Today’s Top Story
Study: Return-to-sport rates similar for primary and revision ACL reconstruction patients, but primary patients more likely to return to previous activities.
A study published online in The American Journal of Sports Medicine finds no significant difference in return-to-sport rates between primary and revision anterior cruciate ligament (ACL) reconstruction. The authors conducted a single-center, prospective, cohort study of 552 patients who underwent either primary (n = 497) or revision (n = 55) ACL reconstruction. At 1-year follow-up, they found no significant difference in return-to-sport rate across cohorts. However, patients in the primary reconstruction group resumed their usual sport significantly more often compared to those in the revision group. In addition, at 1 year, functional scores were significantly better in the primary reconstruction group for subjective International Knee Documentation Committee score; Knee injury and Osteoarthritis Outcome Score Symptoms/Stiffness, Activities of Daily Living, Sport, and Quality of Life subscales; and ACL–Return to Sports after Injury scores. Overall, there were eight retears during a new sport-related injury within a mean 8.9 months: seven (1.4 percent) in the primary reconstruction group and one (1.8 percent) in the revision reconstruction group. Read the abstract…

Other News

Study: Does increased pharmacy access help reduce readmission rates?
Findings from a study published online in the Journal of the American Pharmacists Association suggest that improved pharmacy access may be associated with reduced readmission rates. The researchers conducted an ecologic study of 48 rural and urban primary care service areas in Oregon. They found that 30-day all-cause readmission rates ranged from 13.5 percent to 16.5 percent. The researchers state that increased pharmacy density was associated with reduced readmission rates, asymptotically approaching a predicted 14.7 percent readmission rate for areas with high pharmacy density. Read more…
Read the complete study…

Device manufacturer faces whistleblower suit over off-label use.
Stat News reports on a whistleblower lawsuit in which Medtronic is accused of promoting its VERTE-STACK spine device for off-label use. The writer notes that the device was approved by the U.S. Food and Drug Administration for use in the thoracic and lumbar spine, and specifically labeled that it is not for cervical spine use. However, an email obtained by attorneys shows a manufacturer sales representative stating that “many surgeons choose to use it in the cervical spine,” and one observer notes that the device is sized more appropriately for use in the neck than the lumbar spine. A spokesperson for the company states that the device “comes in a variety of sizes to accommodate the unique anatomies of different sized patients.” Read more…

Study: Female providers make less than males, for similar effort and experience.
According to a study published online in the Postgraduate Medical Journal, female healthcare providers may see lower Medicare reimbursement than male providers. The researchers analyzed more than 3 million publicly available Medicare reimbursement claims for calendar year 2012 and compared the reimbursements received by male and female healthcare providers across 13 medical specialties. After adjustment for factors such as productivity (based on number of services provided), experience, and work effort (based on number of patients seen), they found that female providers made $18,677.23 less than male providers. Read more (PDF)…
Read the abstract…

ACS releases guidelines statement on OR attire.
The American College of Surgeons (ACS) has released guidelines for appropriate operating room (OR) attire based on professionalism, common sense, decorum, and available evidence. Recommendations include:

  • Soiled scrubs and/or hats should be changed as soon as feasible, and prior to speaking with family members after a surgical procedure.
  • Scrubs and hats worn during dirty or contaminated cases should be changed prior to subsequent cases even if not visibly soiled.
  • Masks should not be worn dangling at any time.
  • OR scrubs should not be worn in the hospital facility outside of the OR area without a clean lab coat or appropriate cover up, and never worn outside the hospital perimeter.
  • During invasive procedures, mouth, nose, and hair should be covered to avoid potential wound contamination.
  • Earrings and jewelry worn on the head or neck should be removed or appropriately covered during procedures.
  • Clean appropriate professional attire (not scrubs) should be worn during all patient encounters outside the OR.

ACS states that, “As stewards of our profession, we must retain emphasis on key principles of our culture, including proper attire, since attention to such detail will help uphold the public perception of surgeons as highly trustworthy, attentive, professional, and compassionate.” Read more…
Read the guidelines…

Study: Abaloparatide treatment may reduce risk of new fracture compared to placebo.
Findings published in the Aug. 16 issue of The Journal of the American Medical Association suggest that treatment with subcutaneous abaloparatide may reduce risk of new fracture compared to placebo. The research team conducted a double-blind trial of 1,901 women across 28 sites in 10 countries. They found that new morphometric vertebral fractures occurred in four patients (0.58 percent) in the abaloparatide group, 30 patients (4.22 percent) in the placebo group, and six patients (0.84 percent) in the teriparatide group. Kaplan–Meier estimated an event rate for nonvertebral fracture of 2.7 percent for abaloparatide, 4.7 percent for placebo, and 3.3 percent for teriparatide. The research team found that bone mineral density increases were greater with abaloparatide than with placebo, and that incidence of hypercalcemia was lower with abaloparatide than with teriparatide. Read more…
Read the abstract…

Call for volunteers: Communications Cabinet.
Aug. 24 is the last day to submit your application for a position on the Communications Cabinet. The Communications Cabinet directs and evaluates AAOS communication vehicles, oversees special communications projects, provides public and media relations expertise to AAOS governance units, and promotes orthopaedics to internal and external audiences to enhance the image of orthopaedic surgeons and the orthopaedic specialty. The following positions are available:

  • One member-at-large
  • One member with technology expertise

Applicants for these positions must be active fellows, associate members osteopathic, candidate members, or resident members. Learn more and submit your application…(member login required)