Today’s Top Story
FDA asks Endo Pharmaceuticals to stop marketing Opana ER pain medication.
The U.S. Food and Drug Administration (FDA) has requested that Endo Pharmaceuticals voluntarily remove reformulated Opana ER (oxymorphone hydrochloride) from the market due to public health consequences of abuse. Opana ER was first approved in 2006 for management of moderate-to-severe pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time. In 2012, the manufacturer reformulated the drug to make it resistant to physical and chemical manipulation for abuse by snorting or injecting. After a review of postmarketing data, FDA notes a significant shift in the route of abuse of Opana ER from nasal to injection following the product’s reformulation.
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Other News

Study: rESWT may offer little benefit to patients with subacromial shoulder pain.
According to a study published online in The American Journal of Sports Medicine (AJSM), radial extracorporeal shock wave therapy (rESWT) may offer little additional benefit to patients treated with supervised exercise for subacromial shoulder pain. The authors conducted a randomized, controlled trial of 143 patients with subacromial shoulder pain who were treated with supervised exercise and either rESWT or sham rESWT. At 24-week follow-up, they found that patients in both cohorts displayed similar improvement in Shoulder Pain and Disability Index (SPADI) compared with baseline. However, patients with calcification in the rotator cuff who were treated with rESWT displayed a greater improvement in SPADI score compared to sham rESWT patients at 24 weeks.
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Study: What factors increase likelihood of acetabular chondral lesions?
A study published online in AJSM identifies factors that may be linked to development of acetabular chondral lesions. The research team conducted a cross-sectional study of 1,502 patients who underwent hip arthroscopy and in whom acetabular chondral lesions were intraoperatively identified and measured. They found that higher acetabular labrum articular disruption was significantly related to male sex, advanced age, area of the acetabular chondral lesion, anterior extension of the acetabular chondral lesion within the anterosuperior quadrant, labral detachment from the acetabular cartilage, and posterior extension of the labral tear.
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Study: Waist-to-height ratio may be more accurate than BMI for assessment of body fat.
Findings from a study published online in the journal PLoS ONE suggest that waist-to-height ratio (WHtR) may offer a more accurate assessment of body fat than body mass index (BMI). The researchers calculated BMI, WHtR, waist circumference, waist-to-hip ratio, and waist/height0.5 for 81 adults, and compared the measurements to whole-body fat percentage (%FM) and visceral adipose tissue (VAT) mass, as quantified by dual energy X-ray absorptiometry. They found that the best predictor of both %FM and VAT mass was WHtR. “In the absence of more objective measures of central obesity and adiposity,” the researchers write, “WHtR is a suitable proxy measure in both women and men.” However, they note that the obesity cut points derived from the data will require validation in larger studies.
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CMS seeks recommendations to streamline insurance markets.
The U.S. Centers for Medicare & Medicaid Services (CMS) is requesting public recommendations on streamlining the regulatory structure of the individual and small group health insurance markets under the Affordable Care Act. The agency seeks to “identify and eliminate or change regulations that are outdated, unnecessary, or ineffective; impose costs that exceed benefits; or create inconsistencies that otherwise interfere with regulatory reform initiatives and policies.”
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The Orlando Sentinel reports that, in a 4-3 decision, the Florida Supreme Court has determined a state law limiting noneconomic damages in medical liability cases to be unconstitutional. In the majority opinion, the court concluded that “caps on noneconomic damages … arbitrarily reduce damage awards for plaintiffs who suffer the most drastic injuries.” In addition, the court wrote that “…because there is no evidence of a continuing medical malpractice insurance crisis justifying the arbitrary and invidious discrimination between medical malpractice victims, there is no rational relationship between the personal injury noneconomic damage caps … and alleviating this purported crisis.”
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Last call: Committee on Professionalism.
June 11 is the last day to submit your application for a position on the Committee on Professionalism (one member opening). The Committee on Professionalism hears, reviews, and adjudicates complaints against fellows and members for alleged violations of the AAOS Standards of Professionalism. Applicants for this committee must be active or emeritus fellows with a demonstrated understanding of and experience with legal issues related to orthopaedic surgery, including orthopaedic expert opinion and testimony.
Learn more and submit your application…(member login required)