Today’s Top Story
President to offer details of healthcare reform proposal this week; ACA replacement proposal leaked.
Reuters reports that President Trump will offer details on his plan to repeal and replace the Affordable Care Act (ACA) in a nationally televised speech to a joint session of Congress on Tuesday, Feb. 28. Read more…
     In related news, Politico has obtained a draft copy of an ACA replacement bill. According to an analysis by STAT, the proposal includes:

  • Repeal of ACA essential health benefits requirements, which mandates that health plans cover 10 categories of healthcare services
  • Block grants to states for Medicaid
  • Repeal of a tax on pharmaceutical manufacturers
  • A provision that would allow insurers to charge older consumers up to five times as much as younger purchasers, coupled with tax credits that increase based on age
  • Repeal of the Prevention and Public Health Fund

The draft legislation also repeals the individual mandate and does not include a repeal of an ACA provision that prohibits insurers from discriminating against patients with preexisting conditions. Observers note that the draft legislation is likely to be very different from any bill eventually signed into law, but offers an insight into lawmakers’ thinking as ACA repeal and replace moves forward. Read more in Politico
Read more in STAT
Read the draft legislation (PDF)…

Other News

Study: THA revision for PJI associated with increased risk of mortality.
Findings from a study conducted in Denmark and published online in the journal Clinical Orthopaedics and Related Research suggest that revision for prosthetic joint infection (PJI) within 1 year following primary total hip arthroplasty (THA) may be linked to an increased risk of mortality during the first year after the revision surgery. The research team conducted a population-based cohort study of 68,504 primary THAs among 59,954 patients, of which 445 primary THAs underwent revision for PJI and 1,350 underwent revision for other causes. They found that, within 1 year of primary THA, 8 percent of patients who underwent revision for PJI died. Adjusted relative mortality risk for patients with revision for PJI was 2.18 compared with patients who did not undergo revision, and 1.87 compared with patients with aseptic revision. The research team also notes that patients with enterococci-infected THA had a 3.10 higher mortality risk compared to patients infected with other bacteria. Read the abstract…

Study: Primary wound closure following open fracture may reduce risk of infection; nonunion for appropriate patients.
According to a study published in the March issue of the Journal of Orthopaedic Trauma, primary wound closure after an open fracture may be appropriate for selected patients, and may reduce the risk of deep infection and nonunion compared with delayed closure. The authors conducted a matched cohort study of 136 patients and found that, at 1-year follow-up, patients in the primary closure cohort had fewer deep infections and nonunions than patients in the delayed closure cohort. The authors write that a randomized trial is needed to confirm the findings. Read the abstract…

Administration proposal would eliminate Office of National Drug Control Policy.
Modern Healthcare reports that a recently released plan to reduce federal spending would eliminate the U.S. Office of National Drug Control Policy. In a letter to the U.S. Office of Management and Budget, a group of organizations representing the medical community, law enforcement, and patient advocacy has argued for the office to be retained. Among other things, the writers state that the agency eliminates waste and fraud by preventing duplicate programs and strategies among various federal agencies, and coordinates federal efforts to combat the opioid overdose epidemic. Read more…(registration may be required)
Read the letter (PDF)…

Study: Use of a 3-D printed scaffold with rhBMP-2 may help heal ACL rupture.
Data from a pilot study published online in the journal Tissue Engineering, Part A suggest that use of a 3D-printed porous scaffold offering delayed delivery of recombinant-human bone morphogenetic protein 2 (rhBMP-2) may help reconstruct ruptured anterior cruciate ligaments (ACLs) in a rabbit model. The researchers coated scaffolds with carbonate hydroxyapatite, with radiolabeled rhBMP-2 delivered in four experimental groups: polylactic-co-glycolic acid microspheres only, microspheres and collagen, collagen only, and saline solution only. Over 32 days of follow-up, they found that the microsphere delivery groups had a smaller burst release and released a smaller percentage of rhBMP-2 than the collagen and saline only groups. “Combining a synthetic bone mineral coating with microspheres had an additive effect,” the researchers write, “decreasing the initial burst release and cumulative release of rhBMP-2.” Read more…
Read the complete study…

The San Diego Union Tribune reports that a bill under consideration in the California State Assembly would, if enacted, remove probation as an option for physicians whose actions harmed patients through drug or alcohol abuse, sexual exploitation, or other felony-level misconduct. At the same time, physicians who are placed on probation for other reasons would not be required to inform patients regarding that disciplinary action. Under current state law, physicians are often allowed to continue practicing medicine after being placed on probation. The medical board makes disciplinary documents available to the public, but some lawmakers and patient advocates argue that the burden of discovery should not be placed on patients. Read more…
Read the bill…

Call for volunteers: Program Committees.
March 31 is the last day to submit your application for a position on a Program Committee. Members of Program Committees grade symposia in May and abstracts in June and July, and may serve as moderators for paper sessions at the AAOS Annual Meeting. The following openings are available:

  • Adult Reconstruction Hip (five members)
  • Adult Reconstruction Knee (five members)
  • Practice Management/Rehabilitation (three members)
  • Spine (one member)

Applicants for these positions must be active or international fellows with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)