Today’s Top Story
Congressional leadership moves to “rapidly” replace ACA.
Reuters reports that U.S. Senate Majority Leader Mitch McConnell has announced that the Senate will take its first steps toward repealing the Affordable Care Act (ACA) by the end of this week. In an interview with CBS, Mr. McConnell stated, “There ought not to be a great gap” between repeal and replacement, and that Congressional leadership would be “replacing it rapidly after repealing it.” On a related note, U.S. House of Representatives Majority Whip Steve Scalise cited as a benchmark for upcoming legislation a previously proposed repeal bill that laid out a 2-year transition period.
Read more…

Other News

Study: Dedicated orthopaedic trauma OR linked to improved efficiency at pediatric trauma center.
According to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery, use of a dedicated orthopaedic trauma operating room (OR) was associated with improved efficiency at a pediatric trauma center. The research team retrospectively reviewed information on 1,469 orthopaedic procedures performed at a single center, 719 of which were performed prior to implementation of a dedicated orthopaedic trauma OR. After implementation of the dedicated OR, they noted a 48 percent reduction in the frequency of after-hours (5:00 p.m.-7:00 a.m.) procedures. In addition, the mean wait time decreased for supracondylar humeral fractures, lateral condylar fractures, and tibial fractures, with no significant increase in wait time for 2,076 laparoscopic appendectomy cases. The research team found no significant difference in mean duration of surgical procedure and mean time in the OR. Across all orthopaedic procedures, the mean duration of inpatient hospitalization decreased by 5.6 hours, and decreased length of stay was linked to a mean cost reduction of $1,251 per patient. Further, the research team found that supracondylar humeral fracture cases performed after dedicated OR implementation had fewer surgical complications, although there was no significant difference in complication rate among other orthopaedic procedures.
Read the abstract…

Study: ACL reconstruction may be appropriate for some older patients.
Data from a small study published online in The American Journal of Sports Medicine support the use of anterior cruciate ligament (ACL) reconstruction in older patients. The authors reviewed data on 12 consecutive patients older than 60 years with isolated ACL tear and no established osteoarthritic lesions, who were treated with primary ACL reconstruction via single-bundle autologous hamstring tendon graft. At mean 49.6-month follow-up, they found no major complications. Mean subjective International Knee Documentation Committee and Lysholm scores improved respectively from 43.4 and 55.7 preoperative to 83.8 and 93.2 at final follow-up. The authors note that ten patients (83 percent) reported recovery of sports activities, and six (50 percent) reached the same level as before injury. In addition, the side-to-side difference in anterior tibial translation on stress radiographs was 7.2 mm preoperatively and 1.9 mm postoperatively.
Read more…

Study: Smoking linked to increased risk of complication following TSA and RSA.
A study published in the January issue of the Journal of Shoulder and Elbow Surgery suggests that smoking may be a significant risk factor of complications after primary anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). The research team conducted a retrospective case-control study of prospectively collected data on 1,834 shoulders in 1,614 patients (814 smokers and 1,020 nonsmokers). At minimum 2-year follow-up, they found complications in 73 patients: 20 periprosthetic infections (16 in the smoking cohort and 4 nonsmoking), 27 periprosthetic fractures (14 smoking and 13 nonsmoking), and 28 loosenings (14 smoking and 14 nonsmoking). Overall, smokers had reduced periprosthetic infection-free survival rates and lower overall complication-free survival rates compared to nonsmokers. In addition, both current and former smokers were at significantly increased risk of periprosthetic infection in comparison with nonsmokers, and current smokers displayed a higher risk of postoperative fracture than both former smokers and nonsmokers.
Read the complete study…

Study: Plasma tau levels may help predict return-to-play following concussion.
Data from a study published online in the journal Neurology suggest that a blood biomarker may help predict recovery time for patients with a sports-related concussion. The authors conducted preseason plasma sampling and cognitive testing for 46 athletes who experienced a sports-related concussion, 37 controls, and 21 non-athlete control participants. They found that both concussed and control athletes had significantly higher mean tau protein at baseline compared to healthy, non-athlete control participants. Compared to concussed athletes with short return-to-play periods, those with longer return-to-play had higher tau concentrations overall. The authors found that higher levels of plasma tau 6 hours post-concussion were a significant predictor of return-to-play of greater than 10 days.
Read more…
Read the abstract…

According to Lancaster Online, the launch of a prescription drug-monitoring program in Pennsylvania in June 2016 has been linked with a significant reduction in the number of monthly reimbursements for opioid painkillers. One insurer reports that from January 2016 through August 2016, the number of reimbursements for opioids ranged each month from 118,261 to 110,045; from September 2016 through November 2016, those numbers fell to a range of 107,477 to 107,843. Another health plan reports a “small but continued decrease” in opioid reimbursement, and a third states that 16 percent of its members received at least one opioid prescription in 2016, a reduction from 20 percent in 2015.
Read more…

Last call: AAOS Liaison to the 2017 AAOS Team Physician Consensus Conference.
AAOS seeks two members to serve as liaisons to the AAOS/Team Physician Consensus Conference in Orlando, Fla. on January 28-30, 2017. The AAOS/Team Physician Consensus Conference meets yearly to discuss and update the Team Physician Consensus Statement. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae [20 pages maximum] with complete contact information, a letter of interest, highlighting his or her expertise in the subject area and a statement that he or she is able to participate in full capacity, and a 100-word biosketch. All supporting materials must be submitted to Stephanie Hazlett by Tuesday, Jan. 10, 2017 at 11:59 p.m., at
Learn more and submit your application…(member login required)