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| Today’s Top Story
Study: Neuraxial Anesthesia Versus General Anesthesia in Hip Arthroscopy
A retrospective study published in the January issue of Arthroscopy compared pain and opioid requirement outcomes in routine hip arthroscopy performed with neuraxial anesthesia versus general anesthesia. Patients with femoroacetabular impingement syndrome with labral tears underwent hip arthroscopy by a single surgeon and received either neuraxial (n = 77) or general anesthesia (n = 52). The neuraxial group required lower morphine equivalents in the OR and post-anesthesia care unit (PACU) and had lower median PACU arrival and discharge pain scores. Post-incision length of stay and traction time did not differ between the groups. No major adverse events were reported in either group.
Read the abstract… |
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| In Other News
Study Compares Perioperative Risks in Revision TKA Between RA Versus OA
A study published online in the Journal of the AAOS ® observed equivalent perioperative risks between patients with rheumatoid arthritis (RA) versus osteoarthritis (OA) undergoing revision total knee arthroplasty (TKA). Of 132,405 patients who underwent revision TKA, 6,363 were diagnosed with RA. Patients with RA tended to be female and were undergoing revision due to infection, but ages were similar between RA and OA patients. Patients with RA had slightly increased odds of acute postoperative anemia, blood transfusion, prolonged hospitalization, and higher total cost, but decreased odds of acute renal failure and urinary complications. There were no other between-group differences in in-hospital complications.
Read the abstract… |
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| Study Assesses Risk Factors for Flap Coverage After Total Ankle Arthroplasty
A single-center, retrospective review published online in Foot & Ankle International determined risk factors associated with the need for flap coverage after total ankle arthroplasty (TAA). A total of 2,065 patients undergoing TAA were stratified by flap coverage status Overall, flap coverage requirement was associated with older age, higher Charlson Comorbidity Index score, diabetes, and pulmonary disease. Patients who required flap coverage were also more likely to undergo additional procedures. Radial forearm free flap was the most common coverage type and was performed in 50 percent of patients. At 1.5-year follow-up, 75 percent of patients who had received flap coverage had a stable, plantigrade foot.
Read the abstract… |
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| Study: Incidence of Subsequent Vertebral Fracture Following OVF
A post-hoc analysis of a randomized, multicenter trial published online in the European Spine Journal evaluated the incidence and risk factors for subsequent vertebral fracture following osteoporotic vertebral fractures (OVFs). A total of 225 patients were followed for a median of 48 weeks. Fifteen patients (6.7 percent) had a subsequent fracture during follow-up, most of which (73.3 percent) occurred within six months of OVF. Women aged older than 65 years were at highest risk for fracture following fresh OVF. Other risk factors for subsequent vertebral fracture included severe lower back pain and the use of soft braces.
Read the abstract… |
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| Commentary: The Role of Hispanic Ethnicity in Antiracism Discourse in Medicine
A commentary published online in Academic Medicine discussed the need to include Hispanic ethnicity in the race discrimination discourse in the United States in order to address disparities in health and medical training. Currently, there is a shortage of Hispanic physicians and medical school faculty, and Hispanic physicians, trainees, and patients experience racism, which the authors attribute to a lack of inclusion of Hispanics. The authors recommend that medical schools, academic medical centers, and medical accreditation and licensing bodies take an active role in the antiracism course, include Hispanics in the conversation, and increase the representation of Hispanics in medicine.
Read the abstract… |
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| AAOS Now
A Call to Action: High-quality Research Needed
One way that AAOS and specialty society members can serve as advocates for patients and the profession is through participation in high-quality clinical research studies. This article is a plea for surgeons to perform these necessary studies going forward. High-quality research is important to support the development and maintenance of the procedural code set for orthopaedics, aid in the development of Clinical Practice Guidelines that often define the standard of care, and support the efficacy and safety of new procedures to advance the profession.
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| Your AAOS
The Bone Beat Podcast: Repeal of Antitrust Exemption for Health Insurers
For decades, health insurers have been exempt from antitrust laws and allowed to act as a monopoly, setting rates and maximizing profits—until now. Enactment of new legislation removes the McCarran-Ferguson Act, which has protected insurers since 1945 and now requires them to follow the same free-market rules as the rest of the healthcare industry. In episode 15 of AAOS’ advocacy podcast The Bone Beat, George Slover, senior policy counsel for Consumer Reports, discusses why it took so long to repeal this unfair policy and how the new law will introduce more choice and opportunity into the marketplace.
Listen to the episode…
Listen to episode 14, “Shaping Health Policy During the Coronavirus Pandemic”… |
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