Study: One-stage revision strategy may be as effective as two-stage for PJI of the hip
Findings from a study published online in the European Journal of Epidemiology suggest that a one-stage revision strategy may be as effective as a two-stage revision strategy in treating periprosthetic joint infection (PJI) of the hip. The researchers conducted a meta-analysis of 1,856 patients with PJI of the hip from 44 cohorts across four continents. They identified 222 reinfections at median 3.7-year follow-up. The researchers found that one-stage revision was associated with a reinfection rate of 16.8 per 1,000 person-years of follow-up, while two-stage revision was linked to 32.3 reinfections per 1,000 person-years of follow-up. Compared with one-stage revision, the age- and sex-adjusted hazard ratio of reinfection for two-stage revision was 1.70.
Study: Is there a reasonable BMI criterion for TJA?
A study published in the April 4 issue of The Journal of Bone & Joint Surgery attempts to assess various body mass index (BMI) criteria for total joint arthroplasty (TJA). The authors conducted a retrospective, cohort study of 27,671 TJAs to determine if various BMI eligibility criteria had been enforced, how many short-term complications would have been avoided, how many complication-free surgical procedures would have been denied, and the positive predictive value of BMI eligibility criteria as tests for major complications. They found that with a BMI criterion of ≥40 kg/m 2, 1,148 patients would have been denied a surgical procedure free of major complications, and 83 patients would have avoided a major complication. They write that the positive predictive value of a complication based on a BMI of ≥40 kg/m 2 as a test for major complications was 6.74 percent, while the positive predictive value of a complication using a BMI criterion of ≥30 kg/m 2 was 5.33 percent. “Although the acceptable balance between avoiding complications and providing access to care can be debated,” they write, “such a quantitative assessment helps to inform decisions regarding the advisability of enforcing a BMI criterion for [TJA].”
Study: Higher dairy intake linked to increased BMD among older men
According to a study published online in the Journal of Bone and Mineral Research, increased dairy intake may help increase bone mineral density (BMD) for men older than 50 years. Members of the research team conducted a cross-sectional study of 1,522 men and 1,104 women participating in the Framingham Heart Study. They found that in men, higher intake of milk, milk + yogurt, or milk + yogurt + cheese was associated with higher integral and trabecular volumetric BMD (p = 0.006 to 0.057) and vertebral compressive strength (VCS), and a higher cheese intake was correlated with higher cross-sectional area CSA. The associations appeared to be stronger in older men. Among women, the researchers observed no significant link between BMD and dairy foods, with the exception of a positive association of cream intake with CSA.
CMS says new Medicare cards are now being sent to patients
The U.S. Centers for Medicare & Medicaid Services (CMS) has begun mailing newly designed Medicare cards with the new Medicare Beneficiary Identifier (MBI). The agency states that those enrolling in Medicare for the first time will be among the first to receive the new cards, while current Medicare beneficiaries will receive new cards on a rolling basis over the next several months. CMS will continue to accept the Health Insurance Claim Numbers (HICNs) through the transition period, but the American Medical Association (AMA) recommends that providers begin using the MBI in Medicare transactions as soon as it is available for the patient.
Healthleaders Media reports that a hospital in Denver has notified patients who had orthopaedic or spine surgery within the past 20 months that they may have been exposed to surgical site infections for hepatitis B, hepatitis C, or human immunodeficiency virus. A spokesperson for the Colorado Department of Public Health and Environment states that the process for cleaning surgical instruments following certain surgeries was found to be inadequate and may have compromised sterilization.
According to Modern Healthcare, a bill that would allow many nurse practitioners to practice without physician oversight has passed the Virginia General Assembly. If signed by the governor, the bill would allow most types of nurse practitioners with five years of full-time clinical experience to earn approval to practice without maintaining a contract with a physician who oversees them. Supporters of the bill say that current collaborative practice agreements are unnecessary and costly and eliminating them could expand access to health care. Critics argue that the bill as currently written raises concerns about patient safety and quality of care.
AAOS seeks members to serve as content experts on American Board of Orthopaedic Surgery (ABOS) Knowledge Resource Groups, which will identify knowledge resources for the ABOS Web-Based Longitudinal Assessment Program. The following positions are available:
Adult reconstruction (two member openings)
Foot and ankle (two member openings)
General orthopaedics (two member openings)
Hand and wrist (two member openings)
Musculoskeletal oncology (two member openings)
Pediatrics (two member openings)
Shoulder and elbow (two member openings)
Spine (two member openings)
Sports medicine (two member openings)
Trauma (two member openings)
Applicants must be active fellows with a practice emphasis in the relevant topic. The deadline for applications is April 9, 2018.
