May 18, 2020 | Today’s News

COVID-19 Presidential Update from Joseph A. Bosco III, MD, FAAOS

In his latest COVID-19 update, AAOS President Joseph A. Bosco III, MD, FAAOS, shared several spots of good news, including the gradual reopening of elective orthopaedic surgery. There have been no reported unexpected events associated with the relaxed surgery restrictions. Additionally, an AAOS analysis of Department of Health and Human Services data found that approximately $208 million from the Coronavirus Aid, Relief, and Economic Security Act Provider Relief Fund general distribution has been delivered to more than 1,200 orthopaedic practices across the United States. As orthopaedic surgeries are resuming, patients may have concerns about in-office visits or surgeries. This week, AAOS and subspecialty societies will be releasing a resource to help answer questions patients may have about how COVID-19 could affect their treatment.

Read Dr. Bosco’s message…

Tune in on May 27, at 7:15 p.m. C.T. for a two-hour webinar on the future of value-based musculoskeletal care. Immediate Past President Kristy L. Weber, MD, FAAOS, along with David S. Jevsevar, MD, MBA, FAAOS; Robert H. Quinn, MD, FAAOS; Kevin Shea, MD, FAAOS; and Elizabeth Teisberg, PhD, will discuss strategies and steps to help you thrive in this new arena, where quality, value, and outcomes are at the forefront. Programming will cover the role of the orthopaedic surgeon in supply chain management and the future of musculoskeletal registry data. In addition, Dr. Teisberg, coauthor of “Redefining Health Care,” will give a special talk titled, “Achieving High Value for Patients: Outcomes, Relationships, Professionalism.” Registration is free for AAOS members, and the webinar will be recorded and made available to watch again after the event.

Register for the webinar…

Latest COVID-19 Relief Package Passes House of Representatives

The House of Representatives passed a $3 trillion COVID-19 relief package, which allocates about $1 trillion to state and local governments, as well as provides another round of stimulus checks for eligible Americans. Most relevant to orthopaedics is that the bill includes an additional $100 billion in grants for healthcare providers as a fix for the currently suspended Medicare Accelerated and Advance Payment Programs. It did not, however, include liability protections as requested by Republications and advocated for by AAOS. The Democrat-proposed bill was passed largely along party lines and is unlikely to pass in the Republican-controlled Senate.

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Read AAOS’ summary…

Study: Regular Golfers Two Years After TKA

A study published in the May issue of The Journal of Arthroplasty analyzed the effect of unilateral total knee arthroplasty (TKA) on play time and golf level in experienced golfers. Members of the French Golf Federation aged older than 50 years who underwent a primary unilateral TKA were surveyed on the timing of return to play, mode of movement on the course, pain during golfing, physical activity via the University of California Los Angeles (UCLA) scale, level of golf, weekly playing time before and after surgery, and satisfaction with surgery. Among 143 golfers, the average time to return to the 18-hole course was 3.7 months. After at least two years postoperatively, golfers played at a higher level compared to preoperatively and with a handicap improvement of 0.85; average weekly play time increased from 8.9 hours to 10.2 hours. Visual analog scale score for knee pain decreased from 6.13 preoperatively to 1.27 postoperatively; UCLA scores improved from 7.02 to 7.85, respectively.

Read the abstract…

A study published in the May issue of The Journal of Hand Surgery compared illness perceptions among patients scheduled for surgery to treat one of four illnesses: carpometacarpal osteoarthritis (CMC OA), Dupuytren’s disease, carpal tunnel syndrome (CTS), and trigger finger syndrome (TFS). Patients preoperatively completed the Brief Illness Perception Questionnaire (Brief-IPQ), which was used to assess the cognitive and emotional representation of illness. Brief-IPQ scores were measured on an 80-point scale, with zero representing most positive perception. A total of 514 patients were included: 87 with CMC OA, 146 with Dupuytren’s disease, 129 with CTS, and 152 with TFS. The Brief-IPQ sum score was highest in the CMC OA group (42.0), followed by CTS (388), TFS (33.3), and Dupuytren’s disease (28.2). When adjusting for age, sex, hand dominance, and work type, Dupuytren’s disease patients had the most positive illness perception compared to the other groups.

Read the abstract…

A study published online in The American Journal of Emergency Medicine evaluated the diagnostic accuracy of ultrasound for upper extremity fractures in children. Database searches were conducted through November 2019 with key terms including “ultrasound,” “fractures of upper extremities,” and “children.” The searches yielded 32 studies for the meta-analysis. Ultrasounds for fractures of the upper extremities had a sensitivity of 0.95, specificity of 0.95, positive likelihood ratio of 21.1, and negative likelihood ratio of 0.05. The area under receiver operating characteristic (AUROC) was 0.98. Upon subgroup analysis, the outcomes for elbow fracture were: sensitivity, 0.95; specificity, 0.87; positive likelihood ratio, 7.3; negative likelihood ratio, 0.06; and AUROC, 0.96.

Read the abstract…

Sound Off: Another Roadblock to Elective Surgery – The Patient

As medical societies, big pharma, medical technology companies, physician private practices, and health systems try to make projections for the year and adjust their costs, one important variable has not been fully entered into the equation: the patient. In a consumer-driven healthcare model that is heavily based on employer-sponsored coverage, the dynamics are rapidly shifting. Patients will have major concerns about undergoing any elective procedure. This article discusses some of these worries, including getting COVID-19, losing health coverage, fear of taking medical leave, and more.

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