Study: Impact of Postoperative Acetaminophen on Opioid Consumption in Hip Arthroscopy
A randomized trial published online in Arthroscopy evaluated the use of postoperative acetaminophen to reduce opioid consumption after hip arthroscopy for femoroacetabular impingement. Patients were randomized to receive either oxycodone-acetaminophen 285 mg/325 mg every six hours as needed for pain (control; n = 40) or acetaminophen 650 mg every six hours for pain with oxycodone-acetaminophen 5 mg/325 mg for breakthrough pain (treatment; n = 40). Patients were told to take no more than acetaminophen 3 mg in a 24-hour period; if they reached the limit, they were prescribed oxycodone 5 mg. Pain and opioid use during the first week postoperatively did not largely differ between the groups.
Study Evaluates Female Surgeons’ Experiences of Interprofessional Workplace Conflict
A qualitative study published online in JAMA Network Open observed patterns of interprofessional workplace conflict among female surgeons. Between Feb. 19, 2019, and June 21, 2019, 30 female surgeons from the United States were interviewed. Interprofessional conflict resulted in professional and personal ramifications, including self-doubt, depression, anxiety, loss of sleep, frustration, and delays to advancement. Patient safety was also affected due to decreased communication because surgeons became hesitant to engage in certain interactions. Potential strategies included relationship management, rapport building, and social capital.
Study Compares Two- versus Three-component Ankle Arthroplasty
A retrospective study published in the December issue of Clinical Biomechanics compared clinical and functional outcomes between two- versus three-component total ankle arthroplasty (TAA). Three groups were created, with 20 patients each: two-component prosthesis, three-component prosthesis, and healthy patients (control). Both TAA groups presented significant improvements in American Orthopaedic Foot & Ankle Society score. The TAA groups had poorer outcomes in most spatio-temporal and functional parameters compared to the control group, but the operative groups did not largely differ.
Senator Works with AAOS in Urging Leadership to Preserve Physician Payments
In conjunction with efforts by AAOS, U.S. Senator Susan Collins (R-Maine) recently sent a letter to Senate leaders urging them to act quickly to prevent destabilizing cuts to medical providers that could harm patients’ access to health care. The ill-timed payment cuts being proposed for 2021 would affect orthopaedic surgeons as well as numerous other specialty healthcare professionals who continue to face the unprecedented public health emergency (PHE). These cuts are the result of the Medicare Physician Fee Schedule having to remain budget neutral. In the letter, Sen. Collins requested that leadership avoid the cuts by waiving budget neutrality requirements or holding the codes scheduled to receive a cut harmless.
CMS Expands Access to Telemedicine Services During COVID-19
The Centers for Medicare & Medicaid Services (CMS) added 11 services to the list of telemedicine services covered by Medicare fee-for-service during the COVID-19 PHE. CMS also announced continued support for state Medicaid and CHIP agencies to increase telemedicine access. The agency released preliminary data on Medicaid and CHIP telemedicine usage during the PHE, which indicate a significant increase in telemedicine usage during the pandemic.
AAOS members will soon receive the print edition of the October issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue highlights include musculoskeletal outcomes between males versus females, the benefits and implementation of clinical photography, how not to be a “disruptive physician,” and more.
The Bone Beat advocacy podcast recently aired two episodes on the proposed Medicare payment policy changes for 2021. In the special episode, produced in partnership with the American Association of Hip and Knee Surgeons, advocacy leaders from both organizations discussed the overall cuts to the value of orthopaedic procedures and additional cuts to hip and knee arthroplasty. In another episode, “Elimination of IPO and Shift to Outpatient Setting,” AAOS physician leaders, including President Joseph A. Bosco III, MD, FAAOS, discussed the proposal to eliminate the inpatient-only list (IPO) beginning with 266 musculoskeletal procedures. They recount the unresolved challenges with only recently removing several procedures from the list and the critical opportunity for orthopaedic surgeons to lead the decision-making process with patients and safely shift care to the outpatient setting.
