Pros and Cons of Patient-Specific Instrumentation

Mary Ann Porucznik

During the 2014 Specialty Day of The Knee Society and the American Association of Hip and Knee Surgeons (AAHKS), Adolph V. Lombardi Jr., MD, FACS, and Robert L. Barrack, MD, faced off in a debate over the future of patient-specific instrumentation (PSI) in total knee arthroplasty (TKA). PSI systems enable orthopaedic surgeons to template the TKA preoperatively using 3-dimensional imaging. Custom-made and custom-fit jigs are used during the surgery so that the implant can be precisely fitted.

Stem Cell Therapies for Osteoarthritis

Frank B. Kelly, MD; Mary Ann Porucznik

“Almost all of the research on using stem cells in joints is focused on trying to treat focal defects in cartilage,” said Farshid Guilak, PhD, Laszlo Ormandy professor and vice-chair of the departments of orthopaedic surgery, biomedical engineering, and mechanical engineering & materials science at Duke University Medical Center. Speaking at the 2014 AAOS Now Forum on the use of stem cells in orthopaedics, Dr. Guilak compared focal defects to “a pothole in the road.”

Reducing Radiation Exposure for Pediatric Patients, Physicians

Peter Pollack

“Ionizing radiation comes to us from various sources, and a variety of human tissues are sensitive to it,” said Michelle S. Caird, MD, speaking at the 2014 annual meeting of the Pediatric Orthopaedic Society of North America. “In recent years, the use of radioimplant and imaging studies has increased in the United States, both among adults and, alarmingly, in children—especially with computed tomography (CT) scans and an increased use of fluoroscopy in the operating room.” According to Dr.

To Pin or Not to Pin: That Is the Question

Terry Stanton

During the Pediatric Orthopaedic Society of North America Specialty Day, two surgeons took opposite positions on the question of whether or not to treat all supracondylar humerus (SCF) fractures with closed reduction and percutaneous pinning (CRPP). David L.

3-D Printing Helps with Complex Hip Surgery

Pediatric orthopaedists find it helpful for patient education too If the word “printer” calls to mind an ink-stained man and a large wooden press, or even a fancy copy machine, you’re behind the times. Today, printers aren’t limited to ink and paper, or even two-dimensional products. In fact, for more than 30 years, three-dimensional (3-D) printers have been around and able to create custom solid objects.

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 Balaji Govindarajan, MBBS, DOrtho, of Chettinad Health City, India. Dr. Govindarajan writes that he saw a 13-year-old male with a 4-month history of worsening hip pain and stiffness. The patient had no fever, lymphadenopathy, signs of trauma, or constitutional symptoms.

Open vs. Arthroscopic: Which Is Better for Treating Extra-articular Hip Impingement?

Jennie McKee

Jennie McKee Bryan T. Kelly, MD, of the Hospital for Special Surgery (HSS) in New York, and John C. Clohisy, MD, of Washington University in St. Louis, engaged in a point/counterpoint debate during the 2014 Specialty Day of the American Orthopaedic Society for Sports Medicine (AOSSM). They explored factors to consider before choosing an arthroscopic or open approach to treating patients with various forms of extra-articular hip impingement. A role for arthroscopy According to Dr.

Should Angulated Distal Radius Fractures Be Reduced?

Maureen Leahy

Distal radius fractures are common orthopaedic injuries, accounting for about one in six fractures seen in the emergency department (ED). Treatment is based on the type of fracture, and is often tailored to the individual patient’s needs and lifestyle. As a result, there is no general consensus that supports one treatment over another.

Simulation as a Tool to Move the Value Equation

Peter Pollack

“Most of us think of virtual reality when we think of simulation, but it’s important to remember that simpler models like sawbones exercises or even sewing on pig’s feet can be meaningful and impactful,” explained Donald S. Bae, MD, speaking at the annual meeting of the Pediatric Orthopaedic Society of North America (POSNA). “How does simulation add value?” he asked. “With increased volume and improved performance, we can improve our clinical outcomes.

Second Look—Clinical News and Views

Concussion diagnosis rates rising According to findings published online in The American Journal of Sports Medicine, national concussion diagnosis rates for high school sports increased significantly between 2005 and 2012. Based on data from the High School Reporting Information Online sports injury surveillance system, overall concussion diagnosis rates increased significantly from 0.23 per 1,000 athlete-exposures in academic year 2005-2006 to 0.51 per 1,000 exposures during 2011-2012.