Today’s Top Story
Senate passes opioid act, but leaves several initiatives unfunded.
The California Medical Association reports that the U.S. Congress has passed the Comprehensive Addiction and Recovery Act, which authorizes the federal government to award state grants for opioid-related initiatives around education, prevention, treatment, and recovery efforts. However, the association notes that the legislation does not appropriate funding for several key initiatives, including programs to combat opioid misuse and increasing the availability of naloxone. The Act incorporates elements of 18 opioid-related bills passed earlier this year by the U.S. House of Representatives. Following passage of the bill by both houses of Congress, the bill proceeds to President Obama for his signature.
The American Association of Orthopaedic Surgeons (AAOS) is a signatory to a letter urging Congress to provide funding for the unfunded programs. Read more…
Other News
Study: Degenerative lumbar spine disease may influence femoroacetabular flexion in THA patients.
A study published in the August issue of the journal Clinical Orthopaedics and Related Research examines a potential relationship between degenerative disc disease (DDD) and lumbar-pelvic-femoral alignment prior to surgery among patients who undergo total hip arthroplasty (THA). The research team reviewed data on 242 patients undergoing primary THA who had preoperative low-dose EOS spine-to-ankle lateral radiographs in standing and sitting positions. Patients were excluded for scoliosis, spondylolysis, not having five lumbar vertebrae, surgical or disease fusion, or poor image quality attributable to high body mass index (BMI). After adjustment for age, sex, and BMI, the researchers found that patients with DDD spines had a mean of 5° more posterior pelvic tilt and 7° less lumbar lordosis in the standing position compared with patients without radiographic arthrosis. In the sitting position, patients with DDD spines had 4° less posterior pelvic tilt. Finally, from standing to sitting position, patients with DDD spines experienced 10° less spine flexion and 10° more femoroacetabular flexion. The researchers write that, when planning THA, “it may be important to consider which patients sit with less posterior pelvic tilt and those who rotate their pelvises forward to achieve a sitting position, as both mechanisms will limit or reduce the functional anteversion of the acetabular component in a patient with a THA.” Read the abstract…
Study: Implementation of blood utilization guidelines may reduce blood use for surgical patients.
According to findings presented at the annual meeting of the American College of Surgeons National Surgical Quality Improvement Program, the adoption of blood utilization guidelines was associated with a 30 percent reduction in blood use at a single center. The research team revised the hospital’s computerized provider order entry (CPOE) system to allow blood orders to be based on a specific assessment of each case rather than a standard order of two units. In addition, the team developed guidelines for perioperative handling, including:
- When more than one unit of blood is ordered, it is sent in a cooler rather than via pneumatic tube
- Coolers were reconfigured to optimize temperature management
- A specific member of the staff is tasked with “ownership” of the blood products, including returning unused product to the blood bank
- Individual unit wastage is reported to clinical leaders for review, with aggregate data reported monthly
Study: Some referring physicians may not fully understand CT radiation risks.
Findings from a study conducted in Canada and published online in the Journal of Medical Imaging and Radiation Sciences suggest a need for improved knowledge among some physicians regarding radiation levels associated with computed tomography (CT). The researchers surveyed 308 referring physicians, radiologists, and technologists and found that 73 percent of referring physicians, 97 percent of radiologists, and 76 percent of technologists correctly believed that there is a risk for cancer from an abdomen–pelvic CT scan. They found that physicians and technologists who use CT were more likely to select correct CT doses in terms of chest x-ray equivalents than those who do not. Overall, 93 percent of respondents expressed interest in receiving dose feedback from medical imaging procedures. Read more…
Read the abstract…
Stem cell studies suggest potential for future orthopaedic research.
Two recent studies look at potential applications for biologics in orthopaedics. The first, published online in the journal Proceedings of the National Academy of Sciences, describes foundational work for a technique for resurfacing biologic joints with a biodegradable synthetic scaffold. The scaffold is covered with cartilage made from the patient’s own stem cells, which would then be implanted onto the surface of an arthritic joint. Read more…
Read the abstract…
The second study, published in the July 14 issue of the journal Cell, describes the mapping of biologic and chemical signals needed to make 12 cell types from human stem cells. The research team defined extrinsic signals controlling binary lineage decisions, allowing them to rapidly steer pluripotent stem cells toward 80 percent to 99 percent pure human mesodermal lineages at most branch points, enabling the generation of human bone and heart progenitors that could engraft in respective in vivo models. Read more…
Read the abstract…
USBJI releases new video to help patients understand bone health and osteoporosis.
The U.S. Bone and Joint Initiative (USBJI) has released a new 6-minute, animated video focusing on the core messages of Fit to a T—a public education program on bone health and osteoporosis offered by USBJI. View the video and learn more about Fit to a T…
In addition, USBJI offers a PowerPoint slide set to AAOS members who would like to present a live session in their community. There is no charge for the slide presentation. To learn more or to register your interest in presenting or scheduling a session in your community, visit the above link or email USBJI at info@usbji.org.
Last call: Committee positions closing soon!
A number of openings on the AAOS Committee Appointment Program website are closing soon. Act now to apply for the following positions:
- Bylaws Committee (chair; closes July 22)
- ACGME Review Committee for Orthopaedic Surgery (one resident member; July 21)
- FDA Network of Experts Program (eight members; July 20)
