Patients with nonunions should consult endocrinologists

Annie Hayashi

Study shows 84 percent of patients have metabolic or endocrine abnormalities Nonunions continue to confound orthopaedic surgeons. Although most fractures respond well to nailing, plating, and other orthopaedic interventions, some defy even the best efforts of surgeons. These problem fractures led Mark R. Brinker, MD, and his colleagues to investigate whether metabolic and endocrine abnormalities were associated with unexplained nonunions. Dr.

Clearing up the confusion with VTE and/or PE prophylaxis guidelines

Robert H. Haralson III, MD, MBA

Both AAOS and ACCP guidelines meet CMS requirements In 2007, AAOS published clinical guidelines on the prevention of symptomatic pulmonary embolism (PE) in patients undergoing total joint arthroplasty. These evidence-based guidelines differed from previously published guidelines on the prevention of venous thromboembolism (VTE) developed by the American College of Chest Physicians (ACCP).

Second Look: Clinical

If you missed these news items the first time around, AAOS Now gives you a second chance to review them. Links are available online at www.aaos.org/now. Headline News Now, the AAOS thrice-weekly, online update of news of interest to orthopaedic surgeons, brings you the latest on clinical, socioeconomic, and political issues, as well as important announcements from AAOS.

Survey finds no consensus on treatment strategies

Annie Hayashi

AAHKS members asked about osteonecrosis of the femoral head How do you treat osteonecrosis of the femoral head? That was the question the American Association of Hip and Knee Surgeons (AAHKS) posed to its active members. A 16-question survey elicited the evaluation and treatment preferences for this rare, but devastating, condition. The 753 AAHKS members were asked to respond to hypothetical clinical scenarios based on the Steinberg Classification system, and 403 (54 percent) did so.

Symposium focuses on osteolysis and implant wear

Jennie McKee

The prevalence of osteolysis—the “silent disease” that softens, absorbs, and destroys bony tissue—and the impact of wear in joint replacement are issues of concern to orthopaedic surgeons, device manufacturers, researchers, and patients. Every year, osteolysis and implant wear necessitate thousands of revision surgeries that are more difficult to perform, take more time, have a higher complication rate, and often don’t have outcomes as good as those in primary hip or knee arthroplasty.

Biological data shed light on osteolysis and implant wear

Jennie McKee

Symposium identifies potential treatment Targets Osteolysis may do more than destroy bone; it may also block bone formation. This assertion, which could unlock new treatment options for osteolysis, was just one of the many new biological concepts discussed at the 2007 AAOS/National Institutes of Health (NIH) Osteolysis and Implant Wear Research Symposium. (See related story above.

AAOS fellow takes European ‘PRP Tour’

Allan K. Mishra, MD

Research, use of platelet-rich plasma continues to expand Platelet-rich plasma (PRP)—a component of whole blood containing powerful, transforming growth factors—has garnered worldwide attention as a possible biologic method to treat tendinosis and tendon tears, as well as many other challenging conditions. In Europe, PRP is being used to treat conditions ranging from tendinosis to osteitis pubis.

Meetings and Course Listings

Listed below are upcoming continuing medical education (CME) courses and orthopaedic meetings through June 2008. For more information about AAOS-sponsored courses, contact the AAOS customer service department at (800) 626-6726, visit the CME course section of the AAOS Web site at www.aaos.org/courses, or contact the source listed. For more information about other CME courses or orthopaedic meetings, contact the source provided.