Study: Perioperative IV Iron Supplementation Improves Hemoglobin Levels After TJA
A systematic review and meta-analysis published online in the Journal of the AAOS ® assessed whether iron supplementation improved postoperative hemoglobin levels after total joint arthroplasty (TJA). Data from seven randomized, controlled trials were included. Intra- and postoperative intravenous (IV) iron supplementation increased postoperative hemoglobin levels and, in two studies, reduced rates of anemia at 30 days after surgery. Postoperative oral iron supplementation did not impact postoperative hemoglobin levels. Iron supplementation was not associated with adverse events (AEs) or functional outcomes.
Study: Metabolic Syndrome Associated with Increased RTSA Complications
A study published online in the Journal of Shoulder and Elbow Surgery measured complications after total shoulder arthroplasty (TSA) or reverse TSA (RTSA) in patients with metabolic syndrome (defined as having two of the following: hyperlipidemia, hypertension, or BMI > 30 kg/m 2). Outcomes were evaluated for 4,635 patients who underwent TSA or RTSA, including 714 with metabolic syndrome. At a mean 4.5 years of follow-up, there was no difference in complications, reoperation, or revision surgery between TSA groups, but metabolic syndrome was significantly associated with higher rates of deep infection, instability, and deep vein thrombosis/pulmonary embolism among patients who received RTSA.
Study: Hip Arthroscopy for FAI Syndrome in Patients with Concomitant Lumbar Spinal Stenosis
A study published online in Arthroscopy evaluated the impact of concomitant lumbar spinal stenosis on outcomes of hip arthroscopy for femoroacetabular impingement (FAI) syndrome. Twenty-six patients with concomitant lumbar spinal stenosis were case matched to a control cohort without spinal pathology. Patient-reported outcomes (PROs) and revision rates were compared. Patients with lumbar spinal stenosis had similar rates of revision to those without and showed overall improved PROs after two years. Lumbar spinal stenosis was associated with lower one- and two-year modified Harris Hip Scores compared to controls (65.97 versus 85.04 and 69.72 versus 84.71, respectively).
Study Evaluates Noninferiority of Patient-specific Instruments for UKA
A randomized study published online in Knee Surgery, Sports Traumatology, Arthroscopy compared the efficacy of patient-specific instrumentation (PSI) and conventional instrumentation (CI) in unicompartmental knee arthroplasty (UKA). A total of 129 patients were randomized to PSI or CI UKA. No differences in perioperative or functional outcomes were found after two years, with comparable rates of AEs. A statistically significant difference in femoral component alignment in the frontal plane was found, in favor of CI. Approved implant size of the femoral component and tibial component were correct in 98.2 percent and 60.7 percent of PSI cases, respectively.
Study Confirms Utility of Nonsurgical Management of Severe Odontoid Fractures
A retrospective study published online in The Spine Journal determined long-term outcomes of primary external immobilization compared to surgery for treating type III odontoid fractures in 212 patients. Primary external immobilization occurred in 95.3 percent of patients, and 4.7 percent underwent surgical fixation. Five percent of patients treated with external immobilization crossed over to surgical fixation. After a median 38 months of follow-up, there were no significant differences in severe neck pain or Neck Disability Index scores between groups No patients developed new onset spinal cord injury, and 95.7 percent of patients had bony fusion of the odontoid fracture.
February Issue of AAOS Now Is Now Available Online
AAOS members will soon receive the print edition of the February issue of AAOS Now, but the electronic edition is already available on the AAOS Now website. This month’s issue highlights AAOS’ advocacy efforts related to the recent enactment of a federal surprise medical billing law, a new Clinical Practice Guideline on distal radius fractures, 2021 updates in CPT evaluation and management coding for orthopaedic procedures, and more.
Feb. 25 Webinar: CMS Payment Policy Updates for 2021
Each year, the Centers for Medicare & Medicaid Services (CMS) makes modifications to the Quality Payment Program (QPP) through the rulemaking process. In a webinar taking place on Feb. 25, hosted by the American Alliance of Orthopaedic Executives, AAOS staff will describe significant policy changes to both QPP pathways, the Merit-based Incentive Payment System, and Advanced Alternative Payment Models from the 2021 Medicare Physician Fee Schedule Final Rule. They will also provide insight into the Biden Administration’s areas of focus for health care, continued effects of the COVID-19 pandemic, and the future of value-based payment models.
