Today’s Top Story
Study: Extended-release triamcinolone acetonide may offer improved pain relief for patients with knee OA.
Data from a study published in the June 3 issue of The Journal of Bone & Joint Surgery suggest that intra-articular injection of extended-release triamcinolone acetonide may offer improved pain relief for patients with knee osteoarthritis (OA) compared against immediate-release triamcinolone acetonide. The authors conducted a randomized, double-blind, multicenter trial of 228 patients with moderate to severe knee OA pain who were treated with either a single intra-articular injection of FX006 (containing 10 mg, 40 mg, or 60 mg of triamcinolone acetonide), or 40 mg of immediate-release triamcinolone acetonide. Compared to immediate release triamcinolone acetonide, the 40-mg or 60-mg doses of FX006 were associated with clinically significant improved pain relief. However, a 60-mg dose did not provide additional improvement over a 40-mg dose. Read the abstract…

Other News

Study: Machine oil on implants may be linked to inhibited osseointegration.
According to a study published in the July issue of the Journal of Orthopaedic Research, the presence of machine oil residue on orthopaedic devices may inhibit osseointegration. The research team conducted a murine study in which titanium alloy implants were implanted into a unicortical pilot hole in the mid-diaphysis of the femur. They found that machine oil inhibited bone-to-implant contact and biomechanical pullout measures. In addition, machine oil on titanium alloy disks was associated with inhibited early stages of MC3T3-E1 osteogenesis in vitro. Inhibition of osteoblast attachment and spreading occurred in areas both with and without detectable oil. The research team writes that machine oil can inhibit osseointegration through cell autonomous effects on osteoblast cells. Read the abstract…

Study: Routine, 2-week radiographs of surgical DRF repair increase costs, but rarely alter management.
Findings published in the June issue of The Journal of Hand Surgery suggest that routine, 2-week postoperative radiographs of surgically treated distal radius fractures (DRFs) rarely alter patient management, but may add unnecessary cost to the patient and healthcare system. The researchers conducted a retrospective review of 268 patients who underwent surgical fixation of DRF. They found that 1 percent (n = 3) of patients experienced loss of fixation noted radiographically at 2-week follow-up that resulted in reoperation. Overall, there was no statistically significant difference in radial inclination, radial height, or volar tilt measured at 2 weeks, 6 weeks, or final follow-up. Read the abstract…

Special journal issue focuses on disparities in health care.
The June issue of the American Journal of Public Health looks at the impact of disparities in health care in the United States. Among other things, articles address topics such as:

  • Precision medicine
  • Recording demographics in electronic health records
  • Healthcare spending and utilization by race and ethnicity under the Affordable Care Act
  • Reports of insurance-based discrimination

Read more…

Study: Abuse-deterrent opioids curtail abuse, but effectiveness may be limited.
A study published in the May issue of JAMA Psychiatry finds that abuse-deterrent opioid formulations (ADFs) can curtail abuse, but their effectiveness may be limited and associated with a significant level of residual abuse. The authors surveyed 10,784 patients taking part in the Survey of Key Informants’ Patients program (Jan. 1, 2009–June 30, 2014) and found that reformulated oxycodone was associated with a significant reduction of past-month abuse after its introduction—from 45.1 percent (January to June 2009) to 26.0 percent (July to December 2012), apparently owing to a migration to other opioids. However, the reduction leveled off, with 25 percent to 30 percent of the sample persisting in endorsing past-month abuse from 2012 to study end in 2014. The authors note that, among 88 participants who indicated experience using pre-ADF and ADF oxycodone, this residual level of abuse reflected three phenomena:

  • Transition from nonoral routes of administration to oral use
  • Successful efforts to defeat the ADF mechanism leading to a continuation of inhaled or injected use
  • Exclusive use of the oral route independent of formulation type

Read more…
Read the abstract…

More evidence needed to evaluate effect of MTM on readmissions.
An article published in HealthLeaders Media looks at two studies that investigate the impact of medication therapy management (MTM) on readmission, and notes conflicting evidence. The first study, published in the December issue of the Journal of Managed Care & Specialty Pharmacy (JMCSP), analyzed evidence from nearly 300 articles on MTM, and found that most studies noted economic benefits, but the quality of research design and end point measures varied considerably across evaluations.
The second study, published in the May-June issue of the Journal of the American Pharmacists Association (JAPhA), was a prospective study of 90 patients; researchers found that 20 percent of patients treated with usual care were readmitted to the hospital within 30 days, compared to 6.9 percent of patients in the intervention (MTM) group. Read more…
Read the abstract in JMCSP
Read the abstract in JAPhA

Last call: Nominate a colleague for the Diversity, Humanitarian, or Tipton Leadership Award!
June 12, 2015 is the last day to submit nominations for the 2016 Diversity and Humanitarian Awards, and the William W. Tipton Jr., MD, Orthopaedic Leadership Award. These awards are presented annually at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession. Read more…

Call for volunteers: Surgical Quality Alliance.
AAOS seeks one member to serve as liaison to the Surgical Quality Alliance (SQA). SQA is a collaborative initiative of surgical specialties and anesthesiology created to define principles of surgical patient quality measurements, and develop awareness among interested parties about issues related to surgical care and quality in all surgical settings. Applicants for this position must have experience and interest in the areas of performance measures and quality assessment. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a letter of interest highlighting their expertise in the subject area and a statement that they are able to participate in full capacity, and a 100-word biosketch. All supporting materials should be submitted by Sunday, July 12, 2015 at 11:59 p.m. CT, to Kyle Shah at
Learn more and submit your application…(member login required)