Presidential Update from Joseph A. Bosco III, MD, FAAOS
In his latest message, AAOS President Joseph A. Bosco III, MD, FAAOS, discussed the Academy’s decision to move the 2021 Annual Meeting from March 2021 to August 2021. On the advocacy front, he discussed how lawmakers are now considering the long-term effects of COVID-19 response efforts. Plans for 2021 are in the works, including the Centers for Medicare & Medicaid Services’ (CMS) recent payment policy proposals, which include moving 300 musculoskeletal procedures to the hospital outpatient setting in 2021. Dr. Bosco reiterated that the Academy is encouraging CMS to reconsider certain parts of the proposals. He called on members to take action via the AAOS Advocacy Action Center.
Study: Factors Associated with Opioid Use Longer Than 15 Days Post-TKA
A study published in the July issue of The Journal of Arthroplasty identified predictors of opioid use longer than 15 days after total knee arthroplasty (TKA). A total of 621 TKA patients (mean age, 66.3 years; 57.6 percent were female) were retrospectively reviewed. Factors associated with receiving opioid prescriptions for more than 15 days postoperatively included female sex, higher BMI, and receipt of more post-discharge prescriptions in the 60-day follow-up period. Patients with a longer length of stay were more likely to be prescribed more than 1,350 morphine milligram equivalents.
Study Evaluates Effectiveness of Low Tibial Valgization Osteotomy in Severe Ankle Arthritis
A retrospective study published online in Foot & Ankle International observed clinical improvements in severe varus ankle arthritis treated with low tibial valgization osteotomy with medial opening wedge (LTO). Thirty-one patients underwent either LTO or LTO plus inframalleolar correction. Mean talar tilt (TT) did not largely differ postoperatively, but clinical parameters showed significant improvements. Patients with concomitant inframalleolar correction had more corrected TT.
Study Assesses Outcomes for Older Reverse TSA Patients
A study published online in the Journal of Shoulder and Elbow Surgery observed a low complication rate and good functional and pain outcomes in patients aged older than 80 years who underwent primary reverse total shoulder arthroplasty (TSA). A total of 171 shoulders (159 patients; mean age, 84 years) were included; 136 cases underwent a physical examination after a mean 41 months. Relative Constant-Murley and Subjective Shoulder Value scores both significantly improved. The surgical site complication rate was 30 percent, reoperation rate was 8 percent, and overall mortality rate was 16 percent.
Blog: Addressing Racial Inequities in Medical Publications
A blog published online in Health Affairs discussed recent publicized incidents of racism in America and how racism is often not discussed as a cause of health disparities. The blog provides recommendations for researchers, journals, and peer reviewers on how to address the role of racism in health care.
AAOS’ Systematic Review on Management of SSI in Orthopaedic Surgery
Surgical site infections (SSIs) continue to be a daunting challenge for modern healthcare systems, with an estimated 1.0 percent to 2.5 percent annual incidence of SSIs after total joint arthroplasty alone. Although the absolute number of infections is quite low, the individual and financial cost is immense. During the past two decades, orthopaedic research has added to the growing body of knowledge to combat this issue. However, in many instances, the evidence is inconsistent and sometimes conflicting, making it difficult for an individual surgeon to assess the general direction and overall conclusions of the available literature. This article revisits the methodologic approach and major conclusions of AAOS’ 2018 systematic review titled “Systematic Literature Review on the Management of Surgical Site Infections.”
