Infection after TKA: An unsolved problem

Annie Hayashi

Patient factors, medical comorbidities drive infection rates Most serious complications of total knee arthroplasty (TKA) have decreased in the past 10 years, but not infections, according to Daniel J. Berry, MD. Despite the use of perioperative antibiotics and the introduction of antibiotic-loaded cement, the incidence of infection after TKA remains fairly stable. To understand why there has not been a reduction in the rate of infection, Dr.

5 tips for boosting your cultural competence

Jennie McKee

Experts offer advice for better communication with your patients According to Valerae O. Lewis, MD, many physicians take their communication skills for granted—but shouldn’t. “Conscious awareness of one’s communication habits requires considerable work and energy,” said Dr. Lewis. “And yet, it can make such a difference.” 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.

Massive cuff tears have multiple repair options

Peter Pollack

ASES Specialty Day symposium examines four common treatments Current surgical options for treating a massive rotator cuff tear include open or arthroscopic débridement and smoothing, repair, tendon transfers, biceps release, and reverse shoulder arthroplasty (RSA). Several of these approaches were covered during the symposium on “Massive Cuff Tears: A Common Dilemma,” moderated by Joseph P. Iannotti, MD, PhD, as part of the American Shoulder and Elbow Society Specialty Day program.

Meetings and Course Listings

Listed below are upcoming continuing medical education (CME) courses and orthopaedic meetings (June through October 2009). 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 listed, contact the source provided.

Engaging with younger patients

John M. Purvis, MD

Let your pediatric patients bring out the kid in you Some orthopaedists are less than comfortable with children while others more easily relate to them. If you are young at heart—or remember what it was like to play—you may have an easier time, but every orthopaedist can use the four Es—engagement, empathy, enlistment, and education—to facilitate communication with pediatric patients. This article focuses on ways to engage and empathize with pediatric patients and their parents.

Off-label device use: Advice from the frontlines

Annie Hayashi

Panel examines pearls and pitfalls of this complex issue “If you are going to use a product in an off-label manner, it is your responsibility to your patient to make sure your plan is satisfactorily supported by evidence of safety and potential efficacy,” said Daniel J. Berry, MD, during a 2009 Annual Meeting symposium on “Off-label device use: When clinical need outpaces regulatory approval.” “Document, disclose, document, disclose,” added attorney Patrick Hurd, JD.

Outpatient knee replacement requires ‘perfect execution’

Jennie McKee

Some problems, including readmission and ED visits, can occur Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are traditionally considered inpatient surgical procedures. But can recent advances—including minimally invasive techniques, improved perioperative anesthesia, and expedited rehabilitation protocols—enable them to be performed on an outpatient basis? According to Richard A.

Bearing surfaces: Progress but not perfection

Annie Hayashi

Panelists present advantages and drawbacks of various implants Though tremendous advancements have been made in developing alternative bearing surfaces for joint replacement implants, problems persist even with the newest technology. Crosslinking has dramatically decreased wear in both metal and polyethylene prostheses, but wear continues to produce small particles that appear to be more biologically active.

Keeping blood clots at bay after TJA

Jennie McKee

Current prophylaxis has limitations; new medications hold potential for advances “For 20 years, we’ve been aggressively trying to prevent venous thromboembolic disease, but there’s still no clear consensus on which prophylactic agents are best and which should be avoided,” said Fred D. Cushner, MD. Dr.

Pearls and pitfalls in foot and ankle treatment

Jennie McKee

AOFAS “masters” discuss clinical topics, establishing patients’ trust With more than 100 combined years of practice, Angus McBryde, MD; William G. Hamilton, MD; and John S. Gould, MD, have plenty of pearls of wisdom to share—and warnings of pitfalls to avoid. During their American Orthopaedic Foot & Ankle Society’s (AOFAS) 2009 Specialty Day “Notes from the Masters” session, moderated by Richard D.

Osteoporosis and bone health

Osteoporosis is a disease characterized by low bone mass and deterioration of bone structure that increases the risk of fracture. Osteoporosis is often called the “silent disease,” progressing without symptoms until a low-energy fall or minor activity fractures a bone. Osteoporosis can occur without a known cause or be attributed to another secondary condition, such as hyperthyroidism or celiac disease, or to medication, such as steroids.

Osteoporosis: A global concern

Elaine Fiedler

May is Osteoporosis Awareness and Prevention Month “Osteoporosis is an international concern,” said Kimberly J. Templeton, MD, chair of the Academy’s U.S. Bone and Joint Decade Committee. The need to “stay one step ahead of osteoporosis” by educating the public on bone health and steps to prevent osteoporosis was reinforced during the 2009 AAOS Annual Meeting by a panel of international surgeons.