September 18, 2019
Today’s Top Story

Study: What Leads to Readmission after Revision TJA?

A retrospective study published online in The Journal of Arthroplasty identified factors associated with readmission after revision total joint arthroplasty (TJA). Between 2009 and 2016, 1,503 cases of aseptic revision TJA were identified at a single urban tertiary care hospital. There were 87 (5.8 percent) cases of readmission within 90 days of the index surgery date. The primary reasons for readmission were infection (38 percent), wound complications (22 percent), and dislocation/instability of the prosthetic joint (13 percent). The only factor predictive of readmission was preoperative anemia. Postoperative venous thromboembolism prophylaxis with aspirin and discharge to an inpatient rehabilitation facility were associated with a significantly reduced risk for readmission.

Read the abstract…

In Other News

Study Examines Relationship Between HRQoL Scores and PROMs in TSA Patients

When analyzing the cost-effectiveness and value of total shoulder arthroplasty (TSA), health-related quality of life (HRQoL) scores and patient-reported outcome measures (PROMs) may both be important and should be considered separately, according to a study published in the Sept. 4 issue of The Journal of Bone & Joint Surgery. Of 145 patients (145 shoulders) who underwent TSA for glenohumeral osteoarthritis, 93 had one year of follow-up. The Disabilities of the Arm, Shoulder and Hand score; the American Shoulder and Elbow Surgeons score; the Simple Shoulder Test (SST); and a visual analog scale (VAS) for shoulder pain and function were used to measure functional outcomes. The EuroQol-5 Dimensions (EQ-5D), Short Form-6 Dimensions (SF-6D), and VAS quality of life (VAS QoL) were used to measure health utility. One year postoperatively, all PROMs and HRQoL scores were significantly improved. A weak to moderate correlation was observed between changes in VAS QoL and EQ-5D and all changes in PROMs except SST. The VAS QoL and EQ-5D both had large effect sizes (1.833 and 1.163, respectively) and standardized response means (1.603 and 1.228, respectively). All PROMs had larger effect sizes than HRQoL scores. The effect size and standardized response mean of change in SF-6D were both moderate and not significantly associated with changes in any PROMs.

Read the abstract…

Study Compares Outcomes with Different Grafts in ACL Reconstruction

A study published online in Arthroscopy compared PROs and revision risk in anterior cruciate ligament (ACL) reconstruction with the use of semitendinosus (ST), semitendinosus-gracilis (ST-G), and patellar tendon (PT) autografts. Patients aged > 15 years undergoing primary ACL reconstruction were evaluated and stratified into three groups based on autograft choice. The primary outcomes were ACL revision and one- and two-year Knee injury and Osteoarthritis Outcome Score (KOOS), which included the KOOS patient acceptable symptom state (PASS). Final analysis included 622 patients (mean age, 29.7 years; 42.4 percent were female). Revision risk did not significantly differ between the ST group or PT group compared to the ST-G group. The mean two-year KOOS sports and recreation was greatest in the ST group (68.5), followed by the ST-G group (57.4) and PT group (54.1). The ST group also had the highest rate of achieving PASS in sports and recreation (55.3 percent), followed by the ST-G group (37.4 percent) and PT group (33.9 percent).

Read the abstract…

Study: Fewer Training Sessions Before First Soccer Match after Injury May Increase Risk of Re-injury

Injury rates during the first soccer match after injury may be higher than the average injury rate, according to a prospective cohort study published online in the British Journal of Sports Medicine. Researchers evaluated 4,805 first match appearances after at least an eight-day absence following moderate to severe injury. Compared to the average seasonal match injury rate, injury rate for injuries in general in the first match increased by 87 percent For every training session before the first match, the risk for injury dropped 7 percent. The association was similar for muscle injuries but not nonmuscle injuries.

Read the abstract…

Plaintiffs in Opioid Cases Push Back Against Attempt to Disqualify Judge

Lawyers representing cities and counties suing drug companies in relation to the opioid epidemic objected to the defense’s motion to disqualify the federal judge tasked to the cases. The drug companies sought the recusal of U.S. District Judge Dan Polster in Cleveland, claiming that past statements from the judge would prevent him from being impartial. The prosecution argued that the request came in too late to be considered. Judge Polster is set to preside over close to 2,100 cases.

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Action Is Needed for the Right Solution to Surprise Billing

An article published in the August issue of JAMA Internal Medicine confirmed what many suspected: There has been a recent uptick in both the number of surprise bills patients face after emergency department admissions and the average potential financial responsibility of such bills for patients. Every stakeholder agrees that this problem must be solved and that patients should not be held responsible for surprise bills, but Congress has spent the past year grappling with the other side of the equation—who is ultimately responsible for unexpected bills, and how much money should an out-of-network physician be paid?

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Apply for Volunteer Opportunities

Consider applying for the following positions:

  • Resident Bowl Question Workshop member position—applications are accepted until Sept. 27
  • American Joint Replacement Registry Steering Committee member-at-large position—applications are accepted until Oct. 11
  • Basic Science Content Committee chair designee position—applications are accepted until Oct. 15
  • Basic Science Content Committee member position—applications are accepted until Oct. 15
  • Musculoskeletal Oncology Content Committee chair designee position—applications are accepted until Oct. 15
  • Research Development Committee member-at-large position—applications are accepted until Oct. 22
  • Practice Management/Rehabilitation Program Committee chair position—applications are accepted until Nov. 1

Learn more and submit applications…(member login required)


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