Study Finds Zolpidem Use after THA Is Associated with Increased Complications
According to a retrospective case-control analysis in the Journal of Arthroplasty, zolpidem use immediately after total hip arthroplasty (THA) was associated with a significantly increased risk of medical- and implant-related complications. Querying a national insurance database, 50,328 patients with zolpidem use were matched with 251,286 patients who did not use zolpidem. Ninety-day medical complications, falls, fragility fractures, costs, and readmissions were compared between groups. Zolpidem patients exhibited significantly higher rates of medical complications, falls, mechanical loosening, and periprosthetic fracture. Zolpidem patients also had significantly higher healthcare utilization.
Study Identifies Trends in Patients Undergoing Outpatient TKAs at Freestanding Ambulatory Surgery Centers
A study in JAMA Network Open found that, following Medicare’s 2018 removal of total knee arthroplasty (TKA) as an inpatient-only procedure, freestanding ambulatory surgery centers (FASCs) performed significantly more procedures; however, patients treated by FASCs were more likely to be insured by private payers and live in communities of low social vulnerability. A total of 5,567 patients undergoing TKA at FASCs or hospital-owned surgery centers (HOSCs) comprised the study. Patient characteristics were retrospectively reviewed. FASCs saw a greater percentage of white patients compared with HOSCs (90.6 percent versus 87.9 percent).
Study: Comparison of Outcomes after ORIF versus Hemiarthroplasty versus Shoulder Arthroplasty for Proximal Humerus Fractures
A retrospective study in the Journal of Shoulder and Elbow Arthroplasty compared the outcomes and complications of proximal humerus fractures in 27,102 patients aged ≥65 years undergoing ORIF, hemiarthroplasty (HA), or shoulder arthroplasty (SA). The cumulative incidence of conversion to arthroplasty following ORIF within 10 years was 8.2 percent. The cumulative 10-year incidence of all-cause reoperation was <4 percent in HA and SA patients compared with 12.1 percent of ORIF patients. ORIF patients were more likely to experience 30-day readmissions and postoperative complications. Younger age was a risk factor for reoperation, and female sex was associated with increased risk of requiring conversion to arthroplasty after ORIF.
Comprehensive Nonoperative Treatment for Developmental Dysplasia of the Hip in Infants Shows High Success Rate
The Bone & Joint Journal published a prospective, longitudinal cohort study which reported the outcomes of a comprehensive protocol for nonoperative treatment of infant developmental dysplasia of the hip (DDH). A total of 212 infants with DDH underwent a comprehensive nonoperative brace management protocol with a five-year follow-up. The primary radiological outcomes included International Hip Dysplasia Institute (IHDI) grade and evidence of avascular necrosis (AVN). The success rates of bracing for unilateral and bilateral dislocation were 88 percent and 83 percent, respectively. At the final follow-up, all hips were IHDI grade I and none had AVN.
AAOS Submits Comments to CMMI for Episode-based Payment Models
On Aug. 17, AAOS submitted comments to the Center for Medicare and Medicaid Innovation (CMMI) in response to a request for information they released in July regarding the development of episode-based payment models. Highlights of AAOS’ comments include requests to:
expand alternative payment model episodes beyond 30 days
only consider voluntary models with participation incentives
ensure that barriers such as interoperability, multipayer alignment of measures, and administrative burden are resolved in future models
Although CMMI failed to extend the proposal’s comment period per AAOS’ request, the agency agreed to meet with AAOS. The Association is working with member leaders on an in-depth response.
AAOS First Vice President Paul Tornetta III, MD, PhD, Discusses AAOS’ Relevancy and Its Role in Hot-button Issues
In an interview with AAOS Now, Vice President Paul Tornetta III, MD, PhD, FAAOS, shared his perspective on the state of the profession and the challenges and opportunities awaiting him and the Academy. Dr. Tornetta touches on the increasing specialization of orthopaedics, the role of AAOS in addressing social issues, efforts to increase diversity in the Academy’s volunteer structure, and more. “Academy membership is growing, not decreasing, and that’s a good thing,” Dr. Tornetta said. “We are more influential together.”
Call for Action in Orthopaedic Surgery: Safe Pain Control After Surgery Patient Education Risk Reduction Program
The American College of Surgeons’ (ACS’) Patient Education Safe Pain Control After Surgery program is being sent to all patients undergoing hip and knee replacements and/or spine surgeries as part of their Blue Cross Blue Shield preapproval letter in Illinois, Montana, New Mexico, Oklahoma, and Texas. Visit the link below to view and utilize the program’s resources. To learn more and access patient and professional education, register and take a five-minute survey via the link below.
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