Study: Reducing Costs Using Bundled Payment Plans in Outpatient TSA
A study published in the Oct. 1 issue of the Journal of the AAOS ® observed a cost-saving effect associated with bundled payment plans in outpatient total shoulder arthroplasty (TSA) performed at an ambulatory surgery center (ASC). TSA patients at a single ASC were stratified into bundled (n = 39) and unbundled (n = 37) groups. The average age was slightly older in the bundled group (58 years versus 54 years). The bundled group had significantly lower average total implant charges ($24,822.43 versus $28,405.51), mean total outpatient surgical day charges ($29,782.43 versus $33,238.68), and average OR staffing costs ($135.37 versus $162.55).
Study Compares Functional Mobility After TKA by Outpatient Rehabilitation Protocols
A randomized clinical trial published online in JAMA Network Open analyzed the effect four different outpatient rehabilitation protocols had on functional mobility in single total knee arthroplasty (TKA) patients. For 15 to 20 minutes each session, patients used either a standard recumbent bike (control; n = 92), body-weight adjustable treadmill (n = 91), patterned electrical neuromuscular stimulation device (n = 90), or combination of the treadmill and electrical neuromuscular stimulation (n = 90). No significant differences were observed among the groups in Activity Measure for Post-acute Care scores at discharge or distances measured by the six-minute walk test.
Study Measures Effect of Ankle Arthroplasty on ROM
A retrospective study published online in Foot & Ankle International evaluated how three-component total ankle arthroplasty (TAA) affects postoperative ankle range of motion (ROM) Between May 2003 and November 2017, 357 primary TAAs were performed in 336 patients (mean age, 62.6 years). Mean ankle ROM was 31.3 degrees preoperatively, increased to 33.9 degrees one year postoperatively, and decreased to 31.9 degrees at final follow-up. Percutaneous heel cord lengthening had no impact on postoperative ankle ROM development. Ankles with lower preoperative ROM demonstrated greater postoperative improvements.
Study: Are Plastic Surgery Residents Exposed to Core Procedural Competencies in Hand Surgery?
According to a study published in the September issue of The Journal of Hand Surgery, plastic surgery residents may not receive adequate exposure to core procedural competencies (CPCs) in hand surgery during residency. Data were collected for graduating plastic surgery residents at 10 Canadian training programs from 2004 through 2014. Final analysis encompassed 55 residents; 14,909 procedures for 42 CPCs were recorded. In hand surgery subdomain analyses, the most common procedures pertained to traumatic finger injuries and neuropathies, and the least common pertained to flap reconstructions and muscle release. Operative experience among the residents ranged from 2 percent to 100 percent.
Study Assesses Effect of Delayed Spinal Metastasis Treatment
A study published online in the European Spine Journal observed the importance of timely treatment for symptomatic spinal metastases. Patients were stratified by whether they underwent elective (timely; n = 215) or emergency (delayed; n = 102) surgery. Regardless of baseline EuroQol-5D (EQ-5D) and Karnofsky Performance Status Scale (KPS) scores, neurological status, tumor prognosis, and patient age, the delayed patients had poorer EQ-5D and KPS scores as well as higher mortality rates.
Advice from Male Leaders on How to Mentor in the #MeToo Era
The Diversity Advisory Board, which reports to the AAOS Board of Directors and the Membership Council, sponsored a webinar titled “Mentoring in the #MeToo Era,” which included a panel of some of the 2020 Ruth Jackson Orthopaedic Society “He For She” Award nominees. The award recognizes male orthopaedic leaders with a proven track record of supporting women in orthopaedics. Some of the questions and scenarios posed to the panelists were difficult but remain critically important issues. Julie Balch Samora, MD, PhD, MPH, FAAOS, more formally asked these questions for the broader AAOS Now audience.
