June 15, 2018 | Today’s News

Study: Voluntary versus mandatory orthopaedic bundle programs

A study published online in Health Affairs found that while both voluntary and mandatory Medicare joint replacement bundled payment programs can engage hospitals in these payment types, mandatory programs can produce “more robust, generalizable evidence.” Researchers analyzed data from Medicare and the American Hospital Association Annual Survey to compare Bundled Payments for Care Improvement (BCPI) and Comprehensive Care for Joint Replacement Model (CJR) joint replacement bundled programs. BPCI hospitals had higher mean patient volume than CJR hospitals. BCPI hospitals were also larger and more focused on teaching. However, hospitals in both groups had similar risk exposure and baseline episode quality and cost. BPCI hospitals had higher costs attributed to institutional postacute care, which the researchers said was related to inpatient rehabilitation facility costs.

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Study: BMI may be associated with mortality following THA and TKA

Underweight patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) may have increased all-cause mortality, but this was not the case for overweight and obese patients, according to a study published in the June issue of Clinical Orthopaedics and Related Research. Researchers used data from the Australian St. Vincent’s Melbourne Arthroplasty Registry and the US. Kaiser Permanente Total Joint Replacement Registry. They identified adult patients undergoing elective TKAs and THAs between Jan. 1, 2002, and Dec 31, 2013. In both cohorts, being underweight (body mass index [BMI] < 18.5 kg/m ²) was associated with higher all-cause mortality after TKA, while obese class I (BMI 30.0-34.9 kg/m ²) or obese class II (BMI 35.0-39.9 kg/m ²) were associated with lower mortality compared to normal-weight patients (BMI 18.5-24.9 kg/m ²). In the United States, being underweight had a higher risk of mortality after THA, while overweight (25.0-29.9 kg/m ²), obese class I, and obese class II individuals had a lower risk of mortality after THA compared to normal-weight patients. In the Australian cohort, there was no observed association between BMI and mortality for patients undergoing THA.

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The Centers for Medicare & Medicaid Services (CMS) will postpone the release of hospital quality Star ratings, originally scheduled for July. CMS said it needs time to analyze “the impact of changes to some of the measures on the Star ratings and to address stakeholder concerns.” The agency did not indicate when the next update will be available, and the December 2017 ratings will remain on the Hospital Compare website until further notice. The most significant change proposed for the July ratings was how safety measures were calculated, and critics of this proposal support the decision delay to allow more time for analysis of the methodology and measures and to hear from stakeholders.

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According to a study published online in the Journal of Shoulder and Elbow Surgery, endoscopic distal biceps tendon repair was feasible with both button devices and suture anchors in a cohort of 28 fresh-frozen cadaveric elbows. Researchers evaluated the proximity of neurovascular structures to endoscopy portals; iatrogenic injury to neurovascular, musculotendinous, and osseous structures; and changes in compartment pressures in 17 button device repairs (with or without interference screws) and 11 suture anchor repairs. The lateral cutaneous nerve, cephalic vein, and radial artery were close to the portals. The button device cohort had a significantly higher number of iatrogenic injuries than the anchor group. All-suture anchor repairs had significantly higher contact area than repairs with all other devices; however, researchers noted that additional studies are needed to establish the clinical safety of this technique.

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The crisis in orthopaedic technology puts evidence-based medicine at risk

Improvements in orthopaedic patient care are typically connected to improvements in orthopaedic technology. However, the supply of new implants and procedures is not guaranteed. The successful commercialization of truly novel orthopaedic technology currently faces stiff headwinds, including regulatory risk, payer risk, and market risk. This may reduce interest in financing novel technologies within the venture community and among major device manufacturers.

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AAOS presents 23 MORE Awards for outstanding coverage of bone and joint health stories

AAOS announced the 23 recipients of the 2018 Media Orthopaedic Reporting Excellence (MORE) Awards, which are presented annually to journalists who accurately report on bone and joint health topics, increasing public awareness of musculoskeletal health issues and treatments. The recipients represent a diverse group of health and medical writers, producers, and freelance reporters from print, broadcast, and online media outlets that cover an array of topics, from orthopaedic innovation to improved quality of life. Entries were judged by a panel of orthopaedic surgeons and evaluated for overall quality and accuracy.

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The AAOS Exhibits Committee has an open member position, a two-year term that runs from Mar. 17, 2019, to Mar. 13, 2021. The committee manages and develops the AAOS annual meeting industry exhibits program, as well as develops initiatives for meeting participant engagement with industry. The last day to submit an application is Aug. 14.

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