March 2017 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for March 2017. 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.

90 Percent of U.S. Physicians Satisfied With Career Choice

FRIDAY, March 31, 2017 (HealthDay News) -- Nine out of 10 American doctors are happy with their choice of profession, even though they have some challenges, according to an American Medical Association (AMA) survey of 1,200 doctors, residents, and medical students, conducted in February.

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Vertical Integration Insurance Products of Higher Quality

FRIDAY, March 31, 2017 (HealthDay News) -- Insurance products offered by hospitals and health systems, known as vertical integration, are generally of higher quality than other contracts, according to a study published in the March issue of Health Affairs.

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Arm, Hand Function Restored in Tetraplegic Patient

WEDNESDAY, March 29, 2017 (HealthDay News) -- For patients with high-cervical spinal cord injury, reaching and grasping using the paralyzed arm, reanimated through functional electrical stimulation (FES) + commanded using cortical signals through an intracortical brain-computer interface (iBCI), is feasible, according to a proof-of-concept demonstration study published online March 28 in The Lancet.

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Total Knee Replacement Typically Has Minimal Impact on QoL

WEDNESDAY, March 29, 2017 (HealthDay News) -- Total knee replacement has minimal effects on quality of life, but the effectiveness could increase if the procedure were restricted to more severely affected patients, according to a study published online March 28 in The BMJ.

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TV Ads for ACA Enrollment Linked to Decline in Uninsured Rates

TUESDAY, March 28, 2017 (HealthDay News) -- The volume of insurance advertisements during the first Affordable Care Act enrollment period correlated with change in uninsurance rates, with a higher volume of television advertisements linked to declines in uninsurance, according to a study published online March 15 in Health Affairs.

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ACP Issues Challenge to Cut Task Burden and Put Patients First

TUESDAY, March 28, 2017 (HealthDay News) -- In a position paper published online March 28 in the Annals of Internal Medicine, recommendations are presented to address the impact of administrative tasks and reduce the administrative burden on clinicians.

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Post-Op Urinary Retention Common After Spinal Stenosis Sx

TUESDAY, March 28, 2017 (HealthDay News) -- Postoperative urinary retention (POUR) is a common morbidity after surgery for degenerative lumbar spinal stenosis, according to research published in the April issue of The Spine Journal.

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Paid Malpractice Claims Cut in Half From 1992 to 2014 in U.S.

MONDAY, March 27, 2017 (HealthDay News) -- From 1992 to 2014 there was a decrease in the rate of malpractice claims paid on behalf of physicians in the United States, but mean compensation amounts increased, according to a study published online March 27 in JAMA Internal Medicine.

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30-Day Mortality Down During Joint Commission Survey Weeks

THURSDAY, March 23, 2017 (HealthDay News) -- Patients admitted to the hospital during The Joint Commission on-site inspections (surveys) have reduced mortality compared to that seen during non-survey weeks, according to research published online March 20 in JAMA Internal Medicine.

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Low Serum Levels of DHEAS Predict Fractures in Older Men

WEDNESDAY, March 22, 2017 (HealthDay News) -- For older men, low serum levels of the adrenal-derived hormones dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) are a risk marker for fractures, according to a study published online March 9 in the Journal of Bone and Mineral Research.

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Black, Asian Medical Students Less Likely to Be AΩA Members

TUESDAY, March 21, 2017 (HealthDay News) -- Black and Asian medical students are less likely to be members of the Alpha Omega Alpha (AΩA) honor society than white students, according to a study published online March 6 in JAMA Internal Medicine.

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Intradiscal Steroid Offers Short-Term Relief of Lower Back Pain

TUESDAY, March 21, 2017 (HealthDay News) -- For patients with chronic low back pain (LBP) with active discopathy, a single glucocorticoid intradiscal injection (GC IDI) is associated with reduced LBP at one month but not 12 months after the intervention, according to a study published online March 21 in the Annals of Internal Medicine.

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New Device for Peripheral Nerve Stim Cuts Chronic Low Back Pain

MONDAY, March 20, 2017 (HealthDay News) -- A novel method of short-term percutaneous peripheral nerve stimulation (PNS) is useful for producing pain relief and reducing medication use among patients with chronic low back pain (LBP), according to a case report published online March 14 in Pain Practice.

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Los Angeles eConsult Program Can Reduce Wait Times

FRIDAY, March 17, 2017 (HealthDay News) -- Implementation of an electronic system for provision of specialty care was rapidly adopted in Los Angeles, and it can reduce wait times to see specialists, according to a study published in the March issue of Health Affairs.

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Initial Rx Can Affect Likelihood of Long-Term Opioid Use

FRIDAY, March 17, 2017 (HealthDay News) -- Doctors who limit the supply of opioids they prescribe to three days or less may help patients reduce their risk of dependence and addiction, according to research published in the March 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Patients Have High Confidence in Self-Testing INR

FRIDAY, March 17, 2017 (HealthDay News) -- Most patients have high confidence in self-testing their international normalized ratio (INR), according to a study published online Feb. 23 in the Journal of Clinical Nursing.

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High-Intensity Aerobic Exercise May Help Reverse Cellular Aging

THURSDAY, March 16, 2017 (HealthDay News) -- High-intensity exercise training can reverse some manifestations of aging in the body's protein function, according to a study published in the March issue of Cell Metabolism.

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Clinical Decision Support System Use Tied to Fewer VTE Events

THURSDAY, March 16, 2017 (HealthDay News) -- Use of computerized clinical decision support systems (CCDSSs) among surgical patients is associated with an increase in the rate of appropriate ordering of venous thromboembolism (VTE) prophylaxis and a decrease in the risk of VTE events, according to a review published online March 15 in JAMA Surgery.

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Depressive Symptoms Linked to PTSD Post Hip Fracture Repair

THURSDAY, March 16, 2017 (HealthDay News) -- For older individuals, hip fracture does not induce full posttraumatic stress disorder (fPTSD), according to a study published online Feb. 27 in the Journal of the American Geriatrics Society.

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Women Underrepresented Among Grand Rounds Speakers

WEDNESDAY, March 15, 2017 (HealthDay News) -- Women seem to be underrepresented among academic grand rounds (GR) speakers, according to a research letter published online March 6 in JAMA Internal Medicine.

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Inpatient Rehab Doesn't Up Total Knee Arthroplasty Outcomes

WEDNESDAY, March 15, 2017 (HealthDay News) -- The use of inpatient rehabilitation in addition to home-based rehabilitation does not improve mobility at 26 weeks after total knee arthroplasty, according to a study published in the March 14 issue of the Journal of the American Medical Association.

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Support for Health Law Up to 48 Percent in February

TUESDAY, March 14, 2017 (HealthDay News) -- Support for the health law is increasing, with most Americans feeling that Medicaid should continue as it is today, according to a report published by Kaiser Health News.

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Higher Spending by Physicians Not Tied to Better Outcomes

MONDAY, March 13, 2017 (HealthDay News) -- Medicare patients treated by higher-spending physicians are just as likely to be readmitted or die within 30 days of being admitted to the hospital as patients treated by doctors who order fewer or less-expensive tests and treatments, according to a study published online March 13 in JAMA Internal Medicine.

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ACA's Medicaid Expansion May Pose Challenges to Timely Care

THURSDAY, March 9, 2017 (HealthDay News) -- People living in states that expanded Medicaid under the Affordable Care Act (ACA) are less likely to be uninsured or struggling with the strain of unpaid medical bills, but they also seem to have increased difficulty receiving timely care, according to research published in the March 9 issue of the New England Journal of Medicine.

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CDC: Arthritis Limits the Activities of 24 Million U.S. Adults

WEDNESDAY, March 8, 2017 (HealthDay News) -- One in four adults in America report an arthritis diagnosis, with the number of individuals disabled by it up 20 percent since 2002, according to a report from the U.S. Centers for Disease Control and Prevention.

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Republicans Introduce Affordable Care Act Replacement

TUESDAY, March 7, 2017 (HealthDay News) -- An initial Republican replacement for the Affordable Care Act was formally introduced in the House of Representatives on Monday.

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Increased Nonvertebral Fracture Risk After Roux-en-Y Bypass

TUESDAY, March 7, 2017 (HealthDay News) -- Roux-en-Y gastric bypass (RYGB) is associated with increased nonvertebral fracture risk compared with adjustable gastric banding (AGB), according to a study published online March 2 in the Journal of Bone and Mineral Research.

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Most Health Care Providers Can Offer Cost Estimate

MONDAY, March 6, 2017 (HealthDay News) -- Most provider organizations can offer a cost estimate, although few patients request one, according to a report published by Becker's Hospital CFO.

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Judgement Bias in Medical Device Recall Decisions

FRIDAY, March 3, 2017 (HealthDay News) -- The characteristics of the signal in user feedback of adverse events associated with medical devices and the situated context of decision makers correlate with judgement bias in reacting to these adverse events, according to research published online Jan. 29 in Production and Operations Management.

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Overall, 8.8 Percent of U.S. Population Uninsured in 2016

THURSDAY, March 2, 2017 (HealthDay News) -- Overall, 8.8 percent of individuals of all ages were uninsured in the first nine months of 2016, which marked a nonsignificant reduction from 2015, according to a Feb. 14 report from the National Center for Health Statistics.

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Poor Knowledge of Charcot Neuroarthropathy Reported

WEDNESDAY, March 1, 2017 (HealthDay News) -- Most non-foot specialist clinical faculty members at a large academic institution have poor or complete lack of knowledge of Charcot neuroarthropathy (CN), according to a study published online Feb. 8 in Clinical Diabetes and Endocrinology.

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Hospitals May Be Overcharging for Hip, Knee Replacements

WEDNESDAY, March 1, 2017 (HealthDay News) -- Some U.S. hospitals might be charging private insurers twice as much for knee and hip replacements as the implants typically cost, according to a research letter published in the Feb. 28 issue of the Journal of the American Medical Association.

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