The AAOS Business Meetings will be held on Thursday, March 26 at 11:30 a.m E.D.T. via the GoToWebinar platform. During the Business Meetings, members will have two ways to comment on the AAOS Resolutions Committee Report and the AAOS Bylaws Committee Report. Comments may be submitted in advance of the Business Meetings to governance@aaos.org. Additionally, members may submit comments through the webinar platform. Comments will be read aloud during the Business Meetings by staff.
HHS Office of Inspector General Warns About COVID-19 Fraud
The Department of Health and Human Services (HHS) Office of Inspector General issued a public warning about fraudulent schemes related to COVID-19. Scammers are offering COVID-19 tests to Medicare beneficiaries in exchange for personal information, but HHS warns that these services are not legitimate.
How to Manage Your Practice During the COVID-19 Crisis
The American Academy of Dermatology released tips for managing your practice during the COVID-19 outbreak, including how to protect yourself and your patients, what to tell patients about handwashing, and more.
A new Current Procedural Terminology (CPT) code has been created pertaining to testing of COVID-19. An accompanying fact sheet provides additional information, including a code descriptor and purpose, a clinical example, a description of the procedure, and frequently asked questions.
Study Assesses Inpatient Opioid Consumption and Discharge Prescription Patterns in Orthopaedic Patients
According to a retrospective study published in the April 1 issue of the Journal of the AAOS ®, postoperatively prescribed opioid regimens were often much higher compared to inpatient opioid use among orthopaedic patients. Opioid-naïve patients aged 18 to 95 years admitted after any orthopaedic procedure (n = 613) were assessed for daily and total prescription quantities and patient-specific factors. Comparisons were made between total opioids used one day before discharge versus total opioids prescribed one day after discharge, as well as refill rates in patients whose discharge regimen significantly exceeded their inpatient regimen versus those who had similar discharge and inpatient regimens. Across orthopaedic subspecialties, total opioid consumption for the 24 hours after discharge was significantly greater than the total consumption during the 24 hours before discharge. The excessive-prescription group received greater daily and total opioids at discharge and had a greater chance of refilling their prescription within 30 days of discharge.
Study: Outcomes in Operative Supination-adduction Type II Ankle Fracture Patients
A study published online in Injury compared outcomes for operative supination-adduction (SAD, AO/OTA 44A2.3) type II ankle fracture patients versus the general ankle fracture population. SAD type II ankle fracture patients presenting at one of two hospitals between 2006 and 2018 were identified. Data collected included demographics; operative information; and complications, including deep infection, superficial infection, delayed union, failure of fixation, and unplanned reoperation. An eight-question Patient-reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) questionnaire was collected from patients by telephone. Final analysis included 65 patients. Average time to surgery was 14.0 days, and average follow-up was 20.5 weeks. Nine complications (deep infections, n = 4; superficial infections, n = 3; delayed union, n = 1; and failure of fixation, n = 1) and six unplanned reoperations were observed, but no significant risk factors for either could be identified. After a mean 3.4 years postoperatively, 11 patients responded to the PROMIS score questionnaire. The average PROMIS PF T-score was 42.3, and the average PROMIS PI T-score was 55.8. Younger patients had higher PF scores, and patients who were treated with a direct medial approach to the medial malleolus had lower PI scores.
Office-based Orthopaedic Surgery: WALANT and Beyond
Office-based orthopaedic surgery (OBOS) was historically limited to superficial mass excisions and other minor surgeries that could be done within the time constraints of a tourniquet. The development of wide-awake local anesthesia with no tourniquet (WALANT) removed that constraint and expanded the scope of OBOS in fully awake patients. Considering that WALANT was developed within the field of hand surgery, hand surgeons are the leaders in OBOS and have enjoyed the most benefits. OBOS is not limited to hand surgery, however, and can be easily applied in foot and ankle surgery and other fields.
