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| Today’s Top Story
One Percent Medicare Pay Cut Takes Effect Today
Statutory sequestration cuts begin today with a 1 percent cut to Medicare reimbursement across all healthcare professionals. This is the first of two phases of cuts, with a 2 percent fee reduction starting July 1. While physicians initially faced an almost 10 percent cut in Medicare fees, advocacy efforts led by AAOS substantially reduced this potential decrease in reimbursement. AAOS also joined with 49 associations in February to urge Congress to extend the current 2 percent sequester moratorium during the COVID-19 public health emergency. As advocacy efforts continue, AAOS calls for immediate stability in Medicare reimbursement, including an indefinite delay to further pay cuts and overall reformation of physician Medicare payments.
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| In Other News
Study: Similar Clinical Outcomes with Robotic- or Computer-assisted TKA versus Conventional TKA
In a systematic review published online in The Journal of Arthroplasty, robotic-assisted total knee arthroplasty (RA-TKA) and computer-assisted TKA (CA-TKA) demonstrated improved radiographic alignment compared with conventional TKA. However, most studies did not find clinically significant differences in patient-reported outcomes. Twenty-one CA-TKA studies and eight RA-TKA studies were included. Ninety percent and 100 percent of CA-TKA and RA-TKA studies, respectively, showed greater postoperative radiographic improvement compared with conventional TKA. Two CA-TKA studies achieved a minimal clinically important difference (MCID) relative to conventional TKA. No RA-TKA studies achieved a MCID.
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| Study: Preoperative MRI Does Not Alter Surgical Plans in Arthroscopy for FAI
According to a study published online in Arthroscopy, preoperative MRI did not change surgical plans and delayed surgery in patients scheduled for arthroscopy for femoroacetabular impingement (FAI). Overall, 1,786 patients aged ≤40 years who received primary hip arthroscopy were included. Of 934 patients with preoperative MRI, none had surgical plans changed after MRI. Time to surgery was 85 days for the no MRI group and 107 days for the MRI group. Eighty-five percent achieved at least a minimal clinically important difference in Hip Disability and Osteoarthritis Outcome Score (HOOS)–Pain scores, with no between-group differences.
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| Study: Poor Outcomes of Ulnar Component Excision and Radial Component Reconstruction for Preaxial Polydactyly of the Hand
A retrospective study published online in The Journal of Hand Surgery reported a 59.1 percent reoperation rate after ulnar component excision and radial component reconstruction for preaxial polydactyly of the hand. Of 809 preaxial polydactyly patients, 2.6 percent underwent excision and reconstruction. Mean follow up was 49 months Six patients experienced poor results, seven reported fair outcomes, and two had good outcomes. No patients reported excellent results. The mean postoperative Japanese Society for Surgery of the Hand score was 12.8. Fifty percent and 27 percent of patients were satisfied with thumb function and appearance, respectively.
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| Study: Similar Radiologic Outcomes of PSI versus Standard Instruments in TAA
A study published online in Foot & Ankle International found no advantage to patient-specific instrumentation (PSI) over standard referencing (SR) in total ankle arthroplasty (TAA). Tibial component alignment, tibiotalar tilt, sagittal view talar offset, presence of radiolucent lines, surgery time, and wound healing were compared between 24 patients treated with PSI and 25 treated with SR at six weeks, four months, and one year postoperatively. Both groups had similar implant positioning. One SR patient and two PSI patients had radiolucent lines around the tibial component, and two SR patients had delayed healing.
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| AAOS Now
Use of Intraoperative Neuromonitoring during Spine Surgery Varies Widely
A survey of spine surgeons found that use of intraoperative neuromonitoring (IONM) during spine surgery varied depending on the surgical indication. The respondents also noted frequent out-of-network billing and high costs associated with IONM. The findings were presented by Madison L. Goss, MD, at the AAOS 2021 Annual Meeting. “Although there is increasing use of IONM, this has not translated to an absolute requirement for every spine surgery,” the authors wrote in their summary.
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| Your AAOS
AAOS Issues Update Regarding Humanitarian Efforts in Ukraine
On Wednesday, AAOS International Committee Chair Coleen S. Sabatini, MD, MPH, FAAOS, issued a follow-up message regarding AAOS’ support of humanitarian efforts in Ukraine, including a process for shipping medical supplies to trauma hospitals in impacted areas. Dr. Sabatini and the International Committee worked with the Ukrainian Association of Orthopaedic Surgeons to create a list of the most needed medical supplies as well as contacts to coordinate shipment of these items from the United States.
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