COVID-19 Updates

OCR Announces Enforcement Discretion for Healthcare Professionals Using Telehealth Communication Services

The Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) announced it will employ its enforcement discretion and waive potential penalties for violations of the Health Insurance Portability and Accountability Act against healthcare professionals who utilize telehealth services to deliver care communications amid the COVID-19 pandemic. The discretion primarily applies to apps such as FaceTime or Skype when used in good faith, whether or not the service is directly related to COVID-19.

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Surgery Cancellations Due to COVID-19 Pose ‘Double-whammy’ for Hospitals

Hospitals are facing a financial “double-whammy” amid the COVID-19 pandemic because many surgeries are being put on hold in lieu of caring for COVID-19 patients, an expensive and complex population, with no clear foresight of what reimbursement will be.

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In Other News

Study Measure Value of Metric to Predict Hip Fracture Outcomes

A retrospective study published in the March/April issue of Current Orthopaedic Practice assessed a metric designed to predict postoperative length of stay and adverse events in operative hip fracture patients. Those who sustained a femoral neck fracture or intertrochanteric femoral fracture between 2002 and 2014 were identified using the National Inpatient Sample. Models were created using either the Elixhauser Comorbidity Measure (ECM) or Charlson Comorbidity Index; a model using only patient demographic characteristics was assessed as well. A combined model including each index and the base model was also created. Final analysis included 477,648 hip fractures; mean patient age was 82.3 years, and inpatient mortality rate was 2.2 percent. The base demographic variables and ECM model yielded the best predictive results; C statistics were 0.767 for inpatient mortality, 0.713 for cardiac complications, 0.818 for pulmonary complications, 0818 for renal complications, and 0.615 for thromboembolic complications.

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Study: Proximal Row Carpectomy Versus Four-corner Fusion

A study published online in The Journal of Hand Surgery compared proximal row carpectomy (PRC) versus four-corner fusion (4CF) based on incidence, demographic trends, and rates of subsequent fusion. A total of 3,636 PRC patients and 5,047 4CF patients treated between 2005 and 2014 were identified in the PearlDiver database. Comparisons were made regarding regional distribution, demographic characteristics, annual incidence, comorbidities, and subsequent wrist fusion. A total of 3,512 patients from each group were age- and sex-matched and compared. Comorbidities did not largely differ between the groups. Incidence increased in both procedure groups during the study period. 4CF patients were more likely than PRC patients to require subsequent fusion (2.67 percent versus 1.79 percent) and had significantly greater average direct costs; 30- and 90-day readmission rates did not largely differ between the groups

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Study Compares Treatments for Lumbar and Lumbosacral Spinal Tuberculosis

A retrospective study published online in the Journal of Orthopaedic Surgery and Research observed acceptable long-term outcomes in lumbar spinal tuberculosis (LSTB) and lumbosacral spinal tuberculosis (LSSTB) patients who received both posterior-only as well as combined posterior-anterior treatment approaches. Patients were stratified into two groups: posterior-only (LSTB, n = 30; LSSTB, n = 12; group A) and combined posterior-anterior (LSTB, n = 26; LSSTB, n = 14; group B) Group A had less intraoperative bleeding, shorter surgery time, and fewer hospitalization days than group B. At two-year follow-up, all patients achieved complete healing, and all patients achieved bony fusion. At final follow-up, outcomes including the visual analog scale, Japanese Orthopedic Association score, Oswestry Disability Index, and Kirkaldy-Willis functional evaluation were satisfactory for the whole cohort. Angle correction and maintaining correction did not differ between the groups. Both groups presented complications.

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March AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the March issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue highlights include AAOS’ advocacy efforts on Capitol Hill, office-based orthopaedic surgeries, the story of a transgender orthopaedic surgeon, and more.

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Call for Content: Submit an Article for AAOS Now

Do you have timely research or an interesting story to tell? AAOS Now is seeking editorial submissions from orthopaedic surgeons and orthopaedic- and practice-related product and service providers that qualify as subject matter experts. The magazine features various formats and opportunities to highlight your information or topic. AAOS Now encourages interested authors to contact staff prior to writing in order to review suggestions and provide feedback. Submit an article suggestion online or email AAOS Now Publisher Dennis Coyle at

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