White House opioid proposal to take three-pronged approach
CNN reports that a Donald J. Trump administration plan to address the opioid epidemic will focus on three areas: tougher law enforcement, including stiffer penalties and possibly the death penalty for drug traffickers; improving the ability to fund treatment through the federal government; and prevention and education through a public service campaign.
Study: Preoperative skin culture may predict Propionibacterium load for revision shoulder arthroplasty patients
According to a study published online in the Journal of Shoulder and Elbow Surgery, a culture of unprepared skin taken preoperatively may help predict Propionibacterium load among revision shoulder arthroplasty patients. The authors conducted a prospective study of 60 patients without clinical evidence of infection. They took a preoperative culture of each patient’s skin surface prior to skin preparation, along with multiple deep tissue and explant cultures at the time of surgery. Based on multivariate analysis, the authors found that preoperative specimen Propionibacterium value was predictive of Propionibacterium load in the revised shoulders as indicated by total and averaged shoulder Propionibacterium score.
Study: Arthroscopic treatment of FAI may reduce economic burden on society
Data from a study published online in The American Journal of Sports Medicine suggest that hip arthroscopy may reduce the economic burden on society linked to femoroacetabular impingement (FAI). The researchers reviewed data from a private insurance database on 32,143 individuals aged 16 years to 79 years and identified a statistically significant increase of mean aggregate productivity of $8,968 after surgical treatment for FAI. A cost-effectiveness analysis showed a mean cumulative total 10-year societal savings of $67,418 per patient from hip arthroscopy compared to nonsurgical treatment, along with a gain of 2.03 quality-adjusted life years. The researchers estimated the mean cost for hip arthroscopy to be $23,120 ± $10,279, while the mean cost of nonsurgical treatment was estimated to be $91,602 ± $14,675.
Study: GAE may help reduce pain and improve function for certain patients with knee OA
Findings from a pilot study presented at the annual scientific meeting of the Society of Interventional Radiology suggest that geniculate artery embolization (GAE) may help reduce pain and disability for patients with mild to moderate knee osteoarthritis (OA). The researchers performed GAE using 75 um or 100 um microspheres in 13 patients with median baseline OA of Kellgren Lawrence stage III. They found that GAE was technically successful in all patients. At 1-month follow-up, the researchers noted significantly improved visual analog scores and decreased global Western Ontario and McMaster Universities Osteoarthritis Index score. They identified no major adverse events related to the procedure.
The U.S. Centers for Medicare & Medicaid Services (CMS) will hold a conference call to discuss evaluation and management (E/M) services. The agency is seeking comments from stakeholders regarding potential updates to E/M guidelines to reduce burden and better align coding and documentation with the current practice of medicine. The call will take place Wednesday, March 21, 2018, from 1:30 p.m. to 3:00 p.m. ET.
Study: Roux-en-Y gastric bypass surgery linked to increased risk of nonvertebral fracture
According to research presented at the annual meeting of the Endocrine Society, patients who undergo Roux-en-Y gastric bypass (RYGB) surgery may be at increased risk of nonvertebral fracture compared to those who undergo adjustable gastric banding (AGB) surgery. Members of the research team analyzed Medicare billing claims data for 50,649 adults, of whom 35,920 underwent RYGB and 14,729 underwent AGB. They found that 1,109 nonvertebral fractures were reported during follow-up. The estimated incidence rates of nonvertebral fractures per 1,000 person-years were 9.8 in the RYGB group and 7.1 in the AGB group. The researchers note that, RYGB patients were younger than AGB patients and more likely to have diabetes and a shorter average follow-up time. However, age and diabetes status did not affect RYGB-associated fracture risk.
Last chance to submit public comments on Management of Hip Fractures in the Elderly Performance Measure
A quality measure developed by the AAOS related to the timing of surgical intervention of hip fractures in the elderly is entering the public commentary stage. The period of public commentary will close on Monday, March 26, 2018.