Today’s Top Story

CDC Updates Guideline for Prescribing Opioids for Chronic Pain

The Centers for Disease Control and Prevention (CDC) has replaced its 2016 opioid guideline for chronic pain. Published in Morbidity and Mortality Weekly Report, the guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. The guideline addresses four key areas, including initiating opioids for pain, selecting opioids and dosages, deciding duration of initial opioid prescription and conducting follow-up, and assessing risk and potential harms of opioids. “This voluntary clinical practice guideline provides recommendations only and is intended to support, not supplant, clinical judgment and individualized, person-centered decision-making,” the CDC stated.

Read the guidelines…

In Other News

Study: Redislocation Rates after Bereiter Trochleoplasty for Recurrent Patellar Instability with Severe Trochlear Dysplasia

A case series published in Knee Surgery, Sports Traumatology, Arthroscopy investigated the clinical outcomes of Bereiter trochleoplasty in patients with recurrent patellar instability and severe trochlear dysplasia. Incidence of redislocation, infection, arthrofibrosis, chondral necrosis, and reoperation were retrospectively reviewed from 58 trochleoplasties. Patients also completed the visual analog scale for pain (VAS-P) and Banff Patella Instability Instrument (BPII) postoperatively. Overall, 93 percent of patients had concomitant medial patellofemoral ligament reconstructions, and 47 percent underwent tibial tuberosity transfer. The rates of both dislocation and arthrofibrosis were 5 percent. The mean postoperative BPII and VAS-P scores were 58.4 and 30.4, respectively.

Read the abstract…

Study: Ten-year Outcomes of Osseointegrated Prostheses in Patients with Transfemoral Amputations

The Journal of Orthopaedic Translation published a prospective cohort study online comparing the patient-reported outcomes (PROs) and complications before osseointegrated implants, within the first five-year period, and the later five-year period in patients with transfemoral amputations. Fifty-one patients treated with the Osseointegrated Prosthesis for the Rehabilitation of Amputees (OPRA) system were followed for 10 years. PROs, implant revision, mechanical complications, and deep infections were recorded. PROs showed statistically significant mean improvements. The incidence of mechanical complications was 3.9 per 10 person-years, and they were the most common serious adverse event.

Read the study…

Study Examines Factors Associated with Additional Clinic Visits after Sports-related Concussion Treatment

Published in the Clinical Journal of Sports Medicine, a retrospective cohort study evaluated variables associated with additional concussion clinic visits before discharge to athletic trainers (ATs) in athletes aged 12 to 23 years. There were 236 patients discharged to ATs after the initial clinic visit, and 288 patients who required additional clinic visits. Patient demographics, initial visit symptom scores, family history of psychiatric disorders and/or migraines, and history of prior concussions were analyzed. After conducting a multiple variable model, family history of psychiatric disorders, prior concussions, greater initial symptom score, and younger age had strong associations with additional clinic visits.

Read the study…

Advocacy News

CMS Finalizes 2023 Medicare Payment Changes

The Centers for Medicare & Medicaid Services (CMS) have released the 2023 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) final rules. Key changes to the MPFS include a $155 decrease in the conversion factor due to budget neutrality requirements, the temporary extension of telehealth services, and delayed implementation of the split/shared visits policy. In the OPPS final rule, CPT code 22632 is removed from the inpatient-only list, and CMS are adding facet joint interventions to the list of outpatient services that require prior authorization, effective July 1, 2023.

Read the MPFS fact sheet…

Read the OPPS fact sheet…


U.S. Surgeon Treats Patients from the Ukraine-Russia Conflict

Eli Ziv, MD, FAAOS, an orthopaedic surgeon from California, recently spent two weeks in Ukraine on a medical mission with the charity Global Response Management. During this time, he lived in a hospital about 12 miles from the front lines of the ongoing conflict between Ukrainian and Russian forces and received and treated patients who were wounded on the front lines. AAOS Now Editorial Board member Boris A. Zelle, MD, FAAOS, interviewed Dr. Ziv about his trip and his experience.

Read more…


Take Part in the Development of an Appropriate Use Criteria

AAOS is seeking volunteers to take part on the writing and rating panels for the development of the Management of Anterior Cruciate Ligament Injuries Appropriate Use Criteria. Writing panelists will be responsible for constructing a comprehensive patient indications list and a treatment list for patients with anterior cruciate ligament injuries. Rating panelists will be charged with rating appropriateness of included treatments based on patient indications/ scenarios via two rounds of voting. Applications will be reviewed and approved on a first-come, first-served basis.

Submit your application here…