Study Finds Objective Test for Preoperative Pain Predicts Postoperative Opioid Use

A study that used an objective method to measure preoperative pain threshold (PPT) demonstrated that total joint arthroplasty patients with higher preoperative pain tolerance required less narcotic medication after surgery. The study also revealed that one-fifth of the patients received opioid prescriptions from physicians other than their orthopaedic providers in the postoperative period.

Quality Initiative Results in Practice Changes, Cost Savings

A quality improvement project aimed at increasing the use of removable braces instead of casting to treat distal radius buckle fractures (DRBFs) at two pediatric centers changed minds and resulted in significant savings, according to a report presented at the 2017 annual meeting of the American Society for Surgery of the Hand.

Board Approves Performance Measures for Carpal Tunnel Syndrome, Appropriate Use Criteria for Hip OA

Terry Stanton

During its December 2017 meeting, the AAOS Board of Directors approved the release of two quality-focused products that will provide orthopaedic surgeons with additional evidence-based resources for clinical decision making. The new performance measures for carpal tunnel syndrome are the first set of performance measures that are based on a previously published AAOS Clinical Practice Guideline (CPG). The measures, to be submitted to the U.S.

Making the Case for Collecting PROMs

Alyssa DelPrete

In a recent American Alliance of Orthopaedic Executives (AAOE) survey, only 35 percent of the participating practices are collecting patient-reported outcomes measures (PROMs). However, most practices indicated they are collecting patient satisfaction surveys (61 percent) and identified quality measures (71 percent) (Fig. 1). Orthopaedic practice executives, particularly those from small practices, may not be shocked by these figures.

AAOS Develops 'Impactful Statements'for Carpal Tunnel Syndrome

Julie Balch Samora, MD, PhD

The AAOS 2016 Management of Carpal Tunnel Syndrome (CTS) evidence-based clinical practice guideline (CPG) has been endorsed by the American Society for Surgery of the Hand (ASSH), the American College of Radiology, and the American College of Surgeons. From this guideline, members of the Evidence-Based Quality and Value Committee, with input from the CPG work group chairs, have developed four “impactful statements.”

Will Biologic Treatments for Cartilage Restoration Become the Standard of Care?

Rivka C. Ihejirika, MD

Prevention of degenerative joint disease and the restoration of articular cartilage through minimally invasive means is a major focus of basic science and orthopaedic sports research. That research has led to advances in technology that enable the long-term storage of cartilage and the replication of “chondroinductive” cells, resulting in cartilage restoration procedures that may potentially set a new standard of care in orthopaedic clinical practice.

Orthopaedic Surgeons Play Key Role in Device Recalls

Patrick Maher, MD; Chatón T. Turner, Esq.; Kenneth L. Urish, MD, PhD; the AAOS Biomedical Engineering Committee

Orthopaedic surgeons are in a unique position to discover possible issues with orthopaedic devices. Accordingly, the surgeon’s role in ensuring the quality of those devices cannot be overstated. This responsibility requires surgeons to report device failures to the U.S. Food and Drug Administration (FDA) and to understand the hospital’s role in reporting as well. Recent innovations in arthroplasty have resulted in many positive advances for patients.

The Biology of Fracture Healing

Jay D. Lenn

A number of factors influence the risk of delayed union or nonunion after fracture treatment, including the fracture site, severity of injury, patient age, nutrition, tobacco use, and diabetes. Delays or failures to heal result in more intensive medical care, a decline in quality of life, and increased expenses. To improve outcomes in these difficult cases, investigators have been exploring means to identify and alter biologic barriers to healing.

Plan to Attend the AAOS Biologics Research Symposium

The AAOS Optimizing Clinical Use of Biologics in Orthopaedic Surgery research symposium will take place Feb. 15–17, 2018, at Stanford University. Chaired by Constance Chu, MD, and co-chaired by William J. Maloney, MD; Jeremy Mao, DDS, PhD; Scott Rodeo, MD; and Rocky Tuan, PhD, the purpose of the collaborative and interactive meeting is to develop a collective impact agenda to promote informed regulation and funding of new pathways for the clinical evaluation of biologics.