Today’s Top Story

Trump administration rolls out new healthcare option for small businesses

President Donald Trump’s administration issued a final rule yesterday allowing small businesses to unite and create health insurance plans that cost less but offer fewer benefits. The association health plans allow small-business owners, their employees, and other self-employed individuals to band together to buy or supply insurance in the large-group market. President Trump said the association health plans could “provide more affordable health insurance options to many Americans, including hourly wage earners, farmers, and the employees of small businesses and entrepreneurs that fuel economic growth.” The Department of Labor estimates that 11 million Americans could find coverage under these plans. The new entities would be exempt from many Affordable Care Act mandates and will be available as early as Sept. 1.

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Read the statement from the Department of Labor…

Other News

Study: Hip arthroscopy may be effective for obese patients with femoroacetabular impingement and labral tears

According to a study published in the June 6 issue of the Journal of Bone & Joint Surgery, hip arthroscopy may be an effective treatment for obese patients with femoroacetabular impingement and labral tears. This retrospective, prospective study included data on patients who underwent arthroscopy between Feb. 2008 and Dec. 2011. Obese patients (n = 96, mean body mass index [BMI], 34.3 kg/m 2) were matched 1:1 with normal-weight controls (n = 74, mean BMI, 22.7 kg/m 2) by age at the time of arthroscopic hip surgery within five years, sex, capsular treatment, and acetabular Outerbridge grade (0–1 versus 2–4). Preoperative patient-reported outcome and visual analog scale scores were worse in the obese cohort. Researchers observed significant improvements in each group’s mean outcome scores after five years. The conversion rate to total hip arthroplasty was 29.7 percent in the obesity group and 14.9 percent in the control group.

Read the abstract…

Study: Bone bruising associated with ACL tear appears to occur less often in skeletally immature patients

Bone bruising resulting from tearing of the anterior cruciate ligament (ACL) may be less prevalent in patients with an open versus closed physis, according to a study published online in The American Journal of Sports Medicine. The cross-sectional study included 106 patients 16 years or younger with ACL tears who underwent MRI within six weeks of injury between Jan. 2012 and Dec. 2016. Researchers compared outcomes for 53 patients with an open physis (skeletally immature [SI] group) and 53 with a closed physis (skeletally mature [SM] control group). SI patients had significantly fewer incidences of bone bruising across the physis and metaphysis than the SM group in the tibia (25 percent versus 85 percent) and femur (4 percent versus 42 percent). The most common patterns observed in the SI group were type IIICa in the tibia (42 percent) and type Ia in the femur (59 percent).

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Study assesses ankle-sparing bone transport for periarticular distal tibial nonunions

Ankle-sparing bone transport may be an effective alternative to bone graft and arthrodesis in treating periarticular distal tibial nonunions, according to a study published online in Foot & Ankle International. Researchers assessed 21 patients, 13 of whom had infected nonunions, who received ankle-sparing bone transport between Jan. 2006 and July 2016. All patients achieved union, with a mean time to union of 37.4 weeks and mean American Orthopaedic Foot & Ankle Society score of 86.3 (range, 37–100). Researchers observed mean lateral distal tibial and mean anterior distal tibial angles of 89.2 degrees and 76 degrees, respectively. In all patients, discrepancy of leg length was less than 1.2 cm. Seven patients experienced superficial pin infection and three experienced operative wound infection at the level of bone resection.

Read the abstract…

Study: Femoroacetabular impingement prevalence in radiographs of a young Indian population

Radiographic morphology of femoroacetabular impingement appears to be similar in prevalence in a young asymptomatic Indian population compared to other ethnicities, according to a study published online in The Journal of Arthroplasty. The multicenter, cross-sectional study included 452 radiographs from young asymptomatic Indians across 10 centers in India. Crossover sign, ischial spine sign, and posterior wall sign were included in “acetabular rotation abnormalities(R),” lateral center edge angle and acetabular index were included in “acetabular overcoverage abnormalities(O),” while pistol grip deformity and alpha angle were included in “femoral abnormalities(F).” Hips were classified as normal, type I with single abnormality (R/O/F), type II with combination of any two (RO/RF/OF), and type III with all three abnormalities. Of the 904 hips, 68 percent had at least one type of abnormality; 47.5 percent showed signs of pincer impingement, 7.9 percent showed signs of cam impingement, and 10.8 percent showed mixed signs. Type I.R hips were most common (32 percent), followed by type I.O (18 percent) and type I.F (8 percent).

Read the abstract…

AAOS Now

Have you heard the latest professional liability risk?

The list of liability risks for physicians continues to increase. On behalf of the Medical Liability Committee, this article presents new risks via highlights from a recent discussion with Jeannine M. Foran, BSN, JD, a Connecticut healthcare attorney who leads the Health Care Practice Advisory Group at Heidell, Pittoni, Murphy & Bach, LLP, in Bridgeport, Conn.

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Your AAOS

Apply for International Committee member position

The AAOS International Committee has an open member position, a two-year term that runs from Mar. 18, 2019, to Mar. 12, 2021. The committee directs and reviews the international activities of the Academy, with responsibilities including planning and conducting overseas education programs, increasing international participation in the annual meeting, driving international membership, and more. The last day to submit an application is Aug. 6.

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