Today’s Top Story
Study: Long-term (7-year) results show CDA compares favorably to ACDF.
A multicenter, prospective randomized clinical trial of patients treated for symptomatic spondylosis between C3-C4 and C7-T1 (with or without prior cervical fusion) finds that patients had good long-term outcomes after undergoing anterior cervical diskectomy and fusion (ACDF) or cervical disk arthroplasty (CDA). The per protocol patient sample included 293 patients (163 CDA, 130 ACDF) at 5 years after surgery. The study also reports secondary surgical procedures and adverse events on the patient cohorts (110 patients; 68 CDA, 42 ACDF) to 7-year follow-up. The investigators found that CDA patients had greater improvement in neck pain scores and neck disability index scores, and also had decreased incidence of radiographical adjacent-level degeneration. The researchers also linked CDA to a trend toward fewer secondary surgical procedures. Adjacent-level degeneration was radiographically more frequent after ACDF and the primary indication for the increase in late-term secondary surgical procedures. Read the abstract…

Other News

Study: Obese pediatric patients are not at risk for increased complications in lower-extremity procedures requiring external fixation.
Obesity is not associated with increased complications when external fixation is used for lower-extremity pathology in pediatric orthopaedic patients, according to a study published in the Journal of Pediatric Orthopaedics. The researchers conducted a retrospective chart review of 208 patients (mean age = 11 years) who had undergone external fixation as definitive surgical treatment for any condition at a tertiary care hospital over a 15-year period. Patients were grouped into normal weight (n = 93), overweight (n = 22), and obese (n = 94) cohorts based on Centers for Disease Control and Prevention definitions. External fixation had been applied to the tibia (n = 82), the femur (n = 77), and to both bones (n = 49). The mean duration of fixation was 160 days; the mean follow-up was 3.9 years. The researchers found no statistically significant difference in the rate of complications among the three cohorts (P = 0.61). Read the abstract…

Study finds link between CTS and migraine headaches.
A study published online in Plastic and Reconstructive Surgery – Global Open® suggests an association between carpal tunnel syndrome (CTS) and migraine headaches. The researchers examined data from 25,880 respondents to the 2010 National Health Interview Survey and calculated prevalence estimates of CTS and migraine headaches. CTS (n = 952) was associated with older age, female gender, obesity, diabetes, and smoking; migraine headache (n = 4,212) was associated with younger age, female gender, obesity, diabetes, and current smoking. Logistic regression analysis revealed that migraine headache was prevalent in 34 percent of patients with CTS, compared to 16 percent of patients without CTS. CTS was prevalent in 8 percent of patients with migraine headache, compared to 3 percent in those without migraine headache. Read the study…

Number of solo practitioners is on the decline.
Data from consulting company Accenture indicate that the number of independent physicians in the United States will fall to 33 percent in 2016, down from 57 percent in 2001, an article in the Orlando Sentinel reports. The reasons, according to the article, include new government regulations and standards, changing practice and payment models, and the high cost of implementing electronic health records. At the same time, “health systems are buying physician practices to improve their market share, and commercial insurance companies have less incentive to negotiate reimbursement rates with some small practices.” The article states that advocates of independent practices are concerned that as hospitals acquire practices, the cost of care for patients will increase, a claim hospitals refute. Read more…

July 1 is last day to file for meaningful use hardship exception and avoid 2016 pay adjustment.
Healthcare providers have until July 1 to file a hardship exception and avoid a 2016 payment adjustment for unsuccessful participation in the Medicare EHR Incentive Program in 2014. To file a hardship exception, providers must take the following steps:

  • Show proof of a circumstance beyond their control
  • Explicitly outline how the circumstance significantly impaired their ability to meet meaningful use requirements

If approved, the exception is valid for the 2016 payment adjustment only. Supporting documentation must be provided for certain hardship exception categories. If a hardship exception is to be claimed for a subsequent payment adjustment year, a new application must be submitted for the appropriate year. Read more…
Learn more about hardship exceptions…

Missouri.
Missouri Gov. Jay Nixon recently signed Senate Bill 239, which sets new limits on non-economic damages against healthcare providers sued for malpractice, reports the News Tribune. Specifically, the bill sets three different limits on awards of non-economic damages: $400,000 for non-catastrophic personal injury, $700,000 for catastrophic injury (such as brain injury, loss of vision, and paralysis) and $700,000 for death. Lost wages, medical costs linked to the injury, and any other measurable economic damages are not subject to the limits, which will increase by no more than 1.7 percent per year. During an appearance at St. Mary’s Hospital in Jefferson City, Gov. Nixon said the bill signing represented “the successful completion of a bipartisan effort to make sure that our healthcare providers can continue to do what they do best—helping heal Missourians in need.” Read more…

Nominate a colleague for the Diversity, Humanitarian, or Tipton Leadership Award!
June 12, 2015 is the last day to submit nominations for the 2016 Diversity and Humanitarian Awards, and the William W. Tipton Jr., MD, Orthopaedic Leadership Award. These awards are presented annually at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession. Read more…

Call for volunteers: Committee on Professionalism.
June 30 is the last day to submit your application for a position on the Committee on Professionalism (chair, two member openings). The Committee on Professionalism reviews and hears complaints against AAOS fellows and members for alleged violations of the AAOS Standards of Professionalism and makes recommendations to the AAOS Board of Directors regarding possible official actions. Applicants for the chair position must be active fellows with a thorough understanding of the AAOS Professional Compliance Program and the AAOS Professional Compliance Program Grievance Procedures, and a demonstrated understanding of and experience with legal issues related to orthopaedic surgeons, including expert opinion and testimony. Applicants for the member position must be active or emeritus fellows with a demonstrated understanding of and experience with legal issues related to orthopaedic surgeons, including expert opinion and testimony. Learn more and submit your application…(member login required)