Study Evaluates Tool to Assess Postoperative TKA Recovery
A retrospective study published online in BMC Musculoskeletal Disorders described and validated a reference chart to monitor knee flexion after total knee arthroplasty (TKA). The reference charts were created with Generalized Additive Models for Location Scale and Shape, as well as 1,173 observations from 327 TKA patients during the first 120 days postoperatively. The best fitting model used a nonlinear time trend and incorporated smoothing splines for median and variance parameters; the model fit was further improved with optimization of the number of knots in smoothing splines and power transformation of time. Using a test set of 377 observations in 171 patients, the reference chart had adequate performance.
Study: Which Hand and Upper Extremity Surgery Patients Are Most Likely to Receive Insurance Claim Rejections?
A study published in the Aug. 1 issue of the Journal of the AAOS ® identified factors predictive of insurance claim rejections in hand and upper extremity procedures. Five surgeons’ billing records spanning a one-year period were evaluated. Final analysis included 11,839 unique patient encounters with an overall claim rejection rate of 19.3 percent. Significant variations were observed by payer, with the lowest rate for private insurance (14.0 percent) and highest for Medicare (31.2 percent). An independent relationship was observed between the use of multiple Current Procedure Terminology codes and claim rejection risk in the office and surgical settings.
Study Assesses Treatment of Neglected Pediatric Hip Dislocation
A study published in the August issue of the Journal of Pediatric Orthopaedics reported outcomes of operative reduction in children with neglected hip dislocation. Seven patients (mean age, seven years) were followed for a mean 44 months. Most children (86 percent) were able to walk and run without a limp, could squat, had no pain, and the mean Harris Hip Score was 98.9. At final follow-up, radiographs demonstrated no evidence of growth disturbance in 29 percent of cases, coxa magna in 57 percent, and partial femoral head collapse in 14 percent. Patients treated within eight months of injury had minimal to no evidence of growth disturbance.
Study: What Factors Influence Surgeon Decision Making for Shoulder Instability Treatment?
A study published online in the Journal of Shoulder and Elbow Surgery used a contingent-behavior questionnaire to determine how surgeons choose to perform bony procedures versus soft-tissue procedures in recurrent anterior shoulder instability. A total of 70 orthopaedic surgeons completed the survey. The most significant factor that influenced a surgeon to choose bony procedures over soft-tissue procedures was the amount of glenoid bone loss, followed by the patient age (19–25 years) and activity level. Surgeons who performed at least 10 open procedures annually were more likely to choose a bony procedure.
HHS Extends Deadline for Medicaid Providers to Apply for Funding
The Department of Health and Human Services (HHS) extended the deadline for Medicaid, Medicaid managed care, CHIP, and dental providers affected by COVID-19 to apply for aid from the Provider Relief Fund. The extension also applies to Medicare providers who had difficulties during the first application period. The new deadline to apply for both groups is Aug. 28.
Higher Facility Costs Do Not Improve THA and TKA Outcomes
Costs associated with total hip arthroplasty (THA) and TKA vary significantly at different facilities. A study presented as part of the Annual Meeting Virtual Experience compared short-term outcomes of THAs and TKAs performed at higher- versus lower-cost facilities and observed no significant differences.
From Aug. 1 to 31, AAOS members across the United States have the unique opportunity to serve as advocates in their own communities. During this monthlong, first-of-its-kind event, orthopaedic surgeons will engage with members of Congress in their district and regional offices as well as virtually to advocate for access to the very best orthopaedic care on behalf of their patients and the profession. Get involved today by (1) connecting with your AAOS Board of Councilors representatives and state orthopaedic societies, (2) participating in a grassroot initiative via the AAOS Advocacy Action Center, or (3) raising awareness of these efforts on social media using the hashtag #OrthoAdvocacyinAction.
