromise at presentation, evidence of implant failure or fracture displacement after fixation, and reoperation. Of 47 fracture cases included, 41 patients underwent surgery, and six were managed nonoperatively. In total, 21 patients (44.7 percent) presented either soft tissue compromise or an open fracture requiring urgent treatment. Of the 39 patients treated operatively with three-month follow-up, 11 (28.2 percent) presented evidence of implant failure or fracture displacement The only reliable predictor of catastrophic fixation failure was age. Failure rate was not largely influenced by the use of washer(s), suture anchor(s), addition of soft-tissue procedures, or the number or size of screws used. Secondary surgeries were performed in 14 patients (35.9 percent).

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CMS Puts Alternate Payment Model on Hold, Calls for Providers to Apply

The Centers for Medicare & Medicaid Services (CMS) pushed back the implementation of a new alternate payment model but is recommending that providers submit applications now. The Primary Care First model options and Kidney Care Choices model are designed to pay Medicare providers based on the value of their care and incentivize providers to improve how they manage chronic disease, thereby cutting costs and improving patient satisfaction.

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AAOS Core Values: Will We Take Them Seriously?

Do you know the Academy’s new core values? Did you know the previous core values? Regardless of the actual words or phrases, do you have a sense of the organizational culture? Are we where we want or need to be? In this editorial, AAOS President Kristy L. Weber, MD, FAAOS, discusses AAOS’ updated core values: leading to serve, shaping our future, excellence together.

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New AAOS Courses OnDemand: Learn Like You Were There

Grab your front-row virtual seat at recorded AAOS courses with on demand video programs that bring the finished events to you. Self-directed programs offer the flexibility to engage with trusted AAOS content at your convenience, across your devices. Watch and listen to the experts and their presentation slides, patient case discussions, and surgical demonstration videos. Content is segmented by topic, so you can select lectures you prefer to watch, pick up where you left off, and earn continuing medical education credit at your own pace. Explore the growing collection today.

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