Today’s Top Story
Study: THA linked to societal savings of nearly $33,000 per patient.
Data from a study published in the December issue of the journal Clinical Orthopaedics and Related Research suggest that use of total hip arthroplasty (THA) may be associated with societal benefits that offset the costs of surgery. The researchers used a Markov model to assess overall cost-effectiveness of THA compared with nonsurgical treatment for osteoarthritis. They found that THA was associated with increased average annual patient productivity of $9,503. Overall, the researchers project that THA increases average lifetime direct costs by $30,365, which are offset by $63,314 in lifetime savings due to increased productivity. Read the abstract…

Other News

CDC releases recommendations for antibiotic prescribing.
The U.S. Centers for Disease Control and Prevention (CDC) has released a set of recommendations for antibiotic prescribing in the outpatient setting, with the goal of reducing antibiotic resistance. Core Elements of Outpatient Antibiotic Stewardship was developed through evidence-based antibiotic stewardship practices, as well as building on or adapting known best practices for antibiotic stewardship. The core elements include:

  • Dedication to and accountability for optimizing antibiotic prescribing and patient safety.
  • Implementation of at least one policy to improve antibiotic prescribing and assessment of its effects.
  • Monitoring of antibiotic prescribing practices.
  • Education of clinicians and patients regarding antibiotic prescribing.

CDC notes that antibiotic resistance is linked to an estimated 2 million infections and 23,000 deaths per year in the United States. Read the recommendations…

Study: MHT linked to improved bone quality in older women.
According to a study conducted in Switzerland and published online in The Journal of Clinical Endocrinology & Metabolism, menopausal hormone therapy (MHT) may be associated with preservation of bone microarchitecture in older women. The authors conducted a cross-sectional study of 1,279 women aged 50 to 80 years who were categorized according to MHT status (current, past, and never users). They found that patients in the current user cohort displayed higher trabecular bone score (TBS) values and bone mineral density (BMD) values compared to those in the past or never user cohorts. In addition, compared to never users, past MHT users exhibited higher lumbar spine and total hip BMD, and a trend for higher TBS. The authors state that the 10-year loss of TBS and BMD at lumbar spine and total hip was significantly lower for both current and past users compared to never users. They note that MHT duration had no effect on bone parameters. Read more…
Read the abstract…

Study: Higher level residents more likely to prefer flexible duty hour policies.
A survey published online in the Journal of the American College of Surgeons suggests that a majority of surgical residents may prefer to work under flexible duty hour policies compared to standard policies. The research team surveyed participants in the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial regarding their perceptions of the effect of duty hour policies on aspects of patient safety, continuity of care, resident education, clinical training, and resident well-being. They found that, in the standard policy arm, as PGY level increased, residents more frequently reported that duty hour policies negatively affected patient safety, professionalism, morale, and career choice. In the flexible policy arm, as the PGY level increased, residents less frequently perceived negative effects of duty hour policies on resident health, rest, and time for family/friends and extracurricular activities. The research team notes that the proportion of residents expressing a preference for training in programs with flexible duty hour policies increased with PGY level, with a preference for flexible duty hour policies even more apparent among residents in the flexible policy arm. Read more…
Read the abstract…

Study: Electronic prescribing of high-risk medications may increase risk of falls for older patients.
Data published online in the Journal of the American Geriatrics Society suggest that electronic prescribing of high-risk medications may be associated with increased risk of falls among older patients. The researchers retrospectively reviewed data on 328 falls among patients 65 years or older at a single center. They found that 62 percent of falls occurred in individuals who were administered at least one high-risk medication within the 24 hours before the fall, with 16 percent of falls involving individuals receiving two high-risk medications, and another 16 percent in individuals receiving three or more high-risk medications. Further, high-risk medications were often administered at higher-than-recommended geriatric daily doses, in particular benzodiazepines and benzodiazepine-receptor agonists, among which the dose was higher than recommended in 29 of 51 cases (57 percent). Overall, the researchers note that hospital electronic medical records (EMR) default doses were higher than recommended for 12 of 29 (41 percent) medications examined. “Decreasing EMR default doses for individuals aged 65 and older and warnings about the cumulative numbers of high-risk medications prescribed per person may be simple interventions that could decrease inpatient falls,” the researchers write. Read more…
Read the abstract…

Submit your entries now! MORE Awards honor excellence in orthopaedic journalism.
The Media Orthopaedic Reporting Excellence (MORE) Awards recognize and honor journalistic efforts that further the public’s understanding of musculoskeletal health issues and encourage healthy behaviors in the care of bones and joints. AAOS is asking members to submit stories from broadcast, radio, print, or websites that accurately and compassionately highlight orthopaedic procedures, treatments, and preventive care and practices. Stories must have been published or broadcast between Oct. 1, 2015, and Oct. 1, 2016. Winners will be recognized at the 2017 MORE Awards ceremony and dinner during the National Orthopaedic Leadership Conference in Washington, D.C., on April 27, 2017. For more information, please contact Kelly King Johnson at 847-384-4033. To enter a submission, please email the story link to: media@aaos.org.

Call for volunteers: Communications Cabinet.
Dec. 16 is the last day to submit your application for a position on the Communications Cabinet (one member-at-large opening). The Communications Cabinet directs and evaluates AAOS communication vehicles, oversees special communications projects, provides public and media relations expertise to AAOS governance units, and promotes orthopaedics to internal and external audiences to enhance the image of orthopaedic surgeons and the orthopaedic specialty. Applicants for this position must be active fellows, associate members osteopathic, candidate members, or PGY4/PGY5 resident members. Learn more and submit your application…(member login required)