AAOS Now, October 2014
-
Does Graft Force Make a Difference in ACL Reconstruction?
Study data presented at the 2014 annual meeting of the American Orthopaedic Society for Sports Medicine indicate that anterior cruciate ligament (ACL) graft-bone tunnel healing is sensitive to changes in graft forces from knee motion. The paper, “The Effect of Dynamic Changes in ACL Graft Force on Soft Tissue ACL Graft-Tunnel Incorporation,” won the 2014 Aircast Award for Basic Science.
-
Newest AUC App Focuses on Supracondylar Humerus Fractures
A newly approved set of Appropriate Use Criteria (AUC) for the management of pediatric supracondylar humerus fractures will help guide orthopaedic surgeons and other physicians in treating patients with these common but potentially complex and serious injuries. The AUC, accessible at www.aaos.org/aucapp, features a Web and mobile app that incorporates algorithms for following an optimal course of treatment, depending on the type and severity of the injury (Fig. 1).
-
DDH Guideline Highlights
The clinical practice guideline (CPG) for “Management of Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip (DDH) in Infants Up to Six Months of Age” helps clarify the criteria for determining which patients should be screened and when (Table 1).
-
Managing Hip Fractures in the Elderly
The ongoing magnitude of hip fracture as a clinical challenge led to the development of a clinical practice guideline (CPG) on the “Management of Hip Fractures in the Elderly.” The resulting document includes 25 recommendations (Table 1), more than any previous CPG. Notably, 8 recommendations are supported by Strong evidence and 15 by Moderate evidence, indicating that relatively compelling research can guide clinical practice in this area (Table 2).
-
Strong Recommendations Support ACL Treatment
The newly approved clinical practice guideline (CPG) on the “Management of Anterior Cruciate Ligament (ACL) Injuries” is remarkable both for the total number of recommendations (20) and the percentage of those recommendations backed by evidence characterized either as Strong or Moderate (Table 1). “Due to the amount of higher-quality research, there is a lot of good information for physicians and patients about best practices for ACL injury,” said Kevin G. Shea, MD, of St.
-
Should Achilles Tendon Rupture Patients Wait to Bear Weight?
Immediate weight bearing following nonsurgical treatment of acute Achilles tendon rupture may offer benefits to patients, according to the results of a Danish study published in the Journal of Bone and Joint Surgery (JBJS) (Sept. 17, 2014).
-
AOFAS Joins Choosing Wisely Campaign
Releases list of 5 common, but often unnecessary, tests, procedures The American Orthopaedic Foot & Ankle Society (AOFAS) has followed the lead of the AAOS and the North American Spine Society to become the third orthopaedic society to join the Choosing Wisely Campaign, an initiative of the American Board of Internal Medicine (ABIM) Foundation designed to advance medical professionalism in clinical practice.
-
Second Look—Clinical News and Views
Radiographs for children Findings from a study published online in Annals of Emergency Medicine suggest that plain anteroposterior (AP) pelvic radiographs may have limited sensitivity for identifying children with pelvic fractures or dislocations after blunt trauma. The prospective, multicenter, observational study of children younger than 18 years with blunt torso trauma involved 12,044 patients in the Pediatric Emergency Care Applied Research Network. Of the 451 (3.