Checklists Put Guidelines Into Practice

Terry Stanton

Michael J. Goldberg, MD But, convinced of the value of guidelines, Dr. Goldberg was determined to find ways to adapt them to orthopaedic practice. To do so, he turned to a simple but increasingly common tool—the checklist. “We’re trying to make guidelines useable, and not just as a doorstop,” he says. Using checklists in surgery is one way to promote safety, prevent errors, and standardize practices.

Meetings and Course Listings

General Through MAR. 5 Wounded in Action Art Exhibition Evans Army Community Hospital and Soldier Family Care Center, Fort Carson, Colo. Website: www.woundedinactionart.org MAR. 6 AAOS Webinar: Part II 2013 Board Certification Preparatory Course directors: Daniel Zelazny, MD; Vineeta T. Swaroop, MD MAR. 14–15 Research Capitol Hill Days Washington, D.C. MAR.

Intraoperative Factors Closely Linked to SSI Rates

Jennie McKee

James S. Harrop, MD “Current literature has demonstrated that measures such as contact-precaution gowns, adhesive incision drapes, and preoperative hair shaving seem to have a limited effect on lowering SSI rates,” wrote lead author James S. Harrop, MD, and his colleagues.

Childhood Obesity: Lessons for the Orthopaedist

Howard R. Epps, MD

The impact of childhood obesity on orthopaedic practices is increasing as this unhealthy epidemic spreads. Traditionally, an orthopaedic surgeon treating an obese child was most concerned about the common associated musculoskeletal disorders such as Blount disease and slipped capital femoral epiphysis (SCFE). But today, orthopaedists must consider other significant health problems as well.

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 Craig Denlinger, MD, a resident at the University of Tennessee–Campbell Clinic, who provided the following information: The patient is a 15-year-old female with a 1-week history of right elbow pain. Her medical history includes a diagnosis of multiple epiphyseal dysplasia.

Sell Those Residency Slots

Joseph Bernstein, MD

Joseph Bernstein, MD When I was a college student, I enjoyed going to New York City’s Shakespeare in the Park at the Delacorte Theatre. If nothing else, the price was right: The tickets were distributed free of charge. When I started medical school, only 4 miles away, I stopped going to Shakespeare in the Park. It wasn’t because I lost interest; it was because I could not afford the free tickets. You see, the “free” tickets were not so free after all.

Crosslinked Liners for THA Reduce Wear and Osteolysis

Peter Pollack

Based on our findings, crosslinked polyethylene liners demonstrate substantially reduced wear and osteolysis compared to non-crosslinked polyethylene,” reported Charles A. Engh Jr, MD, to attendees at the 2011 American Association of Hip and Knee Surgeons annual meeting. Dr. Engh’s paper, “A Prospective, Randomized Study of Crosslinked and Non-crosslinked Polyethylene for Total Hip Arthroplasty at 10-Year Follow-up,” received the Lawrence D.

Epidural Steroid Injections Do Not Improve Outcomes in Lumbar Stenosis Patients

Maureen Leahy

Although epidural steroid injections (ESIs) are a common treatment for lumbar spinal stenosis, data presented at the 2011 annual meeting of the North American Spine Society indicate that long-term outcomes are worse for patients who receive them, compared to those who have never had an ESI. The study also found that patients who had received ESIs and later opted for surgical treatment tended to have a longer hospital stay and longer surgical times than those who did not receive ESIs.

Second Look- Clinical News and Views

Risk factors for ION after spinal fusion A study published in Anesthesiology (January 2012) identifies risk factors for ischemic optic neuropathy (ION), a common cause of perioperative visual loss as a complication of spinal fusion surgery.

Using Simulation, Metrics to Improve Orthopaedic Surgical Skills

Maureen Leahy

New technologies, along with increasing concern over patient safety, are driving changes in surgical education. Nowadays, virtual reality, robotics, and computer simulations are being used to teach a range of surgical techniques, allowing surgeons to practice and refine their skills in a nonclinical environment.