Is hamstring autograft a “strong” option in ACLR?

Jennie McKee

Isometric testing finds weakness after hamstring graft ACL reconstruction Despite the popularity of hamstring autograft in anterior cruciate ligament reconstruction (ACLR), questions exist about potential negative effects of autologous hamstring harvest (Fig. 1). Perhaps the most notable concern—the potential loss of knee flexion strength—is supported by the results of a study Kenneth R. Morse, MD, presented at the 2009 American Orthopaedic Society for Sports Medicine annual meeting.

Hand transplantation not cost-effective

Peter Pollack

Prosthetics more effective from a cost standpoint Prosthetic adaptation is a more cost-effective treatment for patients who may be candidates for hand transplantation, according to data from a cost/utility study presented at the annual meeting American Society for Surgery of the Hand, by Takashi Oda, MD, PhD, of the University of Michigan. “To date, 43 hand transplantations have been performed worldwide,” said Dr. Oda.

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.

Vitamin C doesn’t help outcomes for wrist fractures

Annie Hayashi

Antioxidant also not effective in resolving complex regional pain syndrome Distal radius fractures are common and occur in a relatively young age group (younger than age 60). As a result, complications can have a long-term, deleterious effect on a patient’s ability to function. “Current treatment methods are aimed at providing stability but no methods have been proven to help soft tissue healing,” said Ingri Ekrol, MD, at the 2009 annual meeting of the Orthopaedic Trauma Association.

What’s your diagnosis?

Beginning this month, AAOS Now introduces a new feature, “What’s your diagnosis?” Every other month, we will publish a series of images, challenging readers to diagnose the condition depicted. In alternate months, we’ll publish the responses we receive. The images for this month’s challenge were submitted by Stephen A. Albanese, MD, a member of the AAOS Now editorial board and professor and chief of orthopaedic surgery at Upstate Medical University, Syracuse, N.Y. Dr.

Weigh options in tarsal navicular stress fractures

Jennie McKee

Researchers find non–weight-bearing immobilization as effective as surgery Surgical treatment of tarsal navicular stress fractures (TNSF) is becoming more common, said Barry P. Boden, MD, at the 2009 annual meeting of the American Ortho-paedic Society for Sports Medicine (AOSSM). This trend is based on the unproven assumption that surgery will enable patients to return to activity sooner than conservative treatments, such as casting and immobilization. But according to Dr.

Satellite course keeps orthopaedists close to home—and their patients

Maureen Leahy

AAOS/AAHKS leverage technology to promote shared learning on tja Thanks to the latest in satellite and Internet technology, orthopaedic surgeons at three locations across the country will be able to simultaneously share in the latest innovation and thought surrounding cutting edge developments and controversies in total joint arthroplasty (TJA).

Meetings and Course Listings

Listed below are upcoming continuing medical education (CME) courses and orthopaedic meetings (February through June). 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.

Styloid fractures may not affect outcomes of distal radial fractures

Peter Pollack

Income more significant in patient-rated outcomes The presence of an ulnar styloid fracture may have little effect on patient-rated outcomes among patients treated with open reduction and internal fixation (OR/IF) for a distal radius fracture, as long as the distal radioulnar joint (DRUJ) is stable, reported Douglas M. Sammer, MD, at the 2009 annual meeting of the American Society for Surgery of the Hand.

Bisphosphonate use associated with low-energy femoral fractures

Annie Hayashi

Unique fracture pattern and cortical thickening found “Bisphosphonates have been extensively and successfully used for the treatment of vertebral compression and osteoporotic hip fractures,” said Brett A. Lenart, MD, at the Orthopaedic Trauma Association’s 2009 annual meeting. “Several animal studies have recently linked bisphosphonate use to the suppression of bone turnover, which has the potential to alter the biomechanical properties of bone.” According to Dr.

Clearing the cervical spine in blunt trauma patients

Annie Hayashi

Researchers consider use of MRI after negative CT scan Relying solely on a negative or normal multidetector computed tomography (MDCT) to ensure that a trauma patient doesn’t have issues with the cervical spine can lead to missed injuries, according to Mitchel B. Harris, MD, FACS, at the 2009 annual meeting of the Orthopaedic Trauma Association. “Both CT alone and CT with magnetic resonance imaging (MRI) are useful,” he said.

Wearing arm splint affects driving ability

Peter Pollack

Study finds that arm splints make it more difficult to control a vehicle An arm splint can negatively affect a driver’s ability to control a vehicle—especially if that splint is applied to the left upper extremity, according to Paul Y. Chong, MD, who presented the results of a study on driving performance at the 2009 annual meeting of the American Society for Surgery of the Hand.

Newer THA bearing surfaces fail to show early advantages for elderly

Mary Ann Porucznik

Study compares effectiveness of bearing surfaces in Medicare population Metal-on-polyethylene (M-PE) may be the gold standard in hip replacement bearing surfaces, but newer designs have promised better outcomes, particularly with regard to reducing the risk of complications and reoperation. According to the results of a study presented at the American Association of Hip and Knee Surgeons (AAHKS) 2009 annual meeting, these new designs fail to deliver on that promise, at least in the U.S.

Poor outcomes for surgically treated patella fractures

Annie Hayashi

Study shows long-term significant objective and subjective deficits Patients with patella fractures continue to experience significant pain, reduced range of motion, and muscle deficits at a median of 6.5 years following their surgery, according to the results of a study presented by Christopher T. LeBrun, MD, at the 2009 annual meeting of the Orthopaedic Trauma Association.

Is DVT a valid proxy measure for PE?

Mary Ann Porucznik

Study raises questions about assumed connection “If we assume that deep venous thrombosis (DVT) is a proxy for pulmonary embolism (PE), a reduction in DVT should, by definition, lead to a reduction in PE,” proposed Javad Parvizi, MD, FRCS. That hypothesis triggered research into the potential link between DVT and PE, the results of which Dr. Parvizi presented at the 2009 annual meeting of the American Association of Hip and Knee Surgeons (AAHKS).

Minimally invasive TKA shows little benefit in outcomes

Mary Ann Porucznik

Postoperative strength, functional recovery similar to standard approach A prospective, randomized, double-blinded study comparing postoperative strength and functional recovery after minimally invasive or standard total knee arthroplasty (TKA) showed limited benefits for the minimally invasive (MIS) approach—and those benefits had disappeared by 6 weeks after surgery. “The cited advantages of minimally invasive TKA are well known,” said presenter Bryan J. Nestor, MD.