Orthopedics
Association between skilled nursing facility use and postop readmission rates
Editor's Note Use of postacute care in skilled nursing facilities (SNFs) for total hip replacement (THR) and coronary artery bypass grafting (CABG) patients was not associated with changes in readmission rates, in this study. Of 176,994 CABG patients at 804 hospitals and 233,955 THR patients at 1,220 hospitals, SNF use…
Joint Commission revises requirements for THKR program
Editor's Note The Joint Commission on July 11 announced that effective January 1, 2019, it will implement a revised eligibility requirement and two revised requirements for the Advanced Certification for Total Hip & Knee Replacement (THKR) program. The revised eligibility requirement and revision to the Performance Measure chapter of the…
Prevalence of unused opioids after joint, spine surgery
Editor's Note In this study, many patients reported unused opioids after joint and spine surgery, infrequent use of nonopioid analgesics, and lack of knowledge on safe opioid storage and disposal. Of 140 patients analyzed, 35% were taking preoperative opioids. Among those who stopped taking opioids after surgery, possession of unused…
Effect of neuraxial anesthesia for total joints on outcomes
Editor's Note Increased use of neuraxial anesthesia for total hip and knee patients was linked to lower hospitalization costs in this study. National data on 808,237 total knee and 371,607 total hip replacements were used in the analysis. Multivariable associations were measured between hospital neuraxial anesthesia volume (quartiles) and outcomes…
Researchers identify biomarkers for total hip patients likely to develop osteolysis
Editor's Note Researchers at Rush University Medical Center, Chicago, have identified two protein biomarkers that indicate which total hip patients are likely to develop osteolysis. Osteolysis is the destruction of bone tissue around the hip joint that causes the implant to loosen and results in a revision surgery. The researchers…
New formulation of bupivacaine does not reduce opioid use after TKA
Editor's Note Contrary to what some studies are suggesting, use of the local anesthetic liposomal bupivacaine as part of a multimodal approach to postoperative pain did not reduce in-hospital opioid use or opioid-related complications after total knee arthroplasty (TKA) in this study. Researchers analyzed data on 88,830 TKAs performed with…
Opioid prescriptions drop after orthopedic team changes protocol
Can hospital leaders and surgeons partner to reduce opioid use while maintaining high patient satisfaction scores? Leaders at OSS Orthopaedic Hospital in York, Pennsylvania, answer that question with a yes. Meghan McNelly, PharmD, MHA, FACHE, who was director of pharmacy at OSS when the opioid-reduction project started, says that from…
Type 2 diabetes linked to hip fracture risk
Editor's Note A statistically significant association was found between type 2 diabetes and the risk of hip fracture in this study. Researchers analyzed 158,984 patients with and without diabetes. The incidence of hip fracture in diabetics was 2.3% using the competing risk with death methodology (Fine-Gray models) and 2.6% using…
Effect of anesthetic technique on mortality, morbidity after hip fracture repair
Editor's Note Spinal anesthesia was associated with lower mortality and morbidity rates after hip fracture repair than general anesthesia in this study that will be presented Saturday April 19 at the 2018 World Congress on Regional Anesthesia & Pain Medicine in New York City. In this analysis of 2,591 patients,…
Denver hospital breach may have exposed patients to HIV, hepatitis
Editor's Note Patients at Porter Adventist Hospital in Denver may be at risk for HIV or hepatitis after the hospital discovered a surgical instrument sterilization breach, the April 5 LiveScience reports. The process for precleaning surgical instruments was found to be inadequate, which may have put patients who had orthopedic…
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