Today’s Top Story

Study: Revision THA rate fell for all age groups but one over six-year period

A study published in the March 21 issue of The Journal of Bone & Joint Surgery ( JBJS) finds that the rate of revision total hip arthroplasty (THA) significantly increased among patients 45 to 64 years of age from 2007 to 2013. The authors reviewed data on 320,496 THA revisions performed from 2007 through 2013 and found that, after adjustment for population growth, the THA revision rate increased by 30.4 percent among patients 45 to 64 years of age, while it decreased in all other age groups. Overall, the rate of surgically treated THA dislocations decreased 14.3 percent during the term of the study. The authors note that the mean length of hospital stay and hospital costs for THA revision were significantly lower in 2013 compared to 2007, and the risk of complications such as deep vein thrombosis, pulmonary embolism, myocardial infarction, transfusion, pneumonia urinary tract infection, and mortality fell significantly from 2007 to 2013.

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Other News

Study: Arthroscopy may relieve symptoms of knee OA, but is unlikely to delay TKA

According to a study published in the March issue of the journal Arthroscopy, arthroscopic treatment may not reduce or delay the need for arthroplasty for knee osteoarthritis (OA) but could help relieve symptoms compared to conservative treatment. The researchers conducted a retrospective, comparative study of 382 patients, 214 of whom were treated with arthroscopy and 168 of whom were treated conservatively. At one- and two-year follow-ups, they found that Western Ontario and McMaster Universities Osteoarthritis Index score was significantly lower in the arthroscopy group than in the conservative group. However, at five years, there was no significant difference across cohorts in number of patients who had undergone total knee arthroplasty (TKA).

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Study: Vancomycin powder may reduce risk of SSI following scoliosis surgery even when previous surgeries were performed without it

Findings from a preliminary study published in the March 21 JBJS suggest that vancomycin powder may be effective for reducing risk of surgical site infection (SSI) following surgery for early-onset scoliosis, even when previous surgeries have been performed without it. Members of the research team performed a retrospective study of 36 patients who underwent 191 procedures for early-onset scoliosis. During the study period, they found that 14 of patients (39 percent) developed one or more deep SSI, and two patients had multiple acute infections. The researchers noted 87 procedures with 12 infections in the control cohort (13.8 percent SSI rate per procedure) and 104 procedures with five infections in the vancomycin cohort (4.8 percent SSI rate per procedure).

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Prior authorizations process may impede access to care

A survey of physicians conducted by the American Medical Association suggests that prior authorizations programs may negatively impact patient clinical outcomes. The researchers surveyed 1,000 practicing physicians, including 40 percent primary care physicians and 60 percent specialists. They found that 92 percent of respondents said that prior authorizations programs have a negative impact on patient clinical outcomes, 64 percent reported waiting at least one business day for prior authorization decisions from insurers, and 30 percent said they wait three business days or longer. In addition, 78 percent said that prior authorization sometimes, often, or always leads to patients abandoning a recommended course of treatment. Finally, the survey finds that every week a medical practice completes an average of 29.1 prior authorization requirements per physician, which takes an average of 146 hours to process.

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CMS proposes to reduce “red tape” in state Medicaid programs

The U.S. Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking that, if adopted, the proposal would provide flexibility to states when they make nominal rate reductions to fee-for-service payment rates under the Medicaid program. In addition, it would exempt states from requirements to analyze certain data and monitor access when the vast majority of their covered lives receive services through Medicaid managed care plans. The agency states that the proposal is designed to “support CMS efforts to move away from micromanaging state programs and instead focus on measuring program outcomes and holding states accountable for achieving results.”

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HHS secretary names Robert R. Redfield, MD, to lead CDC

The U.S. Department of Health & Human Services (HHS) announced that Secretary Alex Azar will name Robert R. Redfield, MD, as the 18th director of the Centers for Disease Control and Prevention and Administrator of the Agency for Toxic Substances and Disease Registry. Dr. Redfield was the founding director of the Department of Retroviral Research within the U.S. Military’s human immunodeficiency virus (HIV) Research Program and served for 20 years in the U.S. Army Medical Corps. He also served as a member of the President’s Advisory Council on HIV/AIDS from 2005 to 2009 and was appointed chair of the International Subcommittee from 2006 to 2009.

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Call for volunteers: Instructional Course Committees

May 25, 2018, is the last day to submit an application for a position on an Instructional Course Committee. Committee members grade Instructional Course Lecture applications in May and evaluate courses at the AAOS Annual Meeting in March. The following openings are available:

  • Hand and Wrist (chair)
  • Practice Management (chair)

Applicants for these positions must be active fellows with a practice emphasis in the relevant topic.

Learn more and submit your application…  (member login required)