Today’s Top Story
Study: Frailty linked to increased risk of 1-year mortality after joint arthroplasty.
According to a study published online in the journal JAMA Surgery, preoperative frailty-defining diagnoses may be associated with a significantly increased risk of 1-year mortality after joint arthroplasty. The researchers conducted a population-based, retrospective, cohort study of 202,811 patients aged 65 years or older in Ontario, Canada. Of those, 6,289 were defined as frail based on the Johns Hopkins Adjusted Clinical Groups frailty-defining diagnoses indicator. At 1-year follow-up, 13.6 percent (n = 855) of frail patients and 4.8 percent (n = 9,433) of nonfrail patients had died. An interaction between frailty and postoperative time demonstrated an increased relative hazard for death in frail patients (hazard ratio [HR], 35.58) on postoperative day 3. The researchers noted significant variations in mortality risk for different surgery types, but the effect was greatest after total joint arthroplasty procedures (HR, 3.79 for hip arthroplasty; HR, 2.68 for knee arthroplasty). Read more…
Read the abstract…

Other News

Study: Hyperextension may not negatively affect outcomes after certain ACL reconstructions.
Data from a study published online in The American Journal of Sports Medicine (AJSM) suggest that a high degree of hyperextension may not affect objective stability, graft tear or failure rates, or subjective scores after certain anterior cruciate ligament (ACL) reconstruction procedures. The authors conducted a retrospective cohort study of 553 patients who underwent ACL reconstruction with patellar tendon autograft and who had ≥6° of knee hyperextension before and after surgery (group A; n = 278) or ≤3° of knee hyperextension before and after surgery (group B; n = 275). At mean 4.1-year follow-up, they found that KT-1000 arthrometer manual maximum difference between knees was 2.0 ± 1.4 in group A and 2.1 ± 1.6 in group B, and subsequent ACL graft tear or failure occurred in 22 patients (6.9 percent) in group A and 30 patients (9.8 percent) in group B. In addition, there was no significant difference in International Knee Documentation Committee and Cincinnati Knee Ratings Scale scores between cohorts after surgery. Read the abstract…

Study: MRI and physical examination appear to offer limited sensitivity in diagnosing SSc tears.
Findings presented online in the journal Arthroscopy suggest that diagnosis of subscapularis (SSc) tears is challenging due to limited sensitivity of magnetic resonance imaging (MRI) and physical examination. The researchers conducted a retrospective, comparative study of 139 patients at a single center who underwent SSc repair, either in isolation or concurrently with other rotator cuff procedures. There were 22 tears of the superior one-third of the SSc (16 percent), 96 tears of the superior two-thirds of the SSc (69 percent), and 21 complete SSc tears (15 percent). MRI diagnosis of SSc tears produced a sensitivity of 83 percent and specificity of 70 percent. Overall, MRI sensitivity was linked to tear severity, with complete tears having an MRI sensitivity of 100 percent; superior two-thirds, 82 percent; and superior one-third, 67 percent. Physical examination sensitivity for belly-press weakness and lift-off test was 61 percent and 63 percent, respectively, and did not correspond with tear size. The researchers note that increased SSc tear size corresponded with history of trauma and presence of concurrent supraspinatus tears and biceps pathology. Read the abstract…

Study: Injury type may affect return-to-play for professional basketball players.
A study published online in AJSM examines postoperative performance for injured National Basketball Association (NBA) players. The research team conducted a retrospective cohort study of 348 players who underwent surgical intervention for ACL reconstruction, Achilles tendon repair, lumbar discectomy, microfracture, meniscus surgery, hand/wrist or foot fracture fixation, or shoulder stabilization. They found that return-to-play rates were highest among patients with hand/wrist fractures (98.1 percent) and lowest for players with Achilles tendon tears (70.8 percent). Players who underwent Achilles tendon repair and arthroscopic knee surgery displayed a significantly greater decline in postoperative performance outcomes at 1- and 3-year time points, and had shorter career lengths compared to those who underwent other procedures. The research team found that age ≥30 years and body mass index ≥27 kg/m2 were overall predictors of not returning to play. Read the abstract…

CMS releases guide to help reduce readmissions in diverse populations.
The U.S. Centers for Medicare & Medicaid Services (CMS) Office of Minority Health has released a “Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries.” CMS notes that minority populations are at increased risk of readmission within 30 days of discharge for certain chronic conditions. The guide is designed to assist hospital leaders and stakeholders in identifying root causes and solutions for preventing avoidable readmissions among these populations. Topics covered in the guide include:

  • An overview of the issues related to readmissions for diverse Medicare beneficiaries
  • Seven key recommendations to prevent avoidable readmissions in diverse populations
  • Concrete examples of initiatives and strategies that may be applied to reduce readmissions

Read more…
Read the complete guide (PDF)…

Study: Protein may serve as biological marker of head trauma.
Findings from a study published online in the Journal of Neurotrauma suggest that serum neurofilament light polypeptide may serve as a biological marker of head trauma. The authors compared serum neurofilament light polypeptide (NFL) for non-contact sport athletes and 20 collegiate football players (11 starters, 9 non-starters) at baseline (9 weeks of no contact) and eight time points during the playing season. Compared to non-starters and controls, they found that serum NFL among starters was higher at baseline. Over the course of the season, the researchers noted increases in serum NFL among starting players relative to baseline at the post-camp and beginning of conference play time points. The researchers write that elevations in serum NFL, which is indicative of axonal injury, may be a result of head impacts. Read the abstract…

Nominations sought for AMA Foundation Excellence in Medicine Awards program.
The American Medical Association (AMA) Foundation Excellence in Medicine Awards program was created to recognize physicians who exemplify the highest values of volunteerism, leadership, and dedication to underserved populations, and present inspirational physician stories to the medical community and public. Awards include:

  • The Jack B. McConnell, MD, Award for Excellence in Volunteerism—recognizes the work of a senior physician who provides volunteer treatment to U.S. patients who lack access to health care
  • The Pride in the Profession Award—honors physicians who practice medicine in areas of crisis or devote their time to volunteerism and public service
  • The Dr. Debasish Mridha Spirit of Medicine Award—recognizes the work of a U.S. physician who has demonstrated altruism and compassion while providing quality health care to marginalized populations
  • The Dr. Nathan Davis International Award in Medicine—honors physicians whose influence reaches international patients for a positive impact on health care in the global arena

The 2016 awards celebration will be held in conjunction with the 2016 AMA annual meeting. Nominations must be submitted by Friday, Feb. 26, 2016, at 5 p.m. CT. For more information, please contact Kyle Shah, at:
Learn more and submit your nominations…

Call for volunteers: U.S. Bone & Joint Initiative.
AAOS seeks to nominate members for the U.S. Bone & Joint Initiative president-elect position. The president-elect will serve from June 2016 to June 2017, as president from June 2017 to June 2019, and as immediate past-president from June 2019 to June 2020. Applicants for this position must be active fellows. In addition, all applicants must provide the following: an abbreviated biographical sketch, a letter outlining the nominee’s interest in serving and what he or she would like to accomplish, and a commitment to dedicate time to the position. All supporting materials must be submitted by Friday, Feb. 19, 2016, to Donna Malert at:
Learn more…(member login required)