Today’s Top Story
Study: MFR may be appropriate for some patients with chronic low back pain.
According to a study published in the May 1 issue of the journal Spine, myofascial release (MFR) therapy may be appropriate treatment for certain patients with chronic low back pain (CLBP). The authors conducted a double-blind, randomized, controlled trial of 54 participants with nonspecific CLBP, who received either four 40-minute sessions of myofascial treatment (n = 27) or sham MFR (n = 27). Compared to patients in the control cohort, they found that patients in the experimental cohort displayed significant improvements in pain and sensory Short Form McGill Pain Questionnaires. However, they found no difference as measured by the visual analog scale. Read the abstract…

Other News

Study: POCUS may offer advantages over radiographs for pediatric patients with distal forearm injury.
Findings published online in the journal Academic Emergency Medicine suggest that point-of-care-ultrasound (POCUS) may offer accurate, timely, and low-pain assessment of distal forearm injuries in pediatric patients. The research team conducted a cross-sectional study of 169 children aged 4 to 17 years with a suspected nonangulated distal forearm fracture, who underwent both radiographic and POCUS assessment. Overall, 76 patients were diagnosed with fracture. The research team found that sensitivity of POCUS for distal forearm fractures was 94.7 percent and specificity was 93.5 percent. In addition, POCUS was associated with a significantly lower median pain score compared to radiography, and no significant difference in median caregiver satisfaction score. Investigators also found that, compared to radiographs, POCUS was associated with significantly lower median procedure duration. Read more…
Read the abstract…

Opioid guideline offers recommendations for chronic, non-cancer pain.
A guideline published in the May 8 issue of the Canadian Medical Association Journal offers recommendations for reducing the prescribing of opioids for chronic, non-cancer pain. Recommendations include:

  • Non-drug and non-opioid pharmacotherapy be considered first and optimized for patients with chronic non-cancer pain.
  • Opioid trials for patients who have not responded to non-opioid treatment and who do not have a current or past substance use disorder or other current psychiatric disorder.
  • Dose restrictions of less than 50mg morphine equivalents a day for patients starting opioid therapy, and a strong recommendation that the daily dose be less than 90 mg a day.
  • A trial tapering of opioids to the lowest effective dose, potentially to none, for patients currently using 90 mg morphine equivalents a day or more, recognizing there are some patients who may need tapering paused or abandoned.

Read more…
Read the guideline…
Access the AAOS Pain Relief Toolkit…

Study: Research methodology accepted by FDA to approve high-risk orthopaedic devices may vary widely.
A study published in the May 3 issue of The Journal of Bone & Joint Surgery finds wide variation in reporting and strength of clinical research methodology accepted by the U.S. Food and Drug Administration (FDA) to approve high-risk orthopaedic devices. The researchers audited study design and methodology of 49 studies used by FDA to evaluate the safety and effectiveness of high-risk orthopaedic devices approved between 2001 and 2015. They found that 46 were prospective, 37 were randomized, and 47 were controlled in some form. Of 35 studies that reported it, 13 were double-blind and 8 were single-blind. Of the 37 randomized trials, outcome assessors were clearly blinded in six (16 percent), while 15 (41 percent) were deemed impossible to blind, as implants could be readily discerned on imaging. When the Checklist to Evaluate a Report of a Nonpharmacological Trial was applied to the 37 randomized trials, more than 70 percent of studies were deemed “unclear” in describing generation of allocation sequences, treatment allocation concealment, and adequate blinding of participants and outcome assessors. Read the complete study…

CMS debuts online tool to help providers determine their MIPS participation status.
The U.S. Centers for Medicare & Medicaid Services has announced the availability of an online tool to help healthcare providers determine their participation status in the Merit-based Incentive Payment System (MIPS). To determine your status, enter your national provider identifier number into the entry field. Information will be provided on whether MIPS participation is required, along with links to additional resources. MIPS participation is required for providers who bill Medicare Part B more than $30,000 per year and see more than 100 Medicare patients per year. Access the tool…

Manuscript submission open for 2018 Kappa Delta and OREF Clinical Research Awards.
Manuscripts are currently being accepted for the 2018 Kappa Delta Awards and the Orthopaedic Research and Education Foundation (OREF) Clinical Research Award. Up to two $20,000 Kappa Delta awards (Elizabeth Winston Lanier Award and Ann Doner Vaughan Award), one $20,000 Kappa Delta Young Investigator award, and one $20,000 OREF award will be bestowed, provided manuscripts of requisite quality are submitted. Manuscripts should represent a large body of cohesive scientific work, generally reflecting years of investigation. If the submission reflects a single project, it should be of high significance and impact. Manuscripts must be submitted by members (or candidate members) of the AAOS, Orthopaedic Research Society, Canadian Orthopaedic Association, or Canadian Orthopaedic Research Society. Submissions for the 2018 Kappa Delta and OREF Clinical Research Awards will be accepted in electronic format only. A PDF of the entire submission must be emailed no later than 11:59 p.m. CT on July 1, 2017. Late submissions will not be considered. Read more…

Call for abstracts: AAOS 2018 Annual Meeting.
Share your knowledge with orthopaedic surgeons from around the world at the AAOS 2018 Annual Meeting, to be held March 6-10, in New Orleans. Nowhere else will your discoveries reach such a wide-ranging orthopaedic audience. Please note the following deadlines:

  • June 1, 2017—Paper presentations, posters, or scientific exhibits
  • July 17, 2017—Orthopaedic Video Theater presentations

Presenters and all coauthors must disclose financial relationships in the AAOS Disclosure Database Program prior to abstract submission. Disclosure reported on April 1, 2017 or later is acceptable. Submit your abstracts…
Update your disclosures…