AAOS Now, July 2010
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Sensors show success of bracing for scoliosis
Bracing is effective for adolescent idiopathic scoliosis when compliance is good Investigators who used sensors to monitor brace wear by patients with idiopathic adolescent scoliosis found that patients who wore their Boston brace consistently achieved better results than those who were less compliant. The study, “Brace Treatment Controls Progression in Adolescent Idiopathic Scoliosis,” conducted by Donald E. Katz, CO; J.
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OREF awards CDP fellowship grants
With support from 12 industry partners, the Orthopaedic Research and Education Foundation (OREF) awarded 252 grants totaling $7.1 million for 2010–2011 through its Clinician Development Program (CDP). The list of grant recipients is available at www.oref.org/grantrecipients Given to support fellowship studies in eight practice categories, 115 fellowship grants totaling $6.5 million dollars were awarded.
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Arthroscopy after traumatic hip dislocation?
Hip arthroscopy is a safe and effective subsequent procedure for patients who have sustained a traumatic hip dislocation, and loose fragments inside the joint are the clearest indication for such arthroscopy, according to data presented by Victor M. Ilizaliturri Jr., MD, at the annual meeting of the Arthroscopy Association of North America. “Subsequent treatment is indicated for residual intra-articular fragments or for a noncongruent reduction,” explained Dr. Ilizaliturri.
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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.
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Meetings and Course Listings
Listed below are upcoming continuing medical education (CME) courses and orthopaedic meetings (September through November). For more information about AAOS-sponsored courses, contact the AAOS customer service department at (800) 626-6726 or visit the CME course section. For more information about other CME courses or orthopaedic meetings listed, contact the source provided.
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Splints as good as casts in some wrist fractures
In a study of children with distal radius and/or ulnar fractures, a prefabricated wrist splint was found to be as effective as a cast and possibly superior. The Canadian study—conducted by Andrew W. Howard, MD, and colleagues and presented by Dr. Howard at the 2010 annual meeting of the Pediatric Orthopaedic Society of North America (POSNA)—evaluated splints versus casts in fractures that had an angulation deformity of 15 degrees or less. Dr.
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Managing supracondylar humerus fractures: The puzzle of pulse and perfusion
Two studies examine pulseless fractures and risk for brachial artery injury The management of supracondylar humerus fracture—the most common fracture around the elbow in children—has long been a controversial topic. Debate has focused on the prevention and treatment of brachial artery injury, in particular on how to proceed when the radial pulse is absent but the hand is pink and warm.
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Keeping younger OA patients active
Due to the breakdown of cartilage that can occur with aging, osteoarthritis (OA) is often associated with older patients. However, OA is becoming increasingly common in younger, active patients (aged 40 to 60 years), especially those who have sustained serious joint injuries, such as anterior cruciate ligament tears. What challenges, if any, are associated with treating OA of the knee in this patient population? AAOS Now posed this question and others to Brian T.
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Tibial eminence fractures reviewed in JAAOS
Tibial eminence fractures are most commonly seen in children and adolescents aged 8 to 14 years. The injury is typically incurred in sports play or in mishaps such as falls from a bicycle or vehicle accidents. Any mechanism, especially a pivoting or twisting force, that can cause an anterior cruciate ligament (ACL) injury may result in a tibial eminence fracture. Russell M. LaFrance, MD AAOS Now: What is the typical diagnostic approach? Dr.
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One condition, two viable treatments
Single-surgeon study compares open and arthroscopic approaches for treating FAI “Surgical dislocation for the treatment of femoroacetabular impingement (FAI) has arguably been the gold standard,” explained Benjamin G. Domb, MD, speaking at the annual meeting of the Arthroscopy Association of North America, “but arthroscopic techniques have advanced to the point of potentially reproducing the outcomes of open surgery.” Dr.
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What’s your Diagnosis?
In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. The images published in May 2009 were of a 14-year-old male who sustained a wrist injury. They included a radiograph taken 10 days after the injury and two magnetic resonance images (MRIs). Scott Langford, MD, correctly identified the injury as a scaphoid nonunion with osteonecrosis of the proximal pole. The images for this month’s challenge were submitted by Stephen A.
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Two views on multimodal pain management
Protocols share one objective: Reducing narcotic use “Of all the developments and changes in the way orthopaedic surgeons practice over the past 5 or 6 years, the impact of better pain management has been truly significant,” according to Steven MacDonald, MD, who moderated a panel on the topic during the 2009 annual meeting of the American Association of Hip and Knee Surgeons. “It’s really changed how well our patients do postoperatively.”
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OMeGA awards GME grants
OMeGA Medical Grants Association announced that 71 graduate medical education (GME) grants have been awarded for the 2010–2011 academic year. The list of grant recipients is online at www.omegamedicalgrants.org Grant recipients were chosen from 218 applications submitted by academic programs in the Americas. The nonconflicted OMeGA board and review committee evaluated applications based on objective educational criteria and thorough knowledge of the academic environment.
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Closing the TJA gender gap
Two patients—one male, one female, both with osteoarthritis of the knee and with identical clinical scenarios of chronic knee pain—visit their primary care provider. The man is referred to an orthopaedist for a possible arthroplasty. The woman is given prescriptions for an analgesic and physiotherapy. Is this appropriate care—or does it demonstrate a gender disparity?
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Has MOM worn out its welcome?
Recently, the United Kingdom’s Medicines and Healthcare Products Regulatory Agency issued an alert on metal-on-metal (MOM) hip devices. That prompted AAOS Now to contact several prominent joint replacement specialists to discuss the use of MOM in hip resurfacing and hip replacement and how to address the issue with patients.