Today’s Top Story

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, said that restrictions on “nonessential” orthopaedic surgeries have either partially or completely relaxed in all 50 states. An increase in COVID-19 cases associated with the increased surgery volume has not been reported, but Dr. Bosco said surgeons must be prepared to respond if and when an uptick in COVID-19 cases occurs. AAOS has also unveiled patient-centered frequently asked questions for undergoing orthopaedic surgery during the pandemic, available on OrthoInfo, with a Spanish translation in the works. On the advocacy front, the Provider Relief Fund (PRF) grant program has, to date, distributed more than $238 million to more than 1,440 orthopaedic practices. Providers have until June 3 to accept the PRF’s terms and conditions and be eligible to receive a future payment. Meanwhile, the AAOS Office of Government Relations continues to work to ensure AAOS Fellows receive a fair portion of the $3.3 trillion from the Coronavirus Aid, Relief, and Economic Security Act. Finally, First Vice President Daniel K. Guy MD, FAAOS, is working to organize in-district visits with Congressional members over a two-week period in August. Dr. Bosco said to look out for details in the coming weeks.

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In Other News

WHO Pauses Hydroxychloroquine Trial After Study Raises Safety Concerns

The World Health Organization (WHO) is temporarily stopping the use of hydroxychloroquine in COVID-19 treatment experiments. The decision follows the publication of a study in The Lancet, which found that hydroxychloroquine and chloroquine, alone or with a macrolide, decreased in-hospital survival in COVID-19 patients. The study included 96,032 COVID-19 patients (mean age, 53.8 years; 46.3 percent were female) in 671 hospitals across six continents who received either one of the treatment combinations or none of them. When adjusting for confounders, hydroxychloroquine, hydroxychloroquine with a macrolide, chloroquine, and chloroquine with a macrolide were all independently correlated with an increased risk of in-hospital mortality compared to the control group, as well as de novo ventricular arrhythmia during hospitalization.

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COVID-19 Testing Guidance for Orthopaedics and Spine Clinical Settings

An article published on the International Society for the Advancement of Spine Surgery’s website discussed testing options, benefits, and limitations for orthopaedics and spine clinical settings as elective surgeries resume. In the article, Nitin Khanna, MD, a spine care specialist, discusses preoperative testing, false negative tests, antibody testing, and more.

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Hospitals to Allow Visitors for Pilot Project in New York

New York Governor Andrew Cuomo announced that a pilot project will allow visitors at 16 hospitals across the state. Among the included institutions is Maimonides Medical Center, as well as hospitals in the Northwell Health, New York-Presbyterian, NYU Langone, and Mount Sinai health systems. Visits will include a time limit, temperature checks, and mandatory personal protective equipment.

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Study Analyzes Blood Glucose Control Effect on COVID-19 Outcomes in Patients with Diabetes

A retrospective study published online in Cell Metabolism found that blood glucose control significantly impacted outcomes and required medical interventions in COVID-19 patients with preexisting type 2 diabetes (T2D). Of 7,337 patients with COVID-19 across several centers in Hubei, China, 952 had preexisting T2D. Compared to nondiabetic patients, T2D patients required more medical interventions, had significantly higher mortality (7.8 percent versus 2.7 percent), and had greater multiple organ injury. Patients with well-controlled blood glucose (defined as glycemic variability within 3.9 to 10.0 mmol/L) during hospitalization, compared to poorly controlled blood glucose (upper limit of glycemic variability exceeding 10.0 mmol/L), had significantly lower mortality risk.

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Latest COVID-19 Webinar from Academy Leadership Provides Updates on Advocacy, Return to Surgery, and Research

In a COVID-19 webinar presented on May 13, AAOS’ Presidential Line provided updates on advocacy, return to surgery, COVID-19 member research, patient information, and virtual education. Similar to previous webinars, a question-and-answer session shed some light on members’ top concerns about navigating the COVID-19 pandemic.

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“The Bone Beat”: CMS Regulatory Response to COVID-19

In this second add-on episode of AAOS’ advocacy podcast “The Bone Beat,” Marion Everett Couch, MD, PhD, MBA, senior medical advisor for the Centers for Medicare & Medicaid Services (CMS), shares details on the agency’s response to the COVID-19 pandemic. She covers the sweeping regulatory changes made to support America’s healthcare system, the gradual resumption of nonemergent surgeries and procedures, and COVID-19’s potential long-term effects on various value-based programs in what she is calling the greatest transformation in medicine in the last century.

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