Study assesses PROs before and after primary and revision TAA
A retrospective, longitudinal study published online in Foot & Ankle International found that clinical and patient-reported outcomes (PROs) for revision total ankle arthroplasty (TAA) improved significantly after surgery but may not be as positive as outcomes following primary surgery. Researchers reviewed prospectively collected data on 29 patients with failed primary TAA; 51.7 percent of patients had revision of only the talar and polyethylene components (n = 15), and 44.8 percent required full revision (n = 13). At follow-up (3.2 years after revision), 103 percent of patients needed further surgery (n = 3). Two patients needed conversion to arthrodesis, and one needed a second revision TAA.
Bill to eliminate ‘gag clause’ for pharmacists proposed in House
During a hearing held this week, members of the House of Representatives discussed proposed legislation that would allow for more transparency between pharmacists and beneficiaries. The bill would put an end to “gag clauses” in contracts for Medicare and private health insurance plans that prevent pharmacists from telling patients—unless patients request the information directly—when their prescriptions would cost less out-of-pocket than under their insurance plan. Representatives said the legislation would not only lower drug prices but also allow pharmacists to do what many of them consider to be the right thing.
GAO calls for improvements for reprocessing reusable medical equipment
A report from the Government Accountability Office (GAO) called for more oversight of reusable medical equipment (RME) in the Department of Veterans Affairs (VA). Reprocessing RME includes cleaning, disinfecting or sterilizing, and storing the equipment between uses. GAO reiterated three recommendations it made in a previous report that highlighted issues including addressing workforce needs and incomplete inspection reports. The VA said it concurred with and would implement these recommendations.
Study: Young patients’ risk factors for recurrent shoulder instability
A retrospective review published in the September issue of the journal Arthroscopy examined risk factors for recurring anterior-inferior shoulder instability in patients younger than 30 years of age following arthroscopic Bankart repair. The study included 170 patients (mean age, 22.7 years). Patients were divided into two groups: without-recurrence (n = 138) and recurrent (n = 32). The overall postoperative recurrent instability rate was 18.8 percent. The two groups showed significant differences in time between the first dislocation and surgery, number of preoperative dislocations, and off-track Hill-Sachs lesions. Although there was significant improvement in the mean Rowe and Walch-Duplay scores at two years after surgery in both groups, the mean scores were lower in the recurrent group. According to the authors, the results suggest that surgery should be considered within six months of the first dislocation, with meticulous attention paid to patients with a high number of preoperative dislocations or off-track Hill-Sachs lesions.
A video from the Centers for Medicare & Medicaid Services discusses the importance of accurate documentation for providers and patients and its impact on items/services, claim payment, and medical review. It details the top five documentation errors, how to submit documentation for a Comprehensive Error Rate Testing review, and how your Medicare Administrative Contractor can help you comply with documentation requirements.
Studies find concerning rates of persistent opioid use after common foot and ankle procedures
Two studies examining opioid use by patients treated for foot and ankle conditions show that a substantial number of the patients continued to consume opioids persistently after the therapeutic course for pain had concluded. The studies’ findings, both conducted by a group at the University of Michigan, show that new chronic opioid use is “a major problem following orthopaedic procedures” and point to the need to identify the factors correlated with persistent use, the authors said.
Caring for orthopaedic patients and treating musculoskeletal conditions is a team effort. AAOS offers unique opportunities for learning alongside surgeons, as well as focused educational activities developed specifically for physician assistants, emergency medical responders, and other providers, through strategic partnerships.