Outcomes of Skilled Nursing Facility Partnership in Total Joint Arthroplasty at a Single Center
A retrospective, single-center study of 189 total joint arthroplasties, treated under a Comprehensive Care for Joint Replacement pilot program, reported that partnering with a skilled nursing facility (SNF) led to reduced costs and favorable outcomes at four years. This study was published in the Journal of the AAOS ®. Sixty-eight percent of patients discharged to the partner SNF, and 32.2 percent discharged to a nonpreferred facility. SNF costs were significantly lower with use of the partnered facility ($7,343.34 versus $10,981.23 for nonpreferred facility). Discharge to the partnered facility was associated with a shorter length of stay and reduced readmission rates compared with the nonpreferred SNF.
Study: Do Preoperative Expectations of Arthroscopy for FAI Correlate with Postoperative iHOT-33 Scores?
A study published online in Arthroscopy reported that preoperative expectations before hip arthroscopy for femoroacetabular impingement (FAI) do not correlate with postoperative International Hip Outcome Tool (iHOT-33) scores and patient satisfaction. Sixty-nine patients with at least two years of follow-up were assessed. The correlations between preoperative Hip Preservation Surgery Expectations Survey scores and postoperative iHOT-33 or patient satisfaction were not statistically significant. However, postoperative iHOT-33 scores were significantly associated with patient satisfaction.
Randomized Study Shows Benefit of Topical Treatments for Pes Anserinus Bursitis Compared to NSAIDs, Corticosteroids
A randomized trial of 45 patients, published in Current Orthopaedic Practice, found that a 20-day topical treatment regimen for pes anserinus (knee tendon) bursitis outperformed regimens with corticosteroids or NSAIDs for pain relief and functional improvement. Fifteen patients each were randomized to a 20-day regimen combining three topical treatments, one intralesional corticosteroid injection, or NSAIDs plus three weeks of cold application. Knee Injury and Osteoarthritis Outcome Scores and Visual Analog Scale scores were rated in favor of the topical regimen.
Study: Favorable Outcomes with Allograft Augmentation in Humerus Fractures in Older Patients
A meta-analysis published online in the Journal of Shoulder and Elbow Surgery reported that managing proximal humerus fractures with a locking compression plate (LCP) and fibular allograft augmentation led to positive outcomes and fewer complications compared with management without allograft in older patients. Ten studies (n = 802) were analyzed. Changes in humeral head height and neck shaft angle were significantly different between treatment types, in favor of allograft. Final American Shoulder and Elbow Surgeons scores were significantly higher in the allograft group compared to the LCP-only group, and risk of major complications was significantly lower with allograft.
Additional Provider Relief Funds Being Distributed This Week
The Department of Health and Human Services announced that it will be distributing $9 billion to small, medium, and large practices this week from the Provider Relief Fund. Most of the funds are being distributed based on reported expenses and decreased revenues experienced by providers from July 1, 2020, to March 31, 2021. One quarter of the funds distributed in this Phase 4 tranche will be “bonus” payments based on the amount and type of services provided to Medicaid, Children’s Health Insurance Program, and Medicare patients.
Mental Health: More Than an Afterthought in Orthopaedics
Psychosocial issues have always affected surgical outcomes, but their full impact is just now starting to be appreciated. Orthopaedic systems have been slower to incorporate behavioral healthcare, with little collaboration between providers when a referral to behavioral health is made. In this article, physicians from the Novant Health Orthopedics & Sports Medicine Institute discuss their implementation of an integrated care model that embeds behavioral health providers in orthopaedic clinics.
The AAOS Awards Committee has oversight of the review process for all award nominees and recommends the AAOS Award winners to the AAOS Board of Directors for approval. To view the specific award criteria and submit nominations, please visit the AAOS Awards page (linked below). Nominations will remain open through Dec. 17. Questions about the AAOS Awards should be directed to governance@aaos.org.
