Today’s Top Story
House passes 21st Century Cures Act.
In a strong bipartisan vote, the U.S. House of Representatives has passed the 21st Century Cures Act. If enacted, the bill would increase funding for the National Institutes of Health by $8.75 billion and streamline the U.S. Food and Drug Administration’s drug approval process. Supporters of the bill say that it will improve patient care for a variety of conditions, but critics argue that the regulatory alterations, which include an extension of manufacturer’s rights to market brand name drugs if the drugs are repurposed to treat a rare disease, could have negative consequences. Read more…
Read the text of the bill (PDF)…
Read the AAOS statement…

Other News

Study: Only about half of potential child-abuse patients evaluated for occult fractures.
Data from a study published online in the journal Pediatrics suggest that there may be substantial variation in evaluation for occult fractures among young children with a diagnosis of abuse or injuries potentially linked to abuse. The researchers conducted a retrospective study of 4,935 children aged younger than 2 years with a diagnosis of physical abuse and infants younger than 1 year with non-motor vehicle crash–related traumatic brain injury or femur fractures. They found that evaluations for occult fractures were performed in 48 percent of 2,502 children with an abuse diagnosis, in 51 percent of 1,574 infants with traumatic brain injury, and in 53 percent of 859 infants with femur fractures. The researchers noted that occult fracture evaluations were more likely to be performed at teaching hospitals than at nonteaching hospitals. The researchers write that their findings highlight opportunities for quality improvement among a vulnerable population. Read more…
Read the abstract…

Study: Pre-collegiate lower extremity surgery linked to increased likelihood of orthopaedic surgery among college athletes.
According to findings presented at the annual meeting of the American Orthopaedic Society for Sports Medicine (AOSSM), college-age athletes who underwent lower extremity surgery before entering college may be at increased risk of undergoing orthopaedic and knee surgery during their collegiate careers compared to their peers who have not. The research team reviewed data on 1,142 athletes across 12 sports at a single National Collegiate Athletic Association Division I school, and found 262 documented orthopaedic surgeries among 182 athletes. They found that pre-college lower extremity surgery was an independent predictor of orthopaedic and knee surgery. In addition, type of sport was an independent predictor of orthopaedic, shoulder, and knee surgery, with participation in gymnastics, basketball, and volleyball being the strongest predictors of orthopaedic surgery. Read more…
Read the abstract (PDF, paper 71)…

Study: Arthroscopic rotator cuff repair may help elderly athletes return to sport.
Data presented at the annual meeting of AOSSM suggest that arthroscopic rotator cuff repair may reduce pain and improve function among active elderly patients. The researchers collected prospective and retrospective data on 44 patients aged 70 years or older (49 shoulders) who were recreational athletes and who had undergone a primary or revision arthroscopic repair of full-thickness supraspinatus tears with or without infraspinatus and subscapularis tendon involvement. At mean 3.6-year follow-up of 43 shoulders, they found that ASES scores had improved from 56.0 preoperative to 90.3 postoperative, with significant improvements in both pain and function components. SANE score improved from 63.1 to 85.1, QuickDASH from 34.1 to 11.3, and SF-12 PCS from 43.0 to 51.6. In addition, 24 of 31 patients were able to return to their sport at a similar level of intensity to preinjury levels. Read the abstract (PDF, paper 42)…

Study: Surgical treatment for acute proximal hamstring rupture may offer improved lower extremity function compared to nonsurgical approach.
A study presented at the AOSSM annual meeting suggests that patients who undergo surgical treatment for acute proximal hamstring ruptures may have improved lower extremity function and greater likelihood of returning to pre-injury activities compared to patients who undergo nonsurgical treatment. The research team conducted a retrospective case-control study of 25 patients with acute proximal hamstring rupture, 14 of whom were treated surgically, and 11 of whom were treated nonsurgically. At follow-up, they found that both patient cohorts had similar SF-12 mental and physical components scores. However, the average single leg hop of the injured extremity in the surgical group was 119.1 cm, compared to 56.1 in the nonsurgical group. All patients in the surgical group were able to return to pre-injury activities, but only 8 of 11 in the nonsurgical group were able to do so. Read more…
Read the abstract (PDF, paper 62)…

Do nursing homes need to better monitor patients who are prescribed warfarin?
A report released jointly by ProPublica and The Washington Post examines the use of warfarin among nursing home residents. The publications analyzed government inspection reports and found that, from 2011 to 2014, at least 165 nursing home residents were hospitalized or died after errors involving warfarin. In addition, they note that a 2007 study published in The American Journal of Medicine estimated that nursing home residents suffer 34,000 fatal, life-threatening, or serious events related to warfarin each year, and a 2011 report published in The New England Journal of Medicine found that the drug accounted for some 33,000 emergency hospitalizations among the elderly from 2007 to 2009—more than twice as many as the next highest drug, insulin. Read more…

Wisconsin.
According to an analysis conducted by the Milwaukee Journal Sentinel, during 2014, fewer medical liability claims were paid in Wisconsin per capita than in any other state. The researchers reviewed records from the National Practitioner Data Bank and found that 6 of every 1 million Wisconsin residents collected a medical liability claim last year, compared with a national rate of 27 per 1 million people. Observers say that one factor may be the state’s $750,000 cap on noneconomic damages, which reduces attorneys’ fees. Because these fees are generally based on a percentage of court awards, the cap may discourage attorneys from taking malpractice cases. Read more…

Last call: Committee positions closing soon!
A number of openings on the AAOS Committee Appointment Program website are closing July 15. Act now to apply for the following positions:

  • American Joint Replacement Registry Board of Directors (one member-at-large opening)
  • Central Evaluation Committee
    • Hand (one member)
    • Spine (one member)
  • Council on Research and Quality (chair)

Learn more and submit your application…(member login required)