MoM, Healthcare Decision Are Top Issues of 2012

S. Terry Canale, MD

Orthopaedics made news in 2012—some good, some not-so-good. A recent survey of the AAOS Now editorial board found that two continuing controversies—metal-on-metal (MoM) total hip implants and the U.S. Supreme Court decision upholding President Obama’s healthcare reform legislation—were far-and-away the most interesting and impactful stories of 2012. And, like the polls leading up to the national presidential election, these two issues were neck-and-neck as the votes came in.

MOC Myths—BUSTED!

In this feature, AAOS Now explores common misconceptions about the American Board of Orthopaedic Surgery’s (ABOS) Maintenance of Certification (MOC) process. MYTH: The AAOS Learning Portfolio only manages continuing medical education (CME) credits earned through the Academy. FACT: The Learning Portfolio, an AAOS member benefit, enables you to track CME credits applicable to MOC (including credits from scored and recorded self-assessment examinations [SAE]).

Orthopaedic Trivia Quiz

AAOS Now tests your knowledge of orthopaedic trivia. Take a minute and see how well you know your orthopaedic trivia—but don’t peek at the answers! An expanded explanation of the correct answers can be found below. 1. Who would you pick for your basketball team, an individual with Morquio syndrome or Marfan syndrome? Morquio syndrome Marfan syndrome 2. In what part of the body are the gemelli muscles located?

Hip Fractures Require Different Approaches

Peter Pollack

Speaking at the annual meeting of the Clinical Orthopaedic Society, Michael D. Stover, MD, addressed various types of hip fractures and approaches to treatment in patients ranging in age from pediatric to elderly. “For femoral neck fractures in the young,” he said, “open reduction internal fixation (ORIF) is the treatment of choice. Closed reduction rarely results in anatomical alignment, so the threshold for open reduction should be very low.

Best Treatment for Lateral Epicondylitis Remains a Matter of Debate

Terry Stanton

Lateral epicondylitis—also known as tennis elbow—is “one of the most difficult problems in our practices,” said Jennifer Moriatis Wolf, MD, of the University of Connecticut, leading off a roundtable on the subject at the annual meeting of the American Society for Surgery of the Hand. Lateral epicondylitis affects about 2 percent of the population, most often in the fourth and fifth decades, explained Graham J. W. King, MD, FRCSC, of the University of Western Ontario.

Surgery versus Sling for AC Joint Dislocations

Maureen Leahy

Data presented at the 2012 annual meeting of the Orthopaedic Trauma Association indicate that surgical repair with hook plate fixation is not superior to nonsurgical treatment for acute dislocation of the acromioclavicular (AC) joint (Fig. 1). The study also found no clear evidence that hook plate fixation improves short-term outcomes for complete AC joint dislocations. Although the current literature suggests no advantage to surgical intervention, according to presenter Michael D.

The Impact of Concussion Legislation

Protecting youth sport participants by regulating treatment During the past few years, orthopaedic surgeons around the country who cover scholastic and club athletic teams have learned that their state legislatures have passed laws mandating that every child who sustains a concussion must be cleared by a qualified health professional before returning to sports.

Rotation Is Key to Treating Both-Bone Pediatric Forearm Fractures

Peter Pollack

“Forearm fractures account for almost 4 percent of all pediatric fractures and almost a third of pediatric upper extremity fractures,” said Christine B. Caltoum, MD, speaking at the 2012 annual meeting of the Clinical Orthopaedic Society. “When you take into account wrist and diaphyseal fractures, they’re the third most common pediatric fracture.” The most common mechanism of injury, she noted, is falling onto the outstretched arm, which leads to rotational displacement.

Operation Walk USA 2012: Strength Is in Numbers

Although approximately 750,000 total hip and total knee arthroplasties are performed in the United States each year, many Americans continue to live with severe arthritic pain and impaired function because they cannot afford the surgery. Although among the most cost-effective procedures, hip and knee replacements are usually out of reach for those who are poor, economically disadvantaged, or without health insurance.

Face Off: ACL Return to Play

POINT: ACL-injured Players Need Time to Heal Edward M.

Second Look-Clinical News and Views

Study: Impact of smoking on spine outcomes A study in the Oct. 1 Spine analyzes the treatment effect (TE) among patients treated surgically and nonsurgically for spinal stenosis (SpS). The review of data on 654 patients (419 treated surgically) participating in the Spine Patient Outcomes Research Trial used 53 baseline variables to define subgroups for calculating the time-weighted average TE for the Oswestry Disability Index (ODI) over 4 years.

MOC Deadline Reminder

The American Board of Orthopaedic Surgery (ABOS) has extended deadlines for AAOS fellows whose certification expires in 2014 and who plan to take the ABOS Maintenance of Certification (MOC) examination in 2014. The deadline for submitting 120 AMA PRA Category 1 CME Credits™, previously due by Dec. 15, 2012, is now May 1, 2013. Fellows taking the computer examination pathway must also submit a 3-month surgical case list, or a maximum of 75 consecutive cases, by May 1, 2013 (previously Dec.