Today’s Top Story

Study: Disabled Medicare beneficiaries may use more opioids

A study published online in The BMJ found that disabled Medicare beneficiaries used opioids more often over a 10-year period than other Medicare beneficiaries and commercial beneficiaries. Researchers analyzed administrative medical and pharmacy claims data between Jan. 1, 2007, and Dec. 31, 2016, for 48 million Medicare Advantage and commercial insurance beneficiaries to determine prevalence of use, dose, and duration of prescription opioids. They found that 14 percent of commercial beneficiaries, 26 percent of Medicare beneficiaries, and 52 percent of disabled Medicare beneficiaries used opioids across all years. Among commercial and Medicare beneficiaries, quarterly use rates remained relatively stable over the course of the study. However, for disabled Medicare beneficiaries, quarterly use rates and average daily dose increased, from 26 percent quarterly use and 53 milligram morphine equivalents (MME) daily in 2007 to 39 percent quarterly use and 56 MME in 2016.

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Study: Strength levels based on age and sex may affect shoulder injury

A single experiment study published online in BMC Musculoskeletal Disorders found that age- and sex-related differences in strength may be more predictive of shoulder injuries than muscle fatigue resistance. Researchers measured muscle fatigability in 40 participants (20 males, 20 females) based on upper trapezius muscle fiber conduction velocity (CV) and relative maximum strength at three levels of shoulder abduction. Both male and female groups had 10 young (mean age, 26 years) and 10 older (mean age, 59.6 years) participants. Upper trapezius CV differed based on age and sex, with the older and female groups having greater levels of muscle fatigue resistance. Shoulder abduction endurance time varied significantly between age groups; the young and male groups exhibited greater levels of strength. Since work-related musculoskeletal disorders more commonly affect older and female populations, the researchers noted that muscle fatigability is not likely a contributor.

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CMS updates Quality Payment Program Participation Status Tool to include early 2018 data

The Centers for Medicare & Medicaid Services (CMS) added 2018 Qualifying Alternative Payment Model (APM) Participant (QP) and Merit-based Incentive Payment System (MIPS) APM status to its Quality Payment Program Participation Status Tool. The update includes data from Medicare Part B claims with dates of service from Jan. 1 to March 31. Qualifying QPs are eligible for the 5 percent APM incentive bonus and are exempt from participating in MIPS CMS will reveal data for the second and third QP and MIPS APM determinations for Jan. 1 to Aug. 31 later this year.

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Total knee replacement market projected to exceed $10 billion by 2024

The global total knee replacement market is expected to increase over the next six years, surpassing $10 billion worldwide by 2024, according to a report from Global Market Insights, Inc. During this time, there will be an estimated compound annual growth rate of 3.7 percent. This spike will be driven by the increasing prevalence of chronic bone disorders and an aging population. In addition, the number of younger patients undergoing knee replacement surgeries has increased since many patients are able to return to normal functions after surgery. Increased use of three-dimensional implants will also drive up market value; however, growth will be hindered in lower-income economies because, as the technology advances, costs will rise.

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Study: Obesity may not impact TKA

Results of a retrospective, observational study published online in The Knee did not indicate greater blood loss or higher risk of red blood cell transfusion in severely or morbidly obese patients who underwent total knee arthroplasty (TKA) compared to obese or nonobese patients. The study included 922 patients; 35.90 percent were obese class I (obese) and 18.76 percent obese class II–III (severe and morbidly obese). Blood volume was approximately 4,390 mL among the nonobese, 4,736 mL among obese class I, and 5,030 mL among obese class II–III. The global estimated blood volume lost was 1,502 mL. The percentage of lost blood volume was slightly lower for obese class II–III patients (29.65 percent) than nonobese (33.55 percent) and obese class I (30.97 percent) patients. A negative transfusion risk was observed in patients in obese class II–III: Transfusion rates were 12.7 percent, 12.1 percent, and 6.4 percent for nonobese, obese class I, and class II–III, respectively.

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Pediatric fractures of the femoral shaft: Arriving at the algorithm

There is no single treatment algorithm to guide in the management of fractures of the femoral shaft, said Anthony I. Riccio, MD, of Texas Scottish Rite Hospital for Children, during the AAOS 2018 Annual Meeting Symposium titled “Staying out of Trouble in Pediatric Trauma.” Treatment guidelines are often based upon age, he said, but “you have to consider the other variables, including weight and fracture stability.” In school-age children, weight may a determining factor in the approach and hardware selection.

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Last call: Apply for Exhibits Committee member positions

The Exhibits Committee has an open member position, a two-year term that runs from March 17, 2019, to March 13, 2021. The committee helps plan, organize, and develop new programs and initiatives for the Academy’s industry exhibits at the Annual Meeting. The last day to submit an application is Aug. 14.

Learn more and submit your application…(member login required)