August 24, 2018 | Today’s News

Study identifies possible risk factors for limited knee function following ACL surgery

A long-term cohort study published online in The American Journal of Sports Medicine concluded that some risk factors for inferior knee function after anterior cruciate ligament (ACL) reconstruction may be modifiable. Researchers used prospectively collected data from the Swedish National Knee Ligament Register to identify 874 patients who underwent ACL reconstruction between January 2005 and December 2006. Patient- and surgery-related risk factors were assessed using patients’ mean Knee injury and Osteoarthritis Outcome Score (KOOS) across four subscales: pain, knee-related symptoms, function in sport and recreation, and knee-related quality-of-life (KOOS ₄). Patients who reported a higher preoperative KOOS pain score were more likely have higher scores on the pain, symptoms, and sport subscales and the KOOS ₄. A higher preoperative body mass index was also a predictor of lower scores on three KOOS subscales and on the KOOS ₄. None of the predictors were significant across all four subscales.

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Study: RIAP may be helpful for rheumatoid arthritis damage in the wrist

Resection interposition arthroplasty (RIAP) may be a good alternative for severe wrist damage resulting from rheumatoid arthritis, according to a retrospective study published online in BMC Musculoskeletal Disorders. Researchers assessed data from 34 wrists (28 patients) between 1989 and 2002, with a mean follow-up of 9.3 years. A modified, 100-point version of Clayton’s scoring system and a functional questionnaire were used to determine patients’ results. They observed the following Clayton scores: 29.4 percent of wrists (n = 10) were excellent (90–100 points), 41.2 percent (n = 14) were good (70–89 points), 11.8 percent (n = 4) were fair (60–69 points), and 17.6 percent (n = 6) were poor (< 60 points). Seventy-one percent of patients reported satisfaction with subsequent pain levels, function, and daily activities. Patients more likely to report positive outcomes included those who were younger, underwent the surgery earlier, did not have long-term disease, and had lesser involvement of other joints.

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Same-day discharge (SDD) following total hip arthroplasty (THA) could be related to personal patient preference, according to a prospective cohort study published online in The Journal of Arthroplasty. The study included 106 patients younger than 75 years who did not need to use a walker, had an American Society of Anesthesiologists score of 1–3, a body mass index < 40 kg/m ², and agreed to SDD prior to surgery. Seventy-four percent of SDD-eligible candidates were discharged on schedule (n = 78), while the remaining 26 percent (n = 28) were not due to patient preference (n = 12), dizziness/hypertension (n = 8), failure to clear physical therapy (n = 5), urinary retention (n = 2), and pain management (n = 1). Those who did not leave the same day as their surgery were also more likely to report multiple allergies, anxiety/depression, obstructive sleep apnea, and rheumatoid arthritis.

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The last day to apply for a Merit-based Incentive Payment System (MIPS) targeted review is Oct. 1 at 8:00 p.m. Eastern time. A Centers for Medicaid & Medicare Services (CMS) review can be requested if there is a possibility of errors/data quality issues on submitted activities, eligibility issues, being erroneously excluded from the alternative payment model participation list, not being automatically reweighted despite qualifying, or other circumstances. Requests can be made through the Quality Payment Program website.

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View the MIPS targeted review fact sheet…

CMS grants states nearly $9 million for healthcare marketplaces

CMS awarded 30 states and Washington, D.C., $8.6 million in unused Affordable Care Act grants to improve affordable healthcare options and access to mental health and substance use disorder treatment services. The grants range from $225,000 to $290,000 and will be awarded over a two-year period. CMS Administrator Seema Verma said, “We recognize that states are in the best position to assess the needs of their consumers and develop innovative measures to ensure access to affordable health coverage.”

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Read the CMS press release…

Platelet-rich plasma: The path forward

For just about every orthopaedic condition, there is a platelet-rich plasma (PRP) treatment that purports to remedy it. Yet evidence of efficacy for PRP and other blood-derived formulations remains elusive for many applications. During the AAOS 2018 Annual Meeting symposium titled “Use and Misuse of Biologics,” Scott A. Rodeo, MD, of Hospital for Special Surgery, surveyed the current landscape of “indiscriminate and sometimes inappropriate use of biologics” and provided an overview of what is known about these agents and the questions that remain to be answered.

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Last call: Apply for Education Assessments and Examinations Committee basic science member position

The Education Assessments and Examinations Committee has an open position for a basic science member, a three-year term that runs from March 18, 2019, through March 25, 2022. The committee prepares and administers the Orthopaedic In-Training Examination annually, the Orthopaedic Self-Assessment Examination triennially, and the Orthopaedic Special Interest Examinations. The deadline to apply is Aug. 27.

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