Today’s Top Story
GAO: Many children lack access to pediatric trauma centers, but effect on outcomes is not clear.
A report from the U.S. Government Accountability Office (GAO) finds that only 57 percent of 73.7 million children in the United States during the period 2011-2015 lived within 30 miles of a pediatric trauma center. The agency notes that among states, the proportion of children who lived within 30 miles of a pediatric trauma center varied widely. The writers state that some studies have found that children treated at pediatric trauma centers have a lower mortality risk compared to those treated at adult trauma centers and other facilities, although other studies found no difference in mortality. GAO states that, as overall mortality is low among severely injured children, additional information on outcomes other than mortality may be required to fully assess the effect of a lack of access to pediatric trauma centers.
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Other News

Study: Outcome factors rank high on surgeon preference for TKA devices and techniques.
A study published online in The Journal of Arthroplasty examines factors linked to surgeon preference for certain total knee arthroplasty (TKA) devices and techniques. The authors conducted a multi-national survey of 347 TKA-performing orthopaedic surgeons regarding surgeon preference in TKA, including self-assigned utility of preferred prosthesis, reasons to alter usual preference, and barriers to permanently changing preference. They found that the highest rated of 17 attributes were “reproducibility of outcome,” “best functional outcome,” and “better kinematics.” Lowest rated attributes included a “key-opinion leader or mentor uses it” and “new or innovative.” The authors note that “lowest revision risk” ranked 10th overall, with 19.9 percent of respondents stating it did not influence their preference. Overall, the authors found that 52.1 percent of surgeons were not influenced by cost, while 33.7 percent of surgeons agreed that their institution or system limited their preference.
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Study: Bone shape features may be linked to abnormal knee kinematics following ACL reconstruction.
Findings from a study published online in the journal Clinical Orthopaedics and Related Research suggest that bone shape features in the tibia and femur may be associated with abnormal knee kinematics after anterior cruciate ligament (ACL) injury and reconstruction. The research team conducted a prospective study of 38 patients who were followed after acute ACL injury and prior to ligamentous reconstruction. Based on magnetic resonance imaging, they found that two of 20 specific femur bone shape features and two of 20 specific tibial bone shape features were associated with an increasingly anterior side-to-side difference (SSD) in the tibial position for the patients with ACL injury before surgical treatment. At 1 year after surgical treatment, the research team found that two of 20 femoral shape features were associated with SSD in the tibial position in extension, one of 20 femoral shape features was associated with SSD in the tibial position in flexion, and three of 20 tibial shape features were associated with SSD in the tibial position in flexion.
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Study: Higher BMI associated with increased risk of pulmonary complication after outpatient surgery.
According to a study published online in the Journal of the American College of Surgeons, high obesity may be linked to increased risk of pulmonary complication following outpatient surgery. The researchers analyzed 444,532 outpatient surgery cases from the 2012-2013 National Surgical Quality Improvement Program database. They found 996 all-cause pulmonary complications (defined as pneumonia, pulmonary embolism, unplanned intubation, or ventilator-assisted respiration for greater than 48 hours within 30 days of surgery). Binary logistic regression identified body mass index (BMI) as an independent predictor of a pulmonary complication, with increasing risks associated with higher BMI. However, the researchers note that obesity-associated risk “was low compared with the risk associated with advanced age, prolonged surgical duration as well as the risk of comorbidities including congestive heart failure, chronic obstructive pulmonary disease and renal failure.”
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House bill would extend and expand waiver program for international physicians who train in the United States.
The California Medical Association reports that a bill under consideration in the U.S. House of Representatives would reauthorize and expand the Conrad 30 Waiver program. Under current law, international medical students with J-1 visas who study in the United States are required to return to their country of origin for 2 years after completion of their medical residency, prior to application for a green card or visa. The Conrad 30 program waives the return requirement for a limited number of new physicians each year who agree to work for 3 years in an underserved area. If enacted, the bill would reauthorize the program until 2021 and increase the number of available visas.
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Nebraska.
According to Stateline, Nebraska has become the 19th state to adopt the Interstate Medical Licensure Compact, which offers an expedited pathway to licensure for qualified physicians who wish to practice in multiple states. The Federation of State Medical Boards says that six additional states and Washington, D.C. have also introduced legislation to adopt the compact.
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Call for volunteers: CMS Quality Measure Development panel.
AAOS seeks to nominate members to the U.S. Centers for Medicare & Medicaid Services (CMS) Technical Expert Panel on Supporting Efficiency and Innovation in the Process of Developing CMS Quality Measures. Members of this panel will help inform development of the CMS Measures Management System Blueprint. 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, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, a letter of interest highlighting their expertise in the subject area, and a CMS nomination form (available below). All supporting materials must be submitted by May 7, 2017, at 11:59 p.m. CT, to Kyle Shah at shah@aaos.org.
Learn more and submit your application…(member login required)
Learn more about Technical Expert Panels…
Download the nomination form (ZIP)…