Today’s Top Story
Study: Oral TXA may be as effective as intravenous TXA for primary THA patients.
Findings from a study published in the March 1 issue of The Journal of Bone & Joint Surgery (JBJS) suggest that oral and intravenous formulations of tranexamic acid (TXA) may offer equivalent reductions in blood loss for patients who undergo primary total hip arthroplasty (THA). The authors conducted a randomized, double-blind trial of 83 primary THA patients who received either 1.95 g of TXA orally 2 hours preoperatively (n = 40) or a 1-g TXA intravenous bolus in the operating room prior to incision (n = 43). They found that the mean reduction of hemoglobin was similar between oral and intravenous groups, and the mean total blood loss was equivalent between oral and intravenous administration. Overall, three patients (7.5 percent) in the oral group and one patient (2.3 percent) in the intravenous group were transfused, but the difference was not significant. No patients in either group experienced a thromboembolic event. The authors conclude that oral TXA may offer similar efficacy to intravenous TXA, at a greatly reduced cost. Read the abstract…
Study: Range of motion only partially correlates with patient self-assessments of shoulder function.
According to a study in the March 1 JBJS, active range of abduction may only partially correlate with patients’ self-assessed function of osteoarthritic shoulders. The researchers analyzed the relationship between objective range-of-motion measurements as recorded by an observer-independent motion capture system against Simple Shoulder Test (SST) patient self-assessments of shoulder function for 104 patients with osteoarthritis. They found poor correlation between objective measurements of active abduction and total SST scores of osteoarthritic shoulders of patients seen prior to shoulder surgery. The relationship between objective motion and subjective function did not differ significantly between male and female patients. The researchers write that both objective and subjective measurements are important in characterizing clinical status, and argue that studies of treatment outcomes should include separate assessments of both complementary aspects of shoulder function. Read the abstract…
The Joint Commission to offer certification of compounding pharmacies.
Healthleaders Media reports that The Joint Commission is launching a new program to certify compounding pharmacies. The certification is voluntary, but Michigan has already begun to require certification of compounding pharmacies, and several other states are considering certification programs. Compounding pharmacies have faced stricter scrutiny after a 2012 fungal meningitis outbreak linked to 64 deaths and nearly 700 illnesses. Read more…
Report examines clinician hiring trends.
The Medicus Firm has released a report based on the hiring activity of more than 250 healthcare employers from 2012 through 2016. Among other things, the report notes that 90 percent of physicians hired during that period received signing bonuses. The report also notes that:
- Physician employment as a practice model continues to dominate physician recruiting activity nationwide, with 91 percent of physicians placed being hired on as employees.
- The placement rate of advanced practice clinicians such as physician assistants and nurse practitioners increased significantly for the fourth consecutive year.
- International physicians accounted for 31.77 percent of placements made in 2016.
According to Law Firm Newswire, the Florida Supreme Court has overturned an appeals court ruling and ordered a hospital to turn over medical records to a patient’s family in a medical liability case. The hospital system had argued that a 2004 federal law provides confidentiality to hospitals that voluntarily submit information about medical errors. However, the state Supreme Court determined that the federal law does not preempt state requirements regarding disclosure of medical information. Read more…
In a separate case, the Florida Supreme Court declined to alter the state’s expert evidence rule. In 2013, the state enacted a law changing Florida’s expert evidence rule to the more stringent Daubert standard used by federal courts and the majority of state courts. Under the state constitution, the legislature has authority over the “substance” of court operations and the courts decide matters of “procedure.” “We decline to adopt the Daubert Amendment to the extent that it is procedural,” the court wrote, “due to the constitutional concerns raised, which must be left for a proper case or controversy.” In doing so, Florida courts will retain the Frye standard, under which it is generally considered easier for plaintiffs to obtain expert testimony. Read more…
The Courier-Journal reports that a bill under consideration in the Kentucky Legislature would, if enacted, call for a three-member panel of physicians to review claims and determine the merits of medical liability suits before they proceed to court. Supporters of the bill argue that it would limit frivolous lawsuits; critics respond that similar measures have been ineffective in other states, and may be unconstitutional. Read more…
Call for volunteers: Biological Implants Committee.
March 31 is the last day to submit your application for a position on the Biological Implants Committee (one member opening). This committee monitors and reviews scientific and regulatory developments in the field of implantable biologics as they relate to orthopaedic surgery. Applicants for this position must be active fellows with knowledge in the area of biologic products used in the practice of orthopaedics. Learn more and submit your application…(member login required)