Today’s Top Story
Study: Many THA readmissions may not be preventable.
A study published online in the journal Clinical Orthopaedics and Related Research suggests that many readmissions following total hip arthroplasty (THA) may not be preventable. The authors conducted a retrospective evaluation of 1,096 elective THAs for osteoarthritis (OA) conducted at a single center. Of those, 69 patients who met inclusion criteria were readmitted within 90 days of discharge. Overall, 31 patients (45 percent) were readmitted for orthopaedic reasons and 38 were readmitted for medical reasons (55 percent). Overall, three readmissions (4 percent) were identified as potentially preventable. Of the potentially preventable readmissions, one was orthopaedic (hip dislocation) and two were medical. The authors note that 30-day readmissions were more likely to be for orthopaedic reasons than 90-day readmissions. Read the abstract…

Other News

Study: Post-acute exercise program may not improve outcomes for primary TKA patients.
Data from a study conducted in Australia and published online in the journal Arthritis Care & Research suggest that participation in a post-acute outpatient group exercise program for patients following primary total knee arthroplasty (TKA) surgery for OA may not improve outcomes compared to usual care. The research team conducted a multicenter, randomized trial of 422 patients aged 45 to 75 years who were allocated to a post-acute group exercise program or usual care. At 6-week, 6-month, and 12-month follow-up, they found no significant difference between cohorts in pain in the operated knee, activity limitations, health-related quality of life, knee extension and flexion strength, stair-climb power, 50-foot walk speed, or active knee range of motion. At 12 months, 69 percent of patients allocated to post-acute exercise and 72 percent of patients allocated to usual care were considered to have responded to treatment. Read the abstract…

Study: Overlapping surgery in ambulatory setting may not be associated with increased complication rates.
Findings from a study published in the Nov. 16 issue of The Journal of Bone & Joint Surgery suggest that, in an ambulatory setting, the practice of overlapping surgery may not be associated with increased complication rates compared to non-overlapping procedures. The researchers conducted a retrospective review of 3,640 orthopaedic cases performed, 68 percent of which were overlapping. They found no significant difference across cohorts in mean procedure time, total operating room time, or 30-day complication rates. In addition, they found that stratification based on subspecialty surgery also demonstrated no difference in complications between groups. Finally, the researchers noted no link between amount of overlap between cases and complication rate. The researchers note a distinction between concurrent surgery—in which critical portions of procedures occur simultaneously—and overlapping surgery, in which they do not. Read the abstract…

Study: Obesity may be associated with increased risk of bone porosity in adolescents.
According to information presented at the annual meeting of the Radiological Society of North America, adolescent obesity may be associated with a reduction in bone mineral density (BMD). The research team conducted a prospective study of 23 participants with a mean age of 17 years and a mean body mass index (BMI) of 44 kg/m2. Using 3D HR-pQCT to measure BMD and bone microarchitecture along with dual-energy x-ray absorptiometry to determine body composition, they found that BMI was positively associated with cortical thickness and area, while visceral fat mass was positively associated with cortical porosity. In addition, lean mass was positively associated with trabecular density, volume, and integrity. Read more…

Political shifts linked to uncertain future for healthcare industry.
An article in Kaiser Health News looks at uncertainty in the healthcare industry in the wake of the presidential election. President-elect Donald Trump has stated that the Affordable Care Act (ACA) will be repealed and replaced. However, a spokesperson for the Federation of American Hospitals states that healthcare stakeholders did not discuss a rewrite of the ACA “because the working assumption was we had a program that wasn’t going anywhere. That working assumption is now no longer operative,” and a spokesperson for physician organization trade group CAPG notes that “Nobody was ready for this. We didn’t have a Plan B.” The writer notes that the “hospital industry may be the most vulnerable to proposed changes,” due to the effect ACA repeal could have on healthcare coverage, both through policies purchased on ACA exchanges and Medicaid expansion. Read more…

Diversity discussion brings physician stories to the fore.
An article in AMA Wire reports on a discussion held at the interim meeting of the American Medical Association, which addressed the issue of diversity in the medical profession. Physicians discuss their personal experiences in areas such as being a minority participant in a medical residency program and in helping an unconscious person on an airplane. An accompanying video expands on stories in the article. Read more…

Call for volunteers: Program Committees.
Dec. 21 is the last day to submit your application for a position on a Program Committee. The following openings are available:

  • Adult Reconstruction Hip (chair, 11 members)
  • Adult Reconstruction Knee (seven members)
  • Hand & Wrist (chair, one member)
  • Musculoskeletal Tumor & Metabolic Disease (chair, two members)
  • Pediatrics (chair)
  • Practice Management/Rehabilitation (five members)
  • Spine (four members)
  • Trauma (chair, three members)

Applicants for chair positions must be active fellows; applicants for member positions must be active fellows or international members. All applicants must have a practice emphasis in the relevant topic. Learn more and submit your application…(member login required)

Note: AAOS offices will be closed Nov. 24 and 25 for the Thanksgiving holiday. AAOS Headline News Now will not be published on Friday, Nov. 25. Publication will resume Monday, Nov. 28.