July 6, 2020 | Today’s News

Study: Do Patient Point of Entry, Medicaid Status Affect THA Outcomes?

According to a study published in the July issue of The Bone & Joint Journal, Medicaid status significantly affected hospital length of stay (LOS) and facility discharge in total hip arthroplasty (THA) patients. Electronic medical records (EMRs) for 114 Medicaid and 312 non-Medicaid THA patients were retrospectively reviewed. Mean age was younger in the Medicaid than in the non-Medicaid group (54.68 years versus 63.10 years). When adjusting for patient risk factors, Medicaid status had a significant impact on LOS and facility discharge, but not surgical time There were no significant between-group differences in 30- and 90-day readmission and infections, or in 90-day mortality.

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Study Assesses 90-day Postoperative Narcotic Use after Orthopaedic Surgeries

A study published in the July 1 issue of the Journal of the AAOS® observed a correlation between patient-reported pain at time of discharge and narcotic use during the first 90 days after orthopaedic trauma surgery. EMRs for 5,030 patients were stratified by spine, adult reconstruction, and trauma procedures. The spine group had the longest LOS and highest mean pain during LOS and was prescribed the greatest amount of morphine equivalents during the 90 days after surgery. Narcotic prescriptions during the 90-day period were largely predicted by pain scores at discharge.

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A study published online in Arthroscopy evaluated 20-year meniscal allograft survivorship and outcomes. A total of 48 patients were contacted, of whom 21 required surgery on the graft. Isolated partial meniscectomy was performed in 13 patients. Eight patients had knee arthroplasty, including one prior partial graft removal and one high tibial osteotomy; the average time to arthroplasty was 12.7 years. The 20-year graft survivorship rate was 56.2 percent. In general, activity levels did not deteriorate from preoperatively to follow-up. One patient said they would not undergo the procedure again.

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According to a study published in the July issue of Clinical Orthopaedics and Related Research, female orthopaedic surgeons were authors of a small proportion of the orthopaedic literature over a 30-year period. Publications from the first issue of six major orthopaedic journals in 1987, 1992, 1997, 2002, 2012, and 2017 were assessed to gather the senior author’s gender, academic degree and specialty, as well as the publication’s study category. Over the study period, 1.7 percent of senior authors and 4.4 percent of first authors were women orthopaedic surgeons; the rate of growth of women senior authorship was lower compared to the rates of practicing women orthopaedic surgeons and women first authorship.

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A study published in the June issue of Foot & Ankle International compared outcomes for open reduction and internal fixation ankle fracture patients with two- versus six-week weight bearing. Fifty patients were randomized to the early or late weight-bearing groups. At six-week follow-up, the early group had a higher mean EuroQol-5D visual analog scale score than the late group (77 versus 66). There were no differences at other follow-up points or between the groups for physician-based outcome measures. At 26 weeks, the mean Olerud and Molander ankle scores were similar between the groups.

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Annual Meeting Committees Promote Diversity Among Educational Faculty

AAOS’ Central Program, Instructional Course Lecture, and Annual Meeting Committees are asking orthopaedic surgeons who submit applications for Instructional Course Lectures and symposia to consider the diversity of their speaker panels as they plan their submissions and, whenever possible, include speakers from demographic groups that are underrepresented in orthopaedics. According to the Central Program, Instructional Course Lecture, and Annual Meeting committee chairs, there is an opportunity to improve the diversity in all areas of the Annual Meeting’s educational programming. This will ultimately forge new professional relationships, increase communication and understanding, and benefit our patients, our institutions, ourselves, and our Academy. The deadline to submit your research for the AAOS 2021 Annual Meeting is July 15.

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The Bone Beat Podcast: “Reducing Disparities in Health Care”

In the sixth episode of AAOS’ advocacy podcast The Bone Beat, Mary O’Connor, MD, FAAOS, chair of Movement Is Life, explains how public policy and individual surgeons together can strengthen community-based programs to ultimately help narrow the health equity gap. She covers how the COVID-19 pandemic has put a spotlight on existing structural inequities and barriers to health care, which has also recently become the focus of advocacy efforts nationwide.

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