Study: Vulnerable Healthcare Markets Less Likely to Have High-performing Joint Replacement Hospitals
A cross-sectional study in the Journal of the AAOS® examined healthcare market- and hospital-level disparities in access to high-quality hip/knee replacement hospitals. A total of 2,682 hospitals and 304 healthcare markets were identified via 2021 Centers for Medicare & Medicaid Services (CMS) outcome measures and the 2022 Joint Commission (JC) process-of-care measures. Hospitals in the top quartile for low-income patient loads were less likely to be designated by CMS as “better than the national average” but were not more or less likely to be certified as “advanced” by the JC. Additionally, vulnerable healthcare markets had lower odds of having high-performing hip/knee hospitals.
Revision Hip Arthroscopy Results in Similar Survivability but Worse Outcomes versus Primary Arthroscopy
Arthroscopy published a study comparing the clinical outcomes of patients with femoroacetabular impingement undergoing primary hip arthroscopy (HA) versus revision HA (RHA). Fifty-one RHA patients were propensity matched in a 1:4 ratio to 204 HA patients. Hip Outcome Score Sports subscale (HOS-SS), modified Harris Hip Score (mHHS), and international Hip Outcome Tool (iHOT-12) scores were compared between groups. There were no significant differences regarding the rates of conversion to total hip arthroplasty or reoperation. RHA patients had significantly lower HOS-SS (64.9 versus 75.3), mHHS (72.2 versus 80.1), and iHOT-12 (61.4 versus 71) scores.
Does an Anterior Intrapelvic Approach Affect Blood Loss during Early Treatment of Acetabular Fractures?
The Journal of Orthopaedic Trauma published a retrospective study investigating whether time from hospital admission to surgery for acetabular fractures using an anterior intrapelvic approach affects blood loss. Estimated blood loss, calculated blood loss, and packed red blood cell (PRBC) transfusion requirements were used to evaluate blood loss in 195 patients. Patients who underwent surgery <48 hours after admission had significantly greater blood loss (453 mL versus 364 mL); however, there were no significant differences observed in terms of PRBC transfusion.
Study Finds Orthopaedic Specialty Hospitals Are Optimized for CMS Payments
According to a study in Current Orthopaedic Practice, orthopaedic specialty hospitals (OSHs) performed major joint/limb reattachment procedures of upper extremities (diagnosis-related group 483 [DRG-483]) at a 15 percent lower average Medicare payment (AMP) than nonspecialty hospitals (NSHs). To examine the cost-effectiveness of upper extremity arthroplasties at OSHs, CMS inpatient charge data on DRG-483 procedures and the influence of volume, hospital demographics, and orthopaedic specialization was analyzed. DRG-483 volume was weakly negatively correlated with AMP, and metropolitan centers performed DRG-483 procedures at the lowest cost to the Centers for Medicare & Medicaid Services (CMS).
The Spine Journal published a retrospective study that found pedicle screw fixation utilizing 3D-printed guides reduced intraoperative revision rates compared with freehand techniques during adolescent idiopathic scoliosis surgery. Seventeen and 15 patients were in the 3D-guided and fluoroscopy-guided freehand cohorts, respectively. The revision rate of pedicle screws and operative times were compared between cohorts. The overall revision rate for 3D-guided screw placement was 5.5 percent, compared with 8.5 percent for the freehand technique. There were no significant differences in number of levels fused or surgical time between groups.
Cato T. Laurencin, MD, PhD, Brings Science, Engineering, and Medicine to Higher Levels with Establishment of New Institute for Regenerative Engineering
The University of Connecticut has recently launched the Cato T. Laurencin Institute for Regenerative Engineering, a groundbreaking initiative aimed at advancing the fields of medicine, science, engineering, and technology. This institute is a testament to Cato T. Laurencin, MD, PhD, FAAOS, and his exceptional contributions to musculoskeletal regenerative engineering, dedication to promoting diversity in orthopaedics, and visionary goal of achieving limb regeneration.
Take Part in a Clinical Practice Guideline Review Period
AAOS has completed the development of two clinical practice guidelines (Management of Carpal Tunnel Syndrome and Management of Osteoarthritis of the Hip) and is now seeking volunteers to review the manuscript drafts prior to their approval and publication. Taking part in the review period gives members who were not involved in the development process an opportunity to provide feedback. The deadline to apply is Sept. 1.
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