Today’s Top Story
Study: Low rate of adverse events reported for hand and upper-extremity surgeries at ASC.
Findings published in the April 20 issue of The Journal of Bone & Joint Surgery (JBJS) suggest that, given a selected patient population, a very low adverse event rate can be achieved for patients who undergo hand and upper-extremity surgical procedures at freestanding ambulatory surgery centers (ASCs). The research team conducted a retrospective review of 28,737 cases at a single ASC. They found 58 reported adverse events (0.20 percent of cases), including 14 infections, 18 postoperative transfers to a hospital, 21 hospital admissions after discharge, one medication error, and four postoperative hematomas. There were no cases of wrong-site surgical procedures, retained foreign bodies, or patient deaths.
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Other News

Study: Use of robotic surgical arm may be associated with improved component positioning following UKA.
According to a study published in the April 20 issue of JBJS, use of a robotic surgical arm may be associated with improved accuracy of implant positioning compared to conventional techniques for patients undergoing unicompartmental knee arthroplasty (UKA). The authors conducted a prospective, randomized, single-blind, controlled trial of 120 patients, 62 of whom underwent robotic-assisted UKA and 58 of whom underwent conventional UKA. At 3-month follow-up with computed tomography, they found that use of the robotic surgical arm was associated with improved component positioning accuracy, with lower root mean square errors and significantly lower median errors in all component parameters. Overall, the proportion of patients with component implantation within 2° of the target position was significantly greater in the robotic cohort compared to the conventional cohort, with regard to femoral component sagittal position, femoral component coronal position, femoral component axial position, tibial component sagittal position, and tibial component axial position.
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Study: Longer surgeries linked to hand recolonization; rescrubbing may be beneficial prior to hour 5.
Findings from a pilot study published online in the journal Clinical Orthopaedics and Related Research suggest that it may be beneficial for surgeons to rescrub between the fourth and fifth hours of an operation. The researchers assessed data on 20 spine procedures of 3 hours or more duration, performed by three surgeons using the same scrubbing technique. They found that a longer duration of surgery was associated with more colony-forming units recovered from gloved hands at the end of surgery. The researchers write that the receiver-operating characteristic curve suggested 5 hours as the cutoff point for hand recolonization; at 5 hours, contamination reached or exceeded prescrub levels, whereas before 5 hours, there was no contamination detected at the end of surgery.
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Study: Preconcussive somatization symptoms linked to longer recovery time following concussion.
According to a study published online in the journal Neurology, athletes with preinjury somatization symptoms may take longer to recover following sport-related concussion. The research team analyzed data on 2,055 high school and collegiate athletes who completed preseason evaluations. Overall, 127 concussed athletes repeated assessments serially at
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Medicare initiative may penalize hospitals with more aggressive adverse event screening programs.
An article in The New York Times profiles unintended consequences of an Affordable Care Act initiative designed to penalize hospitals that have higher rates of adverse events. The writer observes that hospitals that have implemented more aggressive screening programs may uncover more adverse events, increasing observed rates and resulting in Medicare reimbursement penalties. “Medicare is reducing a year’s worth of payments to 758 hospitals,” the writer states, “including some of the most prestigious teaching hospitals in the country, with the highest rates of infections and other potentially avoidable complications, including blood clots after surgery, bed sores, hip fractures and sepsis.”
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Submit your 2017 AAOS Annual Meeting abstracts now!
Share your knowledge with orthopaedic surgeons from around the world at the 2017 AAOS Annual Meeting, to be held March 14-18, 2017, in San Diego. Nowhere else will your discoveries reach such a wide-ranging orthopaedic audience! June 1 is the deadline to submit abstracts for paper presentations, poster presentations, and scientific exhibits. The deadline for Orthopaedic Video Theater submissions is July 15. Please note that, prior to abstract submission, presenters and all coauthors must disclose current financial relationships in the AAOS Disclosure Database Program. Disclosure reported on April 1, 2016 or later is acceptable.
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Call for volunteers: AMA House of Delegates.
AAOS seeks one delegate representative to join the American Medical Association (AMA) House of Delegates. Members of the AMA House of Delegates serve as an important communications, policy, and membership link between the AMA and grassroots physicians. The delegate is a key source of information on activities, programs, and policies of the AMA. The delegate is also a direct contact for the individual member to communicate with and contribute to formulation of AMA policy positions, identification of situations that might be addressed through policy implementation efforts, and implementation of AMA policies. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, applicants must be AMA members and practicing orthopaedic surgeons.
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