Today’s Top Story
Study: Standards for “critical” bone loss in arthroscopic Bankart reconstruction may need to be reconsidered.
Data from a study published online in The American Journal of Sport Medicine suggest that standards for bone loss often considered to be “critical” in arthroscopic Bankart reconstruction may be too high and should be lowered. The authors conducted a cohort study of 72 consecutive patients with anterior instability (73 shoulders) who underwent isolated anterior arthroscopic labral repair at a single military institution. After dividing patients into quartiles based on bone loss, the authors noted significant differences between consecutive quartiles in Western Ontario Shoulder Instability and Single Assessment Numeric Evaluation scores. Between quartiles 2 and 3 (bone loss, 13.5 percent), WOSI score increased to rates consistent with a poor clinical outcome. The authors state that, historically, 20 percent to 25 percent has been accepted as the “critical” cutoff where glenoid bone loss should be addressed in a primary procedure. Read the abstract…
Other News
Study: Computer navigation may reduce risk of revision for younger TKA patients.
According to a study published in the April 15 issue of The Journal of Bone & Joint Surgery, use of computer navigation may reduce revision rates for non-elderly patients who undergo total knee arthroplasty (TKA). The authors reviewed registry data on all primary TKAs performed in Australia from 2003 to 2012. At 9-year follow-up, they found that the overall cumulative revision rate following TKA without navigation was 5.2 percent, compared with 4.6 percent for computer-navigated TKAs. Patients younger than 65 years who had undergone TKA without navigation had a cumulative revision rate of 7.8 percent, compared to 6.3 percent for those who had undergone navigated TKA. In addition, computer navigation was associated with significant reduction in the rate of revision due to loosening/lysis. Read the abstract…
Study: Initial complete displacement biggest risk factor for loss of reduction in pediatric DRF.
A study published in the April/May issue of the Journal of Pediatric Orthopaedics suggests that completely displaced distal radial fractures (DRFs) that cannot be anatomically reduced have a high risk of redisplacement after closed reduction. The research team conducted a prospective study of 135 pediatric patients (mean age, 9.9 years) with displaced DRFs. They found that redisplacement occurred in 39 cases (28.8 percent). The most important risk factor for loss of reduction was initial complete displacement, with completely displaced fractures seven times more likely to redisplace than fractures with some bony contact or no translation. Read the abstract…
Study: Feedback coupled with P4P program may improve compliance with VTE prophylaxis guidelines.
According to information published in the March issue of the Journal of Hospital Medicine, direct feedback to hospitalist physicians coupled with a pay-for-performance (P4P) program may improve physician compliance with venous thromboembolism (VTE) prophylaxis measures. The researchers conducted a retrospective analysis of 3,144 inpatient admissions. They found that monthly VTE prophylaxis compliance rates among hospitalist physicians were 86 percent at baseline, 90 percent after implementation of a web-based hospitalist dashboard VTE prophylaxis feedback system, and 94 percent when the feedback system was couple with a P4P initiative. Read more…
Read the abstract…
Study: Various tendons may react differently to loading and stress.
Research from a horse study published online in the Journal of the Mechanical Behavior of Biomedical Materials offers insight into how different tendons respond to injury and stress. The research team exposed fascicles and interfascicular matrix (IFM) from the equine superficial digital flexor tendon (SDFT) and the common digital extensor tendon (CDET) to cyclic loading followed by a test to failure. They found that the IFM mechanical behavior was not a result of irreversible deformation, but that the matrix was able to withstand cyclic loading and was more elastic in the SDFT than in the CDET. They also demonstrated that the IFM is less able to resist repetitive loading as it ages, becoming stiffer with increasing age in the SDFT. “These results provide further indications that the IFM is important for efficient function in energy storing tendons,” they write, “and age-related alterations to the IFM may compromise function and predispose older tendons to injury.” Read more…
Read the abstract…
California.
The California Medical Association (CMA) states that United Healthcare (UHC) recently issued notifications to 19,000 practices included in its commercially contracted provider network, advising of their inclusion in the UHC Core product. The organization points out that the new UHC Core plan accesses a significantly narrowed network and will be marketed to employer groups seeking lower premiums for their employees. In addition, CMA states that UHC also advised them that the only option for physicians who wish to opt out of the Core product network is to terminate the underlying UHC commercial agreement. There is no ability to opt out of just the Core network. Read more…
Texas.
The Austin Business Journal reports that a bill under consideration in the Texas House of Representatives would, if enacted, allow physical therapists to render services for 45 days or 20 visits without a physician referral. Supporters of the bill say that it is designed to promote consumer choice and access. Critics of the bill, including the Texas Orthopaedic Association, argue that, lacking a comprehensive medical review and diagnosis, therapists may deliver inappropriate care to patients. Read more…
Call for volunteers: Central Evaluation Committee.
July 15 is the last day to submit your application for a position on the Central Evaluation Committee. Members of the Central Evaluation committee write questions for the Orthopaedic In-Training Examination. The following positions are available:
- Hand (one member opening)
- Spine (one member opening)
Applicants for these positions must be active or emeritus fellows with a practice emphasis in the relevant topic. Learn more and submit your application…(member login required)
