Today’s Top Story
Study: Operative approach may offer some benefits for patients with displaced midshaft clavicular fracture.
Findings from a study published in the June 21 issue of The Journal of Bone & Joint Surgery (JBJS) suggest that plate fixation for displaced midshaft clavicular fracture may reduce risk of nonunion compared to nonsurgical treatment. The research team conducted a meta-analysis of six randomized, controlled trials covering 614 patients. The investigators found that surgical treatment was associated with reduced likelihood of nonunion, and that secondary operations for adverse events were performed less often among surgically treated patients. When plate removal was included, a secondary operation was performed in 17.6 percent of patients in the surgical cohort and 16.6 percent of patients in the nonsurgical cohort. At 1-year follow-up, the research team noted that mean Constant and Disabilities of Arm, Shoulder and Hand scores were somewhat better overall in the surgical cohort compared to the nonsurgical cohort. Read the abstract…

Other News

Study: What factors are linked to ED presentation after joint arthroplasty?
A study published in the June 21 issue of JBJS looks at trends in emergency department (ED) visits following major joint arthroplasty surgery. The authors reviewed records on 152,783 patients from three states and found that 5,229 (3.42 percent) returned to the inpatient setting and 8,883 (5.81 percent) presented to the ED for care within 30 days. Of those who presented to the ED, 17.94 percent had a primary diagnosis of pain and 25.75 percent had both a primary and/or a secondary diagnosis of pain. Overall, patients who presented to the ED had more comorbidities and were more frequently non-white with public insurance compared to those who did not present to the ED. Read the abstract…

Study: Drug “cocktail” may reduce risk of organ failure for patients with sepsis.
According to a study published in the June issue of the journal Chest, early use of an intravenous “cocktail” consisting of vitamin C, corticosteroids, and thiamine may help reduce risk of progressive organ dysfunction for patients with severe sepsis and septic shock. The research team reviewed information on 94 patients, 47 of whom were treated with the cocktail and 47 controls. The researchers found that hospital mortality was 8.5 percent (n = 4) in the treatment group and 40.4 percent (n = 19) in the control group. In addition, they note that Sepsis-Related Organ Failure Assessment score decreased in all patients in the treatment group, with none developing progressive organ failure. Read more…
Read the abstract…

Study: Readmission rates following major surgery vary by race.
Data from a study published online in the journal Health Affairs suggest significant disparities in readmission rates between black and white Medicare patients. The authors reviewed 30-day hospital readmission rates from a state of New York database for six major surgical procedures, including hip arthroplasty. They found that overall, black patients on traditional Medicare plans were 33 percent more likely to be readmitted compared to white patients. Further, black patients enrolled in Medicare Advantage plans were 64 percent more likely to be readmitted compared to white patients. Read more…
Read the abstract…

Study: microRNA profiling linked to sex-specific differences in OA progression.
A study published online in the journal Scientific Reports suggests a link between sex-specific microRNAs in synovial fluid and osteoarthritis (OA) progression. The researchers isolated exosomes in discarded human synovial fluid from patients with and without OA, and demonstrated sex-specific microRNA profiling in extracellular vesicles of synovial fluid linked to OA. The researchers suggest that differentially expressed female microRNAs might be estrogen-responsive and play a role in toll-like receptor signaling during pathogenesis of OA Read more…
Read the complete study…

Ohio.
An article in HealthLeaders Media reports on statewide efforts to reduce sepsis in Ohio. In 2015, hospitals in the state began a campaign to reduce sepsis encounters and related deaths by 30 percent by 2018 by adopting leadership and organizational interventions. Areas covered include:

  • Resource allocation
  • Organizational certification
  • Training and accountability
  • Hospital metrics
  • Collaboration
  • Staff performance evaluation

The writer states that 9 months after implementation of the initiative, the Ohio Hospital Association is reporting an 8 percent reduction in mortality due to sepsis. Read more…

Call for volunteers: International Committee.
July 15 is the last day to submit your application for a position on the International Committee. This committee directs and reviews the international activities of the AAOS. The following openings are available:

  • Member (two openings)
  • International member (one opening)

Applicants for the member position must be active fellows, resident members, resident members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. Applicants for the international member position must be international members of the Academy. Learn more and submit your application…(member login required)