April 2014 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for April 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Spinal Fx Complications, Mortality Up With Ankylosing Spondylitis

WEDNESDAY, April 30, 2014 (HealthDay News) -- Spinal fracture patients with ankylosing spondylitis (AS) disorders have higher complication and mortality rates, compared with control patients, according to a study published in the May 1 issue of The Spine Journal.

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Lower Levels of Physical Capability Linked to Mortality

WEDNESDAY, April 30, 2014 (HealthDay News) -- Lower levels of physical capability are associated with increased mortality, and daily activity is inversely associated with disability in those with or at risk of knee osteoarthritis, according to two studies published online April 29 in BMJ.

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Training Programs Protect Young Athletes From ACL Tears

MONDAY, April 28, 2014 (HealthDay News) -- Certain training methods can greatly reduce young athletes' risk of serious and potentially debilitating knee injuries, a new report says. Overall, anterior cruciate ligament (ACL) surgery is about 90 percent successful in restoring knee stability, according to the report published online April 28 in Pediatrics.

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Wrong-Level Localization in Spine Surgey Rare but Still Occurs

MONDAY, April 28, 2014 (HealthDay News) -- Most surgeons admit wrong-level localization during spinal surgery during their career, according to a study published in the May 1 issue of The Spine Journal.

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CDC: Workplace Ladder Falls a Major Cause of Deaths, Injuries

FRIDAY, April 25, 2014 (HealthDay News) -- Workplace tumbles off of ladders are a major cause of injury and death among American employees, according to a study published in the April 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Physician Groups Find Fault With Medicare Payment Data Release

THURSDAY, April 24, 2014 (HealthDay News) -- Physician groups cite major problems associated with the release of Medicare payment data, according to an article published April 16 in Medical Economics.

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At-Risk Screw Misplacement Common in Spine Deformity Sx

THURSDAY, April 24, 2014 (HealthDay News) -- About one-quarter of patients undergoing surgery for pediatric spine deformity have pedicle screws close to vital structures, according to a study published in the April issue of the Journal of Spinal Disorders & Techniques.

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Educational Changes Suggested for Patient-Centered Medicine

THURSDAY, April 24, 2014 (HealthDay News) -- Changes in medical education and training are suggested to help new physicians address the needs of patients and their families, according to an ideas and opinions piece published in the April 22 issue of the Annals of Internal Medicine.

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New Scale Useful for Predicting Sick Leave for Back Pain

WEDNESDAY, April 23, 2014 (HealthDay News) -- A new user-friendly 10-item rating scale is useful for predicting the duration of sick leave in patients with acute lumbar back pain, according to a study published in the April 20 issue of Spine.

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FDA Proposes Accelerated Medical Device Approval Plan

WEDNESDAY, April 23, 2014 (HealthDay News) -- The U.S. Food and Drug Administration has proposed a new program that would provide expedited access to high-risk medical devices intended for patients with serious conditions whose medical needs are not met by current technology.

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Obstructive Sleep Apnea Linked to Osteoporosis

TUESDAY, April 22, 2014 (HealthDay News) -- Obstructive sleep apnea (OSA) is associated with an increased risk of osteoporosis, according to a study published online April 15 in the Journal of Clinical Endocrinology & Metabolism.

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Economic Downturns Haven't Impacted Hip, Knee Arthroplasty

MONDAY, April 21, 2014 (HealthDay News) -- Recent economic downturns have not substantially impacted the growth in hip and knee arthroplasty in the United States, according to a study published in the April 16 issue of The Journal of Bone & Joint Surgery.

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Task Force Recommends Ways to Improve Price Transparency

MONDAY, April 21, 2014 (HealthDay News) -- Price transparency frameworks, which provide price information presented in the context of other relevant information, should be developed to meet patients' needs, according to recommendations presented in a report from the Healthcare Financial Management Association (HFMA).

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AMA Examines Economic Impact of Physicians

FRIDAY, April 18, 2014 (HealthDay News) -- Physicians who mainly engage in patient care contribute a total of $1.6 trillion in economic output, according to the American Medical Association (AMA)'s Economic Impact Study.

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Int'l Medical Education Standards Not Equivalent to U.K. Standards

FRIDAY, April 18, 2014 (HealthDay News) -- International medical graduates passing the Professional and Linguistic Assessments Board (PLAB) of the General Medical Council (GMC) have lower performance on MRCP(UK) (Membership of the Royal Colleges of Physicians) and MRCGP (Membership of the Royal College of General Practitioners) and on annual review of competence progression (ARCP) examinations, according to two studies published online April 17 in BMJ.

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White House: 8 Million People Signed Up for Health Insurance

FRIDAY, April 18, 2014 (HealthDay News) -- Eight million Americans signed up for private health insurance during the just-concluded first enrollment period under the Affordable Care Act, the White House announced Thursday afternoon.

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One in 20 U.S. Adults a Victim of Diagnostic Errors

THURSDAY, April 17, 2014 (HealthDay News) -- Diagnostic errors affect at least one in 20 U.S. adults, according to research published online April 17 in BMJ Quality & Safety.

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Patient-Clinician Relationship Impacts Health Care Outcomes

THURSDAY, April 17, 2014 (HealthDay News) -- The patient-clinician relationship has a small but significant effect on health care outcomes, according to a study published online April 9 in PLOS ONE.

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Educator Discusses Key Issues for Future Doctors to Consider

THURSDAY, April 17, 2014 (HealthDay News) -- The key issues for future physicians are discussed in an article published by the American Medical Association (AMA).

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MRI Connects Vestibulopathy and Damage From Brain Injury

WEDNESDAY, April 16, 2014 (HealthDay News) -- Damage to specific brain regions may be linked to the prognosis of concussion patients with vestibulopathy, according to a study published online April 14 in Radiology.

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Continued Reliance on Windows XP May Threaten Data Security

WEDNESDAY, April 16, 2014 (HealthDay News) -- Physicians who use Windows XP in their practices may be affected by Microsoft's recent discontinuation of support for the program, according to an article published April 8 in Medical Economics.

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Evidence Lacking for Long-Term Opioid Use in Low Back Pain

WEDNESDAY, April 16, 2014 (HealthDay News) -- There is evidence of short-term efficacy (moderate for pain and small for function) of opioids for treatment of chronic low back pain (CLBP) compared with placebo; however, the effectiveness and safety of long-term opioid therapy for treatment of CLBP remains unproven, according to a review published in the April 1 issue of Spine.

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Patients Paying Much More for Specialty Drugs

TUESDAY, April 15, 2014 (HealthDay News) -- Many Americans are paying less for prescription drugs, but some are having to deal with sharp rises in the cost of specialty medicines for rare or serious diseases, according to a new report.

Health Highlights: April 15, 2014

NSAIDs With Anticoagulant Tx Ups Major Bleeding in VTE

TUESDAY, April 15, 2014 (HealthDay News) -- Concomitant use of a nonsteroidal anti-inflammatory drug (NSAID) or aspirin in patients with venous thromboembolism receiving anticoagulant therapy is tied to increased risk of bleeding, according to a study published online April 14 in JAMA Internal Medicine.

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New Health Secretary to Confront Health Care Reform Hurdles

MONDAY, April 14, 2014 (HealthDay News) -- With the resignation of U.S. Health and Human Services Secretary Kathleen Sebelius on Friday, the Affordable Care Act will get a fresh face. But turning around public perception of the controversial health care reform law in a politically charged mid-term election year poses an enormous challenge for the department's next leader, policy experts said.

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Sebelius Stepping Down As HHS Secretary

FRIDAY, April 11, 2014 (HealthDay News) -- U.S. Health and Human Services Secretary Kathleen Sebelius is stepping down from her position, after overseeing the troubled rollout of the Affordable Care Act that remains unpopular with some Americans and virtually all Republican lawmakers.

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Psychosocial Education Doesn't Lead to Substantial LBP Savings

THURSDAY, April 10, 2014 (HealthDay News) -- Implementation of a brief psychosocial education program (PSEP) achieves only modest savings in low back pain (LBP)-related health care costs, according to a study published in the April 1 issue of The Spine Journal.

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Fewer Americans Overwhelmed by Medical Bills

WEDNESDAY, April 9, 2014 (HealthDay News) -- While millions of Americans still feel hamstrung by medical expenses, a new government report shows that some people are getting relief.

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More Justification Needed for Choosing Wisely Selections

WEDNESDAY, April 9, 2014 (HealthDay News) -- Most services included in specialty medical societies' Top 5 lists for the Choosing Wisely campaign are based on evidence demonstrating equivalent but not superior benefit, with higher risk or higher costs compared to other options, according to a research letter published in the April 9 issue of the Journal of the American Medical Association.

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Advice, Exercise Equally Effective for Chronic Whiplash

WEDNESDAY, April 9, 2014 (HealthDay News) -- Simple advice is as effective as a comprehensive exercise program for reducing pain in patients with chronic whiplash, according to research published online April 4 in The Lancet.

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Some Doctors Paid at Least $3 Million Each by Medicare

WEDNESDAY, April 9, 2014 (HealthDay News) -- A small number of doctors received at least $3 million each in Medicare payments in 2012, for a total of nearly $1.5 billion, according to an analysis of Medicare claims data released Wednesday by the White House. In total, Medicare paid individual physicians nearly $64 billion in 2012. The median payment was just over $30,000, the Associated Press reported.

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Newly Eligible for Expanded Medicaid Are Healthier

MONDAY, April 7, 2014 (HealthDay News) -- Persons newly eligible for expanded Medicaid coverage under the Affordable Care Act (ACA) are not sicker than pre-ACA enrollees, according to research published online March 26 in Health Affairs.

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Patients Select Fewer New Docs at Bottom of Tiered Ranking

MONDAY, April 7, 2014 (HealthDay News) -- Patients are less likely to select a new physician ranked in the bottom of a tiered network, but often don't switch if their current physician is ranked at the bottom, according to research published online March 11 in Health Services Research.

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AMA Provides Resources to Aid Physicians' Collections

FRIDAY, April 4, 2014 (HealthDay News) -- The American Medical Association (AMA) has released resources to help doctors confront policy jumpers who may pose a financial risk to physicians during the Affordable Care Act's 90-day premium grace period, according to an article published March 25 in Medical Economics.

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Pending Malpractice Litigation May Bias Parents' Reports

FRIDAY, April 4, 2014 (HealthDay News) -- Following neonatal brachial plexus palsy, medical malpractice litigation is associated with worse parent reports of their child's function and pain, according to a study published in the March 5 issue of The Journal of Bone & Joint Surgery.

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Minority of Spine Surgeons Conduct Pre-Op Psych Screen

THURSDAY, April 3, 2014 (HealthDay News) -- Less than 40 percent of U.S. spine surgeons report use of presurgical psychological screening (PPS), according to a study published online in the April issue of the Journal of Spinal Disorders & Techniques.

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Half of Uninsured Don't Intend to Sign Up for Health Coverage

WEDNESDAY, April 2, 2014 (HealthDay News) -- About 50 percent of uninsured adults do not intend to sign up for coverage through the Affordable Care Act's health care exchanges, according to an article published March 26 in Medical Economics.

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CMS: Medicare Beneficiaries Saved $3.9B on Meds in 2013

TUESDAY, April 1, 2014 (HealthDay News) -- In 2013, 4.3 million seniors and people with disabilities saved an estimated $3.9 billion on prescription drugs, an increase from the 2012 savings, according to a report published by the U.S. Department of Health and Human Services.

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