Today’s Top Story
Study: Measured tensioning of ACL graft may not improve clinical outcomes.
Data from a study published online in The American Journal of Sports Medicine suggest that measured tensioning of hamstring anterior cruciate ligament (ACL) grafts may not improve clinical outcomes compared with conventional tensioning. The authors conducted a randomized, controlled trial of 113 patients undergoing primary ACL reconstruction, 55 of whom were treated using a measured tensioning device for graft tensioning, and 58 of whom were treated with conventional tensioning maneuvers. At baseline and 6-, 12-, and 18-month follow-ups, the authors found no significant differences between cohorts in side-to-side laxity, or International Knee Documentation Committee Subjective Knee Evaluation Form and ACL Quality of Life Questionnaire scores. Read the abstract…
Other News
Study: Perioperative opioid use linked to lower outcome scores following TSA.
A study published in the April issue of the Journal of Shoulder and Elbow Surgery suggests that preoperative opioid use may be linked to significantly lower preoperative baseline and final outcome scores after total shoulder arthroplasty (TSA), compared with patients who do not have a history of preoperative opioid use. The research team conducted a retrospective cohort study of 224 TSAs performed for primary glenohumeral joint osteoarthritis with 2- to 5-year follow-up. Overall, 60 patients had a history of preoperative opioid use. The research team found that both groups significantly improved on all outcome scores and range of motion measurements from preoperative to most recent follow-up. However, preoperative opioid use was associated with significantly worse preoperative patient-reported outcome scores for nearly all outcome measures and significantly worse postoperative outcome scores. Read the abstract…
Apology initiatives may help avert medical liability suits.
An article on CNN.com discusses the issue of apologies and medical liability suits. The writer notes that 36 states have enacted so-called “I’m sorry” laws, which prevent apologies from being used as evidence against medical professionals in court. The writer also profiles a resolution program initiated at Stanford University and several other major healthcare institutions that encourages providers to “acknowledge and apologize” in place of a “deny and defend” approach following medical errors. Since implementation of the program in 2009, the Stanford resolution program has seen a 27 percent reduction in indemnity costs and a 24 percent reduction in money spent defending lawsuits. Read more…
AAOS has released an Information Statement on Patient-Physician Communication. Read more (PDF)…
Much work remains in efforts to understand CTE.
An article in The New York Times discusses the issue of chronic traumatic encephalopathy (CTE). The writer notes that research into the condition is hampered by a number of factors, including the fact that it can only be definitively diagnosed after death. One recent study found CTE in 21 of 66 brains of people who had played contact sports, but no evidence of the disorder in 198 people with no record of playing such sports. However, the American Academy of Clinical Neuropsychology states that existing evidence should not be interpreted to mean that parents must keep their children from playing sports. Researchers have identified four pathological stages of the condition, but acknowledge that little is known about how pathology stages may relate to specific symptoms. Efforts are also underway to develop a method to diagnose CTE in the living. Read more…
Massachusetts.
According to The Boston Globe, information released by the Massachusetts Health Policy Commission finds that annual opioid-related hospital visits in the state increased from 31,000 in 2007 to nearly 57,000 in 2014. The report also finds that opioid patients are distributed unevenly around the state, with certain “hot spots” in which higher concentrations of people required hospital care related to opioid use. Read more…
Pennsylvania.
The Legal Intelligencer reports that the Patient Trust Act under consideration in the Pennsylvania General Assembly would, if enacted, prevent the state and its political subdivisions from interfering with the physician-patient relationship. The publication notes that a number of state legislatures have enacted laws that require medical providers to give patients medically inaccurate information, perform medically unnecessary tests and procedures, and prevent physicians from discussing certain topics with patients, often as a part of a political agenda that has nothing to do with enhancing patient health or protecting privacy. Read more…(registration may be required)
Volunteers needed to help develop AUC for management of carpal tunnel syndrome.
The Appropriate Use Criteria (AUC) Section seeks AAOS fellows to participate on the voting panel of the Management of Carpal Tunnel Syndrome AUC. The voting panel will participate in two rounds of voting, in which it will rate the appropriateness of various surgical treatments for patients who have carpal tunnel syndrome. Voting panel members will be required to attend a 1-day, in-person meeting in Rosemont, Ill. Nominees for the voting panel are required to complete the AAOS conflict of interest enhanced disclosure form online. If you are interested in participating on the voting panel for this AUC topic, please contact Erica Linskey by Monday, April 11, 2016, at: linskey@aaos.org.
