Today’s Top Story
Senate falls short of votes needed for “skinny” ACA repeal.
In a narrow 51-49 vote, the U.S. Senate failed to pass the Health Care Freedom Act—the so-called “skinny” repeal of the Affordable Care Act (ACA) that among other things would have eliminated the ACA’s individual and employer mandates, removed a tax on medical devices for three years, and granted states more flexibility in obtaining ACA waivers. Proponents of the bill had expected to turn it over to a House-Senate conference committee to forge a compromise measure. Some critics of the bill stated that they would not support it without assurances that the U.S. House of Representatives would not vote on it outright. Read more…(registration may be required)

Other News

CMS issues proposed rule to implement mandated cuts to hospital uncompensated care funding.
The U.C. Centers for Medicare & Medicaid Services (CMS) has released a proposed rule to begin implementing cuts in federal funding to help hospitals cover uncompensated care costs. The ACA mandated that the funds be cut by $43 billion between FY2018 and FY2025. The cuts were originally supposed to take effect in 2014, but after hospitals argued that increased patient traffic under the ACA wasn’t outpacing uncompensated-care costs, the U.S. Congress delayed the start date to Sept. 30, 2017. Read more…
Read the proposed rule…

Study: Periarticular infiltration may be safe alternative to femoral nerve block following TKA.
A study conducted in the United Kingdom and published online in The Bone & Joint Journal suggests that periarticular infiltration may be a viable and safe alternative to femoral nerve block for the early post-operative relief of pain following total knee arthroplasty (TKA). The authors conducted a pragmatic, single patient-blinded, randomized controlled trial of 230 TKA patients treated with either periarticular infiltration or femoral nerve block. They found no significant difference across cohorts in visual analogue score for pain on post-operative day 1. Compared with patients in the femoral nerve block group, patients in the periarticular group used less morphine in the first post-operative day. The authors note that, at 6-week follow-up, the femoral nerve block group had reported 39 adverse events (27 serious) in 31 patients, while the periarticular group reported 51 adverse events (38 serious) in 42 patients. However, none of the adverse events were directly attributed to either of the interventions under investigation. Read more…
Read the abstract…

Study: Low surgeon volume linked to increased risk for shoulder arthroplasty and rotator cuff repair procedures.
Findings from a study published in the July issue of the Journal of Shoulder and Elbow Surgery suggest that low surgeon volume may be linked to increased surgical complications, length of stay, surgical time, and surgical cost for patients who undergo shoulder arthroplasty and rotator cuff repair. The researchers conducted a systematic review of 10 studies covering 88,740 shoulder arthroplasties and 63,535 rotator cuff repairs. For arthroplasty, they found that fewer than 5 cases per year met the criteria for a low-volume surgeon and the cases were associated with increased length of stay, longer operating room time, increased in-hospital complications, and increased cost, but no significant increase in mortality. For rotator cuff surgery, fewer than 12 surgeries per year met the criteria for low volume, and were associated with increased length of stay, increased operating room time, and increased in reoperation rates. Read the abstract…

Antibiotics: “Complete the course” or “take as prescribed?”
An opinion piece published in the journal The BMJ argues that policy makers, educators, and physicians should refrain from stating that failing to complete a prescribed antibiotic course may contribute to antibiotic resistance. “[T]he idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence,” the writers state, “while taking antibiotics for longer than necessary increases the risk of resistance. Without explicitly contradicting previous advice, current public information materials from the U.S. Centers for Disease Control and Prevention (CDC) and Public Health England have replaced ‘complete the course’ with messages advocating taking antibiotics ‘exactly as prescribed.'” Read more…

August AAOS Now is available online.
AAOS members will soon receive the print edition of the August issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue includes a look at the societal impact of periprosthetic joint infection; an interview with Thomas E. Arend Jr, Esq, CAE, the new chief executive officer of AAOS; a look at National Orthopaedic Leadership Conference efforts on Capitol Hill, and much more. Read more…
Read “PJI and Cancer: More Similar Than Different?”…
Read “New Academy CEO Outlines Plans for the Future”…
Read “NOLC Makes a Stand on Capitol Hill”…
Read AAOS Now in the Access app…

Call for volunteers: NQF Scientific Methods Panel.
AAOS seeks members to nominate to the National Quality Forum (NQF) Scientific Methods Panel. The panel will provide NQF standing committees with evaluations of the reliability and validity of measures, using NQF’s standard measure evaluation criteria. 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, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by Aug. 2, 2017, at 11:59 p.m. CT, at:
Learn more and submit your application…(member login required)

Last call: Committee positions closing soon.
A number of openings on the AAOS Committee Appointment Program website are closing Aug. 1, 2017 Act now to apply for the following positions:

  • Biological Implants Committee (two members)
  • Biomedical Engineering Committee (four members)
  • Communications Cabinet (two members-at-large, one resident member)
  • Content Committees (one member—generalist)
  • Council on Research and Quality (Communications Cabinet liaison)
  • Diversity Advisory Board (chair, Communications Cabinet liaison, Education Council liaison, one member-at-large)
  • Education Assessments and Examinations Committee (one member each)
    • Pediatric orthopaedics
    • Shoulder and elbow
    • Spine
    • Sports medicine
  • Emerging Professionals Committee (one member, one candidate member, one resident member)
  • Hand & Wrist Evaluation Committee (chair, seven members)
  • Hand & Wrist Program Committee (one member)
  • Health Care Systems Committee (chair, two members-at-large, two members)
  • Medical Liability Committee (four members)
  • Performance Measures Committee (chair, four members-at-large, one resident member)
  • Shoulder & Elbow Evaluation Committee (chair, eight members)
  • Shoulder & Elbow Program Committee (one member)
  • Trauma Evaluation Committee (chair)

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