COVID-19 Updates

Trump Signs $484 Billion COVID-19 Relief Bill for Small Businesses, Hospitals

President Donald J. Trump signed a $484 billion COVID-19 relief bill that provides $370 billion for small businesses: $310 billion to replenish the Paycheck Protection Program, and $60 billion for small lenders. The latest bill also provides $75 billion for hospitals and $25 billion for COVID-19 testing efforts. This is the fourth COVID-19 relief bill passed by Congress.

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Read AAOS’ Paycheck Protection Program and Health Care Enhancement Act resource…

 
 
 
 
In Other News

Study Examines Relationship Between Surgeon Opioid Prescribing Habits and New Persistent Use in THA Patients

According to a study published online in The Journal of Arthroplasty, surgeon prescribing habits played a significant role in the development of persistent opioid use after total hip arthroplasty (THA). Researchers retrospectively analyzed Michigan-based Medicare claims. Orthopaedic surgeons performing THAs between 2013 and 2016 and their opioid-naïve patients aged older than 65 years were included. High-risk prescribing was defined as high daily doses, overlapping benzodiazepine prescriptions, concurrent opioid prescriptions, prescriptions from multiple providers, or long-acting opioid prescriptions. Individual exposures included the occurrence of a preoperative prescription, initial prescription size, and 30-day prescription dosage. High-risk prescribing was observed in two-thirds of encounters. Patients treated by surgeons with the highest rates of high-risk prescribing, compared to those treated by surgeons with the lowest risk, had a higher likelihood of developing persistent use. Patients of surgeons whose initial prescription sizes were “high” and 30-day prescription doses were in the “highest” quartiles of 30-day prescription doses were more likely to develop persistent opioid use than those treated by surgeons with low initial and 30-day prescription sizes, respectively.

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Study: Incidence and Spontaneous Healing Rate of Segond Fracture in ACL Reconstruction Patients

A retrospective study published in the April issue of The American Journal of Sports Medicine assessed the incidence and spontaneous healing rate of Segond fractures among anterior cruciate ligament (ACL) reconstruction patients. Consecutive isolated ACL reconstruction patients treated between 2002 and 2016 were analyzed. Radiographs from the time of injury and preoperatively were assessed for Segond fractures and healed Segond fractures. Final analysis included 1,364 patients. Segond fracture incidence was 7.4 percent, and 10.4 percent of patients had signs of healed Segond fractures; 15.2 percent of patients had at least one of those findings. Overall healing response was 35.6 percent. Segond fracture patients tended to be older and had a shorter interval from injury to surgery. Segond fractures were more common among patients who were injured during downhill skiing compared to other injury mechanisms. Second fracture was not correlated with a greater risk of revision.

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Study Compares Outcomes of Same-day Discharge versus Inpatient Stay for Shoulder Arthroplasty

A study published in the May issue of the Journal of Shoulder and Elbow Surgery compared 90-day readmission, emergency department (ED) visit, deep infection, and venous thromboembolism (VTE), as well as one-year mortality, between shoulder arthroplasty patients discharged the day of surgery versus those with an inpatient stay. A total of 6,503 elective primary unilateral total shoulder and reverse total shoulder arthroplasties were retrospectively reviewed, of which 6 percent (n = 405) had same-day discharge. No difference was observed between same-day discharge and one- to four-night stay regarding 90-day readmission, 90-day ED visit, and one-year mortality. The study authors said same-day discharge was not inferior to one- to four-night stay in terms of readmission, but they did not find evidence to support noninferiority for 90-day ED visits or one-year mortality. The rates of 90-day deep infections and VTE were too low to be included in adjusted analyses.

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Study: Percutaneous Vertebroplasty versus Kyphoplasty for Osteoporotic Kümmell’s Disease Treatment

A study published online in BMC Musculoskeletal Disorders compared the clinical efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) to treat Kümmell’s disease. Clinical data on Kümmell’s disease patients treated with PVP (n = 28) or PKP (n = 28) were assessed. Preoperative characteristics, including gender, age, course of disease, injury segment, bone mineral density, visual analog scale (VAS), Oswestry Disability Index (ODI), and imaging measurement indexes, did not largely differ between the groups. Outcomes included bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis, and refracture rate of adjacent vertebra in two years. The amount of bone cement injected, incidence of bone cement leakage, and refracture rate of adjacent vertebrae did not largely differ between the groups. The PVP group had significantly lower operation time, intraoperative blood loss, and fluoroscopy times than the PKP group. In both groups, VAS scores and ODI were significantly lower at one day, one year, and two years compared to preoperative values, with no significant between-group differences at any time point. Similarly, the rate of vertebral compression and kyphosis correction were significantly corrected in both groups and decreased significantly with time, with no significant between-group differences at any time point.

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AAOS Now

April Issue of AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the April issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue highlights include a new COVID-19 section, an update on the surprise medical billing debate, evidence to support fixing meniscal tears, and more.

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Your AAOS

Submissions are Open for Kappa Delta and OREF Awards

AAOS is soliciting manuscripts for the 2021 Kappa Delta Orthopaedic Research Awards and the Orthopaedic Research and Education Foundation (OREF) Clinical Research Award. Up to two $20,000 Kappa Delta awards (Elizabeth Winston Lanier Award and Ann Doner Vaughan Award), one $20,000 Kappa Delta Young Investigator award, and one $20,000 OREF award will be bestowed, provided manuscripts of requisite quality are submitted. Manuscripts should represent a large body of cohesive scientific work generally reflecting years of investigation. Manuscripts must be submitted by members (or candidate members) of AAOS, Orthopaedic Research Society (ORS), Canadian Orthopaedic Association, or Canadian Orthopaedic Research Society. The awards will be presented at the AAOS 2021 Annual Meeting, and recipients will be invited to speak at the ORS 2021 Annual Meeting. Submissions are due no later than 11:59 p.m. C.D.T. on July 1.

Learn more and submit your application…