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| Today’s Top Story
Presidential Update from Joseph A. Bosco III, MD, FAAOS
In his latest message, AAOS President Joseph A. Bosco III, MD, FAAOS, shared updates on AAOS’ Office of Government Relations (OGR), the Nominating Committee, and the American Joint Replacement Registry (AJRR). The OGR formed and is leading a coalition of musculoskeletal organizations that are jointly offering their support for the Holding Providers Harmless from Medicare Cuts During COVID-19 Act (H.R. 8702) (read below for more information on this legislation). In a Nov. 16 letter to the bill’s sponsors, the coalition thanked them for introducing the vital legislation. After months of deliberation and sorting through dozens of qualified candidates, the Nominating Committee announced its slate of candidates for the 2021 Board of Directors positions. Finally, the AJRR released its seventh Annual Report, which includes actionable data on more than 1.5 million patients and 2.1 million total joints.
Read Dr. Bosco’s message… |
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| In Other News
Study Assesses Racial Differences in Bilateral Versus Unilateral TKA
A retrospective study published online in The Journal of Arthroplasty evaluated bilateral versus unilateral total knee arthroplasty (TKA) and compared utilization and in-hospital complications between Black versus white patients. A query of the National Inpatient Sample – Healthcare Cost and Utilization Project database (2007–2016) identified 276,194 bilateral and 5,528,429 unilateral TKAs performed during the study period. Bilateral procedures declined overall; during the study, Black patients were less likely than white patients to undergo bilateral TKA. In unilateral TKAs, Black patients had higher in-hospital complication rates, but there were no significant differences in bilateral TKAs.
Read the abstract… |
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| Study Explains Modified Transfibular Technique of Ankle Arthrodesis
A study published online in PLOS ONE described the safety and efficacy of a modified transfibular technique of ankle arthrodesis partial fibular resection and onlay bone graft. Twenty-seven consecutive patients (mean age, 68.5 years) were retrospectively reviewed. In this modified approach, the distal anterior half fibula was resected and fixed as an onlay graft. Mean follow-up was 17.3 months. Four months postoperatively, patients achieved complete (n = 13), near-complete (n = 8), and partial (n = 6) union. At final follow-up, complete union was achieved and neutral ankle alignment was maintained in all patients. One minor complication was observed.
Read the study… |
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| Study Compares Cost-effectiveness of Three Wrist Arthritis Surgeries
A study published in the November issue of Plastic and Reconstructive Surgery compared the cost-effectiveness of three motion-preserving procedures for wrist arthritis. Using a simulation model, the researchers created a hypothetical cohort of patients (mean age, 45 years) with painful wrist osteoarthritis who underwent four-corner fusion, proximal row carpectomy, or total wrist arthroplasty. Complication rates for the three procedures were: four-corner fusion, 27.1 percent; total wrist arthroplasty, 20.9 percent; and proximal row carpectomy, 17.4 percent. Secondary surgery rates were 87 percent, 46 percent, and 57 percent, respectively. Mean expected lifetime costs were highest for four-corner fusion ($13,632), followed by total wrist arthroplasty ($11,033) and proximal row carpectomy ($6,003).
Read the abstract… |
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| Study: Multidimensional Fluoroscopy in Percutaneous Iliosacral Screw Fixation
A study published in the November issue of the Journal of Orthopaedic Trauma evaluated the use of multidimensional pelvic fluoroscopy to determine the accuracy and safety of percutaneously placed iliosacral screws intraoperatively. Fifty-two patients were retrospectively reviewed. Upon intraoperative multidimensional fluoroscopy and postoperative CT scan, no screws were intraforaminally seen. All iliosacral and transsacral screws were deemed safe. Among three patients who received multidimensional fluoroscopy to evaluate guidepin placement, two underwent a fixation change upon reviewing multidimensional fluoroscopy.
Read the abstract… |
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| AAOS Now
Taxes, Subsidies, and Road Hogs: Minority Groups Are Still Underrepresented in Orthopaedics
Minorities experience disproportionately more micro- and macroaggressions, as well as implicit and explicit biases, compared to their majority counterparts. This can result in poor patient care, decline in clinical performance, burnout, and attrition. Several diversity initiatives at the national level have tried to address the various disparities. Multiple orthopaedic societies have assembled diversity committees and task forces for their practicing members. Despite these efforts, the number of minorities in orthopaedic surgery is far from reflective of the patient populations served.
Read more… |
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| Your AAOS
AAOS-led Coalition Offers Support for Bill to Mitigate Medicare Changes
The American Association of Orthopaedic Surgeons (AAOS), jointly with 63 other musculoskeletal organizations, is offering its support for the Holding Providers Harmless from Medicare Cuts During COVID-19 Act (H.R. 8702). The cuts being proposed by the Centers for Medicare & Medicaid Services in the 2021 Medicare Physician Fee Schedule would reduce the value of all orthopaedic surgical services by 5 percent plus an additional 5 percent for hip and knee replacements. H.R. 8702 would offer a relief payment to mitigate the impact of these changes on surgeons in 2021 and 2022 as the COVID-19 pandemic endures.
Read the letter…
Read the press release… |
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