Squeaky hips make media, medical noise

Cale A. Jacobs, PhD, A. Seth Greenwald, DPhil (Oxon), Paul A. Anderson, MD, Matthew J. Kraay, MS, MD; William M. Mihalko, MD, PhD

What’s behind those squeaking hips? “You didn’t put one of those squeaking hips in me, did you, doc?” “My hip made a funny sound last week, and my husband read in the paper that there’s been a recall. Am I going to have to have my new hip taken out?” Orthopaedic surgeons have been answering these questions ever since The New York Times published “That Must Be Bob. I Hear His New Hip Squeaking” this past May.

Reframing the debate on computer-navigated TKA

Annie Hayashi

AICKH symposium examines new uses for computer-assisted navigation Using computer-assisted (CA) navigation in total knee arthroplasty (TKA) has become a hotly debated issue in the United States—effectively dividing the orthopaedic community into two “camps,” according to S. David Stulberg, MD, in his presentation of “Navigation TKA: State of the art and rationale” at the Advanced Imaging and Computer Assisted Surgery of the Knee and Hip (AICKH) symposium, held in March 2008.

Clostridium difficile: An old bug with a new twist

Calin S. Moucha, MD; Lisa L. Dever, MD

By Calin S. Moucha, MD, and Lisa L. Dever, MD While orthopaedic surgeons and infectious disease specialists are diligently treating surgical wound infections caused by multidrug-resistant bacteria, an old enemy, Clostridium difficile, is causing troubles elsewhere. C. difficile infection (CDI), a colonic infection related to antibiotic use, represents a considerable public health threat.

Why do revision ACL reconstructions fail?

Annie Hayashi

Large, prospective study begins to look at this important question What factors account for the different success rates for primary and revision anterior cruciate ligament (ACL) reconstructions? Why do revision ACL reconstructions have worse outcomes? What is the most appropriate graft choice for revision ACL reconstruction? Finding the answers to these and other questions is the goal of the Multi-Center ACL Revision Study (MARS), and Rick W.

Meetings and Course Listings

Meetings and courses sponsored by Board of Specialty Societies members and regional orthopaedic organizations may be listed in the print version of AAOS Now. Send information, including contact name and e-mail address to: AAOS Now 6300 N. River Rd. Rosemont, Ill. 60018-4262 Fax: (847) 823-8033 E-mail: aaoscomm@aaos.org For more information about other CME courses or orthopaedic meetings listed, contact the source provided. GENERAL NOV.

Improving quality of care—one guideline at a time

Fareeha Shuttari-Khan, MPH

A year’s effort pays off for patients and practitioners First identified more than 150 years ago, carpal tunnel syndrome (CTS) is one of the most commonly diagnosed and treated entrapment neuropathies. CTS is estimated to affect up to 10 percent of the entire population. With the variety of tests and treatment options used for this condition, it’s no wonder that developing evidence-based clinical practice guidelines (CPGs) for CTS was high on the AAOS agenda.

AAOS Clinical Guidelines on the Treatment of Carpal Tunnel Syndrome

Summary of Recommendations See the online version of the guidelines, available at www.aaos.org/guidelines, for a complete description of how the quality of evidence is rated and the recommendations are graded. Recommendation 1 A course of nonoperative treatment is an option in patients diagnosed with carpal tunnel syndrome (CTS). Early surgery is an option when there is clinical evidence of median nerve denervation or the patient elects to proceed directly to surgical treatment.

Can TAA be as successful as THA and TKA?

Jennie McKee

New designs, improved techniques raising TAA’s profile When total ankle arthroplasty (TAA) was first introduced in the 1970s, implants had good short-term results; long-term data, however, showed severe problems such as osteolysis, component loosening, impingement, infection, and soft-tissue breakdown.

Loosening up a stiff toe

Jennie McKee

Fusion isn’t the only option for end-stage hallux rigidus What treatments can an orthopaedic surgeon offer a patient with end-stage hallux rigidus? Is hallux metatarsophalangeal (MTP) fusion—a procedure that relieves pain but leaves the patient unable to bend the toe—the only viable surgery? No, according to Alexander J. Pappas, MD, of Strand Orthopaedic Consultants, LLC, in Myrtle Beach, S.C. Dr.

Second Look – Clinical News and Views

If you missed these Headline News Now items the first time around, AAOS Now gives you a second chance to review them. 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.

Does (lesion) size matter?

Jennie McKee

By Jennie McKee Studies explore how much defect size should affect treatment of OLT Osteochondral lesions of the talus (OLT) commonly affect young, athletic people (Fig. 1). It’s unclear, however, how great an impact defect size should have on the treatment algorithm.

Getting athletes back in the game: A global view

Annie Hayashi

International panel presents novel strategies for managing sports injuries “World-wide, we have seen an exponential growth in the number of individuals who participate in organized and recreational sports. Treatment algorithms for injuries are being constantly revised as we learn more about sports-related injuries,” said Pietro Tonino, MD, moderator of the symposium Current Trends in Sports Medicine: An International Perspective held at the AAOS Annual Meeting.

PED use: Legal, natural, and deadly

Annie Hayashi

Doping, athletes, and how orthopaedic surgeons can help The use of performance-enhancing drugs (PEDs) among young athletes as well as among aging “baby boomers” has become widespread, according to Michael J. Stuart, MD, a participant in the American Orthopaedic Society for Sports Medicine (AOSSM) symposium on “Anti-Doping: Where do we go from here?” “This is not a new problem but it is certainly growing,” said Dr. Stuart.

MRSA: From the hospital and into the community

Annie Hayashi

A more virulent form of these bacteria challenges the orthopaedic community The death of Ricky Lannetti, a senior at Lycoming College and a wide receiver on the football team, in 2003 due to community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) marked a turning point in awareness about the disease. “In the 1980s, we started hearing about ‘community-acquired MRSA,’” said Kathleen Weber, MD, MS, at the annual meeting of the American Orthopaedic Society of Sports Medicine.