Today’s Top Story
Study: Data suggest little advantage to surgery for patients with displaced fracture of the proximal humerus involving the surgical neck.
Data published in the March 10 issue of The Journal of the American Medical Association suggest that there may be little advantage to surgical treatment of certain displaced proximal humeral fractures, compared to nonsurgical treatment. The researchers conducted a pragmatic, multicenter, parallel-group, randomized clinical trial of 231 patients aged 16 years or older who were seen in the orthopedic departments of United Kingdom National Health Service hospitals within 3 weeks after sustaining a displaced fracture of the proximal humerus involving the surgical neck. Averaged over 2 years follow-up, researchers found no significant difference across surgical and nonsurgical cohorts in Oxford Shoulder Score, SF-12 physical component score, SF-12 mental component score, complications related to surgery or shoulder fracture, or mortality. However, 10 medical complications (2 cardiovascular events, 2 respiratory events, 2 gastrointestinal events, and 4 others) occurred in the surgical group during the postoperative hospital stay. Read more…
Read the abstract…

Other News

Study: Surgical treatment for SK displays greater risk of complications than surgical treatment for AIS.
According to a study published in the March 1 issue of the journal Spine, major complications are 3.9 times as likely among patients treated surgically for Scheuermann kyphosis (SK) than those treated surgically for adolescent idiopathic scoliosis (AIS). The authors reviewed prospectively collected data on 97 patients with SK and 800 patients with AIS. They found that patients in the SK cohort were at significantly greater risk of infection and reoperation. In addition, operative time was longer and more levels were fused in the SK group. There were no significant differences in length of stay or blood loss. The number of levels fused was an independent predictor of major complication: in both groups, each additional level fused increased the odds of a complication by 36 percent. Read the abstract…

Study: Genetics could increase likelihood of ACL injury in some female athletes.
Findings published in The Journal of Bone & Joint Surgery suggest that a genetic factor could increase the likelihood of anterior cruciate ligament (ACL) for some female athletes. The research team analyzed biopsy samples of ruptured ACL tissue from seven female and seven male athletes. They identified 32 genes with significant differential expression, 14 of which were not linked to the X or Y chromosome. The researcher team examined three genes that gave rise to specific proteins related to ligament structure and integrity, and found that all three genes regulated ligament tissue in a much different manner in female tissue compared to male tissue. Read more…
Read the abstract…

CMS, FDA disagree on where to store UDIs.
The Wall Street Journal reports that the U.S. Centers for Medicare & Medicaid Services (CMS) opposes a U.S. Food and Drug Administration (FDA) proposal to store device unique device identifiers (UDIs) along with insurance claims data to monitor safety. Officials at CMS argue that including UDIs on claims would entail significant technological challenges, costs, and risks for the Medicare system, and say that the agency “does not support any scenario wherein the UDI is integrated into a claim transaction, stored in claims history, or utilized anywhere in the claims adjudication and payment process.” A recent letter from the previous CMS administrator suggests that storing the UDI in electronic health records (EHRs) or company device registries could be sufficient to promote patient safety, but some medical safety experts respond that insurance databases, with their national reach, are a more reliable way to capture such data. Read more…

HHS announces plans for next generation ACO model.
The U.S. Department of Health and Human Services (HHS) has announced the Next Generation Accountable Care Organization (ACO) model of payment and care delivery. Under the initiative, ACOs will take on greater performance risk than in current models while potentially sharing in a greater portion of savings. To support increased risk sharing, HHS states that ACOs will be given a stable, predictable benchmark and flexible payment options to support their investments in care improvement infrastructure. An article in Modern Healthcare notes that the new program will allow patients to voluntarily enroll in ACOs, and in exchange, reduce or eliminate co-pays for some services. CMS will accept ACOs into the Next Generation ACO model through two rounds of applications in 2015 and 2016, with participation expected to last up to 5 years. Organizations interested in applying in 2015 must submit a Letter of Intent by May 1, 2015, and an application by June 1, 2015. A second round Letters of Intent and applications will be available in spring 2016. Read more…
Read the HHS statement…

Congressional bills would streamline transfer of healthcare data.
An article in Government Health IT notes that lawmakers in the U.S. Congress are considering two bills to streamline the exchange of healthcare information. If enacted, the Quality Data, Quality Healthcare Act would reform the Qualified Entity program by allowing organizations that receive Medicare data to analyze and redistribute it to authorized subscribers (insurers, health systems, and physicians) for a fee, so that subscribers can make more informed decisions. A second bill, currently in the drafting stage, proposes to establish a congressionally appointed advisory committee to develop interoperability standards for electronic health records systems. Under that proposal, current federal advisory committees would be replaced by a bipartisan 12-member board.
The American Association of Orthopaedic Surgeons (AAOS) plans to submit comments on the interoperability bill. Read more…
Read the press release on the Quality Data, Quality Healthcare Act…
Read the interoperability bill discussion draft…

CMS rules will require insurers to keep physician directories up to date.
Kaiser Health News reports that a pair of rules published by CMS will require health insurers to make available up-to-date information on physician networks to Medicare Advantage beneficiaries and consumers who purchase insurance through Affordable Care Act exchanges. The rules have been issued in response to complaints that insurer directories often include physicians who have retired from practice, moved, or died. The rules are set to take effect in 2016. Read more…

Vote now for 2015 AAOS leadership!
Online voting is now open on the AAOS website. Voting will be available until 1 p.m. PDT on Wednesday, March 25, with the results of the balloting announced on Thursday, March 26, during the 2015 Association business meeting at the AAOS Annual Meeting. The new leaders will take office at the conclusion of the 2015 Annual Meeting. The 2015 Nominating Committee has identified and announced the following candidates for the named positions:

  • Second Vice-President: William J. Maloney, MD (Calif.)
  • At-Large Member of Board of Directors (no age designation): Howard R. Epps, MD (Texas)
  • At-Large Member of the Board of Directors (under age 45): Daniel C. Farber, MD (Pa.)
  • Member of the National Membership Committee: Robert M. Orfaly, MD (Ore.)
  • Four nominees to the American Board of Orthopaedic Surgery (ABOS):
    • Joshua J. Jacobs, MD (Ill.)
    • Keith Kenter, MD (Ohio)
    • Gregory A. Mencio, MD (Tenn.)
    • Dean C. Taylor, COL, MD (N.C.)

Submit your ballot…(member login required)