Pearls from Two Decades of Revision ACLR

Jennie McKee

When an anterior cruciate ligament reconstruction (ACLR) needs to be revised, surgeons are faced with numerous challenges, including the following: removing the hardware implanted during the primary ACLR procedure avoiding previously drilled tibial and femoral tunnels selecting the most appropriate graft type for the patient managing patient expectations after revision surgery During his presentation at the 2014 American Orthopaedic Society for Sports Medicine Speci

Second Look—Clinical News and Views

Recurrent lumbar disk herniation Data from a Swedish study published in Clinical Orthopaedics and Related Research (CORR) suggest that repeat surgery for recurrent lumbar disk herniation (LDH) may be efficacious, although with less improvement, compared to primary LDH surgery. Data on 8,497 patients from the Swedish National Spine Register were reviewed; 8,350 patients underwent primary surgery for LDH and 147 underwent reoperation for recurrent LDH within the first year.

Open or MIS: Which Is Better for Lytic Spondylolisthesis?

Peter Pollack

Lytic spondylolithesis typically occurs after a stress fracture has divided the pars interarticularis. These stress fractures, which often occur in late adolescence or early adulthood, disconnect the vertebral body and pedicles anteriorly from the laminae and spinous processes posteriorly (Fig. 1). This disconnection bypasses the hooking mechanism of the facets. Over time, shear stress through the disk and longitudinal ligaments allows spondylolisthesis to occur.

Perfecting the Artificial Arm

Maureen Leahy

Due to wounds sustained during military operations in Iraq and Afghanistan, more than 1,600 American service members have required extremity amputations, 14 percent of which were upper limb. However, current body-operated and myoelectric upper extremity prosthetics lack the sensation, durability, and function that patients desire. AAOS Now: How have upper extremity prosthetics evolved over the years? What is the current state of the technology? Dr.

The Challenge of Atypical Femur Fractures: Identifying Those at Risk

Terry Stanton

While riding a New York City subway, Jennifer P. Schneider, MD, PhD, was jolted and shifted all her weight to one leg. She felt a bone snap, and she fell to the floor. Radiographs revealed a comminuted spiral fracture involving the upper half of the right femur (Fig. 1). At the time, the internal medicine specialist was 59 years old, 5'9" tall, 155 pounds and with no significant medical problems other than osteoarthritis of the knees and thumb.

Don’t Get Burned by Sunshine Data

Register now to gain access to Sunshine Act data Under the “Physician Payments Sunshine Act,” data on payments and gifts made to physicians and teaching hospitals by medical device and pharmaceutical companies must be publicly available on a searchable federal database, starting in September 2014. The Centers for Medicare & Medicaid Services (CMS) is preparing for the release of these data, which have been collected since 2013, under what it is calling the “Open Payments Program.”

MOC Updates: What Orthopaedic Surgeons Need to Know

Shepard R. Hurwitz, MD

The American Board of Orthopaedic Surgery’s (ABOS) Maintenance of Certification (MOC) process first went into effect for those diplomates whose board certification expired in 2010. Although much of the MOC process has remained the same since its inception and will continue to do so, diplomates should make note of the following recent changes to MOC and should be aware that other changes may be on the horizon.

Preventing Hospital Readmissions and Managing Complications

Mary Ann Porucznik

If we want to reduce hospital readmissions and limit complications, we have to know what they are,” said William L. Healy, MD, at the 2014 Specialty Day program of the Hip Society and the American Association of Hip and Knee Surgeons (AAHKS). “Although we all think we know what a complication is and deal with it, there’s very little consensus definition of complications of hip replacement.” Dr. Healy, who is associated with Newton Wellesley Hospital in Newton, Mass.

Treating Clavicle Fractures

Maureen Leahy

Historically, most clavicle fractures have been treated conservatively with a sling. Traditional indications for surgical fixation are open fractures, fractures that tent the skin, brachial plexus injuries, and the floating shoulder, according to Andrew H. Schmidt, MD, professor of orthopaedic surgery at the University of Minnesota, and director of orthopaedic research at Hennepin County Medical Center.

Transparency in Academics: A Pathway to Growth

Evalina L. Burger, MD; Jennifer Bruining-Doner, BA; Robert D. D’Ambrosia, MD

Evalina L. Burger, MD; Jennifer Bruining-Doner, BA; and Robert D. D’Ambrosia, MD Transparency, as generally used, implies openness, communication, and accountability. Driven by the concept of transparency and shared governance, the department of orthopedics at the University of Colorado School of Medicine (CU SOM) has recently gone through a metamorphosis. In the traditional academic CU SOM department, governance is from the top down.