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| Today’s Top Story
Study: Effect of TXA on Hemarthrosis-related Complications in Arthroscopy Patients
A systematic review published online in Arthroscopy compared the safety and efficacy of tranexamic acid (TXA) versus no TXA in reducing hemarthrosis-related complications in patients undergoing arthroscopy. Five studies encompassing 299 total patients with TXA and 299 without TXA were examined. Average follow-up was 43.9 days. The studies assessed partial meniscectomy (n = 1), ACL reconstruction (n = 3), and rotator cuff repair (n = 1). In all studies, the TXA groups had significantly improved Coupens-Yates hemarthrosis grades.
Read the abstract… |
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| In Other News
Study: Does Bisphosphonate Exposure Longer Than Three Years Affect Femur Fracture Risk?
A retrospective study published online in BMC Musculoskeletal Disorders compared the risk for atypical femur fracture (AFF) between women who underwent bisphosphonate (BP) therapy for at least three years versus less than three years. Of 87,820 women who initiated BP (mean age, 68.6 years), 16,180 sustained treatment for at least three years. Forty-six AFFs were confirmed in the whole cohort. BP treatment for less than three years was associated with greater AFF-free survival. At five years, the AFF risk per 100,000 was 27 in the shorter BP treatment group and 120 in the longer BP treatment group; at 10 years, the risks were 27 and 363, respectively.
Read the study… |
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| Study Highlights Residents’ Experiences with Biased Patients
A retrospective study published online in JAMA Network Open analyzed the frequency of resident physicians’ experiences with biased patients, as well as how residents responded. A total of 232 second- and third-year internal medicine residents from three academic medical centers in California and North Carolina responded to an email survey. Half of respondents were female; 47 percent were white; and 10 percent identified as LGBTQ (lesbian, gay, bisexual, transgender, or queer). Women, Black, Latinx, and Asian residents were more likely to experience biased behavior more frequently. Most respondents never reported incidents to their institution (85 percent) and identified training and policies as necessary or very necessary (89 percent).
Read the study… |
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| Consensus Statement Recommends New Classification and Nomenclature: Progressive Collapsing Foot Deformity
An expert consensus statement published in the October issue of Foot & Ankle International (FAI) proposes a new nomenclature and classification for adult acquired flatfoot deformity, including the adoption of the term “progressive collapsing foot deformity” (PCFD) for the condition. Participants for the expert consensus were selected based on their publications in PCFD. The statements were made following a review of articles independently submitted to FAI for peer review that were accepted for independent publication; they were then put to a vote. “We believe the series of consensus statements and articles published will be crucial in fostering additional research in regard to PCFD in the near future. The new terminology describes much better the frequent progressive nature of the symptomatic patients, providing a better understanding of the disease to patients,” said senior author Cesar de Cesar Netto, MD, PhD, of the University of Iowa.
Read the abstract… |
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| COVID-19 Updates
Senate Introduces Companion Bill to the Holding Providers Harmless From Medicare Cuts During COVID-19 Act
Yesterday, Senators John Boozman (R-Ark.), Kevin Cramer (R-N.D.), Cindy Hyde-Smith (R-Miss.), Tom Cotton (R-Ark.), and Susan Collins (R-Maine) introduced legislation that seeks to delay pay cuts for physicians during COVID-19. The new legislation in the Senate mirrors the Holding Providers Harmless From Medicare Cuts During COVID-19 Act (H.R. 8702), which was introduced in the House by Representatives Ami Bera, MD (D-Calif.), and Larry Bucshon, MD (R-Ind.), in October. That bill currently has nearly 100 cosponsors and is endorsed by AAOS. The Centers for Medicare & Medicaid Services (CMS) finalized the Medicare Physician Fee Schedule in early December. The new fee schedule cut Medicare payments to some surgical specialties by up to 9 percent. If Congress fails to act, the cuts will take effect on Jan. 1, 2021
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| AAOS Now
Machine Learning in Orthopaedics Is Ready for Prime Time
Over the past decade, machine learning (ML) has become an important tool, with promising early results, yet its adoption in orthopaedic surgery has been slow. Overall, although the ideal role of ML in orthopaedics is still being determined, we can rest assured that it is here to stay. Therefore, we should become familiar with both its potential to improve patient care and pitfalls when creating and interpreting it. The use of ML in medicine and orthopaedic surgery can be divided simply into fields of diagnosis, prediction, and automation.
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| Your AAOS
E/M 2021 Changes are CPT-driven
In an effort to reduce administrative burden, the American Medical Association (AMA) CPT Editorial Panel worked with specialty societies and stakeholders to simplify and streamline documentation requirements for reporting evaluation and management (E/M) office or outpatient services (codes 99202–99215). Effective Jan. 1, 2021, the significant changes to these code descriptors and guidelines remove the tallying of key components and allow providers to select E/M levels based on either medical decision-making or time. AAOS Webinars (member login required) address the changes in detail. CMS has adopted the revisions set forth in the 2021 CPT code set issued by the AMA CPT Editorial Panel. These revised CPT codes and guidelines affect all payers, not just Medicare.
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