Today’s Top Story

Study Identifies Risk Factors for Increased Pain Following Knee Surgery

In a cross-sectional study published online in Knee Surgery, Sports Traumatology, Arthroscopy, young age, low body weight, and smoking were associated with higher pain and the need for rescue medication after arthroscopic knee surgery. The study included 57 patients with a median age of 39 years. The most significant association was observed in younger patients and smokers; increased length of surgery was also correlated with higher pain levels. Researchers stated that if these findings are considered preoperatively, personalized pain management after surgery may be more effective.

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Other News

Study: Urinary Retention Risk Factors After TJA

Risk factors for postoperative urinary retention (POUR) in total joint arthroplasty (TJA) patients may most likely be iatrogenic, according to a study published online in The Journal of Arthroplasty. Researchers assessed 187 total hip arthroplasty (THA) and 191 total knee arthroplasty (TKA) patients who underwent surgery between January 2016 and November 2017. Forty percent of TKA and 36 percent of THA patients developed POUR and required bladder catheterization. For the THA cohort, POUR was associated with age > 60 years, intraoperative fluid volume > 1,350 mL, and intraoperative placement of an indwelling bladder catheter. Among TKA patients, POUR was significantly associated with intraoperative indwelling bladder catheter placement. Researchers discouraged the intraoperative use of an indwelling bladder catheter and fluid administration > 1,350 mL, particularly for older patients.

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Study Finds Correlation Between Subclinical Atherosclerosis and Bone Health

Increased carotid artery intimal medial thickness (cIMT) may be associated with risk of hip fracture in elderly patients, according to a study published in the October issue of Osteoporosis International. Researchers followed 3,385 participants (mean age, 74.7 years) from the Cardiovascular Health Study with a median time to fracture of 12.1 years who underwent baseline carotid artery and aortic wall ultrasound scanning and ankle brachial blood pressure index determinations. During follow-up, 494 hip fractures occurred. Among those who did not have clinical cardiovascular disease (CVD), a greater composite score of maximal common and internal cIMT was correlated with greater risk of fracture, despite cIMT being associated with higher bone mineral density. Clinical CVD patients with cIMT and thicker aortic walls were at greater risk of hip fracture. Ankle brachial blood pressure index was not associated with increased fracture risk for either group.

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HHS Releases First Data Sharing Report

The Department of Health and Human Services (HHS) has released its State of Data Sharing report, which indicates that the agency lacks a consistent, transparent, and standardized protocol for interagency data sharing. The report analyzes the technical, legal, and cultural obstacles facing HHS in communicating data throughout the agency. HHS said in a press release, “This report aims to highlight opportunities for improvement so that HHS can become a more data-driven organization.”

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CMS Proposes the Removal of Certain Compliance Measures

The Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would eliminate unnecessary and burdensome Medicare compliance requirements for healthcare facilities. Some of the proposals seek to simplify and streamline Medicare’s conditions of participation, conditions for coverage, and other requirements for participation for facilities, according to the agency. Some of the provisions of the rule include:

  • streamlining hospital outpatient and ambulatory surgical center requirements for conducting comprehensive medical histories and physical assessments
  • allowing multihospital systems to have unified and integrated Quality Assessment and Performance Improvement programs for all their member hospitals
  • simplifying the ordering process for portable X-rays and modernize the personnel requirements for portable X-ray technologists
  • removing duplicative ownership disclosure requirements for Critical Access Hospitals

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Binge Drinking Affects Fracture Healing

During his time as a resident at Loyola University’s Stritch School of Medicine in Maywood, Ill., Roman Natoli, MD, PhD, learned that excessive alcohol consumption correlates with nonunions, although the pathophysiology underlying the association was not well understood. Most fractures heal, but 5 percent to 10 percent go onto nonunion and do not heal—even with the best of care. Patients with nonunions are left in dire straits, explained Dr. Natoli, assistant professor of orthopaedic surgery at the Indiana University School of Medicine in Indianapolis.

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Call for Volunteers: Ambulatory Surgery Center and Hospital Outpatient Measurement Information Gathering Project

AAOS seeks to nominate two members to the Ambulatory Surgery Center and Hospital Outpatient Measurement Information Gathering (AHMI) Project. Through the AHMI Project, CMS will gather stakeholder input to develop new measure concepts in several ambulatory and outpatient healthcare settings. 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.

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