Today’s Top Story
Senate votes to proceed with debate on ACA repeal.
The U.S. Senate has voted to begin debate on repeal of the Affordable Care Act (ACA). Following the 51-50 vote to proceed with debate, a follow-up vote on the Better Care Reconciliation Act (BCRA) was defeated 43-57. The BCRA was drafted by a group of Republican senators as an amendment to and substitute for the American Health Care Act, which was passed earlier this year by the U.S. House of Representatives. Observers expect the Senate to vote on several more proposals this week that would either repeal the ACA and immediately replace it, sunset the ACA without a replacement plan in place, or repeal certain ACA provisions such as the individual mandate, the employer mandate, and the medical device tax. Read more in The Hill
Read more in Medscape(registration may be required)

Other News

CMS releases Medicare OPPS and ASC proposed rule.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released a proposed rule regarding the Hospital Outpatient Prospective Payment System (OPPS), the Ambulatory Surgical Center (ASC) Payment System, and Quality Reporting Programs. Among other things, the rule proposes to remove total knee arthroplasty (TKA) from the inpatient-only (IPO) list. In addition, the rule includes:

  • An overall increase of 1.9 percent in OPPS payments to providers.
  • A 2.0 percent point reduction in payments for hospitals that don’t meet quality requirements.
  • A proposal to add single-level total cervical disk arthroplasty to the ASC procedure list.
  • A new ASC-17 quality measure for the 2020 reporting year: measuring and reporting 7-day unplanned hospital visits for orthopaedic procedures.
  • Requests for comments on physician-owned hospitals, regulatory relief, and social risk factors.

In addition, CMS is requesting comments on removing total hip arthroplasty (THA) and partial THA from the IPO, as well as adding both TKA and THA to the ASC procedure list.
The American Association of Orthopaedic Surgeons (AAOS) plans to submit comments on the proposed rule. Read the rule…

Study: Arthroscopic lateral release may offer benefits over PRP for patients with chronic lateral epicondylitis.
A study published in the July issue of the journal Arthroscopy compares the use of autologous platelet-rich plasma (PRP) injections and arthroscopic lateral release for the treatment of chronic lateral epicondylitis. The researchers conducted a prospective, randomized study of 101 patients who received either ultrasound-guided PRP injection (n = 51) or arthroscopic release (n = 50). They found that both cohorts experience significant improvement in all measures, and between-group comparisons displayed a significantly higher value in the PRP group for grip strength at week 8. However, all other significant differences were in favor of arthroscopy, including overall pain, night pain, and Patient-Rated Tennis Elbow Evaluation score at week 104, and grip strength at weeks 24, 52, and 104. Consumption of rescue pain medication was similar across cohorts. Read the abstract…

Study: Lower radiation CT scan may retain satisfactory imaging for certain fractures.
Findings from a study published in the August issue of the Journal of Orthopaedic Trauma suggest that a reduced radiation protocol for computed tomography (CT) scans may retain satisfactory imaging while reducing radiation burden to the patient. The authors conducted a cadaveric study of 11 adult distal tibia fractures with varying displacements in two planes. Each specimen was scanned at three modified protocols, which were read by both qualified attending orthopaedists and midlevel residents. They found no significant difference with regard to measurements in gap, pattern, and treatment plans across CT images acquired with standard (110 mAs), medium (60 mAs), or low protocols (45 mAs). In addition, they found no significant difference in measuring step-off across standard, medium, and low radiation dose. Read the abstract…

AJRR releases patient-targeted summary of data from its annual report.
The American Joint Replacement Registry (AJRR) has published its first annual Report to the Public About Hip and Knee Replacements—a patient-oriented summary of the clinical data available in the organization’s annual report. The report can be accessed on the AJRR website, and will be made available to consumer groups and participating institutions. Physicians and other stakeholders are encouraged to share this report with the public. Read more…
Read the report (PDF)…

Last call for nominations for future AAOS leadership.
Nominees for AAOS Board positions are asked to submit four documents. By acting today, your nominee will have more time to prepare. The following positions are open:

  • Second Vice President
  • Treasurer-Elect
  • Member-at-Large [Age 45 or Older] (on March 8, 2018)
  • Member-at-Large [Under Age 45] (younger than age 45 on March 8, 2018)
  • Nominees to the American Board of Orthopaedic Surgery (ABOS)

The nominations period closes Friday, July 28. Members may submit nominations electronically and access partial descriptions of the responsibilities, desired experience, and time commitments associated with each position at: Read more…(member login required)
Members may also submit nominations to Frederick M. Azar, MD, chair, 2018 Nominating Committee, c/o AAOS Office of General Counsel, 9400 West Higgins Road, Rosemont, Ill. 60018.

Call for volunteers: GAO Health Information Technology Advisory Committee.
AAOS seeks to nominate a member to the U.S. Government Accountability Office (GAO) Health Information Technology Advisory Committee. This committee will make recommendations regarding a policy framework to advance an interoperable health information technology infrastructure. 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 short bio, and a current curriculum vitae. All materials must be submitted by Aug. 1, 2017, to Kyle Trivedi, at:
Learn more and submit your application…(member login required)

Call for volunteers: Biological Implants Committee.
Aug. 1 is the last day to submit your application for a position on the Biological Implants Committee (two member openings). This committee monitors and reviews scientific and regulatory developments in the field of implantable biologics as they relate to orthopaedic surgery. Applicants for this position must be active fellows, with preference given to surgeons with practice concentrations in trauma, pediatrics, and adult reconstruction and who use or study biologic products. Learn more and submit your application…(member login required)