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| Today’s Top Story
CMS misses deadline to provide data on bundled-payment program
Modern Healthcare reports that the U.S. Centers for Medicare & Medicaid Services (CMS) missed its deadline to provide claims data on its Bundled Payment for Care Improvement Advanced program to all provider groups that applied to participate in the voluntary program, which aims to better coordinate care, improve quality of care, and reduce expenditures. CMS said it would share data in May about the program, which starts in October and runs through 2023. Earlier this week, CMS started transmitting data on target prices it will pay for each bundled episode of care, but it did not share raw claims data. This delay affects applicant providers who must tell CMS which of the 32 bundled-payment clinical episodes they want to participate in by Aug. 1, 2018.
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| Other News
FDA may look to prevent monopolies for first-in-class drugs
Scott Gottlieb, MD, commissioner of the U.S. Food and Drug Administration, said he wants to reduce first-in-class drug monopolies to provide more competition and potentially influence market prices. During an interview at the 2018 American Society of Clinical Oncology annual meeting, Dr. Gottlieb said he believes that over the past 10 to 15 years, the time to market for the second drug in a new class has increased. He said companies that produce breakthrough products should have an opportunity to price those products based on what the market will bear.
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| Study: Poor outcomes in patients with dysplasia of the hip may be related to residual dysplasia
A retrospective cohort study published online in The Bone & Joint Journal shows that one in five children who undergo treatment of developmental dysplasia of the hip with medially approached open reduction may experience poor outcomes. The study included 52 children (58 hips) younger than 1 year at the time of surgery. Radiographs were assessed preoperatively, as well as at one and five years postoperatively and at a mean 12.7 years (range, 4.6-20.8 years) postoperatively. Researchers found that 11 hips (19 percent) showed signs of avascular necrosis, 13 hips (22 percent) needed further surgery, and 13 hips showed poor radiological outcome (defined as Severin type 3 or higher). Patients whose hips showed poor radiological outcomes were significantly older at the time of surgery than patients whose hips had a good Severin classification (1 or 2).
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| Study: Epidural steroid use could be effective for pain management after diskectomy in lumbar disk herniation
A study published online in the European Journal of Orthopaedic Surgery & Traumatology indicates that epidural steroid application after diskectomy in lumbar disk herniation may be a sufficient alternative for pain management. Researchers conducted a meta-analysis of 12 studies that compared outcomes of epidural steroid application and placebo after diskectomy. The studies included 1,006 patients and assessed visual analog scale (VAS) of back and leg pain, morphine intake, hospital stay, and postoperative complications: 502 patients received epidural steroid and 504 received placebo. Nine studies included patients who had undergone traditional diskectomy; patients in the other three studies underwent minimally invasive diskectomy. The unstandardized mean difference of VAS of back pain at one week and one month, leg pain at one week and one month, morphine consumption, and hospital stay was lower with epidural steroid compared to placebo. There were no significant differences in prevalence of complications between the groups.
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| Study assessed pediatric opioid prescribing patterns
A study published in the May/June issue of the Journal of Pediatric Orthopaedics found that the three most commonly prescribed opioid medications were hydrocodone, oxycodone, and acetaminophen with codeine, in that order. The review included data from an electronic survey of the members of the Pediatric Orthopaedic Society of North America, of whom 264 responded. Participants were asked about prescriptions they would provide for seven treatment scenarios. Researchers also noted that education of care providers, patients, and families; standardization of narcotic prescribing practices that incorporate patient characteristics; and appropriate plans for disposal of unused narcotics are needed to help correct the opioid epidemic in the United States.
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| AAOS Now
“Tap Test” may offer simple method for detecting intraoperative syndesmotic instability
A study that evaluated a novel intraoperative test for syndesmotic instability of the ankle involving use of a 3.5 mm blunt cortical tap found the technique served as a “simple, reliable, and accurate tool for diagnosis of coronal syndesmotic instability.”
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| Your AAOS
Apply for Research Development Committee member-at-large position
The AAOS Research Development Committee has an open position for member-at-large, a term that runs through Mar. 27, 2020. The committee promotes orthopaedic research through advocacy, education, and recognition of excellence. The committee is charged with overseeing the annual research symposia, Kappa Delta orthopaedic research awards, Clinician Scholar Career Development Program, and Unified Orthopaedic Research Agenda, and also acts as a liaison to the National Institutes of Health. The last day to submit an application is June 20, 2018.
Learn more and submit your application… (member login required) |
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