Do no harm: Damage control in an acute setting

Peter Pollack

Dealing with open fractures and compartment syndrome Increasingly, the issue of emergency department call has become a hot topic for both orthopaedic surgeons and hospitals. One of the most pressing concerns is whether to treat or to transfer, particularly if the surgeon on call is confronted with a patient whose injuries are on the fringes of the surgeon’s range of experience.

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.

Open repair results in less recurrent instability

Jennie McKee

Study evaluates open, arthroscopic surgical techniques for shoulder repair “Systematic reviews have evaluated whether an arthroscopic or open technique yields better results in patients with recurrent shoulder instability,” said Nicholas G.H. Mohtadi, MD, MSc, FRCSC. “They have shown that an open procedure is less likely to result in recurrent instability; however, this remains a controversial topic.” Dr.

AANA to conduct complications study

Surgeon recruiting now underway “It’s been 25 years since the last comprehensive study on complications associated with arthroscopy,” says Julie A. Dodds, MD, chair of the research committee for the Arthroscopy Association of North America (AANA). “What we want to do is build a prospective data base, identify risk factors, and inform surgeons of the results. The primary goals are patient safety and physician education.” More than 1.

How will MOC measure performance?

Harry N. Herkowitz, MD; David F. Martin, MD; Shepard R. Hurwitz, MD

New tools will help evaluate and enhance quality of care Maintenance of Certification™ (MOC), the American Board of Orthopaedic Surgery’s (ABOS) process for evaluating orthopaedic surgeons with time-limited certificates, is a valuable way to maintain and improve the quality of care orthopaedists provide to patients. As outlined in the recently enacted Patient Protection and Affordable Care Act, physicians who participate in MOC will also be eligible for an added benefit.

Meetings and Course Listings

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

The ASD debate

Terry Stanton

Views vary on adjacent segment degeneration Genetics or biomechanics? It’s a question that can be asked about a number of musculoskeletal disease processes. At the Federation of Spine Associations Specialty Day, the question was applied to adjacent segment degeneration (ASD). Taking the side of “It’s All Biomechanics” was Avinash G. Patwardhan, PhD.

Osteosarcoma in the “growing skeleton”

Jennie McKee

A point/counterpoint on expandable endoprostheses vs. rotationplasty The adage “children are not small adults” is never more relevant than in the surgical treatment of malignant bone tumors. Because osteosarcoma often develops in the distal femur in skeletally immature patients, the growth plate must be removed along with the tumor for local disease control. As a result, significant limb length inequality develops as the uninvolved extremity continues to grow.

When locking plates fail

Maureen Leahy

OTA Specialty Day provides insight into locking plate failures “Things are going to fail, as they always do, through the weak link,” Paul Tornetta III, MD, told attendees at the Orthopaedic Trauma Association’s (OTA) 2010 Specialty Day. During their presentation on locking plate failures, Dr. Tornetta, Mark C. Reilly, MD, and Donald A. Wiss, MD, addressed modes of locking plate failures, techniques for avoiding failures, and how to salvage failures once they occur.

Pearls and pitfalls on fixing hip fractures

Terry Stanton

Symposium addresses strategies for management Hip fractures are a worldwide problem, and their number is expected to grow “exponentially” over the next 50 years, said Kenneth J. Koval, MD, in his opening presentation in a symposium on this injury at the Hip Society’s Specialty Day meeting in New Orleans. Noting that the number of individuals aged 65 or older worldwide will rise from 323 million in 1990 to an estimated 1.6 billion by 2050, Dr.

One set of procedures; 52 years of experience

Peter Pollack

Surgeon offers cautions and tips on lower limb amputation When considering lower limb amputation and management, it is important to retain as much of the lower limb as possible, according to John H. Bowker, MD, who discussed basic principles and a wide range of amputation techniques that he has—using his word—“apprehended” over a 52-year career. Dr. Bowker spoke before the Orthopaedic Rehabilitation Association on Specialty Day at the 2010 AAOS Annual Meeting.

Why does where you live make a difference?

Dartmouth Atlas Project finds variations in joint replacement surgery The number of hip, knee, and shoulder replacement surgeries is rising significantly for Medicare patients, but the rate of increase varies widely among regions of the country, according to a new report from the Dartmouth Atlas Project. The report indicates that rates among regions vary by 10 times for shoulder replacements and by four times for hip and knee replacement surgeries.

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. He provides the following patient information: “The patient is a 14-year-old male who sustained a wrist injury.

Patients put trust in physicians

Terry Stanton

Many believe industry relationships are appropriate A survey of patients who had undergone procedures for instrumented spinal fusion or total joint arthroplasty found that a large majority believe surgeon-industry relationships with regard to implants are beneficial and appropriate. The survey also indicated that most patients believe that their surgeon will choose the best implant for them.

TO covers synthetic bone void fillers

John S. Kirkpatrick, MD

During its March 2010 meeting, the AAOS Board of Directors approved a new technology overview (TO) on synthetic bone void fillers. Kristy L. Weber, MD, chair of the Council on Research, Quality Assessment, and Technology, presented the document, which was developed by a physician workgroup under the direction of the Guidelines & Technology Oversight Committee.