Today’s Top Story
Study: At public medical schools, female physicians often earn less than male colleagues.
A study published online in the journal JAMA Internal Medicine finds significant differences in salary between male and female physicians at public medical schools. The research team compared publicly available salary information for 10,241 academic physicians at 24 public medical schools against data from a physician database with detailed information on sex, age, years of experience, faculty rank, specialty, scientific authorship, National Institutes of Health funding, clinical trial participation, and Medicare reimbursements. After adjustment for age, experience, specialty, faculty rank, and measures of research productivity and clinical revenue, they found that female physicians earned an average of $19,878 less than their male counterparts.
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Other News
Study: Surgical procedures, including THA and TKA, linked to risk of chronic postoperative opioid use.
According to data published online in the journal JAMA Internal Medicine, total hip and total knee arthroplasty (THA and TKA) may be associated with an increased risk of chronic opioid use postoperatively. The research team conducted a retrospective analysis of 641,941 opioid-naive surgical patients who underwent one of 11 surgical procedures, including THA or TKA, and 18,011,137 opioid-naive nonsurgical patients. Among surgical patients, the incidence of chronic opioid use in the first postoperative year ranged from 0.119 percent for Cesarean delivery to 1.41 percent for TKA. The research team found that, with five exceptions, all of the surgical procedures reviewed were associated with an increased risk of chronic opioid use, with odds ratios ranging from 1.28 for Cesarean delivery to 5.10 for TKA. Overall, male sex; age older than 50 years; and preoperative history of drug abuse, alcohol abuse, depression, benzodiazepine use, or antidepressant use were associated with increased likelihood of chronic opioid use among surgical patients.
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Study: Early surgery may be beneficial for young, athletic patients with shoulder dislocation.
Findings presented at the annual meeting of the American Orthopaedic Society for Sports Medicine (AOSSM) suggest that early surgical intervention may be appropriate for many young, athletic patients with shoulder dislocation. The authors reviewed data on 121 patients (mean age 19 years) who underwent arthroscopic Bankart repair across 8 fellowship-trained surgical practices. Overall, 53 patients were determined to have recurrent dislocations and 68 had a first-time dislocation. At mean 51-month follow-up, the authors found that the postoperative instability rate in the first-time dislocation group was 9 percent, compared to 47 percent in the recurrent dislocation group. In addition, the first-time dislocation group reported a 7 percent rate of repeat operation to address instability, compared to a 32 percent rate in the recurrent dislocation group. Finally, the Simple Shoulder Test score in the first-time dislocation group was 11.4 and 11 in the recurrent dislocation group. The authors argue that “young, athletic patients with shoulder instability should be offered early surgical intervention to lower the risk of postoperative instability and reoperation.”
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4. Study: OCA transplant may offer treatment option to active patients with knee cartilage injury.
According to information presented at the AOSSM annual meeting, osteochondral allograft (OCA) transplantation may be a successful treatment option for highly active patients with a cartilage injury to the knee. The research team reviewed data on 149 knees (142 patients) who participated in sport or recreational activity prior to cartilage injury and underwent OCA transplant. At mean 6-year follow-up, 76 percent of patients (113 of 149 knees) had returned to sport or recreational activity. Of those, 28 percent returned to the same level of pre-injury sport, 48 percent partially returned, and 25 percent returned to a different sport or activity. Of the 24 percent of patients who did not return to sport or activity, reasons included lifestyle events such as starting a family, changing careers, end of organized sports, knee-related issues, and concern about reinjury. Overall, 79 percent of knees were able to participate in a high level of activity and 71 percent reported having “very good” to “excellent” function. The research team notes that 38 of 149 knees (26 percent) had further surgery following the OCA transplant, with the OCA treatment considered a failure in 14 knees (9 percent of entire cohort). Patients who did not return to sport following OCA were more likely to be female, have injured their knee in an activity other than sports, and had a larger graft size.
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Study: Some scoliosis patients may not require final surgical fusion at maturity.
A study published in the July 6 issue of The Journal of Bone & Joint Surgery suggests that certain patients with early-onset scoliosis may not require final surgical fusion at skeletal maturity. The authors reviewed data on 167 patients who had received growing-rod treatment and reached skeletal maturity, 30 of whom did not undergo final surgical fusion (observation group). At minimum 2-year follow-up, 26 patients in the observation group retained the growing rods, while 4 patients had them removed at last surgery due to infection. Overall, the mean primary curve correction at the end of treatment was 48 percent in the observation group and 38 percent in the final surgical fusion group. The authors found no significant difference in final curve magnitude across cohorts. Mean increase in trunk height was 30.5 percent in the observation group and 35 percent in the final surgical fusion group. However, final trunk height in the observation group was not significantly less than that in the final surgical fusion group.
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Study: Concussion linked with changes to brain white matter at up to 6 months after injury.
Young athletes with concussion may still exhibit changes in white matter of their brains 6 months after injury, according to findings presented at the American Academy of Neurology Sports Concussion Conference. The researchers conducted diffusion tensor imaging and diffusion kurtosis tensor imaging on 17 high school and college football players with concussion, and compared the scans with those from 18 matched controls who did not have a concussion. At 6-month follow-up, they found no difference between cohorts in self-reported concussion symptoms, cognition, or balance. However, they noted widespread decreased mean diffusivity in the concussion cohort compared with controls, which was similar to acute findings at 24 hours and 8 days.
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In related news, a study presented at the AOSSM annual meeting finds an increase in the number of youth concussions reported in recent years. The researchers reviewed administrative health records of 8,828,248 members of a single private payer and found that the number of concussion diagnoses more than doubled between 2007 and 2014.
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Read the abstract (PDF; Paper 150)…
Call for volunteers: MACRA Episode-Based Resource Use Measures Clinical Committee.
AAOS seeks to nominate members to the MACRA [Medicare Access & CHIP Reauthorization Act of 2015] Episode-Based Resource Use Measures Clinical Committee. As part of its measure development process, the U.S. Centers for Medicare & Medicaid Services asks contractors to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance. The Clinical Committee will provide detailed clinical input on developing fully built out episode groups. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a curriculum vitae or a summary of relevant experience with a maximum 10 pages, a letter of interest (not to exceed two pages), and a signed Technical Expert Panel nomination form (obtained at the email below). Please send materials to Kyle Shah by July 17, 2016 at 11:59 p.m. CT, at shah@aaos.org.
Learn more and submit your application…(member login required)
