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| Today’s Top Story
Study: Most Orthopaedic Surgery Patients Use Fewer Opioids Than Prescribed
A study published in the April 1 issue of the Journal of the AAOS ® surveyed 919 orthopaedic patients regarding opioid use after seven types of elective surgical procedures: total knee arthroplasty, total hip arthroplasty, lumbar fusion, lumbar laminectomy, rotator cuff repair, arthroscopic meniscectomy, and carpal tunnel release. Surveys were conducted between 21 and 35 days postoperatively. Most patients (94.3 percent) were prescribed opioids. Seventy-seven percent of patients reported having leftover opioids, 18.2 percent reported using no opioids, and 50.2 percent of patients consumed less than half of their recommended prescription maximum per procedure. Overall, 60.0 percent of prescribed opioids were unused.
Read the abstract… |
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| In Other News
Medicare Sequester Cuts Suspended Through 2021
On Tuesday, President Joe Biden signed legislation extending the pause on Medicare sequester cuts through the end of the year. Versions of the bill to delay $18 billion in automatic Medicare payment cuts passed the U.S. Senate on March 25 and the U.S. House of Representatives more recently on April 13. The 2 percent federally mandated Medicare sequester cuts were paused by Congress last year in response to the COVID-19 pandemic and its effect on healthcare providers’ finances. That pause technically expired on April 1, however organizations like AAOS consistently advocated for an extension of the moratorium, arguing that the pandemic continues to negatively impact the healthcare industry. The Centers for Medicare & Medicaid Services also told Medicare administrative contractors to hold all claims with dates of service on or after the expiration date in anticipation of congressional action. Unfortunately, the final version of the bill signed by President Biden omitted a provision that would have shielded providers from an additional 4 percent cut to Medicare payments, which AAOS will continue to fight.
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| Study: Risk Factors of Failed Nonsurgical Management of Anterior Shoulder Instability
A study published online in Arthroscopy evaluated risk factors of conversion to surgery after nonsurgical treatment for traumatic anterior shoulder instability. The researchers used the Rochester Epidemiology Project database to identify 379 patients treated between 1994 and 2016. After an average follow-up of 10.2 years, 79 shoulders (20.1 percent) progressed to surgery, reducing these patients’ rate of recurrent instability from 92.4 percent to 10.1 percent at final follow-up. Recurrent instability occurred in 52.3 percent of patients treated nonsurgically. Instability at follow-up and having two or more subluxations or dislocations prior to first evaluation were associated with increased risk of surgery.
Read the abstract… |
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| Study: Extreme Lateral Interbody Fusion with Posterior Stabilization Is Beneficial in Obese Patients
A retrospective study published online in The Spine Journal evaluated long-term outcomes of extreme lateral interbody fusion (XLIF) in patients who are obese (BMI <30 kg/m 2). A total of 115 patients who underwent XLIF with percutaneous posterior stabilization with five years of follow-up were included, of whom 62 were obese and 53 were not. Postoperative Oswerty Disability Index, Visual Analog Scale pain scores, and pelvic incidence-lumbar lordosis mismatch correction were similar between groups. Reoperation was required in 9.6 percent of obese patients, compared to 5.6 percent of non-obese patients. Success rates were 98.39 percent and 96.23 percent in obese and non-obese patients, respectively.
Read the abstract… |
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| Study: Favorable Outcomes for Nonsurgical Management of Displaced Pediatric Distal Radial Fractures
A study published online in The Bone & Joint Journal evaluated management of closed, completely displaced metaphyseal distal radial fractures in children aged ≤10 years. Fifty-six children treated between 2015 and 2020 were included Sixteen patients were treated with straight cast and 40 were treated surgically. Straight cast patients were all discharged with good range of motion after six to 50 weeks. Seventeen children treated surgically had re-displacement with angulation >10 degrees, four had visible cosmetic deformity, nine had restricted movement, and one developed pin site over-granulation with a buried wire. No pin site infections occurred.
Read the study… |
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| AAOS Now
What Is Orthopaedic Surgery’s Environmental Impact?
The environmental impact of health care is a critical issue, especially as procedure volumes are expected to rise. With one of the highest procedure volumes performed annually, orthopaedic surgery is a significant contributor of greenhouse gas emissions. One study found that found that the average amount of waste generated by orthopaedics was 60.0 percent greater than the next closest hospital service. The specialty must take steps to determine and reduce its carbon footprint.
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| Your AAOS
AAOS Courses OnDemand: Learn Like You Were There
Grab your front-row virtual seat at recorded AAOS courses with on demand video programs that bring the finished events to you. Self-directed programs offer the flexibility to engage with trusted AAOS content at your convenience, across your devices. Watch and listen to the experts and their presentation slides, patient case discussions, and surgical demonstration videos. Content is segmented by topic, so you can select lectures you prefer to watch, pick up where you left off, and earn continuing medical education credit at your own pace. Explore the growing collection today.
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