Today, the House of Representatives approved the American Rescue Plan, a $1.9 trillion COVID-19 relief package. Major provisions include a direct payment of $1,400 to qualifying individuals, extended temporary federal unemployment benefits, increased premium support for Affordable Care Act plans, and continuation of COBRA health coverage subsidies. Notably for AAOS members, the bill does not include additional funding for the Provider Relief Fund or a delay in the 2 percent Medicare sequester cut that is scheduled to take effect March 31. The bill was passed by a vote of 220–211 and is expected to be signed by President Joe Biden on Friday, March 12.
Study Measures Cost-effectiveness of Robotic Arm-assisted THA
A study published in the Feb. 15 issue of the Journal of the AAOS ® calculated the cost-effectiveness of robotic arm-assisted (RAA) total hip arthroplasty (THA) compared to manual THA. A Markov model was conducted to assess outcomes and cumulative costs of RAA versus manual THA for the treatment of hip osteoarthritis and degenerative joint disorder over five years. RAA THA had an average cost saving differential of $945 for Medicare and $1,810 for private insurance compared to manual THA. RAA THA was found to be cost-effective in 99.4 percent of simulated cases.
Study: Preoperative Risk Factors for Range of Motion Loss after RTSA
A retrospective study published online in the Journal of Shoulder and Elbow Surgery assessed risk factors for loss of range of motion (ROM) following primary reverse total shoulder arthroplasty (RTSA) using data from a commercial RTSA database. Overall, 7.7 percent of patients (n = 123) lost ≥ 10 degrees of forward elevation, and 11.4 percent (n = 183) lost ≥ 10 degrees of external rotation. Greater preoperative shoulder ROM and functional scores were associated with higher risk of postoperative ROM loss. Irreparable rotator cuff tear or arthropathy and inflammatory arthropathy were also associated with ROM loss.
Study: Impact of Medical Morbidities on Complications in Charcot Foot Reconstruction
A study published online in Foot & Ankle International evaluated risk of perioperative complications of Charcot foot reconstruction in 85 patients with diabetes and multiple medical comorbidities. Overall, 26 percent of patients experienced complications, including six acute kidney injuries, two cases of sepsis, one cardiac event, and one pulmonary embolism. Low preoperative hemoglobin and congestive heart failure were associated with longer lengths of stay. The National Surgical Quality Improvement Program Risk Calculator was 74 percent accurate in predicting complications.
Study: Learning Curve in Dual Attending Surgeon Strategy for Posterior Spinal Fusion Surgery
A retrospective study published online in The Spine Journal determined the learning curve of a dual attending surgeon strategy in posterior spinal fusion surgery for the treatment of idiopathic scoliosis in 415 patients. Cutoff points for the learning curve were identified for operative time and total blood loss. The learning curves were established at the 115th case for operative time and 196th case for blood loss. Before and after cutoff, mean operative time reduced from 147.2 ± 36.5 minutes to 129.5 ± 28.9 minutes, and mean blood loss reduced from 1,015.1 ± 506.6 mL to 770.4 ± 357.3 mL.
Patient Safety Scenario: Leadership Prevails Within the OR
Surgeons have been taught that their job is to do the surgery, and everyone else’s job is to support the surgeon. While this may seem reasonable, it might be better to view the surgeon’s job as to perform the surgery while leading the team, and everyone else’s job is to support the goal of the team, which is the successful surgery. This article analyzes a scenario where surgeon leadership in the OR may help to address human error and improve patient safety.
Member Advantage Program Partners with mymedicalimages
The Member Advantage Program assures that the partners and products selected have been vetted by AAOS to help deliver practical, money-saving solutions for members’ use. The latest offering is from mymedicalimages, which offers patients a cloud-based solution to share and view medical images. This web platform helps to expedite care by receiving and sharing medical images in seconds compared to the old way of transferring files on outdated technology like CDs. Members can view, share, and manage medical images from anywhere, enabling collaboration with colleagues. This program is free for AAOS members who can even earn a small commission for patients who use the app
