FDA orders postmarket studies on MOM hip implants

Jeanie Kennedy; Katherine Sale

On May 9, 2011, the U.S. Food and Drug Administration (FDA) issued orders for postmarket surveillance studies from several orthopaedic device manufacturers of metal-on-metal (MOM) total hip arthroplasty (THA) implant systems. The agency is seeking information on metal ion concentrations and their effects on long-term outcomes for THA patients. Manufacturers must comply with the FDA order and submit a research plan within 30 days of receiving the FDA letter.

Routine DVT, PE prophylaxis questionable in foot, ankle surgery

Terry Stanton

Routine administration may be unnecessary or even harmful The risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) and the appropriate measures to prevent these conditions continue to be subjects of research and discussion among orthopaedic surgeons. At the American Orthopaedic Foot & Ankle Society (AOFAS) 2011 Specialty Day, several surgeons provided information and perspectives on the issue. Chemical thromboprophylaxis Jamie T.

How pertinent is the “6-hour rule”?

Peter Pollack

Well-accepted rule has a place in open fracture management, but does evidence support it? The so-called “6-hour rule” is a long-accepted guideline for dealing with open fractures. In essence, the rule states that, to prevent infection, open fractures should be fully managed within a 6-hour time frame. But is this rule supported by any evidence, and is it still relevant in an era of modern wound management and antibiotics?

“Zero in on zero” to reduce complications

Mary Ann Porucznik

Orthopaedic surgeon leads way to improving care in joint replacement Three years ago, Mark A. Snyder, MD, an orthopaedic surgeon in Cincinnati, Ohio, was recruited by an academic, private hospital center to help develop a program and achieve Joint Commission certification as a “Center of Excellence” in hip and knee replacement. In doing so, Dr. Snyder became passionate about really achieving excellence—far beyond what federal certification regulations required.

Meetings and Course Listings

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

Bringing the MOM issue into focus

Mary Ann Porucznik

An interview with AAOS Second Vice-President Joshua J. Jacobs, MD AAOS Second Vice-President Joshua J. Jacobs, MD, is no stranger to the issue of biomaterials in hip and knee replacement implants. As chair of the department of orthopaedic surgery at Chicago’s Rush University Medical Center, Dr. Jacobs has conducted extensive research on this topic and has served as a consultant on the development, regulation, and testing of orthopaedic devices. Joshua J.

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. FDA clears MRSA/MSSA identification test The U.S.

When pain is part of the game

Jennie McKee

Aggressive pain management can reduce the risk of permanent CNS changes Fractured bones, torn ligaments, and other injuries—some of which can result in chronic, debilitating pain—are a fact of life for many athletes. Treating the pain that accompanies these injuries can be challenging, Mark A.

Platelet-rich plasma: What’s behind the hype?

Kay Daugherty; Mary Ann Porucznik

Does science support PRP use in acute soft-tissue injuries? Although platelet-rich plasma (PRP) has been used for many years in other medical specialties, it has only recently become popular in orthopaedic applications. Media reports of dramatic “cures” in high-profile athletes have helped fuel interest in PRP, resulting in a voluminous collection of publications.

Does time to surgery matter for type 2 supracondylar humerus fractures?

Mary Ann Porucznik

Study finds no increase in complications for pediatric patients A broken elbow—specifically a supracondylar humerus fracture—is a common pediatric injury. Gartland type II supracondylar humerus fractures are displaced fractures with the posterior cortex intact (Fig. 1).

Tackling orthopaedic controversies

Maureen Leahy

Popular CME course explores “hot topics” in orthopaedics Orthopaedic surgeons from around the country will gather in New York this fall to share in thought-provoking discussions surrounding controversies in treating shoulder and elbow, hand, knee, hip, foot and ankle, and spine disorders. Sponsored by the AAOS, the “Top Orthopaedic Controversies” continuing medical education (CME) course will take place in New York City, on October 15. Laith M.

MRI finds abnormalities in both asymptomatic and injured ankles

Terry Stanton

Study points to importance of clinical assessment A study of lateral ankle ligament abnormalities in persons without symptoms indicates that clinical assessment of ankle instability remains critical to diagnosis, even with widespread use of magnetic resonance imaging (MRI). The study, presented by Nelson Fong SooHoo, MD, at the 2011 American Orthopaedic Foot & Ankle Society Specialty Day, involved both asymptomatic patients and those with chronic lateral instability (CLI).

What’s your Diagnosis?

In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. The images for this month’s challenge were submitted by Timothy Bert, MD, a resident member at the University of Tennessee–Campbell Clinic. The images are of a 58-year-old male with left knee pain. What’s your diagnosis? Do you have a challenging case you’d like to submit for publication? E-mail a short case description and any accompanying images to aaoscomm@aaos.