Surgery/Specialties 
Editor's Note The combination of femoral and sciatic nerve blocks is the overall best approach to pain management after total knee arthroplasty, finds this meta-analysis. The best five modalities for pain at rest were: femoral/obturator, femoral/sciatic/obturator, lumbar plexus/sciatic, femoral/sciatic, and fascia iliaca compartment blocks. For reducing opioid consumption, the best…
Editor's Note New persistent postoperative opioid use is common and does not differ between minor and major procedures, but, instead, it is associated with behavioral and pain disorders, this study finds. Of 36,177 elective surgery patients assessed, about 6% filled opioid drug prescriptions between 90 and 180 days after the…
Editor's Note Conscious sedation is a safe and viable option for anesthesia in patients having transcatheter aortic valve replacement (TAVR), finds this study. The use of conscious sedation rather than general anesthesia was associated with: similar rates of adverse events (1.5% in both groups) shortened ICU (30 vs 96 hours)…
Editor's Note This study finds that the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Surgical Risk Calculator serves its intended purpose of providing a general purpose risk calculator, which is applicable across many surgical domains, using easily understood and generally available predictive information. The Surgical Risk…
Editor's Note Over time, electronic health records (EHRs) show a decline in face-to-face patient assessments by physicians and an increase in computer tasks, this study finds. Physicians now spend 50% of their time with patients and 50% of their time on computers. The analysis included 471 physicians who worked on…
Editor's Note Total hip replacement patients experience meaningful and lasting improvement in quality of life (QOL) through at least 5-years after the procedure, this study finds. The analysis included 188 total hip replacement patients at seven hospitals who were evaluated with a standard quality-of-life assessment, called the “Short Form 36,”…
Editor's Note A position paper from the American College of Physicians (ACP) makes recommendations on administrative tasks to mitigate or eliminate their adverse effects on physicians, their patients, and the whole healthcare system. Among the recommendations: Stakeholders external to physician practices (ie, payers, government and other oversight organizations, vendors, and…
Editor's Note Hospital surgical readmissions are primarily explained by patient- and procedure-specific factors and less by broader specialty and hospital effects, this study finds. There was no correlation between specialty-specific readmissions for general and orthopedic, general and vascular, and vascular and orthopedic procedures. Within specialties, there were modest correlations between…
Editor's Note In a March 21 Safety Alert, the Food and Drug Administration (FDA) updated its data on breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) to reflect the World Health Organization designation of BIA-ALCL as a rare T-cell lymphoma that can develop following breast implants. At this time the data…
Editor's Note Differences in perception of hospital care exist between men and women after total hip replacement (THR), finds this study presented March 14 at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons in San Diego. Using patient satisfaction data from Press Ganey, researchers found that staff…
