Hip Fractures: Integrating the AAOS CPG and AUC into a Clinical Care Map

Britton Wells, MD; Carolann Stanek, RN; Jessica Burlile; Kevin G. Shea, MD

Hip fractures in the elderly are life-altering orthopaedic events that are often associated with significant morbidity as well as loss of mobility and independence.

Researchers Seek to Determine the 'Critical Portions' of Surgical Procedures

Peter Pollack

In 2016, the American College of Surgeons (ACS) released a statement of principles that, among other things, addresses potential surgical scenarios in which the primary attending surgeon may have completed "key or critical" elements of an operation, allowing another qualified practitioner to complete noncritical components.

Preoperative Counseling May Reduce Opioid Use

Peter Pollack

"Although the United States represents less than 5 percent of the world's population, it consumes about 80 percent of all the world's opioid production," said Asif Ilyas, MD, FACS. "And when surveyed, 80 percent of heroin users said they started abuse with prescription opioids, then turned to heroin because it was cheaper and easier to get." Dr.

Continued Development of Virtual Care Could Improve Musculoskeletal Health

Karl Koenig, MD; David Ring, MD, PhD; Andrea Leyton-Mange, BA

Virtual care and other technologies (such as clinician-to-clinician electronic consults, self-care apps and websites, and bio- and behavioral feedback devices such as activity trackers) will enhance the variety and quality of tools and connections that we, as orthopaedic surgeons, can use to help people seeking better musculoskeletal health.

Second Look – Clinical News and Views

These items originally appeared in AAOS Headline News Now, a thrice-weekly enewsletter that keeps AAOS members up to date on clinical, socioeconomic, and political issues, with links to more detailed information. Subscribe at www.aaos.org/news/news.asp (member login required). Perioperative morbidity—Data published in JAMA Surgery (online) suggest that frailty may be independently associated with perioperative morbidity in patients undergoing common ambulatory general surgery.

Orthobiologic Interventions Impact Bone Healing

J. Tracy Watson, MD

Orthobiologic interventions have been specifically designed to target the various stages of fracture repair. This article reviews each broad category of intervention in terms of the desired effect these materials have on specific stages of bone healing and incorporation. For bone augmentation, the gold standard is autologous iliac crest bone graft. Fresh cancellous autograft provides the quickest and most reliable type of bone graft.

Surgeons Use Additional Strategies to Improve the Value of Hip Fracture Care

Tiffany C. Liu, BA; Tanmaya Sambare, BA; Aakash Keswani, BA; Kevin J. Bozic, MD, MBA; Karl M. Koenig, MD, MS

As providers and health systems increasingly emphasize outcomes improvement and cost stewardship, care redesign efforts in elective total joint arthroplasty (TJA) have garnered attention for their impact on value. However, due to its emergent nature and degree of variation, redesign of the geriatric hip fracture care segment represents a unique challenge. Success in delivering high-value hip fracture care will require different competencies and care delivery processes than elective TJA.

Why Are We Ignoring Calcitonin?

Christopher M. Bono, MD

Osteoporotic vertebral compression fractures can hurt—a lot—in a population of patients that does not easily tolerate the usual cocktails of narcotics and nonsteroidal anti-inflammatory medications. Yet, orthopaedic surgeons have largely ignored an effective agent that has been specifically shown to decrease spine–fracture-related pain.