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Journal of the American Academy of Orthopaedic Surgeons

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https://www.readbyqxmd.com/read/28489716/the-medicare-access-and-chip-reauthorization-act-macra-of-2015-what-s-new
#1
Zain Sayeed, Mouhanad El-Othmani, William O Shaffer, Khaled J Saleh
The Centers for Medicare and Medicaid Services (CMS) released its Final Rule on the Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act (MACRA) in November 2016. The Rule finalizes the details of the merit-based incentive payment system (MIPS) and the alternative payment model (APM), which will now collectively be referred to as the Quality Payment Program (QPP). This article offers the orthopaedic community a summary of the alterations in healthcare policy that will affect practices nationwide...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489715/assessment-of-malpractice-claims-associated-with-acute-compartment-syndrome
#2
John Mason DePasse, Rachel Sargent, Amanda J Fantry, Steven L Bokshan, Mark A Palumbo, Alan H Daniels
BACKGROUND: Because acute compartment syndrome is one of the few limb-threatening and life-threatening orthopaedic conditions and is difficult to diagnose, it is a frequent source of litigation. Understanding the factors that lead to plaintiff verdicts and higher indemnity payments may improve patient care by identifying common pitfalls. METHODS: The VerdictSearch legal claims database was queried for the term "compartment syndrome." After 46 cases were excluded for missing information or irrelevancy, 139 cases were reviewed...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489714/feasibility-of-and-rationale-for-the-collection-of-orthopaedic-trauma-surgery-quality-of-care-metrics
#3
Anna N Miller, Rosemary Kozar, Philip Wolinsky
INTRODUCTION: Reproducible metrics are needed to evaluate the delivery of orthopaedic trauma care, national care, norms, and outliers. The American College of Surgeons (ACS) is uniquely positioned to collect and evaluate the data needed to evaluate orthopaedic trauma care via the Committee on Trauma and the Trauma Quality Improvement Project. METHODS: We evaluated the first quality metrics the ACS has collected for orthopaedic trauma surgery to determine whether these metrics can be appropriately collected with accuracy and completeness...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489713/denervation-of-the-wrist-joint-for-the-management-of-chronic-pain
#4
R Kumar Kadiyala, Joseph M Lombardi
Wrist denervation for the management of chronic wrist pain is a safe and effective procedure that can delay or eliminate the need for more invasive and kinematically compromising salvage procedures. Wrist denervation has become increasingly popular since it was first described in 1959, and the technique has evolved from more extensive denervations to limited single-incision approaches. Many physicians have performed this procedure as a palliative approach to managing chronic wrist pain and as an adjunct to other procedures...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489712/maximizing-surgical-skills-during-fellowship-training
#5
Brian Shiu, Djuro Petkovic, William N Levine, Christopher S Ahmad
Orthopaedic surgery fellowship provides an opportunity to further develop skills in a particular subspecialty. However, the condensed time frame, complex skill acquisition, and clinical demands require efficient and effective learning techniques to achieve mastery. As with any advanced task, success during fellowship training can be achieved with active participation and a goal-directed approach. Skill acquisition can be successfully achieved by following a framework that includes preparation, execution, and reflection for every surgical case...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489711/resident-selection-beyond-the-united-states-medical-licensing-examination
#6
Scott E Porter, Matt Graves
The resident application process has matured over the decades to become an efficient system. An unforeseen consequence of this efficiency is the massive number of applications that each orthopaedic surgery residency program must sort through to arrive at a manageable rank list. The most widely used filter in today's application cycle is an applicant's performance on the United States Medical Licensing Examination Step 1. Although no evidence exists to prove that this examination is predictive of any of the potentially defining characteristics of a successful resident, orthopaedic surgery programs historically have had few alternative options...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489710/survival-guide-for-the-orthopaedic-surgery-match
#7
Scott E Porter, Charles M Jobin, T Sean Lynch, William N Levine
The process of matching into an orthopaedic surgery residency program can be daunting for medical students. Rumors, innuendo, urban myths, and electronic misinformation can accentuate the angst experienced by students both domestically and internationally. This article dispels myths and presents an up-to-date, evidence-based (where possible), and experience-laden road map to assist medical students interested in pursuing a career in orthopaedic surgery. Our framework takes into account the program selection, test scores, letters of recommendation, visiting rotations, interviews, and communication...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489709/your-academy-opportunities-and-challenges
#8
William J Maloney
No abstract text is available yet for this article.
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28475497/a-perspective-on-the-effect-of-the-80-hour-work-week-has-it-changed-the-graduating-orthopaedic-resident
#9
Vincent D Pellegrini
Orthopaedic residency education has changed substantially in recent decades because of the imposition of the 80-hour work week, a decrease in quality and quantity of general surgical education, regulations mandating closer trainee supervision, and an expansion of orthopaedic subspecialty rotations. These factors pose a challenge in efforts to prepare competent, confident, cautious, caring, and communicative orthopaedic residents within the traditional 5-year program. Evidence suggests that contemporary graduates are more intelligent, better balanced in life and work, and more in touch with humanistic aspects of medicine than were earlier graduates...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28475496/the-effect-of-absorbable-calcium-sulfate-on-wear-rates-in-ultra-high-molecular-weight-polyethylene-potential-implications-for-its-use-in-treating-arthroplasty-infections
#10
Kathleen Lewicki, Brandon Prioreschi, Karl Koenig, Benjamin Keeney, Meredith Bartelstein, Calin Moucha, Douglas Van Citters
INTRODUCTION: Patients, hospitals, and healthcare systems incur substantial burdens when infections result in total joint revisions. One potential solution to mitigate some of these burdens may be to transition from a two-stage infection treatment to a single-stage procedure. Off-label use of an absorbable calcium sulfate antibiotic carrier has been implemented in single-stage and two-stage procedures globally, with the goal of moving toward more single-stage revisions in the United States...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28459712/navigating-postgraduate-orthopaedic-surgery-education
#11
Scott E Porter
No abstract text is available yet for this article.
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28459711/a-cross-sectional-analysis-of-minimum-usmle-step-1-and-2-criteria-used-by-orthopaedic-surgery-residency-programs-in-screening-residency-applications
#12
John B Schrock, Matthew J Kraeutler, Michael R Dayton, Eric C McCarty
INTRODUCTION: The purpose of this study was to analyze how program directors (PDs) of orthopaedic surgery residency programs use United States Medical Licensing Examination (USMLE) Step 1 and 2 scores in screening residency applicants. METHODS: A survey was sent to each allopathic orthopaedic surgery residency PD. PDs were asked if they currently use minimum Step 1 and/or 2 scores in screening residency applicants and if these criteria have changed in recent years...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28459710/cost-minimization-analysis-of-the-management-of-acute-achilles-tendon-rupture
#13
Jeremy N Truntzer, Brian Triana, Alex H S Harris, Laurence Baker, Loretta Chou, Robin N Kamal
BACKGROUND: Outcomes of nonsurgical management of acute Achilles tendon rupture have been demonstrated to be noninferior to those of surgical management. We performed a cost-minimization analysis of surgical and nonsurgical management of acute Achilles tendon rupture. METHODS: We used a claims database to identify patients who underwent surgical (n = 1,979) and nonsurgical (n = 3,065) management of acute Achilles tendon rupture and compared overall costs of treatment (surgical procedure, follow-up care, physical therapy, and management of complications)...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28459709/the-humeral-implant-in-shoulder-arthroplasty
#14
Jay D Keener, Peter Nissen Chalmers, Ken Yamaguchi
Humeral hemiarthroplasty, anatomic total shoulder arthroplasty, and reverse total shoulder arthroplasty all rely on a prosthetic articular surface fixed to the proximal humerus. Humeral implant designs have changed considerably as a result of improved understanding of proximal humeral anatomy and prosthetic biomechanics. Fixed, monoblock implants have been superseded by modular implants with variable inclination, offset, version, and stem length. Press-fit designs now commonly have surface coatings that allow bony ingrowth...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406880/aaos-appropriate-use-criteria-treatment-of-hip-fractures-in-the-elderly
#15
Varatharaj Mounasamy, Pierre Guy, Stephen L Kates
No abstract text is available yet for this article.
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406879/physical-examination-of-the-knee-meniscus-cartilage-and-patellofemoral-conditions
#16
Robert D Bronstein, Joseph C Schaffer
The knee is one of the most commonly injured joints in the body. Its superficial anatomy enables diagnosis of the injury through a thorough history and physical examination. Examination techniques for the knee described decades ago are still useful, as are more recently developed tests. Proper use of these techniques requires understanding of the anatomy and biomechanical principles of the knee as well as the pathophysiology of the injuries, including tears to the menisci and extensor mechanism, patellofemoral conditions, and osteochondritis dissecans...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406878/bone-loss-in-revision-total-knee-arthroplasty-evaluation-and-management
#17
Neil P Sheth, Marcelo Batista Bonadio, Marco Kawamura Demange
With the increasing number of total knee arthroplasty (TKA) procedures being performed annually, the burden of revision surgery is also expected to increase. Addressing bone loss during revision TKA is a considerable challenge that requires proper preoperative evaluation and surgical planning. In addition to an assessment of femoral and tibial bone loss, a systematic approach to the management of bone loss associated with TKA includes careful implant selection, adherence to the general principles of revision TKA, and an understanding of the available reconstruction options...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406877/scapulothoracic-dissociation-evaluation-and-management
#18
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406876/cartilage-restoration-techniques-for-the-patellofemoral-joint
#19
Robert H Brophy, Robert D Wojahn, Joseph D Lamplot
Symptomatic osteochondral lesions of the patellofemoral joint are clinically challenging to manage because of the limited healing potential of articular cartilage; the complex morphology of the patellofemoral joint; the heterogeneity of the articular surface between patients; and high stresses across the joint, which can be altered by malalignment, tilt, or maltracking. Indications for surgery include traumatic lesions, osteochondritis dissecans, and high-grade chondromalacia in association with persistent pain despite a course of nonsurgical management...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379915/total-knee-arthroplasty-in-patients-with-cerebral-palsy-a-matched-cohort-study-to-patients-with-osteoarthritis
#20
Matthew T Houdek, Chad D Watts, Cody C Wyles, Robert T Trousdale, Todd J Milbrandt, Michael J Taunton
INTRODUCTION: Currently, few data examine the use of total knee arthroplasty (TKA) in patients with cerebral palsy (CP). This study reviewed the outcomes of TKA in patients with CP compared with a matched cohort undergoing TKA for primary osteoarthritis. METHODS: Over a 28-year period, 15 TKAs in patients with a diagnosis of CP were identified. The cohort was 53% men, with a mean age of 58 years. Patients with CP were matched 1:2 based on age, sex, body mass index, and year of surgery with a group of patients undergoing TKA for osteoarthritis...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
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