Younger patients driving increase in TKAs

Peter Pollack

Obesity and population growth can’t account for increase in utilization From 1997 to 2007, the number of total knee arthroplasty (TKA) procedures performed annually in the United States doubled, with much of the increase taking place in younger patients, according to a study presented at the 2011 AAOS Annual Meeting. The rising number of TKA cases has been linked to a growing population and a rising national obesity epidemic.

Lumbar spinal stenosis: The growing epidemic

A. Nick Shamie, MD

Lumbar spinal stenosis (LSS) is a common condition that occurs in the aging spine of individuals beyond their fifth decade of life (Fig. 1). Most patients who undergo surgical intervention for LSS are in their sixth and seventh decades of life. The incidence of LSS in the United States has been estimated at 8 percent to 11 percent of the population. As the “baby boomers” age, an estimated 2.4 million Americans will be affected by LSS by 2021.

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.

Managing radiation complications in orthopaedic oncology

Maureen Leahy

Tips on surgery and fracture management from the MSTS Radiotherapy is a valuable adjunct to surgery in treatment of soft-tissue sarcomas, but the late effects of radiation can be significant (Fig. 1), according to H. Thomas Temple, MD, professor of orthopaedics and pathology at the University of Miami School of Medicine. Speaking at the Musculoskeletal Tumor Society (MSTS) 2011 Specialty Day Program, Dr.

Do you have cacography?

John M. Purvis, MD

It’s not contagious, but it is dangerous Has your office been swamped with phone calls from pharmacists and nurses to clarify a prescription or your hospital orders? Ever added up your golf score wrong or needed help reading your own notes? Then you might have cacography. It’s not contagious, but it can cause damage, and in some states, it’s actually illegal. Thankfully, you’re not alone and the condition is treatable. Cacography is bad handwriting.

Margins in sarcoma: Up for debate

Maureen Leahy

Where do you cut to avoid damage and minimize recurrence? Standard treatment for primary soft-tissue sarcomas involves surgical excision of the tumor with a margin of surrounding tissue (Fig. 1). During resection, the surgeon also seeks to avoid damage to nearby structures, such as bone, nerves, and blood vessels. Unfortunately, no consensus exists as to what constitutes an adequate surgical margin.

Meetings and Course Listings

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

Hip dislocation: Is reduction timing key?

Terry Stanton

How much of a difference timing of reduction makes in the outcome of a hip dislocation remains a subject of debate. Although both the scientific and clinical evidence point to a beneficial effect with earlier surgery, some of the data are not so conclusive, especially with regard to outcomes over time. During a symposium featuring a panel of trauma “Mythbusters” at the 2011 Annual Meeting in San Diego, J. Tracy Watson, MD, chief of the Orthopaedic Trauma Service at St.

Rethinking tendinopathy treatments

Jennie McKee

New treatment strategies—such as using MMP inhibitors—may enhance care “Conventional thinking says that tendinopathy—defined as chronic tendon degeneration—is due to tendon overload, leading to microscopic collagen fiber failure and a failed healing response,” said Scott A. Rodeo, MD, during the 2011 American Orthopaedic Society for Sports Medicine Specialty Day program.

The unique challenges of pediatric ACL tears

Jennie McKee

Preoperative assessment of maturity is crucial to reduce risks Managing anterior cruciate ligament (ACL) tears in pediatric patients presents unique challenges, according to Allen F. Anderson, MD, who participated in the 2011 American Orthopaedic Society for Sports Medicine Specialty Day program.

AAOS sponsors comparative effectiveness research symposium

This month, the AAOS is sponsoring a symposium on comparative effectiveness research (CER). The symposium, which will be held May 19–21 in Washington, D.C.

What’s your Diagnosis?

In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. The image for this month’s challenge was submitted by Timothy Bert, MD, a resident member at the University of Tennessee–Campbell Clinic. The radiograph is of a 70-year-old female with right hip pain. What’s your diagnosis? A. Eosinophilic granuloma B. Fibrous dysplasia C. Chondrosarcoma D. Paget’s disease Did you get it right?

Treatment for pediatric pes planus debated

Maureen Leahy

POSNA examines role of subtalar arthroereisis Pes planus, or flexible flatfoot, is often left untreated in children because most eventually outgrow the condition. In some children, however, the condition persists and may be associated with considerable pain. When conservative treatment fails, surgical intervention, such as subtalar arthroereisis, may be indicated.

PTSD: An underrecognized complication

Maureen Leahy

When left untreated, PTSD leads to poor orthopaedic outcomes Posttraumatic stress disorder (PTSD) is an anxiety disorder that may occur in people who have been exposed to a traumatic event. People with PTSD persistently experience nightmares or flashbacks, emotional numbing, and hyperarousal (eg, insomnia, inability to concentrate); they purposely avoid all stimuli associated with the trauma. Symptoms typically begin to develop within 3 months of the event.

ROM loss after ACLR linked to arthritis

Terry Stanton

Prospective study wins 2011 Best Poster Award at AAOS Annual Meeting The 2011 Best Poster Award went to a prospective study examining the link between the loss of normal knee range of motion (ROM) after anterior cruciate ligament reconstruction (ACLR) and the incidence of arthritic changes observed on radiographs. The authors found that patients who were able to obtain and maintain normal knee motion had a lower incidence of such changes than patients who lost knee motion.