Today’s Top Story
Study: TXA linked to reduced blood loss for primary RTSA patients.
Data from a study published in the August issue of the Journal of Shoulder and Elbow Surgery suggest that patients who undergo primary reverse total shoulder arthroplasty (RTSA) may benefit from the use of tranexamic acid (TXA). The authors conducted a prospective, double-blind, randomized, controlled trial of 102 patients undergoing primary RTSA who received either intravenous TXA (n = 53) or placebo (n = 49). They found that total blood loss, total hemoglobin loss, and total drain output were less in the TXA cohort compared to the control cohort. The authors note that seven patients (14.3 percent) and 12 units of blood were transfused in the placebo group, while three patients (5.7 percent) and 3 units were transfused in the TXA group. Read the abstract…

Other News

Study: Medial pivot pattern may not significantly affect clinical success following TKA.
According to a study published in the August issue of The Journal of Arthroplasty, a medial pivot pattern may not significantly affect clinical success after total knee arthroplasty (TKA). The researchers retrospectively reviewed information on 141 TKAs. Overall, 40 percent of TKAs demonstrated a medial pivot kinematic pattern intraoperatively. At minimum 1-year follow-up, the researchers found that, regardless of bearing type, Knee Society scores and University of California, Los Angeles activity level did not significantly differ based on medial compared to nonmedial pivot patterns. However, they noted a trend toward greater median improvement in Knee Society objective and satisfaction scores in medial pivot knees for patients with posterior cruciate-sacrificing implants. Read the abstract…

Study: How does foot morphology correlate to pain for clubfoot patients?
A study published online in the Journal of Pediatric Orthopaedics examines the relationship between foot morphology and pain for patients treated for clubfoot. The research team performed a case-control study of 42 patients treated for clubfoot via comprehensive release (n = 24) or Ponseti method (n = 18) and 48 control participants. They found that foot morphology based on International Clubfoot Study Group score highly correlated with foot function index pain scores, although there was no significant difference in pain scores across the surgical and Ponseti cohorts. The research team notes that compared to the Ponseti group, patients in the surgical group exhibited greater subarch angle and arch indexes than the Ponseti group. In addition, they found more abnormalities in foot progression, decreased center of pressure progression (COPP) in the forefoot, and increased COPP in the midfoot and hindfoot in the surgical group compared with controls. Read the abstract…

Study: What is the relationship between risk and performance in the Medicare PVBM program?
A study published online in the journal JAMA Surgery looks at the relationship between provider risk and performance in the 2015 Medicare Physician Value-Based Payment Modifier (PVBM) Program. The authors conducted a cross-sectional, observational study of 899 physician practices covering 5,189,880 beneficiaries. Of those, 547 practices were categorized as low risk, 128 as high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries) only, 102 as high social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) only, and 122 as high medical and social risk. The authors found that practices categorized as low risk performed the best on composite quality score compared against practices in any high risk category. Practices categorized as high social risk only performed the best on the composite cost score, followed by low risk practices, high medical and social risk practices, and finally high medical risk only practices. Read the abstract…

DHS issues advisory on security vulnerabilities discovered in certain Siemens Molecular Imaging products.
The U.S. Department of Homeland Security and Siemens have issued advisories regarding security vulnerabilities in Siemens Molecular Imaging products. The company states that the vulnerabilities could allow a malicious attacker to execute code on the affected system. Affected products include the following:

  • Siemens PET/CT Systems: All Windows 7-based versions
  • Siemens SPECT/CT Systems: All Windows 7-based versions
  • Siemens SPECT Systems: All Windows 7-based versions
  • Siemens SPECT Workplaces/ All Windows 7-based versions

The company is preparing updates for the affected products and recommends protecting network access to the Molecular Imaging products by running the devices in a dedicated network segment and protected information technology environment. Read the statement from DHS…
Read the statement from Siemens (PDF)…

Survey: Many physicians see business skills as necessary to achieve career goals.
A survey of physicians conducted by suggests that many physicians perceive business and management skills as an important factor in furthering their careers, but note that such knowledge areas are often only minimally addressed in medical training. The researchers surveyed 511 physicians working in the United States and found that the top five skills deemed most important in taking one’s career to the next level were the following:

  • Business and finance (47 percent)
  • Productivity (44 percent)
  • Practice management (44 percent)
  • Computer and technology skills (37 percent)
  • Hospital administration (29 percent)

Read more…

Call for volunteers: Instructional Course Committees.
Aug. 31 is the last day to submit your application for a position on an Instructional Course Committee. Members of Instructional Course Committees grade instructional course lecture applications in June, provide feedback regarding faculty and curricula to the Central Instructional Courses Committee, and evaluate courses at the AAOS Annual Meeting. The following positions are open:

  • Adult Reconstruction Hip (one member)
  • Adult Reconstruction Knee (chair, one member)
  • Hand and Wrist (one member)
  • Pediatrics (chair, one member)
  • Practice Management (chair, one member)
  • Shoulder and Elbow (chair, one member)
  • Spine (chair, one member)
  • Sports Medicine and Arthroscopy (chair, one member)

Applicants for these positions must be active fellows with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)