Is Surgical Approach a Risk Factor for Early Failure in THA?

Maureen Leahy

Total hip arthroplasty (THA) is a reliable treatment for reducing pain and improving function in patients with osteoarthritis of the hip. However, the rate of revision THA procedures being performed is on the rise and is expected to continue to increase, according to of OrthoCarolina's Hip & Knee Center. "In order to improve long-term THA survivorship, we need to better understand the etiology and risk factors for early failure in primary total hips," he said.

Am I Safe to Perform Surgery?

Michael R. Marks, MD, MBA

The following case report is true. It is mine. I am sharing it to shed light on an area of patient safety that all physicians and surgeons must consider. If we do indeed learn best from the mistakes others make, I hope this will be a lesson for thousands of surgeons. My surgery As a fellowship-trained spine surgeon, I have great empathy and sympathy for my patients, because I have also sustained disk herniations and radiculopathy.

What are the Benefits of the Perioperative Surgical Home?

Peggy L. Naas, MD, MBA

"Setting [a] goal as cost containment, rather than value improvement, has been devastating to healthcare reform efforts. A focus on value, not just costs, avoids the fallacy of limiting treatments that are discretionary or expensive but truly effective." —Michael Porter, PhD, in "What is the value in health care?

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) The U.S. Food and Drug Administration (FDA) has issued a safety communication restricting the use of codeine and tramadol in children.

After the Error

David Ring, MD, PhD; Robert J. MacArthur, MD

In the January 2017 issue of AAOS Now, my coauthor Robert J. MacArthur, MD, shared a first-person account of how a wrong-side knee procedure could occur in the era of Universal Protocol. I—David Ring, MD, PhD—also have a personal story of medical error. In 2008, I published an account of my wrong procedure—a carpal tunnel release in a patient who should have had a trigger finger release—and later spoke about my error at several meetings across the country.

Safety Program May Help "Turn the Tables on Concussion"

Terry Stanton

A study involving more than 2,500 high school football players in South Carolina found that those on teams that had participated in the USA Football Heads Up safety program had concussion rates 33 percent lower than those on teams that had not. The study was presented at the Game Changers Paper Session at the AAOS Annual Meeting in San Diego by John M. Tokish, MD.

MOC: What's New and What You Need to Know

James Roberson, MD; David F. Martin, MD

The American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification (MOC) and Recertification programs reflect our commitment to both the public trust and to ABOS Diplomates. As a result, the ABOS priorities are to minimize the expense and burden placed on Diplomates, without compromising the rigor of evaluation necessary for public trust. Those priorities have led to several planned and implemented changes.

Using Telemedicine for Orthopaedic Follow-Up

Alfred Atanda Jr, MD

My first experience with using telemedicine for orthopaedic follow-up was in August 2014. I had performed an anterior cruciate ligament reconstruction on a 17-year-old male named Tom, who lived about 90 miles from our hospital. A week later, during a casual conversation with his father, I learned that Tom was doing well recovering at home, but was having trouble adjusting his postoperative brace. Tom's dad asked if I could "FaceTime" with Tom and show him how to adjust it.

Evidence-based Medicine Meets "Urban Legends" of TKA

Peter Pollack

Evidence-based medicine is something we, as orthopaedic surgeons, are forced to examine more closely as we switch to a value-based healthcare system," explained Bryan D. Springer, MD, during an Instructional Course Lecture (ICL) on "The Urban Legends of Total Knee Arthroplasty (TKA)." "The question is: Do we really follow it? Evidence suggests that many of us practice evidence-based medicine less than 50 percent of the time.

Consensus Performance Standards for Hip, Knee, and Shoulder Arthroplasty Devices

Frederick W. Werner, M Eng; Warren O. Haggard, PhD; William M. Mihalko, MD, PhD; Jack E. Lemons, PhD

Orthopaedic surgeons are often barraged with offers to examine and use a variety of modified or new surgical techniques. These techniques often involve new instruments, new implants, or devices that have new materials associated with them. The selection of a specific surgical device, method, or approach is affected by a number of factors, such as the device's suitability for the procedure and whether it is sufficiently strong, compliant, and biocompatible.