ARM stretching device reduces ankle stiffness

Jennie McKee

Flat foot treatment holds foot in inversion during ankle dorsiflexion “Flat foot deformity can be associated with contracture of the triceps surae muscle, and a corresponding reduction in dorsiflexion of the ankle, especially if the subtalar joint is inverted. Therefore, a stretching regimen where the hindfoot is held in inversion could be effective in reducing ankle stiffness,” said Vinod K.

A superior approach for reverse TSAs

Peter Pollack

Early outcomes show high satisfaction, low complications Reverse total shoulder arthroplasty (TSA) has gained acceptance for complex shoulder conditions, yet the proper surgical approach remains controversial. Support for using a superior approach was presented at the 6th Biennial AAOS/American Shoulder and Elbow Surgeons (ASES) Meeting by Sumant G. Krishnan, MD. His retrospective review of the results of 100 primary reverse TSAs (Fig.

Total knee arthroplasty: Pearls and pitfalls

Paul A. Manner, MD

Common factors and specific recommendations in medical liability cases Total knee arthroplasty (TKA) is one of the most successful and commonly performed surgical procedures in the United States; more than 400,000 TKAs are performed per year. Most TKAs proceed without incident or complication. As with any major surgical procedure, however, substantial risks—including infection, bleeding, venous thromboembolic disease, exacerbation of preexisting disease, and neurovascular disease—do exist.

Meetings and Course Listings

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

Arthroscopic surgery for hip impingement: It works for me

Dean K. Matsuda, MD

A surgeon’s perspective—from both sides of the scalpel In 2003, a colleague asked if I would perform arthroscopic hip surgery on his collegiate athlete daughter. Aware of the inherent technical difficulties in hip arthroscopy, I recommended that he seek the advice of a specialist. Fortunately, my colleague found Thomas G.

Hip arthroscopy for pediatric FAI is safe, reliable

Carolyn Rogers

Femoroacetabular impingement (FAI) frequently results from childhood diseases such as developmental dysplasia of the hip, Legg-Calvé-Perthes, or slipped capital femoral epiphysis. Although FAI in adults is often treated with open surgical dislocation and a greater trochanteric osteotomy, a different approach may be beneficial for treating FAI in pediatric patients.

Warning: Local anesthetics may be toxic to articular cartilage

Annie Hayashi

Amount, duration of local anesthetics can be cytotoxic When Constance R. Chu, MD, began exploring the possibility that local anesthetics could have a toxic effect on articular chondrocytes, she was concerned by what she found. “The results from the first study we conducted were shocking,” she said. “The local anesthetic agents were so toxic, I could not believe it. We observed greater than 99 percent bovine chondrocyte death after a 15-minute exposure to a 0.5 percent bupivacaine solution.”

Better to wedge cuff repairs

Peter Pollack

Derotation wedge may improve outcomes for smaller rotator cuff tears Using a derotation wedge along with a simple sling after rotator cuff repair can result in significant improvement compared to using just a standard sling, especially for small and medium size tears. Gregory P. Nicholson, MD, presented these results at the 6th Biennial AAOS/American Shoulder and Elbow (ASES) Meeting.

Shoulder resurfacing benefits younger patients

Peter Pollack

Shoulder resurfacing arthroplasty may be a viable alternative to standard stemmed implants in younger patients, according to the results of a case-controlled study presented by Anand M. Murthi, MD, at the 6th Biennial AAOS/American Shoulder and Elbow (ASES) Meeting. Dr. Murthi along with Bryan Butler, MD, prospectively followed 17 patients (16 men, 1 woman) who underwent shoulder resurfacing arthroplasty. Patients ranged in age from 19 years to 40 years old (mean: 35 years).

Splinting method doesn’t affect elbow healing

Peter Pollack

Study finds no significant difference between dynamic and turnbuckle methods Does the method of splinting used to treat elbow stiffness make a difference in outcomes? Not according to a study presented by Anneluuk L.C. Lindenhovious, MSc, at the 6th Biennial AAOS/American Shoulder and Elbow (ASES) Meeting.

Second Look: Clinical News and Views

FDA reports more deaths linked to heparin According to the Wall Street Journal, the U.S. Food and Drug Administration (FDA) has more than tripled the number of deaths that it attributes to allergic reactions to heparin. Previously, the agency had reported 19 deaths, but based on recently received reports and an expanded analysis, the FDA adjusted the total to 62 deaths, dating back to January 2007.

Healthy Bone Team halves hip fracture rate

Annie Hayashi

How one orthopaedist transformed osteoporosis patient management Who said that one person can’t make a difference? Richard M. Dell, MD, has reduced the rate of hip fractures at his hospital by more than 50 percent in 2 years. He believes that if every Academy fellow would identify and treat patients at risk of fragility fractures, the number of hip fractures in the United States could decrease by 25 percent.

“If you’re not cheating, you’re not trying”

Michael F. Schafer, MD; Mary Ann Porucznik

Use of performance enhancers has implications for orthopaedic surgeons If you’re an orthopaedic surgeon who serves as a team physician, you’ve had to address the issue of performance-enhancing drugs (PEDs). No matter what the sport, or what the level of play, PEDs have made inroads among athletes—so much so that in some locker rooms, “if you’re not cheating, you’re not trying.”