Orthopaedic Surgeon Shares ACL Reconstruction Techniques for Skeletally Immature Patients

Kerri Fitzgerald

Physicians who treat skeletally immature patients with anterior cruciate ligament (ACL) injuries face a variety of management challenges, particularly because many such patients still are growing and return to youth sports may increase the risk of reinjury. Paul M. Saluan, MD, director of pediatric and adolescent sports medicine at the Cleveland Clinic and a member of the AAOS Now Editorial Board, discussed techniques and considerations for this patient population.

Vertebral Augmentation: Should We Be Doing It?

Stuart Hershman, MD, Eeric Truumees, MD

Low bone density has “gone viral.” With an aging population that is living longer, healthcare practitioners have seen a commensurate increase in the diagnosis of osteoporosis, which now affects an estimated 10 million Americans, while an additional 34 million are believed to have osteopenia. Because bone strength is related to density, it is not surprising that low bone mass increases the risk of fragility fractures.

Lumbar Spinal Stenosis Study Associates Surgical Decompression with Improved Low Back Pain

Terry Stanton

A study examining the effect of surgical lumbar decompression on low back pain (LBP) in patients with lumbar spinal stenosis (LSS) found that the surgical intervention significantly improved pain at three months, which was maintained 12 and 24 months after surgery in most patients.

Study: Higher Cost of IV Acetaminophen Balanced by Reduction in Opioid Usage and Other Indirect Costs

Terry Stanton

Intravenous (IV) acetaminophen has been demonstrated to be safe and effective, but because of its comparatively high cost, it is prescribed far less to patients after spine surgery than oral (PO) formulations.* During a Best Paper session at the North American Spine Society Annual Meeting, researchers reported that IV acetaminophen may be a better value for use in circumferential lumbar spine surgery due to the reduction in indirect costs and avoidance of potential opioid dependence.

Second Look—Clinical

Nerve injury after hip arthroscopy—A prospective study published in the Journal of the AAOS (Nov. 1) found that the rate of nerve injury after hip arthroplasty may be higher than previously reported, but resolution rates are similar to prior studies. The study included 100 patients (mean age, 29 years; mean body mass index [BMI], 25 kg/m2) undergoing hip arthroscopy requiring traction.

Not Your Average Cast

Kerri Fitzgerald

Ahmed Bazzi, DO, a pediatric orthopaedic surgeon at Children’s Hospital of Michigan in Detroit, is locally known for the artwork he adds to patients’ casts postoperatively. About eight years ago, Dr. Bazzi began surprising postoperative patients with a decorated cast, and it all stemmed from a young patient named Michael who was anxious about having a significant forearm deformity from acute fractures after a fall. Dr. Bazzi noticed the patient had Elmo pajamas, slippers, and a blanket.

Antimicrobial Stewardship in Orthopaedics

Angie Fouts, PharmD; Patrick Maher, MD

Antimicrobial resistance (AMR) is responsible for two million infections and 23,000 deaths annually in the United States alone. Globally, more than 700,000 people die each year of antibiotic-resistant infections. By the year 2050, AMR infections are predicted to be a larger killer than cancer and heart disease. The primary drivers for resistance are overuse and inappropriate use of antimicrobials. As much as half of all antibiotic use may be misuse.