Today’s Top Story
Safety notice: Medtronic NavLock Trackers are not to be used with third-party instruments; two patient deaths reported.
The U.S. Food and Drug Administration reports that Medtronic has issued a safety communication regarding the use of non-Medtronic instruments with the company’s NavLock Tracker. The company states that NavLock Trackers are intended to enable navigation of Medtronic instrumentation used during spinal fusion and interbody procedures with the Medtronic StealthStation surgical navigation system, and should only be used with Medtronic instruments. The safety communication notes reports of minor and serious injuries—including two patient deaths—following procedures that involved the use of non-Medtronic instruments with Medtronic’s NavLock Tracker.
Read more…
Read the Medtronic letter…

Other News

Study: EMRs and electronic scheduling may reduce “weekend effect.”
A research letter published online in the journal JAMA Surgery suggests that use of electronic medical records (EMRs) and electronic scheduling may help reduce the so-called “weekend effect,” significantly improving outcomes for patients who undergo surgery on weekends. The authors reviewed data on 2,979 patients who underwent one of three procedures (appendectomy, acute hernia repair, and cholecystectomy) from the U.S. Agency of Healthcare Research and Quality Healthcare Cost and Utilization Project State Inpatient Database. Among other things, they found that patients at hospitals with electronic operating room scheduling were 33 percent less likely to experience the weekend effect (defined as experiencing longer than expected hospital stays) than patients at hospitals with paper-based scheduling, and 35 percent less likely to experience the weekend effect at hospitals with electronic bed-management systems. In addition, the authors found that patients were less likely to experience the weekend effect at hospitals with high-speed EMR connectivity, EMR access in the operating room, and computerized physician ordering systems.
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Read the abstract…

Study: Nonsurgical treatment may be appropriate for selected patients with minimally displaced tibial plateau fracture.
Data from a study published in the May issue of the Journal of the AAOS suggest that nonsurgical treatment may be appropriate for selected patients with minimally displaced tibial plateau fractures. The researchers conducted a retrospective, comparative study of 37 patients who were treated nonsurgically for tibial plateau fracture at a single institution. Indications for nonsurgical treatment were minimal fracture displacement or preclusion of surgery because of comorbidities. At mean 21-month follow-up, they found that 59 percent of patients (n = 22) attained good to excellent functional outcomes. However, surgery that was precluded by a factor other than minimal fracture displacement was a predictor of poor outcome
Read the abstract…

Study: Losing weight may help slow progression of knee cartilage degeneration.
According to a study published online in the journal Radiology, patients with high body mass index (BMI) who lose weight may slow the progression of knee cartilage degeneration. The research team reviewed data from the Osteoarthritis Initiative on 640 overweight (BMI ≥ 25 kg/m2) and obese (BMI ≥ 30 kg/m2) participants, with risk factors for osteoarthritis (OA) or mild to moderate radiographic findings of OA. Patients were assessed via Whole-Organ Magnetic Resonance Imaging Score (WORMS) at baseline and 48 months, and categorized into three groups based on weight loss. Compared with patients in the stable weight cohort (n = 320), the research team found that the adjusted mean increase of cartilage WORMS was smaller in the 5 percent to 10 percent weight loss cohort (n = 238) and smallest in the > 10 percent weight loss cohort (n = 82).
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Read the complete study…

Study breaks down 2015 CMS Open Payments data.
A study published in the May 2 issue of The Journal of the American Medical Association (JAMA) examines 2015 data from the U.S. Centers for Medicare & Medicaid Services (CMS) Open Payments system. The authors conducted an observational, retrospective, population-based study of licensed U.S. physicians linked to 2015 Open Payments reports of industry payments. They found that 449,864 of 933,295 physicians (48.2 percent) reported a total of $2.4 billion in industry payments, including approximately $1.8 billion for general payments, $544 million for ownership interests, and $75 million for research payments. Overall, 47.7 percent of primary care physicians and 61.0 percent of surgeons reported receiving general payments. After adjustment for geographic spending region and sole proprietorship, the authors noted that male physicians within each specialty had increased likelihood of receiving general payments and royalty or license payments compared to female physicians.
Read the abstract…
    The May 2 issue of JAMA is a theme issue with a variety of articles and studies addressing the issue of physician conflict of interest.
View the table of contents…
Visit the Open Payments website…

Iowa.
AMA Wire reports that the Iowa Supreme Court has ruled that the state’s Morbidity and Mortality Study Law can prevent information from being given to a patient who filed a medical liability suit. At issue was a patient safety network incident report and related peer review documents filed with the hospital. A trial court had initially ordered the institution to turn over the documents, but the hospital and others argued that doing so would breach staff confidentiality and reduce incentive for future internal error reporting. The high court agreed that the hospital is not required to share the protected information.
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Read the ruling (PDF)…

Call for volunteers: AHRQ U.S. Preventive Services Task Force.
AAOS seeks to nominate members to serve on the U.S. Agency for Healthcare Research and Quality (AHRQ) U.S. Preventive Services Task Force. The task force is an independent body of experts in prevention and evidence-based medicine that offers evidence-based recommendations regarding the effectiveness of clinical preventive services and health promotion. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting their expertise in the subject area and a statement that they are able to participate in full capacity. All supporting materials must be submitted by June 5, 2017 at 11:59 p.m. CT, to Kyle Shah at  shah@aaos.org.
Learn more and submit your application…(member login required)