Today’s Top Story
Study: Age a factor in likelihood of revision for patients undergoing primary ACLR.
Findings from a study published online in The American Journal of Sports Medicine suggest that age at the time of anterior cruciate ligament reconstruction (ACLR) may be a strong risk factor for revision. The researchers conducted a case-control study of 21,304 patients who underwent primary ACLR, with patients stratified by age into four groups: <21, 21-30, 31-40, and >40 years. They found that the 5-year revision probability was highest among patients in the <21 years cohort and lowest in the >40 years old cohort. Among patients age younger than 21 years, the researchers noted a lower risk of revision in female patients, patients with increased body mass index (BMI), and black patients compared to white patients. Sex, BMI, and race were not associated with the risk of revision in older patients. Among patients ≤40 years old, those with allografts had a higher risk of revision than those with bone-patellar tendon-bone (BPTB) autografts. However, patients <21 years old with hamstring autografts had a higher risk of revision than did patients with BPTB autografts. Read the abstract…

Other News

Review study calls for early assessment of children at risk for type 1 diabetes.
The authors of a review study published online in the European Journal of Endocrinology argue that, because onset of type 1 diabetes (T1DM) often occurs during childhood, the bone health of at-risk children should be assessed and managed. They note that patients with T1DM often have impaired osteoblastic bone formation, with insulin/IGF-1 deficiency, glucose toxicity, marrow adiposity, inflammation, adipokine and other metabolic alterations being pathogenetic mechanisms. Among other things, they write that “increasing physical activity in children with diabetes as well as good glycemic control appear to provide some improvement of bone parameters, although robust clinical studies are still lacking. In this context, the role of osteoporosis drugs remains unknown.” Read more…
Read the abstract…

Do scribes need more training?
An article in Physicians News Digest looks at the topic of medical scribes, noting that there are an estimated 15,000 scribes in the United States, with nearly 1 in 5 physicians now employing them. However, the writer notes that there is no required licensing or certification for scribes, and the “minimum qualification to be a scribe is generally a high school diploma.” The writer notes that physicians are responsible for reviewing scribes’ entries, making corrections if needed, and signing off before leaving the patient care area. Read more…

Study: Sagittal spinal correction following THA may reduce acetabular anteversion.
A study published in the Dec. 2 issue of The Journal of Bone & Joint Surgery (JBJS) investigates the effect that sagittal spinal realignment surgery may have on acetabular anteversion. The authors conducted a retrospective review of 33 patients (41 hips) from a multicenter, prospective, consecutive database of patients with adult spinal deformity who had undergone total hip arthroplasty (THA) prior to surgical spinal realignment. They found that acetabular anteversion significantly reduced after spinal correction by mean change of -4.96°. Changes in anteversion correlated with changes in sagittal pelvic orientation and global spinopelvic alignment. A regression analysis found that anteversion decreased by 1° for each of the following spinopelvic parameter changes: 1.105° for spinopelvic tilt, 1.032° for sacral slope, and 3.163° for lumbar lordosis. Read the abstract…

Study: Long-term health for patients who have undergone percutaneous in situ fixation for stable SCFE poorer than general population.
Findings from a study published in the Dec. 2 issue of JBJS suggest that patients who have undergone percutaneous in situ fixation for stable slipped capital femoral epiphysis (SCFE) may self-report their health as poor compared to the general population. The research team conducted a retrospective study of 64 patients (91 hips) with SCFE. At mean 19.6-year follow-up, they found that the cohort reported higher rates of diabetes, obesity, and hypertension than the general U.S. population. In addition, mean BMI had increased by 10.2 kg/m2, with 72 percent of patients meeting the criteria for obesity at the time of follow-up. Read the abstract…

Many U.S. adults see “others” as the problem when it comes to distracted walking.
A survey conducted on behalf of AAOS finds that 78 percent of U.S. adults call distracted walking a “serious” issue, and 74 percent say it is “other people” who engage in that behavior, while 29 percent say they regularly engage in distracted walking themselves. Other findings of the survey include:

  • 90 percent of respondents said they see walkers talking on the phone (and 37 percent admit doing so themselves)
  • 88 percent say they see walkers listening to music (vs. 34 percent themselves)
  • 64 percent say they see walkers “zoning out,” or not focused on walking (vs. 38 percent themselves)

The researchers surveyed 2,008 adults aged 18 years or older from across the United States. Read more…
Read the complete survey (PDF)…
Read more on OrthoInfo…
Read a related article in The New York Times…

CMA suggests physicians preemptively file for 2015 hardship exemption.
A post on the website of the California Medical Association (CMA) suggests that physicians preemptively file for 2015 hardship exemption under the Medicare meaningful use program. The U.S. Centers for Medicare and Medicaid Services (CMS) “did not publish the updated regulations for stage 2 meaningful use until October 16, 2015,” the post states. “As a result, eligible professionals were not informed of the revised program requirements until fewer than the 90 required days remained in the calendar year.” The writer notes that applying for an exemption will not preclude physicians from receiving an incentive if they meet meaningful use requirements, but submitting the application may offer a safety net in case a penalty is incurred. Read more…

Call for volunteers: AAOS Liaison to the Physician Consortium for Performance Improvement.
AAOS seeks one member to serve as liaison to the American Medical Association-convened Physician Consortium for Performance Improvement (PCPI). PCPI s a national, physician-led initiative that develops, tests, implements, and disseminates evidence-based measures that reflect the best practices and best interest of medicine. 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 provide the following: an online AAOS CAP application, a current curriculum vitae [up to 20 pages] with complete contact information, 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, and a 100-word biosketch. All supporting materials should be submitted for consideration by Sunday, Jan. 10, 2016 at 11:59 p.m. (CT) to Kyle Shah, at: shah@aaos.org
Learn more and submit your application…(member login required)