AAOS Now, September 2017
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Preoperative Opioid Use Increases Risk of Postoperative Narcotic Demand Following ACLR
Preoperative use of opioid medications in patients undergoing anterior cruciate ligament reconstruction (ACLR) is a strong predictor of postoperative opioid demand, according to study data presented at the 2017 annual meeting of the American Orthopaedic Society for Sports Medicine. According to the study's authors, the demand for narcotics drops significantly by the third month after surgery for most patients.
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Study Suggests Surgery is a Safe Treatment Option for Pectoralis Major Tendon Ruptures
Pectoralis major tendon ruptures are relatively uncommon and little information exists about the demographics of these injuries or the surgical outcomes of their repair. Study data presented at the 2017 annual meeting of the American Orthopaedic Society for Sports Medicine, however, indicate that surgical repair of acute pectoralis major tendon ruptures is associated with a low rate of re-rupture and a low risk of complications.
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AAHKS and Rheumatologists Team Up to Issue TJA Guideline
A newly issued set of clinical recommendations offers surgeons guidance in preventing periprosthetic joint infection (PJI) through medication management in arthroplasty patients who have inflammatory rheumatic diseases. Certain drugs may increase a patient's risk of infection.
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Putting Yourself in Your Patient's Place
Identifying a patient's values to appropriately address them during treatment is an important part of medical decision making. In the August issue of AAOS Now, members of the Patient Safety Committee began a discussion focused on identifying and responding to patient preferences in treatment.
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HIV and the Orthopaedic Patient
Since HIV was first documented in the United States in 1981, great strides have been made in the prevention of transmission and the management and treatment of HIV/AIDS. Still, an estimated 1.2 million persons aged 13 years or older are living with HIV infection in the country. Approximately 156,300 (12.8 percent) are unaware of their infection.
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Measures to Avoid Complications in TKA
Wound complications after total knee arthroplasty (TKA) are rare—with only 0.33 percent of more than 17,000 patients in a Mayo Clinic registry requiring surgical intervention within 30 days. However, when complications do occur, they can be serious and expensive.
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Xenograft-derived Bone Scaffold Shows Promise
Managing segmental bone defects can be a major challenge for orthopaedic surgeons. Of the five million-plus musculoskeletal surgeries performed in the United States every year, nearly half utilize bone grafts. Although autologous bone grafting is considered the best approach for repairing large bone defects, the harvest of autologous bone may be painful and is associated with increased morbidity.
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Complying with the Quality Component of MIPS in 2017
The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP) implements the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation, passed in April 2015.