AAOS Now, December 2013
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Outcomes and Opioid Use After Cervical Spine Surgery
“There has been increased attention for healthcare providers to try to relieve pain,” said Marjorie Wang, MD, MPH. “As a result, opioid prescribing has escalated, even in the face of limited evidence for long-term efficacy.” Dr.
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Study: Bracing Really Works for Scoliosis
Bracing has been prescribed for scoliosis since the 1940s, but the actual benefits of wearing a brace were frequently called into question by concerns about compliance and time. Now those doubts have been put largely to rest by the BrAIST (Bracing in Adolescents with Idiopathic Scoliosis Trial) study, a prospective randomized clinical trial. According to results published in The New England Journal of Medicine (Oct.
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Second Look—Clinical
Sentinel Event Alert on retained foreign objects The Joint Commission (TJC) has issued a Sentinel Event Alert on the unintended retention of foreign objects (URFOs).
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Face Off: Robotic Knee Surgery
POINT: Robotic knee surgery is the wave of the future. William M. Mihalko, MD, PhD The use of robotic technology is increasing in many aspects of manufacturing and in our everyday lives. We now have robotic technology to clean our floors and aid in the construction of many everyday devices—from smartphones to automobiles. However, like many other technological advances, robotic technology is infiltrating the field of medicine, particularly orthopaedic surgery, at a slower rate.
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Introducing the AAOS Now ePub
AAOS Now magazine is now available through the AAOS OrthoPortal for electronic devices and e-readers capable of reading files in ePub format. These include iOS devices such as the iPhone and iPad, most Android devices, and desktop computers. Unfortunately, Amazon Kindle does not read ePub format. To download and view the electronic version of AAOS Now, visit www.orthoportal.org/aaosnow/ and log in using your AAOS username and password. Instructions for most devices are provided on the site.
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How Are Back Pain, Obesity, and Exercise Connected?
Americans who are extremely obese have a four-fold increased risk of back pain, yet adding just 20 minutes of light exercise each day can lower that risk by a surprising 32 percent, according to an award-winning study presented at the North American Spine Society (NASS) 2013 annual meeting. The study, “Does Physical Activity Influence the Relationship Between Low Back Pain and Obesity?” was recognized as the “Outstanding Paper” on medical and interventional science by The Spine Journal.
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Reminder: Upcoming MOC Deadlines
Important deadlines are approaching for the American Board of Orthopaedic Surgery’s (ABOS) Maintenance of Certification (MOC) program. In particular, diplomates whose certification expires in 2015, 2016, 2017, 2018, 2019, or 2020 should be aware that they may face important deadlines this month, including deadlines for the submission of continuing medical education credits to the ABOS. Need assistance?
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Outcomes Trend Down for Extremely Obese Patients
“Extreme obesity is a unique, separate population among patients with higher body mass index (BMI),” said Mohammed A. Khaleel, MD, speaking at the 2013 annual meeting of the North American Spine Society. “Such patients have a BMI greater than or equal to 35. It’s the fastest growing group within the obese population, and the condition is associated with greater disability and healthcare expenditures.” Dr.
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NASS Joins Choosing Wisely® Campaign
The North American Spine Society (NASS) announced its participation in the Choosing Wisely® campaign during its 2013 annual meeting and released a list of five specific tests and treatments that are commonly ordered but may not always be necessary in spine care. Choosing Wisely is an initiative of the ABIM Foundation, to support and engage physicians in being better stewards of finite health care resources.
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What's Your Diagnosis?
In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. This month’s challenge was submitted by David M. Waespe, MD, orthopaedic chief resident at the University of Mississippi Medical Center. Dr. Waespe writes that an 18-year-old female patient was seen for left lower extremity pain and difficulty with ambulation.
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Navigating Exceptions to the “MOC Rules”
The American Board of Orthopaedic Surgery’s (ABOS) Maintenance of Certification (MOC) program is meant to be a linear process, with diplomates meeting various requirements throughout recurring 10-year cycles (Table 1). (See “MOC’s 10-Year Cycles,” below.) And yet, it is quite possible that two diplomates whose board certification expires in the same year may have different MOC-related deadlines and may take their recertification examinations in different years, depending on several factors.
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Operation Walk USA 2013 Expands its Reach
Total hip and knee replacement surgeries have improved the lives and mobility of millions of patients afflicted with disabling arthritis and other debilitating bone and joint conditions. Unfortunately, relief remains elusive for many underserved Americans. Now in its third year, Operation Walk USA will again make a difference in the lives of patients who otherwise could not afford such care.
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Helping Addicted Physicians Recover
Relapse rates for alcoholics and other addicts who attempt to abstain are discouragingly high; in the general population, 40 percent to 60 percent or more relapse within a year, even among those who participated in 12-step programs. For physicians, however, the toll of addiction and the challenges of recovery are intensified. Doctors with substance use disorders face dire professional consequences if their condition and associated behavior lead to discipline by state or professional boards.