Today’s Top Story
Study: Surgical and nonsurgical treatments yield similar outcomes for symptomatic nontraumatic RCTs in older patients.
A study comparing the effectiveness of physiotherapy, acromioplasty, and rotator cuff repair for the treatment of symptomatic nontraumatic rotator cuff tears (RCTs) found no significant difference in clinical outcomes among the interventions at 2-year follow-up. The randomized controlled trial, published in The Journal of Bone and Joint Surgery, was conducted at three hospitals in Finland between October 2007 and December 2013. Shoulders with symptomatic, nontraumatic, supraspinatus tears (n = 180) were randomized into one of three intervention groups: physiotherapy, acromioplasty with physiotherapy, and rotator cuff repair, acromioplasty, and physiotherapy. Patient demographics were similar among the groups; the mean patient age was 65 years. All surgeries were performed arthroscopically by four experienced shoulder surgeons. Analysis was by intention to treat; of the six crossover patients, five (4 female, one male) were from the physiotherapy group and one (male) was from the acromioplasty group . Overall, 167 shoulders (physiotherapy: n = 55; acromioplasty: n = 58; rotator cuff repair: n = 54) were available for analysis at 2-year follow-up. The researchers found no significant differences in the mean change of Constant scores (P = 0.38), visual analog scale for pain scores (P=0.45), and patient satisfaction (P =0.28) among the groups. Read the study….
Other News
Insurance commissioners recommend broader health networks under the ACA.
The nation’s insurance commissioners are calling for increased patient access to physicians and hospitals in health plans offered under the Affordable Care Act (ACA). As reported by The New York Times, the National Association of Insurance Commissioners recommends new standards for ensuring that insurers have adequate numbers of doctors and hospitals in their networks to cover all services without patients having to pay exorbitant costs or experience delays in care. The proposed new standards—presented in the form of a model state law and drafted in an 18-month process open to consumers, providers, insurers, and experts—would require hospitals and insurers to alert patients that they could be charged extra fees if they are treated by a healthcare professional who is not in their insurer’s network. In this scenario, patients should not be required to pay more than their usual portion of the bill for services provided by physicians who participate in their health plan, according to the proposal. Read more…
View the draft…
Literature review examines spontaneous knee effusion and Lyme disease.
A review article published in The Journal of the American Academy of Orthopaedic Surgeons suggests that transient episodes of spontaneous knee effusion, or “water on the knee,” may be a primary symptom of Lyme disease, regardless of whether patients exhibit the common Lyme disease symptom of a “bull’s eye rash.” According to the authors, spontaneous knee effusion caused by Lyme disease may present in a similar way to that of a septic or arthritic knee, depending on the stage of disease. Knee effusion may occur in the early disseminating stage of Lyme disease, weeks or months after infection, or as part of Lyme arthritis in the disease’s late disseminating stage. The authors assert that Lyme disease is “easily treatable with antibiotics; therefore, inclusion of Lyme disease in the differential diagnosis as a potential cause of a spontaneous knee effusion can prevent the development of more severe symptoms associated with the disease.” Read more…
Read the review article…
Study: Blood test can detect brain trauma in children.
Researchers from Orlando Regional Medical Center, in Orlando, Fla., have developed a blood test for detecting concussions in kids, Fox News reports. The study, published in the journal Academic Emergency Medicine, involved 152 children who underwent computed tomography (CT) scans of their brains at three Level I trauma centers following blunt head trauma. Each child also underwent a blood test to examine biomarkers in the blood within 6 hours of their injuries. The biomarkers—glial fibrillary acidic proteins (GFAP)—are found in glial cells, which surround neurons in the brain. The researchers found that GFAP measured within 6 hours of injury was associated with traumatic intracranial lesions found on CT scans and was 94 percent accurate at predicting a traumatic brain injury. Read more…
Read the abstract…
Two studies examine impact of screw fixation for lateral condylar fractures.
Two studies in the December issue of the Journal of Pediatric Orthopaedics examine the use of screw fixation of lateral condylar fractures. The first study is a retrospective analysis of 96 patients aged 12 years or younger treated at a single institution during a 7-year period. The overall complication rate was 19 percent, but dropped to 5 percent if lateral overgrowth was excluded as a complication. Initial fracture union was achieved in 99 percent of patients. One patient required revision fixation with a bone graft. Hardware was symptomatic with prominence or loss of flexion in 4 percent of patients. There were no cases of growth arrest or alterations of the carrying angle. In the second study, researchers used a synthetic bone model of pediatric lateral condyle fractures (Milch type II) to calculate stiffness and maximum force through both tension and compression testing. They found that, in tension testing, stiffness and maximum force were significantly greater with screw fixation compared with K-wire fixation; compression testing showed statistically significant increased maximum force and a trend towards increased stiffness with screw fixation as compared with K-wires. Read the abstract for “Screw Fixation of Lateral Condyle Fractures: Results of Treatment”…
Read the abstract for “Biomechanical Analysis of Screws Versus K-Wires for Lateral Humeral Condyle Fractures”…
Zimmer wins first NexGen knee implant trial.
Zimmer Biomet was cleared last week of liability in the first of more than 900 lawsuits to go to trial that claim the company’s NexGen Flex knee replacement implants were defectively designed and are prone to failure, Reuters reports. The trial involved claims brought by a patient who alleged that both her NexGen Flex knee implants failed after one year, forcing her to undergo revision surgery in 2011. The “bellwether” case was being closely watched because it involved similar allegations to those raised in other claims about the implant. Read more…
AJRR launches patient-reported outcome platform.
The American Joint Replacement Registry (AJRR) has announced that it now provides participating hospitals with the ability to submit Level III patient-reported outcomes (PRO) data. Clinical staff are now able to access patient data while having the ability to manage PRO surveys electronically via a secure patient portal. In addition, the AJRR dashboard system can pull site-specific patient reports and summary results for each PRO measure supported on the AJRR system. There is currently no additional cost for Level III data submission. For more information about the AJRR PRO system, contact AJRR at 847-292-0530, or via email at: info@ajrr.net
Learn more about AJRR…
Call for volunteers: NQF Variation in Measure Specifications Project.
AAOS seeks to nominate members to the National Quality Forum (NQF) Variation in Measure Specifications Project. NQF is initiating a project focused on Variation in Measure Specifications to identify how, where, and why variation is occurring across current measures; to create a framework for understanding and interpreting the different types of variation across measures and the implications of this variation; and to develop a common understanding around key terms, concepts, and measure components to help standardize measurement efforts and minimize unnecessary variation. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted by Sunday, Nov. 29, 2015 at 11:59 p.m. CT, to Kyle Shah at: shah@aaos.org
Learn more and submit your application…(member login required)
