August 2014 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for August 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.

Report Highlights Progress, Challenges in Health IT

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Progress has been made toward widespread adoption of electronic health records (EHRs), although there are still barriers to adoption of advanced use of EHRs, according to a report published by the Robert Wood Johnson Foundation.

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Teens Regress After Return-to-Activity Post-Concussion

FRIDAY, Aug. 29, 2014 (HealthDay News) -- High school athletes who return to the field with medical clearance within 60 days often experience a significant regression in their abilities to simultaneously walk and do simple mental tasks, according to a study published online Aug. 5 in Medicine & Science in Sports & Exercise.

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Doctors Frequently Experience Ethical Dilemmas

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

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AMGA: Physician Turnover Still High in 2013

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

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African-Americans Have Worse Cervical Spine Surgery Outcomes

THURSDAY, Aug. 28, 2014 (HealthDay News) -- African-American patients have significantly higher rates of in-hospital complications and mortality associated with cervical spine surgery than Caucasian patients, according to a study published in the Aug. 15 issue of Spine.

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Team Approach Improves Practice Efficiency

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- The increasing administrative requirements of a medical practice are requiring a team-based approach to care, and physicians must learn to manage the team, according to an article published Aug. 7 in Medical Economics.

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Factors Tied to Neck, Back Pain Improvement Identified

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- Observational registry-based research can inform patients and physicians about prognosis for subacute or chronic neck or low back pain, according to a study published in the Aug. 1 issue of The Spine Journal.

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Review: Surgery Doesn't Benefit Age-Related Meniscal Tears

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Evidence suggests that arthroscopic surgery does not benefit middle-aged patients with degenerative meniscal tears, according to research published online Aug. 25 in CMAJ, the journal of the Canadian Medical Association.

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Restrictive, Non-Solicitation Covenants Are Valid

MONDAY, Aug. 25, 2014 (HealthDay News) -- Restrictive and non-solicitation covenants are valid and can be enforced, according to an article published Aug. 5 in Medical Economics.

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U.S. to Tighten Access to Certain Narcotic Painkillers

FRIDAY, Aug. 22, 2014 (HealthDay News) -- The U.S. Drug Enforcement Administration (DEA) is going ahead with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.

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Organizations Can Help Docs Retain Their Independence

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Ways for physicians to remain in independent practice are highlighted in an article published Aug. 7 in Medical Economics.

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Organized Processes Help Practices Hire Well

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- A defined process is necessary to help physicians hire the right staff for their practice, according to an article published July 24 in Medical Economics.

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Boxed Warnings Are Common in Novel Therapeutics

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Boxed warnings are common on recent drug approvals, and many occur years after approval, according to a research letter published online Aug. 15 in JAMA Internal Medicine.

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Post-Op Doc Shopping Ups Narcotic Use in Ortho Patients

THURSDAY, Aug. 14, 2014 (HealthDay News) -- Orthopedic trauma patients who seek multiple narcotic providers postoperatively are at greater risk of prescription drug abuse, according to research published in the Aug. 6 issue of The Journal of Bone & Joint Surgery.

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Limited Sensitivity for Plain Anteroposterior Pelvic Imaging

THURSDAY, Aug. 14, 2014 (HealthDay News) -- For children with pelvic fractures or dislocations after blunt trauma, plain anteroposterior pelvic radiographs have limited sensitivity, according to a study published online July 29 in the Annals of Emergency Medicine.

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Extra Time Spent Counseling, Coordinating Care Billable

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Extra time spent counseling patients and coordinating care can be billed using evaluation and management (E/M) and prolonged service codes, according to an article published July 24 in Medical Economics.

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Nonadherent MRIs Up Subsequent Medical Costs

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Nonadherent magnetic resonance imaging (MRI) utilization is tied to a cascade of higher medical costs and potentially unnecessary and unhelpful medical services following the MRI, according to research published in the Aug. 1 issue of Spine.

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Tranexamic Acid Aids Outcomes With Hip, Knee Surgery

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- The clotting drug tranexamic acid is effective in reducing the need for blood transfusions while not increasing the risk of complications during orthopedic surgery, according to a study published online Aug. 12 in BMJ.

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Meta-Analysis Strategy Impacts Estimation of Tx Outcome

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Estimation of treatment outcome varies with the meta-analysis strategy, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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RCTs Show Bisphosphonates Don't Prevent Breast Cancer

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Data from two randomized controlled trials suggest that bisphosphonate use does not protect against postmenopausal breast cancer, according to research published online Aug. 11 in JAMA Internal Medicine.

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10-Year Survival 61 Percent for Adult Primary Scoliosis Surgery

TUESDAY, Aug. 12, 2014 (HealthDay News) -- In adult middle-aged patients undergoing primary scoliosis surgery, the 10-year survival rate is 61 percent, according to a study published in the Aug. 1 issue of The Spine Journal.

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EHR Adoption Increasing, But Stage 2 Criteria Often Not Met

MONDAY, Aug. 11, 2014 (HealthDay News) -- Most U.S. hospitals and office-based physicians have adopted electronic health records (EHR), according to two studies published in the August issue of Health Affairs.

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Use of Medical Consults for Surgical Patients Varies Widely

MONDAY, Aug. 11, 2014 (HealthDay News) -- Use of medical consultations for surgical patients varies widely among hospitals, according to a study published online Aug. 4 in JAMA Internal Medicine.

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Past Pain Patterns Can Help Predict Future Low Back Pain

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Repeated measurements of low back pain (LBP)-related variables are necessary to identify patterns in a fluctuating condition, according to a study published in the Aug. 1 issue of The Spine Journal.

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Issues to Consider With Integration of Telemedicine

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Integrating telemedicine raises various considerations, including operational and legal issues, according to an article published July 24 in Medical Economics.

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Manipulative Therapy Linked to Cervical Artery Dissection

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Evidence suggests there may be an association between cervical manipulative therapy and cervical artery dissections (CDs), according to an American Heart Association/ American Stroke Association scientific statement published online Aug. 7 in Stroke.

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VA Health Care Reform Bill Signed Into Law

THURSDAY, Aug. 7, 2014 (HealthDay News) -- A bill signed into law Thursday by President Barack Obama is meant to provide veterans with easier access to government-paid health care.

Health Highlights: Aug. 7, 2014

Pain Reduction Tied to One-Year Spine Surgery Outcomes

THURSDAY, Aug. 7, 2014 (HealthDay News) -- For patients undergoing elective surgery for degenerative lumbar spine conditions, postoperative improvement in pain intensity is associated with improvements in physical function and reductions in disability in the year following surgery, according to a study published in the Aug. 1 issue of Spine.

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Portable Shade Structure Use High for Soccer-Playing Youth

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- The rate of use of commercially available portable shade structures is high among soccer-playing youths, according to a research letter published online July 30 in JAMA Dermatology.

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Lasting Clinical Results for Total Lumbar Disc Replacement

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Total lumbar disc replacement (TDR) yields mid- to long-term clinical efficacy and patient satisfaction, according to a study published in the Aug. 1 issue of The Spine Journal.

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Skip the Steroids for Shoulder Pain?

TUESDAY, Aug. 5, 2014 (HealthDay News) -- For relief of shoulder pain, physical therapy and steroid shots provide similar results, according to a study published in the Aug. 5 issue of the Annals of Internal Medicine.

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Many Physicians Have Secondary Income

MONDAY, Aug. 4, 2014 (HealthDay News) -- Many physicians report earning income from sources other than their primary practice/employer, according to an article published July 24 in Medical Economics.

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Coflex Interspinous Device No Extra Benefit in Spinal Stenosis

MONDAY, Aug. 4, 2014 (HealthDay News) -- The use of a Coflex interspinous device does not further improve outcomes beyond decompressive surgery for the treatment of symptomatic lumbar spinal stenosis (LSS), according to a study published online in the August issue of the Journal of Spinal Disorders & Techniques.

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CT Effective in Detection of Significant Cervical Spine Injury

MONDAY, Aug. 4, 2014 (HealthDay News) -- Computed tomography (CT) is effective in detecting clinically significant cervical spine (CS) injuries in patients with neurologic deficit or CS pain, according to a study published online July 30 in JAMA Surgery.

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Guidelines Issued for Cardiac Management of Noncardiac Sx

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Recommendations have been developed for perioperative cardiovascular management of patients undergoing noncardiac surgery. These revised guidelines were published online Aug. 1 in the Journal of the American College of Cardiology.

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CMS Recognizes Telehealth in New Physician Fee Schedule

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Earlier this month, the Centers for Medicare & Medicaid Services issued proposed rules for updates to the Physician Fee Schedule and will accept comments until Sept. 2, according to an article published July 7 in Medical Economics.

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More Than Half of General Surgery Residents Want to Quit

FRIDAY, Aug. 1, 2014 (HealthDay News) -- A majority of categorical general surgery residents seriously consider leaving residency, according to a study published online July 30 in JAMA Surgery.

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