April 16, 2018 | Today’s News

Study: Implementation of HRRP linked to reduction in readmissions after TKA and THA

Findings published in the March issue of the journal JAMA Surgery suggest that implementation of the Medicare Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in readmissions following total knee arthroplasty (TKA) and total hip arthroplasty (THA). The researchers conducted a retrospective, cohort study of 672,135 Medicare beneficiaries across 2,773 hospitals, 507,663 of whom underwent HRRP-targeted procedures (TKA and THA), and 164,472 of whom underwent nontargeted procedures. They found that readmissions for all procedures decreased significantly over the study period. However, readmission rates following TKA and THA decreased faster after HRRP implementation compared with the prepolicy period. The researchers note that the use of observation stays increased slightly, and accounted for 11 percent of the decrease in readmissions.

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Study: What are the trends in medical liability suits after arthroscopy?

A study published online in the journal Arthroscopy examines trends in medical liability lawsuits following arthroscopic procedures. The authors reviewed information on 240 cases and found that 62 (26 percent) resulted in a verdict for the plaintiff, 160 (67 percent) resulted in a verdict for the defense, and 18 (8 percent) were settled without trial. They found that plaintiff verdict or settlement were significantly more frequent for vascular complications and wrong-side surgery, while defense verdicts followed lawsuits alleging surgeon technical error. The authors note that wrong-side surgery, retained instruments, deep venous thrombosis, and postoperative infection were significantly more likely after knee arthroscopy than arthroscopy of other joints, neurological injury was significantly associated with elbow and hip arthroscopy, and allegations of technical error and block-related complications were more common following shoulder arthroscopy.

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The U.S. Food and Drug Administration (FDA) is alerting healthcare professionals to a recall of all nonexpired sterile products made by Coastal Meds LLC, of Biloxi, Miss., due to visible particles in some drug vials for injection. The agency states that on April 5, 2018, the company initiated a voluntarily recall of all products intended to be sterile. FDA requested the compounder inform the public, but as of this writing it has not done so. FDA states that healthcare professionals should immediately check their medical supplies, quarantine any sterile drug products intended for injection from Coastal Meds, and not administer them to patients.

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According to a study published online in the journal Arthroscopy, some patients who undergo arthroscopic surgery of the right hip may display a prolonged reaction time braking while driving a vehicle for up to four weeks after surgery. Members of the research team conducted a prospective, comparative study of 59 patients undergoing arthroscopic surgery for femoroacetabular impingement (FAI) syndrome and 59 age- and gender-matched control participants without FAI. They assessed all participants for total brake reaction time (BRT) and brake pedal depression (BPD) at baseline, and at two-, four-, and six-week follow-up. Prior to surgery, the researchers found that compared to controls, patients with FAI had significantly prolonged BRT but not BPD. For study patients who underwent surgery on the left hip, there was no difference in BRT or BPD between preoperative measurements and any postoperative time point. However, patients who underwent right hip surgery displayed significantly prolonged BRT at two weeks postoperative, compared with their preoperative baseline. By four weeks postoperative, study patients undergoing right hip surgery had returned to their preoperative baseline.

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California

The Los Angeles Times reports that a bill under consideration in the California State Assembly would, if enacted, establish a government commission to set rates for healthcare services based on the cost of such services under Medicare. Supporters say that the bill is designed to shift the discussion on health care from maximizing insurance coverage to addressing the costs of care. Critics argue that capping prices could reduce access to care by driving providers out of the state and hospitals to scale back services.

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Nominate a colleague for the AAOS Diversity, Humanitarian, or Tipton Leadership Awards

Nominations are now being accepted for the 2019 Diversity and Humanitarian Awards and the William W. Tipton Jr, MD, Orthopaedic Leadership Award. These awards are presented annually at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession. The last day to submit nominations for the Humanitarian Award is May 15, 2018; the last day to submit nominations for the Diversity and Tipton Awards is June 15, 2018.

Learn more and submit nominations…

May 11, 2018, is the last day to submit an application for a position on an Instructional Course Committee. Committee members grade Instructional Course Lecture applications in May and evaluate courses at the AAOS Annual Meeting in March. The following openings are available:

• Practice Management (chair, one member)
• Shoulder and Elbow (two members)
• Sports Medicine and Arthroscopy (one member)
• Tumor (three members)

Applicants for these positions must be active fellows with a practice emphasis in the relevant topic.

Learn more and submit your application…  (member login required)