Today’s Top Story
Specialty physician pay remains relatively flat overall, compared to previous year.
A survey of physician pay conducted by Modern Healthcare finds orthopaedic surgeons to be the highest-compensated specialists for the sixth straight year. Of the 23 specialties tracked in the survey, 12 saw increases and 11 reported decreases during 2014. However, only five specialties experienced pay increases greater than the 1.5 percent general inflation rate reported by the Consumer Price Index for 2013. Orthopaedic surgeon pay remained relatively flat with a 0.02 percent increase, a reduction from 3.2 percent growth the previous year. Read more…(registration may be required)
Other News
Study: Casting may offer improved outcomes for patients with non- or minimally displaced scaphoid waist fracture.
Findings from a study published in the July issue of The Journal of Hand Surgery suggest that non- and minimally displaced scaphoid waist fractures may best benefit from casting treatment. The researchers conducted a prospective, randomized trial of 35 patients with acute non- or minimally displaced scaphoid waist fractures who underwent treatment with a below-elbow thumb spica cast (n = 21) or wrist arthroscopy and percutaneous antegrade screw fixation (n = 14). At 26-week follow-up, they found that patients in the casted cohort had improved range of motion compared to those in the surgical cohort. At median 6-year follow-up, the researchers found that radiographic signs of arthritis in the radioscaphoid joint were more common in the surgically treated group (3 of 14) than in the casted group (2 of 21). The researchers noted no significant differences between cohorts in grip or pinch strengths at any time point. Read the abstract…
Study: TXA may help reduce blood loss and need for transfusion in TKA procedures.
Data from a study published online in the European Journal of Orthopaedic Surgery & Traumatology suggest that the use of intravenous and topical tranexamic acid (TXA) may be associated with reduced blood loss and transfusion requirements for patients who undergo primary total knee arthroplasty (TKA). The authors conducted a prospective study of 90 TKA patients who received either intravenous (IV) TXA, intra-articular TXA, or standard treatment. They found that the mean drained blood loss was 192 mL ± 21 mL among IV patients, 121 mL ± 17 mL among intra-articular patients, and 415 mL ± 24 mL among control patients. Further, about 43 percent of control patients required a transfusion, compared to 23 percent of IV patients and 17 percent of intra-articular patients. Read more…
Study: Integrated fixation may allow for more efficient limb salvage among certain patients with posttraumatic tibial bone loss.
According to a study published online in the journal Clinical Orthopaedics and Related Research, integrated fixation at the beginning of the consolidation phase may allow for more efficient limb salvage surgical reconstruction in selected patients with posttraumatic tibial bone loss. The research team reviewed data on 58 patients with posttraumatic tibial bone loss (58 tibiae) and who were treated using the Ilizarov method. Of those, 30 patients were treated with external fixator alone, while 28 were treated using an “integrated technique” with an external fixator and plating or insertion of an intramedullary nail. The research team found that patients treated with integrated fixation spent less time in the external fixator, with no significant difference in severity or number of complications between groups. “The integrated fixation method allows for a more efficient limb salvage surgical reconstruction in patients carefully selected for that approach,” the authors write, “whereas the frequency of adverse events and ability to restore limb lengths was not different between the groups with the numbers available. Careful placement of external fixation pins is critical to decrease cross-contamination with planned internal fixation constructs.” Read more…
Study: Coach education and restricted practice contact may reduce injury rates in youth football.
Findings published in the July issue of the Orthopaedic Journal of Sports Medicine suggest that a comprehensive education program for coaches and practice contact restrictions may help reduce injuries in youth football. The authors reviewed injury data on three groups of players. The first group (741 players) participated in leagues that used both the Heads Up Football (HUF) coaching education program and the Pop Warner Football (PW) guidelines to restrict contact during practice. The second group (663 players) were in leagues that adopted only the HUF program, and the control group (704 players) were in leagues that didn’t participate in either program. The authors found that practice injury rates were lower for the HUF+PW group and the HUF-only group, compared with the control group. Compared against controls, the HUF+PW group had lower game injury rates, but the HUF-only group did not. The effects were stronger among 11- to 15-year-olds than among 5- to 10-year-old players. Read more…
Read the complete study…
Study: Presence of orthopaedic trauma NP may reduce LOS for orthopaedic patients.
A study published in the July issue of the Journal of Orthopaedic Trauma suggests that the presence of a dedicated orthopaedic trauma advanced practice provider at a level I trauma center may help reduce length of stay (LOS) for orthopaedic patients. The researchers conducted a retrospective chart review of all patients discharged from the orthopaedic surgery service of a single, level I trauma center for 1 year prior to and 1 year after the addition of a single, full-time nurse practitioner (NP) to the orthopaedic trauma team. They found that the hiring of the NP was associated with a statistically significant decrease in LOS across the following patient subgroups: patients transferred from the trauma service, patients aged 60 years and older, patients discharged to a rehabilitation facility, and patients discharged on antibiotics/wound vacuum-assisted closure therapy. In addition, they noted that length of time to surgery was also decreased after the staff addition. Read more…
Will shift away from FFS actually save money?
An article in U.S. News & World Report questions whether a shift away from fee-for-service (FFS) reimbursement under the Affordable Care Act will have the desired effect of reducing costs. One expert states that quality initiatives amount to paying providers less for doing more. “Attempts at changing payment models in the past,” the writer states, “have yielded only modest savings at best. Also, what remains unclear is why hospitals would buy into a payment system voluntarily that likely would reduce their bottom lines.” Read more…
Call for volunteers: Performance Measures Committee.
Aug. 14 is the last day to submit your application for a position on the Performance Measures Committee (one resident-at-large opening). This committee oversees the development, validation, dissemination, and implementation of AAOS performance measures. Applicants for this position must be PGY-2, PGY-3, or PGY-4, and provide a letter from their residency program director indicating the program’s support of the resident applicant to fully participate in the committee, including attendance at all committee meetings. Learn more and submit your application…(member login required)