Today’s Top Story
Study: Many orthopaedic patients perceive surgeons to be under-compensated.
Data from a study published online in the journal Orthopedics suggest that patient-perceived values for arthroscopic meniscectomy and anterior cruciate ligament (ACL) reconstruction may be substantially higher than current Medicare reimbursement values. The research team surveyed 231 patients regarding surgeon reimbursement for meniscectomy and ACL reconstruction. They found that, on average, patients thought surgeons should receive $8,096 for meniscectomy and $11,794 for ACL reconstruction, and estimated Medicare reimbursement to be $5,442 for meniscectomy and $6,667 for ACL reconstruction. After being informed of actual reimbursement levels, 65 percent of patients believed that reimbursement for meniscectomy was too low (somewhat low, 36 percent; very low, 29 percent), and 57 percent of patients believed that reimbursement for ACL reconstruction was too low (somewhat low, 30 percent; very low, 27 percent).
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Other News

Study: Romosozumab linked to reduced risk of vertebral fracture for postmenopausal women with osteoporosis.
According to a study published in the Oct. 20 issue of The New England Journal of Medicine, treatment with romosozumab may reduce risk of vertebral fracture for postmenopausal women with osteoporosis. The researchers conducted a randomized trial of 7,180 postmenopausal women who had a T score of –2.5 to –3.5 at the total hip or femoral neck, who were treated with either 210 mg subcutaneous romosozumab or placebo monthly for 12 months, followed by 60 mg subcutaneous denosumab administered every 6 months for 12 months. They found that new vertebral fractures occurred in 16 of 3,321 patients (0.5 percent) in the romosozumab group and 59 of 3,322 (1.8 percent) in the placebo group; clinical fractures occurred in 58 patients (1.6 percent) in the romosozumab group and 90 (2.5 percent) in the placebo group; and nonvertebral fractures occurred in 56 patients (1.6 percent) in the romosozumab group and in 75 patients (2.1 percent) in the placebo group. At 24 months, after both groups were transitioned to denosumab, rate of vertebral fracture remained significantly lower in the romosozumab group than in the placebo group after each group made the transition to denosumab. The researchers found no significant difference in rate of adverse events between groups, although they observed one atypical femoral fracture and two cases of osteonecrosis of the jaw were observed in the romosozumab group.
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Study: Current NSAID use linked to increased risk of heart failure.
A study conducted in Europe and published online in the journal The BMJ examines risk of heart failure linked to use of NSAIDs. The authors reviewed information from five population-based databases on 92,163 hospital admissions for heart failure and 8,246,403 control patients. Compared with past NSAID use, they found that current use of any NSAID was associated with a 19 percent increase risk of hospital admission for heart failure. Overall risk of admission for heart failure increased for seven traditional NSAIDs: diclofenac, ibuprofen, indomethacin, ketorolac, naproxen, nimesulide, and piroxicam; and two COX-2 inhibitors: etoricoxib and rofecoxib. Odds ratios ranged from 1.16 for naproxen to 1.83 for ketorolac. In addition, risk of heart failure doubled for diclofenac, etoricoxib, indomethacin, piroxicam, and rofecoxib when used at very high doses (=2 defined daily dose equivalents), and even medium doses (0.9-1.2 defined daily dose equivalents) of indomethacin and etoricoxib were associated with increased risk. The authors found no evidence that celecoxib increased risk of admission for heart failure at commonly used doses.
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Study: Early data suggest engineered cartilage could help repair articular cartilage defects in the knee.
Findings from a pilot study conducted in Switzerland and published in the Oct. 22 issue of the journal The Lancet suggest that hyaline-like cartilage tissues engineered from autologous nasal chondrocytes may have efficacy for repair of articular cartilage defects in the knee. The researchers conducted a trial of 10 human patients with symptomatic, post-traumatic, full-thickness cartilage lesions on the femoral condyle or trochlea. They engineered cartilage grafts from chondrocytes isolated from a 6 mm nasal septum biopsy specimen, and implanted the engineered tissues into the femoral defects via mini-arthrotomy. At 24-month follow-up, they found significant improvement in self-assessment scores for pain, knee function, and quality of life, and radiological assessment indicated variable degrees of defect filling and development of repair tissue approaching the composition of native cartilage. The researchers noted no adverse reactions.
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Study: Many young athletes still return to play the same day following concussion.
According to information to be presented at the annual meeting of the American Academy of Pediatrics, many young athletes continue to return to play the same day despite signs of concussion. The research team reviewed records from 185 patients aged 7 to 18 years who were treated for concussion at a single pediatric sports clinic. Of those, 71 (38 percent) reported returning to play the same day as their initial injury. The research team found that patients who immediately returned to play initially reported less severe symptoms of dizziness and balance problems, but were statistically more likely than those who did not return to play to report the presence and increased severity of nausea, dizziness, balance problems, and other concussion symptoms at the time of presentation at the clinic.
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Member registration for 2017 AAOS Annual Meeting is now open!
Member registration for the 2017 AAOS Annual Meeting is now open. In addition, the preliminary meeting program is now available online. The 2017 AAOS Annual Meeting will take place March 14-18, 2017, in San Diego.
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View the preliminary program, with related links…

Call for volunteers: NQF Care Coordination Measures.
AAOS seeks to nominate members to a National Quality Forum (NQF) standing committee to evaluate measures against NQF standard measure evaluation criteria and make recommendations for endorsement. 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. All supporting materials must be submitted to Kyle Shah by Oct. 24, 2016 at 11:59 p.m. CT, at:  shah@aaos.org.
Learn more and submit your application…(member login required)