Today’s Top Story
House panel begins work on ACA repeal proposals.
Bloomberg News reports that a panel of the U.S. House of Representatives Energy and Commerce Committee has begun examining drafts of four bills that may serve as the basis for repeal of the Affordable Care Act (ACA). Speaker of the House Paul Ryan states that Congress expects to “be moving Obamacare [ACA] legislation by the first quarter.”
Study: How do treatment techniques compare for distal radius fractures treated with ORIF?
According to a study published online in The Journal of Hand Surgery, both volar locking plates and fragment-specific fixation may offer similar outcomes for treatment of primarily nonreducible or secondarily redisplaced distal radius fractures, although fragement-specific fixation may be linked to an increased risk of complication. The authors conducted a randomized, controlled trial of 50 adult patients who underwent open reduction internal fixation (ORIF) using volar locking plates (n = 25) or fragment-specific fixation (n = 25). At 12-month follow-up, they found no significant difference across cohorts in grip strength, range of motion, or median Quick Disabilities of the Arm, Shoulder, and Hand score. However, the overall complication rate was 21 percent in the volar locking plate group and 52 percent in the fragment-specific group.
Read the abstract…
Study: Prior ACL reconstruction may increase operative time and risk of early reoperation for TKA patients.
A study published in the Feb. 1 issue of The Journal of Bone & Joint Surgery suggests that prior anterior cruciate ligament (ACL) reconstruction may be linked to increased operative time and risk of early reoperation following total knee arthroplasty (TKA). The research team conducted a matched cohort study of 244 patients who underwent TKA, 122 of whom who had a history of ACL reconstruction and 122 of whom did not. At mean follow-up of 3.3 years in the ACL cohort and 3.0 years in the control cohort, they found no significant difference between groups in Knee Society Score or flexion. However, 50 percent (61 of 122) of patients in the ACL group required implant removal at the time of TKA, and mean operative time was 88 minutes in the ACL group and 73 minutes in the control group. There were 11 reoperations in the ACL group—including 4 for periprosthetic infection—and 2 reoperations in the control group.
Read the abstract…
Study: Typical postoperative precautions linked to increased inpatient rehab time for hip arthroplasty patients.
Findings presented at the annual meeting of the Association of Academic Physiatrists suggest that typical postoperative precautions followed after hip arthroplasty may increase inpatient rehabilitation time and slow overall recovery. The research team conducted a retrospective review of 68 hip arthroplasty patients, 31 of whom were admitted to inpatient rehabilitation without post-operative surgical precautions and 37 of whom were admitted with precautions. At discharge, they found that both groups had made similar progress in overall functional independence measures (FIM) scores and daily FIM improvements. However, the average length of stay for patients who entered rehabilitation without postoperative precautions typically was 9 days, compared to 12 days for patients with postoperative precautions.
CDC releases opioid guideline app.
The U.S. Centers for Disease Control and Prevention (CDC) has released an opioid guideline app designed to help providers apply the recommendations of the agency’s Guideline for Prescribing Opioids for Chronic Pain into clinical practice. The application includes a Morphine Milligram Equivalent calculator, summaries of key recommendations and a link to the full guideline, and an interactive motivational interviewing feature to help providers practice effective communication skills. The app is available for free for both Android and iOS platforms.
The Associated Press reports that, given the possibility of repeal of the ACA, the governor of Massachusetts is laying the groundwork for the return of key elements of the state’s 2006 universal healthcare law, which provided a blueprint for the ACA. Among other things, Governor Charlie Baker has asked the General Court of Massachusetts to reinstate a version of the employer contribution that was part of the original state law and urged U.S. congressional leaders to retain certain provisions of the federal law, while offering states flexibility to achieve their own healthcare goals.
Call for volunteers: Content Committees.
April 3 is the last day to submit your application for a position on various Content Committees (four member openings). Content Committees analyze information to identify member knowledge gaps in different specialty areas. These positions are open to generalist orthopaedic surgeons who would be called upon for their perspective on how new products could provide value to generalists in the orthopaedic community. Applicants must be active fellows with a general (non-specialty) practice emphasis.
Learn more and submit your application…(member login required)