November 6, 2017 | Today’s News

Senate bill would offer greater flexibility under MIPS

Healthcare IT News reports that a bill under consideration in the U.S. Senate seeks to increase flexibility in the U.S Centers for Medicare & Medicaid Services meaningful use program. If enacted, the EHR Regulatory Relief Act would create a 90-day period for the determination of whether a participant in the Merit-based Incentive Payment System (MIPS) is a meaningful user of electronic health records (EHRs) and would eliminate the current all-or-nothing approach to meaningful use. The bill also proposes to extend flexibility to providers who seek hardship exemptions for the 2017 EHR reporting period and payment adjustments for 2019.

Read more…

Study: CRFA may be effective therapy for patients with knee OA pain

Data from a study published online in the journal Regional Anesthesia & Pain Medicine suggest that, compared with intra-articular steroid (IAS) injection, cooled radiofrequency ablation (CRFA) may be an effective therapy for patients with knee osteoarthritis (OA) pain. The researchers conducted a prospective, multicenter, randomized trial of 151 patients with chronic knee pain unresponsive to conservative treatment. At 6-month follow-up, they found that, compared to patients treated with IAS, those treated with CRFA displayed more favorable outcomes in knee pain Numeric Rating Scale, Oxford Knee Score, overall treatment effect, and analgesic drug use. The researchers noted no procedure-related serious adverse events in either cohort.

Read more…

Read the abstract…

According to a study conducted presented at the annual meeting of the American College of Rheumatology, higher body mass index (BMI) and obesity may independently predict worse outcomes for patients with axial spondyloarthropathy. The researchers reviewed data on 683 patients enrolled in the Ankylosing Spondylitis Registry of Ireland. They found that the mean BMI of all patients in the cohort was 27.8 kg/m ², with seven patients (1.1 percent) considered to be underweight, 205 (31.6 percent) normal BMI, 252 (38.9 percent) overweight, and 184 (28.4 percent) obese, based on World Health Organization criteria. Based on univariable linear regression, the researchers found that BMI and obesity were both associated with higher Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Quality of Life, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, and Health Assessment Questionnaire scores. In multivariable regression analysis, obesity remained an independent predictor of higher disease activity and worse function.

Read more…

Read the abstract…

A study published online in the journal Foot & Ankle International attempts to quantify the number of opioid pills taken by opioid-naïve patients who undergo outpatient foot and ankle surgeries with regional anesthesia. The authors conducted a prospective, comparative study of 84 patients who underwent outpatient foot and ankle surgery with spinal blockade and long-acting popliteal blocks. Patients were given 40 or 60 narcotic pills, a 3-day supply of ibuprofen, deep vein thrombosis prophylaxis, and antiemetics. On postoperative days (PODs) 3, 7, 14, and 56, the authors surveyed patients as to whether they were still taking opioids, quantity of pills consumed, whether refills were obtained, pain level, and reason for stopping opioids. They found that patients consumed a mean 22.5 pills, with 55 percent of patients still taking opioids on POD 3 and 2.8 percent doing so on POD 56. The authors suggest that “providers consider prescribing 30 pills as the benchmark for this patient population.”

Read the abstract…

According to a study presented at the annual meeting of the American College of Rheumatology suggest that a bisphosphonate “drug holiday” of more than 2 years may be associated with a significantly increased risk of hip fracture for older women who had initiated bisphosphonate treatment and were at least 80 percent adherent for 2 or more years. The researchers reviewed Medicare data of 156,236 women with a mean age of 78.5 years. During a median follow up of 2.1 years, 40.1 percent (n = 62,676) of patients stopped bisphosphonate therapy for at least 6 months. Overall, 3,745 hip fractures occurred during follow-up. The researchers noted that hip fracture rates were lowest among women who were current users, and gradually increased as the length of the drug holiday increased, achieving their maximum with a drug holiday of longer than 2 years.

Read more…

Read the abstract…

An article in The New York Times ( NYT) discusses anterior cruciate ligament (ACL) repair and an increased likelihood of developing osteoarthritis (OA). “Orthopedists have believed for years that torn tendons or ligaments put patients…at risk for arthritis” the writer notes. “But quantifying the long-term risk has been difficult because most orthopedic patients are not studied for extended periods after their injuries.” The writer cites a study published in The American Journal of Sports Medicine ( AJSM), in which the authors evaluated 181 patients 10 to 15 years after ACL reconstruction and found that 74 percent had developed radiographic OA.

Read more…

Read the AJSM study…

Call for volunteers: Diversity Advisory Board

Dec. 15, 2017, is the last day to submit an application for a position on the Diversity Advisory Board (one opening—Communications Cabinet liaison). This board provides resources to assist AAOS members in providing culturally competent care to diverse populations as well as develops and implements strategies to overcome barriers faced by minorities when choosing orthopaedics as a career. The Communications Cabinet liaison is responsible for representing the Advisory Board’s issues and concerns to the Communications Cabinet. Applicants for this position must be active fellows, candidate members, or candidate member applicants for fellowship, with a demonstrated interest in advancing diversity in orthopaedics and fostering culturally competent care.

Learn more and submit your application…  (member login required)