Today’s Top Story

Study: Cam lesion may significantly impact hip flexion ROM; femoral version may affect internal rotation

Findings from a study published in the Feb. 7 issue of The Journal of Bone & Joint Surgery ( JBJS) suggest that cam lesion may have a greater impact on hip flexion range of motion (ROM) than on hip internal rotation. The authors conducted a prospective, cohort study of 220 patients (440 hips) who presented with unilateral or bilateral hip pain. They found that femoral version was a stronger independent predictor than cam lesion of internal rotation ROM. Conversely, the presence of a cam lesion was associated with a significant decrease in the passive hip flexion ROM, with no additional effects linked to degree of femoral version. The authors note that passive hip internal rotation ROM in neutral flexion/extension and with the hip in 90° of flexion were maximized among patients with femoral anteversion, and decreased significantly with each incremental decrease in femoral version.

Read the abstract…

 
 
Other News

Study: Preoperative KOOS and SF-36 scores linked to risk of symptomatic knee OA after ACL reconstruction

A study published online in The American Journal of Sports Medicine suggests that lower preoperative Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-36 scores may be linked to increased risk of symptomatic knee osteoarthritis (OA) after anterior cruciate ligament (ACL) reconstruction. The researchers conducted a prospective, case-control study of 72 patients who underwent ACL reconstruction. At 7-year follow-up, they determined that seven patients were symptomatic based on KOOS pain ≤72. In multivariate analysis, they found that lower preoperative scores for KOOS sports/recreation and SF-36 mental health were associated with a painful knee, with increased likelihood of 82 percent and 68 percent per 10-unit decrease, respectively. The researchers noted no significant difference in Osteoarthritis Research Society International radiographic score or joint space width between symptomatic and asymptomatic patients.

Read the abstract…

 
 
 
Upcoming forums to address BPCI Advanced

The U.S. Centers for Medicare & Medicaid Services Innovation Center has announced a second Open Door Forum to answer questions regarding the Bundled Payments for Care Improvement (BPCI) Advanced Model. BPCI Advanced is an Advanced Alternative Payment Model, under which participants will be expected to redesign care delivery to keep Medicare expenditures within a defined budget, while maintaining or improving performance on specific quality measures. Participants bear financial risk, have payments under the model tied to quality performance, and are required to use Certified Electronic Health Record Technology. The Model Performance Period for BPCI Advanced starts on Oct. 1, 2018 and runs through Dec. 31, 2023. The upcoming Open Door Forum will take place Thursday, Feb. 15, 2018, from 12:00 p.m. to 1:00 p.m. ET The agency has also made available an audio file and transcript of an Open Door Forum held on Jan. 30, 2018.

Read more and register for the forum…

 

AAOS will host its own webinar on BCPI Advanced on Feb. 21, 2018, from 7:00 p.m. to 8:00 p.m. CT.

Read more and register for the webinar…

 
 
 
Study: Medicaid reimbursement varies widely for most common inpatient orthopaedic procedures

A study published in the Feb. 7 issue of JBJS examines variability of Medicaid reimbursement for inpatient orthopaedic procedures. Members of the research team reviewed state-level Medicaid reimbursement data for the 10 most common orthopaedic procedures, and found that the range of variability exceeded $1,500 for all 10 procedures. The coefficients of variation ranged from 0.57 for posterior or posterolateral lumbar interbody arthrodesis (higher coefficient indicates greater variability) to 0.32 for hip hemiarthroplasty. In comparison, the variability for Medicare reimbursements was 0.07 for all 10 procedures.

Read the abstract…

 

On a related note, McClatchy reports that the U.S. Department of Health & Human Services is considering implementing lifetime limits on adult access to Medicaid coverage.

Read more…

 
 
 
Healthcare organizations should provide support to “second victims” of adverse events

The Joint Commission (TJC) issued an advisory report this week urging its accredited healthcare organizations to provide support services to so-called “second victims”—providers who may be emotionally traumatized by adverse events. The organization states that nearly half of healthcare providers may be impacted by such events at least once in their career. According to TJC, second victim effects include difficulty sleeping, reduced job satisfaction, guilt, and anxiety (including fear of litigation or job loss); all of which may affect medical judgment. In the months that follow an adverse event, a provider may experience characteristics of post-traumatic stress disorder. In response, TJC “urges health care organizations to take the following actions to support second victims as soon as possible after an adverse event occurs. By addressing the traumatized health care worker, organizations can help ensure that other patients are protected from the domino effect that adverse events can have on health care worker performance.”

Read more…  (registration may be required)

Read the TJC advisory…

 
 
Your AAOS

February AAOS Now is 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 and on iOS and Android devices through the AAOS Access app. This month’s issue includes an overview of the upcoming AAOS Annual Meeting in New Orleans, a look at the relationship between Press Ganey scores and functional outcomes for joint arthroplasty patients, an examination of occupational hazards faced by pregnant orthopaedic surgeons, and much more.

Read the February issue…

Read “Let the Learning Roll!”…

Read “Study: ‘Little If Any’ Correlation Between Press Ganey Scores and Functional Outcomes in TJA Patients”…

Read “The Pregnant Orthopaedic Surgeon: Risks and Precautions”…

Learn more about AAOS Now in the Access app…

 
 
 
Call for volunteers: OrthoInfo—trauma section editor

Feb. 15, 2018, is the last day to submit an application for the position of OrthoInfo—trauma section editor. OrthoInfo.org provides AAOS members, patients, and the general public with authoritative information on a wide range of musculoskeletal issues and treatments. The section editor must be an active or emeritus fellow, and will be engaged by the Academy as an independent contractor on an annual basis. Applicants for this position must submit the following: an online AAOS CAP application, a current curriculum vitae, a cover letter detailing one’s interest and qualifications, and three references, to Laura Giblin, at:

giblin@aaos.org

Learn more and submit your application…  (member login required)