Today’s Top Story
Study: Preoperative bundled intervention may reduce rates of complex S. aureus SSI for patients who undergo hip or knee arthroplasty.
Findings from a study published in the June 2 issue of The Journal of the American Medical Association suggest that use of a bundled intervention may be linked to a decrease in complex Staphylococcus aureus surgical site infection (SSI). The authors conducted a pragmatic study across 20 hospitals in the United States. They found a modest but statistically significant decrease in the rate of complex S. aureus SSI among hip and knee arthroplasty patients who screened positive for methicillin-resistant S. aureus (MRSA) or methicillin-susceptible S. aureus (MSSA), and who adhered to a bundled intervention consisting of intranasal mupirocin, bathing with chlorhexidine-gluconate, and perioperative antibiotic prophylaxis. Read more…
Read the abstract…
Other News
Study: What factors are linked to reduction loss after locking plate fixation of proximal humerus fracture?
A study published in the June issue of the Journal of Orthopaedic Trauma looks at risk factors for reduction loss after locking plate fixation of proximal humerus fractures. The researchers conducted a retrospective study of 252 patients with proximal humeral fractures who were surgically treated with locking plates at a single center. They found that reduction loss occurred in 6.7 percent (n = 17) of cases, with revision surgeries performed in all cases. Through univariable logistic regression analysis, the researchers noted that older age, osteoporosis, varus displacement, medial comminution, reduction adequacy, and insufficient medial support were significantly correlated to loss of reduction. In addition, under multivariable regression analysis, they found that osteoporosis, displaced varus fracture, medial comminution, and insufficient medial support were independent risk factors for reduction loss in proximal humerus fractures surgery. Read the abstract…
Study: Single cortisone injection may alleviate symptoms of de Quervain tendinopathy.
Data from a study published in the June issue of The Journal of Hand Surgery suggest that use of a single cortisone injection may help alleviate symptoms of de Quervain tendinopathy. The authors conducted a prospective study of 49 patients with de Quervain tendinopathy who were treated with a single corticosteroid injection. At 6-week follow-up, they found that symptoms were resolved in 82 percent of patients. At mean 84-day follow-up, 24 patients had had a recurrence of symptoms. In addition, 11 patients underwent an additional intervention (7 surgical releases and 4 repeat injections) at a median of 129 days after treatment. Overall, the authors estimated freedom from symptom recurrence to be 52 percent at 6- and 12-month follow-up, and at 12-month follow-up, the estimated freedom from repeat intervention was 81 percent. Read the abstract…
Study: CTRA has only minimal impact on provider decisions regarding fracture risk and treatment of femoral lesions.
According to data published online in the journal Clinical Orthopaedics and Related Research, the use of computed tomography-based rigidity analysis (CTRA) only minimally influences providers’ decisions regarding treatment. The research team surveyed 80 academic physicians using simulated vignettes of femoral lesions presented as three separate scenarios: no CTRA input, CTRA input suggesting increased risk of fracture, and CTRA input suggesting decreased risk of fracture. They found that, when CTRA suggested increased risk of fracture, physicians perceived the fracture risk to be slightly greater and were more prone to recommend surgical stabilization. Similarly, when CTRA suggested decreased risk of fracture, physicians perceived the risk to be slightly decreased and were less prone to recommend surgical stabilization. However, the effect size of the influence of CTRA varied with lesion severity and specialty of the responders, and the use of CTRA did not increase interobserver agreement regarding treatment recommendations when compared with the baseline scenario. Read the abstract…
House committee moves forward with bills to repeal two sections of ACA.
The Hill reports that the U.S. House of Representatives Ways and Means Committee has voted to repeal two sections of the Affordable Care Act (ACA): the Independent Payment Advisory Board (IPAB) and a tax on medical devices. IPAB has been criticized because the board would be able to alter Medicare payments with little Congressional oversight, and its repeal has bipartisan support. Support for repeal of the medical device tax generally follows party lines, with critics arguing that it stifles innovation, while supporters point out that its repeal would leave a $26 billion hole in the federal budget.
“H.R. 1190 is an important step in protecting patient access to quality health care, and the AAOS commends the committee for passing this bipartisan legislation and continuing work toward reforming the Medicare program,” states Thomas C. Barber, MD, chair of the AAOS Council on Advocacy. “AAOS is deeply concerned about the specific impact that IPAB-directed cuts will have on patient access to quality musculoskeletal care and we look forward to working with Congress to reach bipartisan offsets and enact this legislation.” Read more…
AMA offers resource to help physicians who may be considering integration.
The American Medical Association (AMA) has updated its report on integration arrangements. “Competing in the marketplace: How physicians may increase their value in the health care market through medical practice integration” is designed to help physicians identify the benefits and limitations of several potential integration arrangements, and determine the level of integration that makes the most sense for their practice. In addition, the report points out possible antitrust pitfalls, and educates physicians on managing antitrust risks. The report is free to all, although AAOS members who are not AMA members will have to create a free account on the AMA website to download the report. Read more…(registration may be required)
California.
An article in The Los Angeles Times reviews recently released Medicare data and finds a wide range of costs billed and paid for joint arthroplasty procedures in the Los Angeles area. One center billed Medicare an average of $237,063 per joint arthroplasty procedure during 2013, although Medicare paid that hospital an average of $17,609 per procedure. A second facility billed Medicare an average of $123,684 per procedure against $15,650 in payments; and a third charged $104,141 per procedure, but was paid an average of $20,604. The average national billing for a major joint replacement procedure was $54,239. Read more…
Call for volunteers: Committee on Professionalism.
June 30 is the last day to submit your application for a position on the Committee on Professionalism (chair, two member openings). The Committee on Professionalism reviews and hears complaints against AAOS fellows and members for alleged violations of the AAOS Standards of Professionalism and makes recommendations to the AAOS Board of Directors regarding possible official actions. Applicants for the chair position must be active fellows with a thorough understanding of the AAOS Professional Compliance Program and the AAOS Professional Compliance Program Grievance Procedures, and a demonstrated understanding of and experience with legal issues related to orthopaedic surgeons, including expert opinion and testimony. Applicants for the member position must be active or emeritus fellows with a demonstrated understanding of and experience with legal issues related to orthopaedic surgeons, including expert opinion and testimony. Learn more and submit your application…(member login required)
