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| Today’s Top Story
President Guy Issues Statement on IPO Elimination Reversal
Yesterday, AAOS President Daniel K. Guy, MD, FAAOS, issued a statement in response to the Centers for Medicare and Medicaid Services’ (CMS) newly released Calendar Year 2022 Hospital Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center Proposed Rule. He said AAOS is encouraged to hear that CMS has heeded the patient safety concerns of the physician community regarding the abrupt elimination of the Inpatient Only (IPO) List. “We continue to support the removal of procedures which have been proven to be done safely in the outpatient setting; however, there is much work left to be done to clarify what these changes mean in order to avoid widespread confusion and unintended consequences for patient care,” noted Dr. Guy. He said CMS should place more emphasis on physicians leading those setting of care decisions and prioritize the value of patient choice. It is important to note that the proposed policy reversal will not impact the performance of total hip and knee arthroplasty in the outpatient setting, as those procedures were removed from the IPO prior to 2021.
Read the full statement…
Read the AAOS OPPS fact sheet… |
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| In Other News
Study: Incidence and Risk Factors of VTE after TJA among Patients with Diabetes
In a study of 400 patients with diabetes who underwent total joint arthroplasty (TJA), 46.8 percent of patients experienced postoperative venous thromboembolism (VTE; proximal vein thrombosis, 7.5 percent; distal vein thrombosis, 92.5 percent). The findings were published online in BMC Musculoskeletal Disorders. Older age, higher preoperative D-dimer scores, Caprini Risk Assessment scores, and total knee versus total hip arthroplasty were factors associated with increased risk of VTE. The authors noted a protective effect of postoperative concomitant mechanical prophylaxis and low molecular weight heparin use.
Read the study… |
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| Study: NSAIDs May Decrease Opioid Requirements, Pain Scores Immediately after RCR
A randomized study published online in the Journal of Shoulder and Elbow Surgery found NSAIDs after rotator cuff repair (RCR) reduced opioid requirements and pain at one week without increasing re-tear risk. Patients received ibuprofen (n = 51) or placebo (n = 50) in addition to postoperative opioids. At one week, ibuprofen was associated with fewer mean total morphine milligram equivalents used (168 versus 211) and reduced pain compared to placebo. At one year, seven patients who received ibuprofen and 13 who received placebo experienced re-tear.
Read the abstract… |
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| Study: Dilute Povidone-iodine Soak Shows No Added Prophylaxis Benefit in Foot and Ankle Surgery
The addition of a three-minute dilute povidone-iodine soak and scrub before standard skin preparation did not reduce infection risk compared to standard care for orthopaedic foot and ankle surgery, according to a randomized, controlled trial of 242 patients published online in Foot & Ankle International. Patients were randomized to a standard antiseptic preparation (alcohol scrub followed by chlorhexidine/alcohol paint) with or without a povidone-iodine soak and scrub. There was no difference in bacterial growth between the experimental and control groups (268 percent versus 26.9 percent, respectively).
Read the abstract… |
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| Study: Mid-term ODI Improvements after Multilevel Spinal Deformity Surgery in Older Patients
In a study of 219 patients aged ≥60 years undergoing multilevel spinal deformity surgery, published online in The Spine Journal, most patients showed significant improvement in Oswestry Disability Index (ODI) scores at two years postoperatively. Mean ODI improvement after two years was 19.3 percent. Forty-five percent of patients achieved ≥20.0 percent improvement and 23.7 percent showed improvement by 10.0 to 20.0 percent. No change (±10.0 percent) occurred in 26.3 percent and 4.5 percent reported a worsening between 10.0 to 20.0 percent.
Read the abstract… |
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| AAOS Now
Talitha Koum: ‘Girl, Rise Up’
Michelle Caird, MD, FAAOS, was recently appointed chair of the University of Michigan Department of Orthopaedics and is one of only a handful of women in such a leadership position. In a conversation with Julie Balch Samora, MD, PhD, MPH, FAAOS, FAOA, Dr. Caird spoke about serving as chair and the inspiring words that a patient’s mother shared with her. “To me, the phrase ‘Talitha koum’ is a tribute and reminder of what we can do as women in medicine and women in orthopaedic surgery,” she said.
Read more… |
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| Your AAOS
AAOS and J3P Healthcare Solutions Partner to Expand AAOS Leadership Institute
This month, AAOS kicked off a three-year partnership with J3P Healthcare Solutions, a consulting and coaching firm focused on strengthening clinicians’ leadership skills, as part of the organizations’ ongoing commitment to leadership development. The AAOS Leadership Institute (ALI) is an interactive and hands-on program providing leadership training, mentorship, and networking to members seeking to progress as a volunteer leader at AAOS. “The opportunity to bring in a dedicated partner like J3P who is so versatile and experienced in physician leadership is very exciting,” said AAOS Past President Joseph A. Bosco, III, MD, FAAOS. “This hands-on program is about developing a personalized and differentiated learning experience for our potential future volunteers that will expand their unique leadership capacity through self-awareness, as the complexities and scope of leadership are dynamic and quite personal in nature.”
Read the press release…
Learn more about ALI… |
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