Today’s Top Story
Study: Prior long-term opioid use linked to early revision following TKA.
According to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery, long-term opioid use prior to total knee arthroplasty (TKA) may be linked to an increased risk of early knee revision for certain patients. The authors conducted a retrospective analysis of 32,636 TKA patients from the Veterans Affairs system, 12,772 of whom had been prescribed opioids for at least 3 months during the year prior to TKA, and 734 of whom (2.2 percent) underwent revision within a year. The authors found that chronic kidney disease, diabetes, and long-term opioid use were associated with revision within 1 year, and were also the leading factors associated with a revision at any time after the index TKA.
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Other News
Study: Older women may be at increased risk of hip fracture compared to older men.
A study conducted in Spain and published online in The European Menopause Journal suggests that older women may be at increased risk of hip fracture compared to older men. The researchers reviewed data from a community sample of 4,803 individuals older than 55 years who were followed for up to 16 years. They found that women were 3.1 times more likely to experience hip fracture compared to men. Overall, illiteracy and depression were associated with increased risk of hip fracture in women, while smoking and disability in basic activities of daily living were associated with increased risk of hip fracture in men.
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Study: Small group of physicians linked to bulk of medical liability payouts.
Findings from a study published online in the Journal of Patient Safety suggest that a small number of physicians may account for half of all paid medical liability claims. The research team reviewed data from the National Provider Data Bank (NPDB) and found that 1.8 percent of physicians were responsible for half of the $83,368,588,200 in paid claims reported to the NPDB over a 25-year period. Among those providers, 12.6 percent had an adverse licensure action reported to the NPDB and 6.3 percent had a clinical privileges action reported. The research team states that physicians with high dollar payouts with one liability claim payout had a 74.5 percent chance of another payout—more than twice the rate for all physicians with a single payout. In addition, the likelihood that a physician would have additional payments increased as the number of previous payments increased. According to the researchers, the total dollar payout per physician was a better predictor of future payouts than the number of payouts. (For 1, 2, and 3 payouts, the P value was less than 0.0001 for each category.) The researchers note that medical liability cases can serve only as an indirect measure of adverse events.
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Overpayments in Medicare Advantage plans often go uncollected.
Kaiser Health News reports that an initiative to audit Medicare Advantage plans found $128 million in potential overpayments in 2007 alone, but the U.S. Centers for Medicare & Medicaid Service (CMS) settled those overpayments in 2012 for less than $3.4 million. The publication states that insurance industry representatives had argued the audits were flawed and unreliable, and after 2 years of negotiation, the agency settled for the lower amount. The nonprofit Center for Public Integrity disclosed in 2014 that billions of tax dollars may be wasted annually due to upcoding, and in 2015 the organization reported that 35 of 37 health plans the agency has audited overcharged the Medicare system, often by overstating the severity of medical conditions such as diabetes and depression.
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Judge halves $1 billion jury award in implant case.
Courthouse News reports that a Texas federal judge has reduced by half a $1 billion jury award against DePuy Orthopaedics and Johnson & Johnson for their metal-on-metal hip implants, citing concerns regarding due process in awarding the punitive damages. A jury in Texas had previously ordered the company to pay more than $1 billion to six patients, agreeing with plaintiffs that the company knew there were flaws in the design of the DePuy Pinnacle metal-on-metal hip replacement system, but that the company had failed to properly warn physicians and patients regarding the risks. The company stopped selling the devices in 2013, but still faces nearly 9,000 additional lawsuits related to the issue.
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CDC report finds 28 traumatic brain and spinal cord injury deaths among high school and college football players over 10-year period.
A report released by the U.S. Centers for Disease Control and Prevention identifies 28 traumatic brain and spinal cord injury deaths among high school and college football players in the United States during the period 2005–2014, for an average of 2.8 deaths per year (range 0 to 7). The researchers, who analyzed data from the National Center for Catastrophic Sport Injury Research, found that approximately 18 percent of identified high school brain injury deaths were preceded by an earlier concussion. Of the 28 deaths, head first/head down contact was identified in eight deaths. The most common playing positions of those fatally injured were running back and linebacker. The researchers write that the findings “support continued surveillance and safety efforts to ensure proper tackling techniques, emergency planning, and medical care, particularly during competition, and adherence to protocols for safe return-to-play after a concussion.”
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Learn more about the CDC HEADS UP program…
Last call: Resolutions Committee.
Jan. 9 is the last day to submit your application for a position on the Resolutions Committee (two member openings). The Resolutions Committee develops concise materials and recommendations on proposed resolutions for distribution to the AAOS fellowship. Applicants for this position must be active or emeritus fellows who are familiar with the AAOS governance structure and decision making processes.
Learn more and submit your application…(member login required)
