Today’s Top Story
FDA to scrutinize abuse-deterrent opioid formulations, engage public on addiction epidemic.
The U.S. Food and Drug Administration (FDA) is looking to take “more forceful steps” to confront opioid addiction, including assessing whether formulations intended to make drugs more difficult to misuse (through injecting or crushing and snorting) are effective or can be improved. FDA Commissioner Scott Gottlieb, MD, said the agency is forming a steering committee to consider regulatory and policy initiatives to address the addiction epidemic and is inviting the public to participate through online forums and a 2-day meeting on July 10 and 11. He said government policy needs to be better informed by scientific information regarding the efficacy of abuse-deterrent formulations. Last week the FDA directed Endo Pharmaceuticals to remove its abuse-deterrent extended-release formulation of oxymorphone (Opana ER) from the market in light of findings that abusers were migrating toward an injection route. Read more…(registration may be required)
Read more in the Boston Globe(paid subscription may be required)

Other News

CMS map projects county-by-county insurer participation in health insurance exchanges.
An analysis performed by the Centers for Medicare & Medicaid Services (CMS) indicates that insurance options on health insurance exchanges are projected to continue to disappear in 2018. The county-level map shows projected health insurance exchange participation based on the known issuer participation public announcements through June 9, 2017. According to the map, there are fewer plan options compared with last year. CMS also notes that in 47 counties nationwide there will be no coverage options on the exchanges. “This is yet another failing report card for the exchanges,” said CMS Administrator Seema Verma. “The American people have fewer insurance choices and in some counties no choice at all. CMS is working with state departments of insurance and issuers to find ways to provide relief and help restore access to healthcare plans, but our actions are by no means a long-term solution to the problems we’re seeing with the insurance exchanges.” Read more…

Researchers uncover E. coli’s defense mechanism.
Researchers from Cornell University have discovered how Escherichia coli bacteria defend themselves against antibiotics and other poisons. To study bacteria’s defensive process, the researchers exposed a genetically engineered strain of E. coli to an environment containing copper atoms, which would otherwise poison the bacteria. By periodically zapping the cell with an infrared laser to induce fluorescence, they were able to see where a tagged protein traveled in the cell. The researchers further genetically engineered various proteins in the cell to turn their metal-binding capability on and off, and observed the effects. They discovered that when undesirable molecules appear, the bacterial cell opens a tunnel through its cell wall to pump them out. This mechanism for defending against toxic metals may also explain how bacteria develop resistance to antibiotics, by mutating their defensive proteins to recognize them. Read more…
Read the abstract…

Study: Increasing BMI linked to higher complication risk following shoulder arthroplasty.
Findings from a study published in the June 7 issue of The Journal of Bone & Joint Surgery suggest that increasing body mass index (BMI) may be linked to higher risk of complication for shoulder arthroplasty patients. The research team reviewed data on 4,567 consecutive shoulder arthroplasty cases from 1970 to 2013 The researchers found that increasing BMI was associated with higher risk of revision surgical procedure, reoperation, revision for mechanical failure, and superficial infection, and was negatively associated with risk of a periprosthetic fracture. The researchers state that revision risk increased in a linear fashion with BMI. In addition, they note that the most marked association between increasing BMI and any complication in shoulder arthroplasty was an association with superficial wound infection. Read more…
Read the abstract…

Study: Tönnis grade 1 alone may not contraindicate hip arthroscopy for certain patients with FAI and labral tear.
Findings from a study published online in The American Journal of Sports Medicine suggest that Tönnis grade 1 alone should not be considered a contraindication to hip arthroscopic surgery for patients with femoroacetabular impingement (FAI) and labral tears with mild osteoarthritis (OA). The authors conducted a matched-pair study of 62 hips with Tönnis grade 0 and 62 hips with Tönnis grade 1. At minimum 5-year follow-up, they found that patients with Tönnis grade 1 displayed significant improvements in all patient-reported outcome and visual analog scale scores, and there were no significant differences across cohorts in preoperative or postoperative scores or survivorship. Read the abstract…

Act now to nominate future AAOS leadership!
The 2018 Nominating Committee is actively soliciting your suggestions for individuals who might serve in the following positions:

  • 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)

Nominations will close on Friday, July 28. You may submit your nominations electronically and access partial descriptions of the responsibilities, desired experience, and time commitments associated with these positions at: login required)

You may also submit your nominations to Frederick M. Azar, MD, chair, 2018 Nominating Committee, c/o AAOS Office of General Counsel, 9400 West Higgins Road, Rosemont, Ill. 60018.

2018 Nominating Committee:

  • Frederick M. Azar, MD, chair
  • James H. Beaty, MD
  • Andrew R. Burgess, MD
  • Serena S. Hu, MD
  • Alexandra (Alexe) Page, MD
  • Alexander R. Vaccaro, MD
  • Joseph D. Zuckerman, MD

Call for volunteers: Emerging Professionals Committee.
Aug. 1 is the last day to submit your application for a position on the Emerging Professionals Committee. This committee reviews research and oversees programming to engage medical students, residents, postgraduates, and candidate members of AAOS. The following openings are available:

  • Member (one opening)
  • Candidate member (one opening)
  • Resident member (one opening)

Applicants for the member position must be active fellows or associate members osteopathic. Applicants for the candidate member position must be candidate members of AAOS. Applicants for the resident member position must be PGY-2, PGY-3, or PGY-4. Learn more and submit your application…(member login required)