The migration of total joint replacements for knees and hips from inpatient hospital ORs to hospital outpatient departments and ambulatory surgery centers (ASCs) is spreading. On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) bolstered the trend when it approved the removal of total knee arthroplasty (TKA)…

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Editor's Note A Persistence Market Research report predicts the global arthroscopic devices market will exceed $1.7 billion by 2022, with a 5.1% compound annual growth rate, according to the January 3 Becker’s Spine Review. A rising demand for minimally invasive procedures and an increasing geriatric population are the main contributors…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 30 announced a final rule that cancels the mandatory hip fracture and cardiac bundled-payment models, which were to begin on January 1, 2018, and implements changes to the Comprehensive Care for Joint Replacement (CJR) Model. In the final…

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Editor's Note The Accreditation Association for Ambulatory Health Care (AAHC) announced on November 2 that it has developed a new Orthopaedic Certification program for ambulatory surgery centers (ASCs). After an ASC achieves overall accreditation, it can acquire the Orthopaedic Certification to demonstrate excellence in the specialty of orthopaedics by meeting…

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Editor's Note Opioid use in total hip and knee patients decreased by one-third between 2006 and 2014, which reflects success in the use of a multimodal approach (ie, opioids plus additional pain management methods, such as peripheral nerve blocks and acetaminophen) to pain management, finds this study presented October 21…

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Editor's Note Most elderly hip fractures occur during warm months, and a greater number happen indoors rather than out, finds this study presented October 23 at the Anesthesiology 2017 annual meeting in Boston. In this analysis of 544 hip fracture patients treated at The Hospital of Central Connecticut from 2013…

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Editor's Note All-cause readmission is the only metric in widespread use, but it overlooks important information that enables readmission risk to be understood, this study finds. Of 514,455 patients in the UK analyzed over a 10-year period, there were 30,489 all-cause readmissions, 16,499 readmissions related to the surgical site, and…

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Editor's Note Physical activity in total joint patients did not change at 6 months after surgery and small-moderate improvement was found at 12 months, despite large improvements in pain and quality of life, this meta-analysis finds. A total of seven studies (336 patients) were analyzed. Reasons for the lack of…

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Editor's Note In this meta-analysis of the effectiveness of nonpharmacological interventions for pain after total knee arthroplasty, electrotherapy and acupuncture were associated with reduced and delayed opioid consumption, but there was low or very low certainty that they improved pain. Continuous passive motion and preoperative exercise did not improve pain…

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Organizations that have adopted the perioperative surgical home (PSH) model of patient care have reaped the benefits of improved outcomes and a healthier bottom line. In particular, the PSH has a proven track record for colorectal surgery and orthopedic surgery. In part 1 of this two-part series (OR Manager, August…

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