Today’s Top Story
Medical organizations offer recommendations for healthcare legislation.
Representatives from five medical organizations met with members of the U.S. Congress this week to discuss priorities they argue should be included in any reform or replacement of the Affordable Care Act. According to a document released by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, and the American Osteopathic Association, recommendations include:

  • Currently insured individuals should not lose their coverage as a result of any action or inaction by policymakers
  • Preservation of current coverage of essential benefits, and consumer and benefit protections
  • Improvements upon current law to ensure a healthcare system optimized for patients and physicians

“We … are hopeful that proposals to modify or improve on current law will be released in detail … before Congress votes on it,” the organizations write. “This can provide a valuable opportunity for analysis, review and input by our organizations and other stakeholders, by members of Congress, and by independent and nonpartisan analysts.” Read more…
Read the document (PDF)…

Other News

AMA requests clarification of executive order regarding immigration.
In a letter to the U.S. Secretary of Homeland Security, the president of the American Medical Association has requested clarification of a recently issued executive order restricting entry to the United States for citizens of certain countries. “While we understand the importance of a reliable system for vetting people from other nations entering the United States,” James L. Madara, MD, writes, “it is vitally important that this process not impact patient access to timely medical treatment or restrict physicians and international medical graduates (IMGs) who have been granted visas to train, practice, or attend medical conferences in the United States.” Dr. Madara references reports suggesting that the executive order has affected physicians and medical students, and may negatively impact patient access to care and create unintended consequences for the healthcare system. Read more…
Read the letter…
     An opinion piece in the Feb. 1 issue of The New England Journal of Medicine outlines similar concerns. “The free exchange of ideas, experience, and perspectives is fundamental to patient care, training, and research,” the writers state. “… there is little controversy that the greatest hope of preventing and curing human disease has long depended on bringing together the best ideas and talent to take on complex problems.” Read more…

Study: Hamstring tendon graft with anterolateral ligament reconstruction may offer reduced failure rates compared to other techniques for ACL reconstruction.
Findings from a study published online in The American Journal of Sports Medicine suggest that hamstring tendon graft combined with anterolateral ligament reconstruction (HT+ALL) may offer reduced failure rates compared to bone–patellar tendon–bone (B-PT-B) graft or quadrupled hamstring tendon (4HT) graft for patients who undergo anterior cruciate ligament (ACL) reconstruction. The research team conducted a prospective, cohort study of 502 patients (mean age 22.4 years). At mean 38.4-month follow-up, they found that graft rupture rates were 4.13 percent for HT+ALL grafts, 10.77 percent for 4HT grafts, and 16.77 percent for B-PT-B grafts. Other prognosticators of graft failure included age ≤25 years and a preoperative side-to-side laxity >7 mm. The research team noted that HT+ALL graft was also associated with increased likelihood of returning to preinjury levels of sport compared to 4HT graft, but not B-PT-B graft. Read the abstract…

Study: ASA class, BMI, and age may help predict functional outcomes for patients with surgically treated ankle fractures.
A study published online in the journal Foot & Ankle International examines factors that may be predictive of decreased physical function for patients who undergo surgery for ankle fracture. The authors retrospectively reviewed data on 142 adult patients (mean age 52.7 years) who underwent surgical management of closed ankle fracture with a minimum 2-year follow-up. At mean 6.3-year follow-up, they found that independent predictors of decreased physical function included higher age, higher American Society of Anesthesiologists (ASA) class, and higher body mass index (BMI), while predictors of increased pain interference included higher ASA class and lower BMI. The authors write that overall, ASA class had the strongest effect on both physical function and pain. Read the abstract…

FDA issues safety announcement regarding allergic reaction to skin antiseptic products containing chlorhexidine gluconate.
The U.S. Food and Drug Administration (FDA) states that rare but serious allergic reactions have been reported with skin antiseptic products containing chlorhexidine gluconate. Chlorhexidine gluconate is mainly available in over-the-counter (OTC) products to clean and prepare the skin prior to surgery and injections in order to help reduce the likelihood of skin infection. Such products are available under many different brand names and as generics. The agency notes that the number of reports of serious allergic reactions to chlorhexidine gluconate products has increased over the last several years, and is therefore requesting manufacturers of OTC products to add a warning about this risk to drug labels. Prescription chlorhexidine gluconate products already contain such a warning. Read more…

Study: “Heading” soccer ball may increase risk of concussion.
According to a study published online in the journal Neurology, “heading” the ball may be independently associated with moderate to very severe concussion symptoms among amateur soccer players. The researchers surveyed 220 soccer players who completed a total of 470 HeadCount questionnaires. They found that heading-related symptoms were reported in 20 percent (93 out of 470) of the surveys. After controlling for unintentional exposure, the researchers observed that heading in the highest quartile was significantly associated with concussion symptoms, and participants with two or more unintentional exposures were at increased risk for concussion symptoms, as were those with a single exposure after controlling for heading. Read more…
Read the abstract…
     On a related note, The New York Times reports that amateur football organization USA Football intends to revise the rules of youth football in order to reduce the incidence of concussion and other injuries. Read more…

Call for volunteers: Foot & Ankle section editor for OrthoInfo website.
Feb. 28 is the last day to submit your application to serve as Foot & Ankle section editor of the AAOS OrthoInfo website. OrthoInfo provides authoritative information on a wide range of musculoskeletal issues and treatments. The website features approximately 500 articles, with approximately 30 articles in the Foot & Ankle section. The section editor is engaged as an independent contractor on an annual basis, with contract subject to renewal up to 6 years. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, candidate member applicants for fellowship osteopathic, or emeritus fellows, with a practice emphasis in foot and ankle. In addition, all applicants must submit the following: an AAOS CAP application, a current curriculum vitae, and a cover letter detailing their interest and qualifications, along with three references, by Feb. 28, 2017, to Laura Giblin at: giblin@aaos.org.
Learn more and submit your application…(member login required)