Doctor, When Can I Drive?

It may not be your decision For many people, driving a car is a necessity of everyday life. In areas without public transportation (and even in cities with good public transportation), people drive everywhere. So when something happens—whether it’s a flat tire or a fractured tibia—drivers want it fixed quickly so they can get behind the wheel again. As Geoffrey S. Marecek, MD, and Michael F.

What Can We Learn from Large ACLR Registries?

Jennie McKee

“The value of using large anterior cruciate ligament reconstruction (ACLR) registries to evaluate patient outcomes, graft function and survivorship, and complications is increasingly being recognized,” said Scott A. Rodeo, MD, moderator of a symposium on large domestic and international ACLR registries held at the 2014 AAOS Annual Meeting.

Second Look—Clinical News and Views

Synovial fluid biomarkers and PJI Study findings published in Clinical Orthopaedics and Related Research (CORR) online suggest that synovial fluid biomarkers may help diagnose periprosthetic joint infection (PJI). The prospective, diagnostic study included 95 patients who were being evaluated for a revision hip or knee arthroplasty.

Wisdom for the Weekend Warrior

Terry Stanton

The weekend warrior is a well recognized subset of orthopaedic patient. Once mostly seen among male patients, the warrior traits are now increasingly being seen among female patients. Precise definitions vary, but generally, this patient is described as an “aging” (age 30 and older, by some reckoning) individual who continues to exercise and participate in sports avidly but often not systematically or judiciously, often in concentrated bursts of vigor.

Study: Enoxaparin and Rivaroxaban Equally Effective as VTE Prophylaxis

Terry Stanton

A study comparing enoxaparin and rivaroxaban used for routine venous thromboembolism (VTE) prophylaxis after primary total hip and knee arthroplasty (THA/TKA) found no statistically demonstrable difference in VTE rate or major bleeding complications. The study, which was presented during the 2014 AAOS Annual Meeting, was one of the largest non–industry-funded studies comparing the two anticoagulants, according to author Nicholas B. Frisch, MD, MBA, of the Henry Ford Hospital in Detroit.

Conservative Treatment Effective for Most Apophyseal Fractures in Adolescents

Jennie McKee

Small percentage of patients who require surgery also have good outcomes Jennie McKee About 95 percent of adolescents with apophyseal avulsion fractures of the hip and pelvis may be successfully treated with conservative treatment, according to data from a retrospective study involving more than 400 such cases. The study was presented at the 2014 American Orthopaedic Society for Sports Medicine (AOSSM) Specialty Day.

Rethinking Baseball Throwing Rehab

Peter Pollack

“When it comes to bringing baseball players back to the mound after they’ve had throwing injuries, sports medicine professionals generally rely on common practice that has been passed down via coaches and players for decades,” explained Neal S. ElAttrache, MD. “However, the rehabilitation and throwing progression can significantly affect the return-to-play process, so we decided to examine some of these traditional throwing programs and see if they make sense from a scientific standpoint.”

Surgical Management of the Unstable Total Knee Arthroplasty

Matthew A. Popa, MD; Glenn D. Wera, MD; Victor M. Goldberg, MD

Total knee arthroplasty (TKA) is a reliable and successful procedure with survivorship greater than 92 percent at 10 years. Although only a small percentage of primary TKAs require revision surgery, the absolute number of these patients is considerable. Nearly 720,000 primary TKA procedures were performed in the United States in 2010. In 2011, based on data from the HCUP Nationwide Inpatient Sample, 2006-2011, nearly 70,000 TKA revisions procedures were performed.

Is Medicare Reimbursement for Revision TJA Adequate?

Terry Stanton

Under the Medicare physician fee schedule, surgical fees are higher for revision total joint arthroplasty (TJA) than for primary joint arthroplasties, but is the increased reimbursement proportional to the time and effort involved in revision surgery? According to research presented at the 2014 AAOS Annual Meeting, the answer is “no,” and that could be problematic in the future, as numbers of both primary and revision TJAs increase. Presenter Gregory K.

Steps to Improve Surgical Safety and Quality

Maureen Leahy

AAOS has been a leader in the patient safety movement since 1997 when it introduced the “Sign Your Site” surgical safety campaign, which brought national awareness to the issue of wrong-site surgery. In 2004, the AAOS partnered with the Joint Commission (JC) and other medical organizations to develop the Universal Protocol (UP), designed to reduce preventable surgical harm including wrong-site surgery.

Treatment Options for Proximal Humerus Fractures in the Elderly

Maureen Leahy

For more than two generations, orthopaedic surgeons have treated 3-part proximal humerus fractures in the elderly with open reduction and internal fixation (ORIF), and 4-part fractures with hemiarthroplasty (HA), noted Andrew Jawa, MD, of Boston University Medical Center, at a symposium on common fracture treatment held during the 2014 AAOS Annual Meeting. This treatment rationale is based on the conclusions of a landmark article published by Charles Neer, MD, in 1970.