Bed rest or balloon kyphoplasty?

Jennie McKee

FREE study compares outcomes of vertebral fracture treatments Acute vertebral fractures are commonly treated with conservative measures aimed at reducing pain.

Should surgery come before the sling?

Jennie McKee

Surgery may be better for displaced clavicle fractures Clavicle fractures, common injuries in active adults, are conventionally treated with arm immobilization in a sling. But according to the results of a study presented by Kaisa J. Virtanen, MD, at the AAOS 2010 Annual Meeting, surgical treatment of clavicle fractures may have some advantages over conservative measures in patients with a high level of activity.

Symposium tackles off-label “conundrum”

Terry Stanton

How does one describe the issue of “off-label” use of an orthopaedic device? As a thicket of thorny clinical questions? A morass of ethical dilemmas, which may ensnare even the most well-intentioned practitioner? Whether it’s called “physician-directed” or “off-label” use, this issue confronts many orthopaedic surgeons. It crosses specialty lines and encompasses not just devices, but drugs and new therapeutic agents.

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. Gram-negative HAIs increasing An article in the New York Times (Feb.

Meetings and Course Listings

Listed below are upcoming continuing medical education (CME) courses and orthopaedic meetings (May through September). 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. For more information about other CME courses or orthopaedic meetings listed, contact the source provided.

Single-level lumbar fusion is cost-effective

Terry Stanton

A study to determine the cost-effectiveness of single-level instrumented posterolateral lumbar fusion at 5 years after surgery found that the procedure falls within an acceptable range both for benefit versus cost and for durability. The study, presented by Steven D. Glassman, MD, at the AAOS 2010 Annual Meeting, is one of the first to examine this issue at the 5-year postoperative interval.

PRP shows little benefit in ACL reconstruction at 6 months

Terry Stanton

The use of autologous platelet concentrate—platelet-rich plasma, or PRP—in a common type of anterior cruciate ligament (ACL) reconstruction surgery yielded no detectable clinical or functional benefit, although it may have led to better maturation and ligamentation, in a clinical study conducted by David Figueroa, MD, and colleagues. The applicability of PRP in ACL reconstruction has been controversial. Dr.

Evaluating nonsurgical treatments for adult scoliosis

Maureen Leahy

Study finds nonsurgical treatment has high cost–low benefit ratio According to a study presented at the AAOS 2010 Annual Meeting, 2 years of nonsurgical treatment in adult scoliosis patients results in substantial expenditures and yields no improvement in health status. Scoliosis is often found in adult patients, many of whom are treated nonsurgically. Few data exist, however, about the frequency and duration of such treatments, nor their impact on patient health. Steven D.

Early bracing may beat casting for JOCD

Peter Pollack

40 percent of patients still require surgery Nonsurgical treatment is appropriate for many patients who have juvenile osteochondritis dissecans (JOCD) of the knee, especially if the disease is in an early stage, according to the results of a prospective cohort study presented by Robert K. Fullick, MD, at the AAOS 2010 Annual Meeting. Furthermore, of nonsurgical treatments, the data suggest that unloader bracing followed by physical therapy may have the greatest efficacy.

DOJ shifting focus to Medicare fraud

Mary Ann Porucznik

Emphasis moving from “bagel police” to HEAT task forces “I’ve been investigating healthcare fraud for 15 years, but within the last year, healthcare fraud has been raised to Cabinet-level attention,” said Kirk Ogrosky, JD, then-deputy chief for healthcare fraud in the criminal division of the U.S. Department of Justice. He was part of a panel discussing “The Orthopaedic Surgeon and Industry Relationship: Evolution or Revolution?” during the AAOS 2010 Annual Meeting.

MOC deadline: May 1

Anyone planning to take the American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification™ (MOC) examination in 2011 must submit an examination application and application fee via www.abos.org by May 1, 2010. Only those who have already submitted documentation of 120 AMA PRA Category 1 Continuing Medical Education (CME) Credits™, including at least 20 credits from one or two scored and recorded self-assessment examinations (due Dec. 15, 2009) will be allowed to sit for the exam.

What’s your Diagnosis?

In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. Last month, Stephen A. Albanese, MD, and E. Mark Levinsohn, MD, provided a set of radiographs and the following patient information: “The patient is a 67-year-old, healthy male who complained of swelling of the middle finger. Upon examination, no inflammation or tenderness was found. Radiographs (anteroposterior and lateral views) of the hand were taken and are shown here.”

Skills labs in a growth spurt

Terry Stanton

As facilities abound nationwide, leaders look to set standards for quality and consistency The medical training facilities known as skills laboratories have proliferated in recent years, offering orthopaedic surgeons and other physicians welcome access to high-quality educational opportunities in conveniently located, up-to-date facilities.