Taking on the biceps tendon

Terry Stanton

An expert roundtable moderated by Jeffrey S. Abrams, MD The biceps continues to be a “pain generator” for many shoulders, and a variety of techniques are used to address anterior shoulder pain that is often combined with other pathology. Jeffrey S. Abrams, MD, asked a group of international experts—including Richard K. N. Ryu, MD; Nikhil N. Verma, MD; and Gilles Walch, MD—how they would evaluate and treat patients with ailments that are commonly seen in an orthopaedic practice.

UK alert prompts new scrutiny of MOM hips

Terry Stanton

In April, the United Kingdom’s Medicines and Healthcare Products Regulatory Agency (MHRA) issued a Medical Device Alert on metal-on-metal (MOM) hip devices. The alert does not impose any restrictions on MOM device use, but notes reports of revisions of MOM total hip replacement or resurfacing procedures involving soft-tissue reactions or pseudotumors.

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.

Meetings and Course Listings

Listed below are upcoming continuing medical education (CME) courses and orthopaedic meetings (July through mid-November). 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.

Arthroscopic hip surgery helpful for athletes

Jennie McKee

Arthroscopy useful in treating FAI, labral tears Femoroacetabular impingement (FAI), labral tears, and other hip disorders are not new conditions in athletes, but orthopaedists’ ability to diagnose and treat them continues to evolve, said J.W. Thomas Byrd, MD, during a session at the American Orthopaedic Society for Sports Medicine’s 2010 Specialty Day. “In the past, many of these athletes fell off our radar screen,” he said. “Many of these disorders went unrecognized and untreated.

Do no harm: Damage control in an acute setting

Peter Pollack

Dealing with unstable pelvic fractures and mangled extremities Thus far in 2010, earthquakes in Haiti, Chile, China, and Mexico (Baja California) have exposed many volunteer orthopaedists to conditions and situations not frequently seen in a private practice. Some of these injuries, however, are similar to those incurred in combat, and military orthopaedists have developed guidelines that can help the general orthopaedist make quality decisions when confronted with unusual trauma.

Gearing up for the coming fragility fracture “epidemic”

Jennie McKee

Symposium explores fragility fracture management and prevention strategies Fragility fractures—low-energy fractures sustained from a fall from standing—are a major problem among our nation’s elderly population. These potentially life-threatening injuries will become even more prevalent in the future, according to Samir Mehta, MD. “At least 1.5 million people need medical care for fragility fractures annually,” said Dr.

Improving outcomes after primary TKA

Mary Ann Porucznik

Current options include implant design, materials, surgical technique Primary total knee arthroplasty (TKA) is quite successful in relieving pain and improving mobility; the National Institutes of Health says that about 85 percent of patients report being satisfied with the results.

Why some hips squeak

Maureen Leahy

In recent years, incidents of squeaking have been reported in patients with total hip arthroplasties (THA) using hard-on-hard (metal-on-metal or ceramic-on-ceramic) bearings. Although the phenomenon is not fully understood, the reasons for squeaking include implant-, patient-, and surgery-related factors. “A Review of Squeaking Hips,” in the June issue of the Journal of the AAOS (JAAOS), explores the factors that contribute to squeaking and the implications for patients.

Tailoring telemedicine to deliver optimum orthopaedic care

Maureen Leahy

U.S. military teleorthopaedic program utilizes VTC, specially trained PAs Technology could soon change the way U.S. soldiers stationed in Bavaria, Germany, receive orthopaedic care. Based on the success of a telemedicine pilot project, injured soldiers could be assessed locally under the watchful eye of an orthopaedic surgeon stationed hundreds of miles away.

Raising a red flag on intra-articular injections

Mary Ann Porucznik

An interview with Constance R. Chu, MD Pain management, particularly after orthopaedic surgery, continues to be an issue for both surgeons and patients. Recent events—including the proliferation of lawsuits following the use of continuous infusion pain pumps after shoulder surgery—have called into question certain pain management practices. Constance R. Chu, MD, has been studying the effects of local anesthetics on articular chondrocytes for several years.

New options for healing torn ACLs

Terry Stanton

Research continues into possible use of PRP, tissue engineering Surgical repair of anterior cruciate ligament (ACL) tears has a high rate of poor outcomes and failures—with a nonunion rate of 90 percent. For this reason, ACL reconstruction, using a patellar tendon or hamstring graft, is the standard treatment. But why is the ACL such a poor healer? Certain other ligaments, including the medial collateral ligament (MCL), heal uneventfully without surgery.

New TO examines CDA vs. ACDF

Michael R. Zindrick, MD; Fareeha Shuttari-Khan, MPH

Since its introduction in the United States in 2003, the artificial cervical vertebral disk has presented physicians and patients with the prospect of achieving relief of radicular arm and neck pain, while at the same time maintaining spine segmental motion and thus eliminating adjacent segment degeneration.