Study: Predictors of Hip Replacement Implant Survival
A study published online in PLOS Medicine evaluated factors associated with implant survival in total hip replacement (THR). The study included records for 664,761 THR patients treated in one of 461 hospitals. The exposure was the unit (hospital) where the patient was treated; THR implant survival was compared by those treated in the “exemplar” unit versus those treated anywhere else. The outcome was all-cause revision. At 13.9 years, the all-cause construct failure rate at the exemplar unit was 1.7 percent compared to 2.9 percent for the rest of the cohort. When adjusting by implant, there were no significant differences at 13.9 years between the exemplar unit versus the other groups.
Study: Predictors of Poor In-hospital Traumatic Spinal Cord Injury Outcomes
According to a study published in the Sept. 1 issue of the Journal of the AAOS ®, older age was correlated with worse in-hospital outcomes for traumatic spinal cord injury (SCI) patients. The National Inpatient Sample database was queried to identify data on 25,988 hospitalized SCI patients. Outcomes included in-hospital deaths, adverse discharge, and prolonged hospital stays. Age older than 65 years, compared to the youngest patients, was significantly associated with in-hospital mortality and increased adverse outcomes at all SCI sites. Patients aged 35 to 64 years with cervical and thoracic injuries, but not lumbosacral injuries, had higher risks of in-hospital death and adverse discharge.
Study: Mobile-bearing TAA Outcomes with Varus or Valgus Deformity
A retrospective study published online in Foot & Ankle International assessed the effects of varus and valgus deformities on total ankle arthroplasty (TAA) outcomes. A total of 164 TAA cases had adequate patient-reported outcome measures data at a mean 61.6 months. Valgus ankles, compared to neutral, had better postoperative pain and function. Pre- to postoperative changes were not statistically significant except in the case of physical health, where valgus had the best outcomes. All groups had a mean final angle of less than 5 degrees, and there were no significant differences in revision rates.
Study: Reoperation Risk Between Total Elbow Arthroplasty Versus ORIF
A study published in the September issue of the Journal of Orthopaedic Trauma compared reoperation risk between intra-articular distal humerus fractures treated with total elbow arthroplasty (TEA) versus ORIF in patients aged older than 65 years. Final analysis included 142 TEA and 522 ORIF cases from 1996 to 2016. TEA patients were older and had a higher Charlson Comorbidity Index as well as prevalence of rheumatoid arthritis and osteoporosis. The overall reoperation risk was lower for TEA versus ORIF patients (11.3 percent versus 25.1 percent), but when assessing cases performed from 2006 through 2016, the difference was no longer significant (12.6 percent versus 18.4 percent).
CMS Issues Final Rule Increasing Hospitalized Medicare Beneficiaries’ Access to Advanced Technologies
The Centers for Medicare & Medicaid Services (CMS) issued the fiscal year 2021 Medicare Hospital Inpatient Prospective Payment System and Long Term Acute Care Hospital final rule. The rule is aimed at providing hospitalized Medicare beneficiaries with access to advanced, potentially life-saving technologies and treatments, impacting an estimated 3,200 acute care hospitals and 360 long-term care hospitals. The rule also finalizes a proposal for hospitals to report their median payment rates negotiated with Medicare Advantage plans to inform future payments under the Medicare inpatient payment system.
Roundtable Participants Encourage Orthopaedic Involvement in the Development and Implementation of Payment Models
Alternative payment models (APMs), specifically bundled payments, are a frequent topic of discussion. As the election cycle kicks into high gear, health care will be at the forefront of the minds of politicians and voters alike. It is important for AAOS Fellows to lead the way in crafting payment options to meet patients’ needs. It remains to be seen whether bundled payments are the answer. In the final installment of a three-part series, Gary W. Stewart, MD, FAAOS, interviewed three AAOS Fellows and experts in the field to discuss how to engage AAOS Fellows in the implementation of APMs.
Is Your Residency Program Ready to Rumble in a Virtual-gaming Environment?
Residents, are you up for a little virtual competition? The AAOS 2020 Virtual Resident Rumble will pit Residency Programs from across the United States against one another in an orthopaedics-based trivia competition.
