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| Today’s Top Story
AAOS-endorsed Prior Authorization Reform Bill Passes House
The U.S. House of Representatives recently passed H.R. 3173, the Improving Seniors’ Timely Access to Care Act, which would streamline prior authorization processes within Medicare Advantage plans. The bill is now headed to the Senate where it already has widespread support. AAOS has been a long-time supporter of the bill and was on Capital Hill advocating for its passage last week, as part of the combined National Orthopaedic Leadership Conference (NOLC) and Fall Meeting, just one day before it passed the House
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| In Other News
Study: Comparing of Manipulation Rates for Robot-assisted, Customized, and Conventional TKA
Arthrofibrosis, a potential complication of total knee arthroplasty (TKA), can be treated by manipulation under anesthesia. Current Orthopaedic Practice published a retrospective cohort study online comparing manipulation rates of robot-assisted, customized, and conventional TKA. Researchers reviewed 717 conventional, 217 customized, and 326 robot-assisted TKAs. Manipulation rates and demographics were obtained from patient records. The overall manipulation rate was 1.3 percent; however, manipulation rates did not vary significantly between groups. Patients who smoked were four times more likely and patients with prior surgeries were 2.8 times more likely to require manipulation.
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| Study Investigates How Obesity Impacts Complications of Shoulder Arthroplasty
Obesity is not an independent risk factor for mechanical surgical complications and revision surgery after total shoulder arthroplasty (TSA), according to a study published online in the Journal of Shoulder and Elbow Surgery. Overall, 113,634 TSA patients were identified through a national database and were matched based on age, sex, diabetes, smoking, tobacco use, and Charlson Comorbidity Index. Odds of readmission, prosthetic joint infection, and deep pulmonary embolism at 90 days postsurgery were higher in patients with obesity. Researchers concluded that the higher rates are likely due to an increased burden of other comorbidities.
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| Study Compares Operative and Conservative Treatment for Closed Displaced Midshaft Clavicle Fractures
A study published online in Hand compared operative versus nonoperative treatments for closed displaced midshaft clavicle fractures (MCFs) and found that higher nonunion rates were associated with operative fixation. Overall, 173,188 patients were retrospectively reviewed, and nonoperative patients were matched with operative patients at a 3:1 ratio. The main outcomes included nonunion, total costs, and complications at 90 days and one year post-treatment. The operative group incurred significantly higher costs at both 90 days and one year. At one year, closed displaced MCFs with operative fixation had significantly increased rates of nonunion (3.97 percent versus 1.63 percent). Both groups showed similar rates of complications.
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| Study: Lumbosacral Transitional Vertebra Associated with Lumbar Disk Herniation in Patients with Lower Back Pain
The European Spine Journal published a retrospective study online reporting lumbar disk herniation (LDH) to be more common in the presence of a lumbosacral transitional vertebrae (LSTV). Standing lumbosacral radiograph and lumbar MRI were reviewed within two weeks of indexed symptoms. Of the 1,821 patients included in the study, LDH was found in 57.7 percent of patients, and LSTV was found in 43.3 percent. Patients with LSTV were significantly more likely to have a LDH affecting >3 intervertebral disk levels LSTV patients had higher incidence of degeneration at the M1 and M2 intervertebral levels.
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| AAOS Now
Telemedicine Presentation: Panelists Offer Strategies for Effective Deployment of Virtual Visits
At an Instructional Course Lecture at the AAOS 2022 Annual Meeting, panelists offered guidance on implementing and operating telehealth services. Sharing lessons learned from the early days of the COVID-19 pandemic, panelists discussed the widespread adoption and challenges of televisits. In addition to serving as the chair of the session, Robert A. Gallo, MD, MHA, FAAOS, of Penn State Hershey Bone and Joint Institute, discussed workflow, patient scheduling and billing issues, technical issues, and the legal issues associated with telemedicine.
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