Today’s Top Story
Study: THC/CBD Use and Opioid Impact in Joint Arthroplasty Patients
A study published online in The Journal of Arthroplasty evaluated tetrahydrocannabinol (THC) and cannabidiol (CBD) product use patterns during the perioperative period and whether THC and CBD use influenced postoperative opioid use in primary unilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA). Data on 195 THA and TKA patients who kept detailed journals of their THC/CBD product usage were included. Among all patients, 16.4 percent used THC/CBD products: 22.6 percent of TKA patients and 11.7 percent of THA patients. Usage patterns varied significantly. THC/CBD users and nonusers did not largely differ in terms of length of narcotic use, total morphine milligram equivalents taken, narcotic pills taken, average postoperative pain scores, percentage of patients who required a narcotics refill, or length of stay.


In Other News
Study Compares Trauma Center Revenue Generation in New versus Established Patients
A retrospective study published in the Feb. 15 issue of the Journal of the AAOS analyzed how revenue generation varies between new and established orthopaedic trauma patients. During the study period, 440 patients presented with high-energy fractures at a single level 1 trauma center. Six-month payment to charge (P/C) ratios for professionals and facilities were determined. New patients had higher mean professional charges per patient ($35,522) compared to established patients ($30,639); mean professional payments were $7,894 and $4,365, respectively. No significant differences were observed between new and established patients in terms of mean P/C for facilities payments, but new patients had higher professional P/C.


Study: Distraction Lengthening in Traumatic Hand Amputation Using Ilizarov Mini-fixator
A study published online in Injury measured the value of distraction lengthening in traumatic hand amputation performed using an Ilizarov mini-fixator. Between 2014 and 2017, 14 phalanges and 12 metacarpals in 15 patients (mean age, 42.8 years; 13 patients were male) received distraction lengthening with an Ilizarov mini-fixator. All digits received traumatic amputation; the remaining digit was shortened despite, in some cases, successful replantation. The mean lengthening of the phalanges and metacarpals was 13.3 mm and 26.5 mm, respectively; mean consolidation times were 144.0 days and 154.1 days, respectively; and mean healing indices were 114 days/cm and 60 days/cm, respectively. Bone grafts were not required in any cases.
Study: Which Patients Undergoing Transforaminal Lumbar Interbody Fusion Will Experience Postoperative Pain?
A retrospective study published online in the European Spine Journal identified risk factors associated with postoperative pain following minimally invasive transforaminal lumbar interbody fusion (TLIF). Single-level, primary minimally invasive TLIF patients were assessed for perioperative outcomes and postoperative inpatient visual analog scale (VAS) pain scores. Possible risk factors for average inpatient pain score of five or higher included age, gender, smoking status, diabetes status, insurance status, body mass index (BMI), comorbidity burden, pedicle screw laterality, operative time, and estimated blood loss. Final analysis included 255 patients. The following factors were associated with increased postoperative pain: age younger than 50 years, workers’ compensation insurance, preoperative VAS pain score of seven or higher, and operative duration of 110 minutes or longer. Gender, BMI, smoking status, comorbidity burden, diabetes status, and pedicle screw laterality were not associated with increased postoperative pain.
ONC Committee’s Two-year Strategy Includes Price Transparency and Health Data Access
The Health Information Technology Advisory Committee (HITAC) issued a list of 31 items it will target over the next two years. HITAC reports to the Department of Health and Human Service’s Office of the National Coordinator for Health Information Technology (ONC). Among HITAC’s target items are interoperability—including drug price transparency—privacy and security, and patient access to information.
From the Ground Up: Growing the AAOS Grassroots Program

Grassroots is broadly defined as the voices of many on the ground level, aggregated together and elevated to those in leadership and decision-making positions. In the field of advocacy, grassroots is a concept that is frequently employed but not always fully understood. Have you recently sent a letter to, called, or met with your member of Congress? If so, you have engaged in grassroots advocacy.
Education and Networking Opportunities Await at AAOS CME Courses
Experience the highest quality continuing medical education (CME) on the latest clinical topics at AAOS courses offered year-round. Exceptional world-class faculty are dedicated to delivering unbiased, unparalleled, peer-reviewed programs to meet your lifelong learning and practice needs. Refine your surgical skills with hands-on labs, prepare for certification with review courses at all stages, or take a deep dive into comprehensive topics with dynamic programming. Save on your registration fees with discounts for AAOS members and residents.