Study questions ED transfers

Maureen Leahy

Finds half of orthopaedic ED transfers inappropriate More than half of the patients transferred from surrounding hospitals to a Level I trauma center could have been treated locally, and nearly 60 percent of the patients transferred were uninsured, said Nikhil A. Thakur, MD, who presented the results of a study on the issue at the 2010 AAOS Annual Meeting.

Study points to savings with infection-screening program before TJR

Terry Stanton

Reduction in infections offsets screening costs The high cost of revision joint arthroplasty can make it worth an institution’s effort to implement an infection-screening program, even if the program results in only a modest reduction in surgical site infections, according to a paper presented by James D. Slover, MD, at the 2010 Annual Meeting. Dr.

Outcomes assessments affected by addition of clinical notes

Jennie McKee

Adding clinical notes to radiographs increases the consistency of clinical study In clinical practice, orthopaedists commonly use radiographs and clinical notes to determine whether a fracture has healed. But in orthopaedic trials, outcomes assessors often only use plain radiographs to evaluate the extent of healing.

What difference does gender make?

Mary Ann Porucznik

Study finds no difference between gender-specific and standard femoral implants No one denies that men and women are built differently. Anatomic and musculoskeletal differences are easily identifiable. But when it comes to total knee arthroplasty (TKA), a “gender-specific” design has no better or worse outcomes than a conventional design, according to the results of a Korean study presented at the 2010 AAOS Annual Meeting. The study involved 30 female patients (average age 69.

Using cells to heal cartilage defects

Jennie McKee

Chondrocyte implantation may be better than microfracture Many orthopaedists consider microfracture the “first-line” strategy for treating articular cartilage defects of the knee (Fig. 1). The procedure—in which tiny fractures are made in the subchondral bone to stimulate new cartilage growth—is cost-effective and minimally invasive. According to Karl Fredrik Almqvist, MD, PhD, characterized chondrocyte implantation (CCI) may be a better option.

Tackling patellar dislocation in young athletes

Jennie McKee

Pearls and pitfalls for treating first-time and recurrent dislocations What’s the most effective strategy for treating a young gymnast with a first-time patellar dislocation? How about a varsity soccer player with recurrent dislocations—what’s the best way to get him back in the game? Donald C. Fithian, MD, addressed these questions and more during a symposium on treating patellofemoral instability in young athletes.

Call for answers: 2009 OITE

The 2009 Orthopaedic In-Training Examination (OITE) now comes in a new DVD-ROM format that enhances your testing experience. The OITE offers a unique experience for practicing surgeons who want to access the latest information in 12 content areas, earn continuing medical education (CME) credits, or prepare for recertification. CME credits will be awarded immediately upon receipt of your responses.

Tips to increase the quality of grant applications

Do you want to improve your program’s chances of being awarded a fellowship or residency funding grant? The following suggestions—provided by Rhonda Taira, director of grants management for the OMeGA Medical Grants Association—should help: Start early so you have time to collect the information you need to complete the application, proofread it, and ask for help in case you encounter problems.

Don’t miss the May 1 MOC deadline

Does your board certification expire in 2011, 2012, or 2013? If so, you may be planning to take the American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification™ (MOC) examination in 2011. To do so, you must submit an examination application and application fee online via www.abos.org by May 1, 2010.

MOC exam to include imaging

Terry Stanton

By Terry Stanton ABOS to add imaging component to certification exams In an initiative that parallels the decision by the Centers for Medicare and Medicaid Services (CMS) to require accreditation of advanced imaging facilities, the American Board of Orthopaedic Surgery (ABOS) is adding a content domain comprising basic and advanced musculoskeletal imaging to its examinations. The new component will appear in the 2010 certifying exam and in the 2011 recertifying exam.

What’s your Diagnosis?

In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. Next month, we’ll publish the responses we receive. The images for this month’s challenge were submitted by Stephen A. Albanese, MD, and E. Mark Levinsohn, MD. They provide 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.

PRP effective in treating chronic Achilles tendinosis

Maureen Leahy

Clinical success achieved in 93 percent of study patients Study data presented at the 2010 Annual Meeting demonstrated that local platelet-rich plasma (PRP) is a safe and effective treatment for patients with chronic Achilles tendinosis who have been unsuccessfully treated with traditional, nonsurgical techniques.

Meetings and Course Listings

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

Classic approach to SCFE may fall short

Peter Pollack

20-year follow-up finds FAI and poor hip scores common after in situ pinning Slipped capital femoral epiphysis (SCFE) is often treated using in situ fixation with no attempt to reduce the slip.

Large-diameter metal-on-metal THAs may have high revision rates

Terry Stanton

Is metal allergy to blame for pseudotumor? Large-diameter head, metal-on-metal devices for total hip arthroplasty (THA) have gained favor for providing greater range of motion and lower rates of dislocation, but their use may incur an unacceptably high rate of early revisions, according to a study conducted in Belgium and presented by Patrick Deprez, MD, at the 2010 Annual Meeting. 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.

Arthroscopic cuff repair remains problematic

Addition of platelet-rich fibrin matrix doesn’t improve clinical results In a prospective, randomized study, the addition of platelet-rich fibrin matrix (PRFM) during arthroscopic repair of the rotator cuff did not significantly improve perioperative morbidity or clinical results, according to a paper presented at the 2010 AAOS Annual Meeting.

In Memoriam

Keisha M. DePass, MD Jan. 19, 2010 Mount Airy, Md. David S. Burton, MD Nov. 19, 2009 Atherton, Calif. Ronald C. Rudy, MD Jan. 30, 2010 Madison, Wis. Robert E. Carroll, MD Aug. 16, 2009 New York City

Is there a better way to correct the varus knee?

Jennie McKee

Retrotubercle osteotomy may have more favorable results than conventional surgery According to Seyed Morteza Kazemi, MD, medial opening wedge osteotomy (MOWO) is a “fast, easy, and precise” method for treating the varus knee, but it does have disadvantages. The surgery can cause changes in posterior tibial slope and the height of the patellar tendon, and can lead to patella baja as well as malunion or nonunion.

Symposium to focus on healthcare disparities

Erin Ransford

The AAOS, the Orthopaedic Research Society (ORS), and the Association of Bone and Joint Surgeons (ABJS) are hosting the first ever research symposium to focus exclusively on disparities in musculoskeletal health care. The AAOS/ORS/ABJS Musculoskeletal Healthcare Disparities Research Symposium (MHD) will take place May 6–7, 2010, in Alexandria, Virginia.