Study: Reduced Dislocation Risk after THA with Dual-mobility Components
A systematic review published in the June 1 issue of the Journal of the AAOS ® found a lower risk of complications in total hip arthroplasty (THA) with dual-mobility components (DMC) versus hemiarthroplasty (HA) or conventional THA (CTHA) for femoral neck fractures. Eighteen studies were included. In noncomparative studies where DMC was used alone, dislocation occurred in 1.2 percent of patients. In comparative studies, relative risk of dislocation with DMC was 59 percent lower than HA and 83 percent lower than CTHA. THA with DMC also had reduced rates of revision compared to HA. The researchers noted there was insufficient evidence to comment on revision rates in DMC versus CTHA.
Study: All-cause Failure Rate after Meniscal Repair for Traumatic Injuries Increase with Time
All-cause failure rates for meniscus repair for traumatic injuries rose from 12 percent at one year to 19 percent at six years postoperatively, according to a meta-analysis published online in Arthroscopy. Repairs included were performed in isolation or with concomitant anterior cruciate ligament reconstruction (ACLR). Pooled all-cause failure within one year postoperatively was 12 percent, 15 percent at two to three years, and 19 percent at four to six years. These rates were comparable in studies of patients receiving concomitant ACLR. Osteoarthritis developed in 4 percent of patients at two to three years and 10 percent at four to six years.
Study: Impact of Statin-treated Hyperlipidemia on Arthroscopic RCR Outcomes
Statin-treated hyperlipidemia did not significantly impact arthroscopic rotator cuff repair (RCR) outcomes and complications after 12 months, compared with controls who did not receive statins, according to a study published online in the Journal of Shoulder and Elbow Surgery. Seventy-seven patients were followed for one year, including 38 who were prescribed statins for hyperlipidemia. All patients showed significant improvement compared to baseline, with no difference in postoperative functional scores between groups. Rotator cuff healing and Goutallier fatty infiltration grades were also comparable between groups at 12 months. Progression of fatty infiltration was seen in four patients in each group. Statin use was not significantly associated with re-tear risk or progression of fatty atrophy.
Study: Increased Subsequent Fracture Risk after Nontraumatic Fracture in Older Women
A study published online in JAMA Internal Medicine found both traumatic and nontraumatic fractures increased the risk of subsequent fracture in postmenopausal woman aged >50 years. The researchers used data from the Women’s Health Initiative Study to assess outcomes in 66,874 patients who were followed for a mean of 8.1 years. In total, 7,142 patients (10.7 percent) experienced incident fracture during the follow-up period. There was a significantly increased association between initial and subsequent fractures in patients with either initial traumatic or nontraumatic fractures.
A study published online in the Journal of Hand Surgery found a 4.8 percent one-year revision rate after carpal tunnel release (CTR), with surgical technique and patient risk factors influencing revision risk. The researchers used insurance claims data from 2015 to 2017 to assess one-year outcomes of 4,549 patients who underwent CTR. In total, 207 patients (4.8 percent) underwent revision, with an average of 135 days between primary and revision surgery. Primary endoscopic CTR was associated with increased risk of revision. Patient factors associated with revision included diabetes, tobacco use, psychiatric condition, cervical disease, and a history of cubital tunnel release.
Coding for Patient Optimization Work in the Presurgical Period
In a recent article, the AAOS Coding Coverage & Reimbursement Committee, in conjunction with the American Association of Hip and Knee Surgeons Health Policy Council, addressed one of the most common coding questions in orthopaedic practices: How should work performed prior to surgery be reported? To answer this question, the AAOS CCRC looked to CPT and payer definitions for the global surgical package and addresses the evolving nature of the work performed during the presurgical period.
From May 24–28, AAOS members amplified year-long advocacy efforts on behalf of the musculoskeletal community during Orthopaedic Advocacy Week The first-ever completely virtual event comprised of daily advocacy activities for delivering critical messages to lawmakers on key healthcare policy issues including prior authorization reform, flexibility for telemedicine services, as well as reduction and prevention of mental health issues for healthcare professionals. The concerted effort of 249 event registrants from 39 states and Puerto Rico resulted in 582 letters sent to policymakers from the Advocacy Action Center, 202 meetings with legislators, 79 new co-sponsorships for AAOS-endorsed legislation, and 81 member signatories on AAOS-led regulatory letters. As part of the event, the Orthopaedic PAC hosted a “Day of Giving” sweepstakes that raised $269,111 from 986 contributors.
