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Study: Minority patients less likely to undergo TKA, more likely to experience complication.
Findings from a study published in the Aug. 3 issue of The Journal of Bone & Joint Surgery (JBJS) suggest that minority patients may be less likely to undergo total knee arthroplasty (TKA), but are more likely to experience adverse outcomes. The research team reviewed 8 years of data across eight racially diverse states and found that, in comparison with whites, black, Hispanic, Asian, Native American, and mixed-race populations had significantly lower rates of TKA utilization. Overall, patients from minority groups were less likely to undergo TKA in high-volume hospitals. In addition, mortality rates were significantly higher for blacks, Native Americans, and mixed-race patients, and blacks and mixed-race patients saw increased complication rates compared to white patients.
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Other News

Study: What factors are linked with deep SSI after plate fixation of proximal tibial fracture?
A study published in the Aug. 3 JBJS examines risk factors for deep surgical site infection (SSI) after plate fixation of proximal tibial fractures. The authors reviewed data on 170 patients with proximal tibial fracture who were treated with open reduction and plate fixation at a single center; 34 patients experienced deep SSI. Independent predictors of SSI identified by the researchers included the following: patient age of ≥50 years; obesity, defined as a body mass index of ≥30 kg/m2; alcohol abuse; OTA/AO-type-C fracture; use of a temporary spanning external fixator; and 4-compartment fasciotomy.
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Study: Subfascial administration of TXA may help reduce transfusion requirements for older patients with intertrochanteric fracture treated by IM nail.
According to a study published in the August issue of the Journal of Orthopaedic Trauma, subfascial administration of tranexamic acid (TXA) around the fracture site may be associated with a significant reduction in blood loss in older patients who undergo intramedullary (IM) nailing for intertrochanteric fractures. The researchers conducted a prospective, randomized trial of 200 patients older than 65 years who had an intertrochanteric fracture treated by IM nail. They found that subfascial administration of 3 g of TXA around the fracture site at the end of the surgical procedure was linked to a 43 percent reduction in transfusion requirements compared to the control cohort, which did not receive TXA. The researchers found no difference between cohorts in terms of late complications and overall mortality rate.
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CMS to penalize 2,597 hospitals based on readmission rates for six common conditions.
Kaiser Health News reports that the U.S. Centers for Medicare & Medicaid Services (CMS) will withhold more than half a billion dollars in hospital payments over the next year due to readmission penalties. Overall, CMS will penalize 2,597 hospitals based on 30-day readmissions for six common conditions, including hip and knee arthroplasty. Although approximately the same number of hospitals were penalized last year, the average penalty will increase from 0.61 percent to 0.73 percent of Medicare payments.
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Study: Symptom spikes may be common in pediatric patients after concussion.
A study published in the Aug. 1 issue of the journal JAMA Pediatrics suggests that some children may experience a recurrence of concussion symptoms, but such an effect may not be a setback in recovery. The research team analyzed clinical trial data from 63 patients with a mean age of 13.8 years. They found that symptom spikes occurred in 20 patients (31.7 percent), but that such spikes tended to partially resolve within 24 hours. The research team writes that an abrupt increase in mental activity such as returning to school or participating in extracurricular activities was associated with an increased risk of symptom spike, but most symptom spikes were not preceded by a documented increase in physical or mental activity. Overall, they note that patients with symptom spikes were initially more symptomatic in the emergency department and throughout the observation period, but did not differ from the group without symptom spikes on cognition or balance at 10-day follow-up.
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Submit your entries now! MORE Awards honor excellence in orthopaedic journalism.
The Media Orthopaedic Reporting Excellence (MORE) Awards recognizes and honors journalistic efforts that further the public’s understanding of musculoskeletal health issues and encourage healthy behaviors in the care of bones and joints. AAOS is asking members to submit stories from broadcast, radio, print, or website that accurately and compassionately highlight orthopaedic procedures, treatments, and preventive care and practices. Stories must have been published or broadcast between Oct. 1, 2015 and Oct. 1, 2016. Winners will be recognized at the 2017 MORE Awards ceremony and dinner at the National Orthopaedic Leadership Conference in Washington, D.C., on April 27, 2017. For more information, please contact Kelly King Johnson at 847-384-4033.
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     Submit a story via email, at media@aaos.org.

Call for volunteers: CMS MEDCAC.
AAOS seeks to nominate members to the CMS Medicare Evidence Development & Coverage Advisory Committee (MEDCAC). MEDCAC reviews and evaluates medical literature and technology assessments, and hears public testimony on the evidence available to address the impact of medical items and services on health outcomes of Medicare beneficiaries. The MEDCAC may also advise CMS as part of the agency’s “coverage with evidence development” initiative. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must supply the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted to Kyle Shah by Sunday, Aug. 28, 2016 at 11:59 p.m. CT, at shah@aaos.org.
Learn more and submit your application…(member login required)