June 29, 2020 | Today’s News

COVID-19 Presidential Update from Joseph A. Bosco III, MD, FAAOS

In his latest COVID-19 update, AAOS President Joseph A. Bosco III, MD, FAAOS, discussed the recent increase in COVID-19 cases in some areas, including Texas, where elective surgeries have once again been postponed. Meanwhile, the Centers for Medicare & Medicaid Services (CMS) called for a renewed national commitment to value-based care based on Medicare claims data. The findings reiterated previous federal data that found minority and older patients, as well as those with chronic conditions, are at greater risk for COVID-19. CMS also announced that clinicians can partially or completely opt out of the 2020 Merit-based Incentive Payment Program by filling out a hardship exemption application.

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Study Identifies Predictors of Prolonged Postoperative Opioid Use, Poor Outcomes in ACL Reconstruction

According to a study published online in Arthroscopy, anterior cruciate ligament (ACL) reconstruction patients with preoperative opioid use had prolonged postoperative opioid use and poorer outcomes. Preoperative opioid users (n = 28) were defined as patients who used opioids prior to the perioperative period (30 days before to 15 days after surgery). Patients who used opioids peri- and postoperatively were defined as opioid-naïve (n = 225). Preoperative opioid use was correlated with opioid use six months postoperatively and significantly lower odds of achieving the patient acceptable symptom state on the International Knee Documentation Committee questionnaire and several Knee Injury and Osteoarthritis Outcome Score subscales.

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A study published online in Archives of Orthopaedic and Trauma Surgery compared eight-year outcomes between total hip arthroplasty (THA) patients who received a short-stem prosthesis versus conventional-stem prosthesis. Each group had 55 patients. In the short-stem group, the pre- and postoperative modified Harris Hip Score (mHHS) improved from 41.9 to 95.0; University of California, Los Angeles (UCLA) activity score increased from 3.75 to 7.90; and visual analog scale (VAS) pain score decreased from 7.6 to 0.9, respectively. In the conventional-stem group, mHHS improved from 44.80 to 96.25, UCLA activity score from 3.6 to 7.7, and VAS pain score from 7.7 to 0.9, respectively.

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A study published online in Foot & Ankle International compared clinical and radiological outcomes between total ankle arthroplasty (TAA) versus ankle arthrodesis (AA) in end-stage hemophilic arthropathy (ESHAA) patients. Painful ESHAA patients were treated with either TAA (n = 16) or AA (n = 13); outcomes included the VAS for pain, Foot Function Index (FFI), range of motion, and postoperative clinical and radiological complications. Both groups presented significant improvements in pain measured by the VAS and FFI scale. TAA patients had better FFI disability and activity outcomes.

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According to a study published in the June issue of the European Spine Journal, cervical spinal cord injury was not a feature of chronic whiplash-associated disorder (WAD). A total of 41 chronic WAD patients (mean age, 39.6 years; 25 were female) and 14 healthy controls (mean age, 39.2 years; nine were female) underwent N-acetylaspartate (NAA), creatine (Cr), and choline (Cho) measurements. WAD patients also provided clinical symptom information. There were no significant differences between the WAD and control groups in NAA/Cr, NAA/Cho, Cr/Cho, and any clinical outcomes.

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Upcoming Webinar: Updates from the Hill with Representative Raul Ruiz, MD

Join the AAOS Office of Government Relations for the last of three free webinars dedicated to providing firsthand insight into the ongoing congressional response to COVID-19. The third webinar is Wednesday, July 1 at 8 p.m. ET and will feature U.S. Representative Raul Ruiz, MD (D-Calif.), being interviewed by the North American Spine Society. Attendees are encouraged to submit questions in advance to dc@aaos.org.

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AAOS’ Biologics Initiative Gains Momentum

AAOS’ strategic investment in orthobiologics is well underway, overseen by the Committee on Devices, Biologics, and Technology (DBT) and the Council of Research and Quality, with goals to lay a strong, sustainable foundation this year, focusing resources toward creating unbiased, evidence-based content, while providing helpful and meaningful position statements, educational programs, regulatory resources, and symposia. During the short tenure of the DBT Committee, the group has already discussed at length the importance of taking an evidence-based and systematic approach to evaluating the effectiveness of emerging treatment modalities.

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