Today’s Top Story
Study: Smoking linked to increased estimated blood loss and perioperative transfusion for lumbar spine surgery patients.
Findings from a study published online in the journal Clinical Orthopaedics and Related Research (CORR) suggest that smoking may be associated with increased surgical blood loss and transfusion use among patients undergoing lumbar spine surgery. The researchers reviewed data on 559 lumbar decompression procedures performed with or without fusion at a single academic spine center. After controlling for potentially relevant confounding variables, they noted that smoking was linked to increased estimated blood loss and increased perioperative transfusion use compared with not smoking. Read the abstract…
Other News
Should physicians take a more direct role in promoting physical activity?
A viewpoint article published online in The Journal of the American Medical Association notes that regular physical activity is a powerful practice for improving health. “Yet,” the writers point out, “as few as 34 percent of adults report being counseled about physical activity at their last physician visit. Even among adults with prediabetes and other vascular risk factors, a similarly low proportion (40 percent) report receiving such counseling.” The writers suggest that reasons for a failure to offer physical activity counseling may include time constraints, lack of tools, and skepticism about the efficacy of such counseling. However, they suggest that healthcare professionals are in a position to perform a vital role in motivating behavioral change, and that even brief counseling sessions may be effective and incorporated into busy clinical settings with demonstrable benefit to patients. Read more…
Read a related article in The Boston Globe…
Study: Ceramic bearing surfaces linked to lower risk of dislocation compared to polyethylene after revision THA.
According to findings published in the December issue of CORR, ceramic bearing surfaces may be linked to lower likelihood of dislocation after revision total hip arthroplasty (THA) compared to polyethylene bearing surfaces. The authors reviewed information on 240 patients (240 hips) who had a THA revision and a normal contralateral hip. They found that 18 percent (29 of 160) of polyethylene liners at the time of index arthroplasty dislocated after revision, compared to 1 percent (1 of 80) of ceramic liners. Among the 80 hips with ceramic-on-ceramic surfaces, no osteolysis was detected before revision, and no muscle fatty degeneration of the gluteus muscles was noted on computed tomography (CT) scan or histology. However, the authors observed osteolytic lesions on the acetabulum and femur in 100 percent of hips with polyethylene liners. They noted that increased atrophy of the gluteus muscles observed on CT scan correlated with an increase of osteolysis. Read the abstract…
Study: TXA may reduce blood loss and transfusion for patients undergoing complex spine surgery.
Data from a study conducted in Thailand and published in the December issue of the journal Spine suggest that treatment with two effective doses of tranexamic acid (TXA) may reduce blood loss and transfusions for low-risk adults who undergo complex spine surgery. The research team conducted a prospective, double-blind, randomized controlled study of 78 adult patients at a single center. One cohort (n = 39) received saline or placebo, while a second cohort (n = 39) received two doses (15mg/kg) of TXA—one prior to anesthesia induction and the second after 3 hours. They found that blood loss was higher in the control group than in the TXA group. In addition, patients in the control group received more crystalloid, colloid, and packed red blood cell transfusions. There were no serious thromboembolic complications. Read the abstract…
Study: Patient function and strength questionnaires appear to offer little predictive power for retear after rotator cuff repair.
Findings from a study published online in the Journal of Shoulder and Elbow Surgery suggest that questionnaires regarding patient function and isokinetic strength evaluation may offer little efficacy in determining early postoperative repair status after rotator cuff repair. The authors prospectively evaluated 60 patients who had undergone arthroscopic supraspinatus repair. At 16-week follow-up, they found no significant correlation between clinical or strength measures in predicting intact repairs (Sugaya grade 1) or partial-thickness retears (Sugaya grades 2 and 3). They authors note that discriminant analysis revealed the 11-item version of the Disabilities of the Arm, Shoulder and Hand produced a 97 percent true-positive rate for predicting partial thickness retears, but also produced a 90 percent false-positive rate, predicting retear in 90 percent of patients whose repair was intact. Further, they state that the ability to discriminate between groups was enhanced with up to 5 variables entered, yet only 87 percent of the partial-retear group and 36 percent of the intact-repair group were correctly classified. Read the abstract…
Hospitals that employ more physicians see increased revenue growth, but lower profits.
According to HealthLeaders Media, a report from Moody’s Investors Service finds that hospitals with high levels of physician employment generate stronger revenue growth, but are generally less profitable than peer institutions with fewer employed physicians. The researchers divided hospitals into four categories, including “low physician employment” (1 percent to 15 percent of total medical staff) and “very high physician employment” (65 percent to 100 percent of total medical staff). They found the median operating cash flow margin to be 10.7 percent for hospitals with low physician employment, compared to 8.5 percent for hospitals with very high physician employment. However, the researchers also point out that hospitals with very high physician employment saw a 6.8 percent 3-year revenue compound annual growth rate, compared to 4.9 percent for hospitals with low physician employment. Read more…
State regulators could affect outcomes of proposed insurance mergers.
An article in Modern Healthcare looks at the influence state insurance regulators may have over proposed mergers between health insurers. The writer notes that a probe by the U.S. Justice Department’s antitrust division of two large proposed insurance mergers has dominated the conversation, but the companies won’t be allowed to merge in states that do not approve the proposals, suggesting that rejections from even a few heavily populated states could reduce the financial viability of the mergers. Read more…(registration may be required)
Call for volunteers: Program Committees.
Dec. 30 is the last day to submit your application for a position on several Program Committees. Members of Program Committees grade symposia in May and abstracts in June and July, and may serve as moderators for paper sessions at the AAOS Annual Meeting. The following openings are available:
- Adult Reconstruction Hip (16 member openings)
- Adult Reconstruction Knee (9 members)
- Practice Management/Rehabilitation (chair, 7 members)
- Trauma (7 members)
Applicants for chair positions must be active fellows; applicants for member positions must be active fellows or international affiliate members with a practice emphasis in the relevant topic. Learn more and submit your application…(member login required)
