September 9, 2019
 
Today’s Top Story

Study: Higher Revision, Mortality Rates in THA at Low-volume Hospitals

A study published in the September issue of The Journal of Arthroplasty found that patients who undergo total hip arthroplasty (THA) at a low-volume hospital may have higher risks for revision and mortality. Nationwide health insurance data were queried for aseptic revision THAs (rTHAs) performed between January 2014 and December 2016. Primary outcomes included 90-day mortality, one-year revision, and in-house adverse events (AEs). Final analysis included 17,773 aseptic rTHAs. Low-volume hospitals had a significantly increased risk for 90-day mortality and one-year revision, but there were no significant differences in in-house AEs based on hospital volume.

Read the abstract…

 
 
 
 
In Other News

Study: Stable versus Unstable Slipped Capital Femoral Epiphysis Treatment with Modified Dunn Procedure

A retrospective review published in the September issue of the Journal of Pediatric Orthopaedics compared acute, unstable versus chronic, stable slipped capital femoral epiphysis treatment using the modified Dunn procedure. Final analysis included 31 hips (29 patients; mean age, 12.5 years) with unstable slips and 17 hips (15 patients; mean age, 13.8 years) with stable slips. The unstable and stable groups were followed for a mean 27.9 months and 35.5 months, respectively. Average postoperative Southwick angles were 14.2 degrees and 25.3 degrees in the unstable and stable groups, respectively, and the average femoral neck lengths were 34.1 mm and 27.1 mm, respectively. Avascular necrosis presented in 6.0 percent (n = 2) of the unstable group and 29.4 percent (n = 5) of the stable group. In the unstable group, greater trochanteric height averaged 6.2 mm below the center of the femoral head and in the stable group, averaged 6.2 mm above center.

Read the abstract…

 
 
 
 
Study: Is C-clamp Stabilization for Unstable Pelvic Fractures Linked to Complications?

A study published online in Injury assessed outcomes and efficacy for the use of C-clamp or external fixation (CC/EF) in unstable pelvic fracture stabilization. Data were gathered from the German Pelvic Trauma Registry on 5,499 patients: 957 with and 4,542 without. Subgroups were also created to evaluate secondary surgery (713 versus 1,695) and ilio-sacral screw implantation following C-clamp stabilization (24 versus 219). CC/EF patients tended to be younger and had C-type fractures, displacement ≥ 3 mm, and more complex fractures—which were independent risk factors for complications. CC/EF stabilization reduced mortality by 32 percent, but the risk of complications in general was slightly elevated. CC/EF did not affect mortality, general complications, or infections in secondary surgery patients. Infection risk increased from 3.2 percent to 20.8 percent in ilio-sacral screw fixation after C-clamp stabilization.

Read the abstract…

 
 
 
Study Compares Screws in Lumbar Interbody Fusion

Cortical screws and pedicle screws may have similar outcomes in lumbar interbody fusion, with cortical screws favorable for certain outcomes, according to a systematic review and meta-analysis published online in the Journal of Orthopaedic Surgery and Research. The PubMed, Cochrane Library, Medline, Web of Science, and Embase databases were queried for comparative studies through March 18, yielding 12 studies with 835 total patients. Compared to pedicle screw fixation, cortical screw fixation was associated with superior outcomes regarding operating time, intraoperative blood loss, hospital length of stay, complications, adjacent segmental disease incidence, and Oswestry Disability Index. Visual analog scale scores for back and leg pain, Japanese Orthopaedic Association scale score, and intervertebral fusion rate did not largely differ between the two groups.

Read the study…

 
 
 
AAOS, Other Medical Organizations Urge Congress to Stop Surprise Billing Without Compromising Access to Care

Some of the nation’s largest medical organizations cosigned a letter to urge the House Education and Labor and Ways and Means Committees to be mindful of potential unintended consequences that threaten access to care as they develop legislative solutions to protect patients from surprise medical bills. AAOS, along with the American Association of Neurological Surgeons, American College of Surgeons, American Medical Association, American Society of Anesthesiologists, and more addressed key policy considerations, such as avoiding rate setting, maintaining patient choice for elective out-of-network care, encouraging transparency from insurers, and more.

Read the coalition’s press release…

 
 
 
AAOS Now

2018 OPUS Survey Illustrates Interesting Orthopaedic Data

This article is the first of a four-part series that examines trends in orthopaedic practice in the United States. The AAOS research, quality, and scientific affairs department gathers demographic and practice data on orthopaedic surgeons through the Orthopaedic Practice in the United States (OPUS) Survey, also known as the Census Survey. The most recent data from the biennial report come from the 2018 Census Survey, the 17th in the series.

Read more…

 
 
 
Your AAOS

AAOS and the American Association of Neurological Surgeons Join Forces to Create the American Spine Registry

The American Spine Registry (ASR) will be jointly owned and developed by both organizations and underscores the commitment to improving the quality and delivery of patient care. The ASR will transform the Quality Outcomes Database (QOD), currently the nation’s largest spine registry, into a more far-reaching program that facilitates the participation of all North American spine surgeons in a shared, quality data collection platform. Current QOD sites will experience a smooth transition to the ASR and can expect more information soon. Information about the launch of the ASR and enrollment for future participants is forthcoming. Sites or surgeons interested in joining the ASR can contact Kristina Rosinia at rosinia@aaos.org.

Read the AAOS press release…

 

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