AAOS Now, May 2019
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Interpreting Vitamin D Controversies Continue to Pose Challenges
Vitamin D has come under public scrutiny in recent years, as articles and studies have explored conflicts of interest (COI) in vitamin D research and questioned the efficacy of the hormone’s use as a supplement. Consequently, those revelations may detract from an important topic in orthopaedics. Here, we attempt to interpret the latest controversies surrounding vitamin D. Fat-soluble vitamin D plays a crucial role in calcium metabolism and bone homeostasis.
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Key Informant Panels Allow for More Content Experts on AAOS CPGs
Throughout the history of the AAOS clinical practice guideline (CPG) program, the Academy has received consistent feedback that guidelines need clinical experts, but clinical experts often have conflicts of interest (COI). The Committee on Evidence-based Quality and Value (EBQV) has long agreed with this statement but is charged with balancing the state of medicine with the rigorous methods of the CPG program.
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AAOS Registry Analytics Institute Now Accepting Applications for Registry Science
The AAOS Registry Program collects data within multiple orthopaedic anatomic registries, thereby creating the exciting potential for analytic insights that improve patient outcomes. In February, AAOS launched the AAOS Registry Analytics Institute, bringing that potential closer to reality for many clinicians. The Institute provides clinicians and clinician-scientists the opportunity to submit proposals for analytic insights that are contained within the registries of the AAOS Registry Program.
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Kaiser Permanente Northern California Leverages AAOS CPG to Improve Pathways for Possible Knee Replacement and Its Alternatives
AAOS’ clinical practice guideline (CPG) program has been continually refined since the first evidence-based guidelines were published in 2007. The CPG for knee osteoarthritis (OA) was first published in 2008 and updated in 2013. The third iteration of the guideline is currently underway, with publication expected in early 2020. The guidelines are available for use by orthopaedic surgeons around the world.
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Redesigned Clinical Quality and Value Website Links Related Content to Improve Reader Experience
Do you find that searching for specific information on a website can be like looking for the needle in the haystack? The AAOS Department of Clinical Quality and Value (CQV) felt that way about its own website. The department fully understood members’ frustrations when they searched for useful information, so the staff made plans for change. The CQV started the project with big ideas.
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Inpatient Opioid Use Should Guide Discharge Prescribing in Surgery Patients
A retrospective review found that inpatient opioid use may be an effective guide for safe and effective opioid prescribing when orthopaedic surgery patients are discharged. The approach could help limit overprescribing and decrease early postoperative habituation, tolerance, and refill needs. Trevor Grace, MD, an orthopaedic surgery resident at the University of California, San Francisco, presented the study during the AAOS 2019 Annual Meeting.
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Study Finds Advantage with Dual-screw Nails for Subtrochanteric Fractures
A study comparing single-screw cephalomedullary nails (CMNs) and dual-screw reconstruction nails (RNs) in the treatment of subtrochanteric fractures found a significantly higher reoperation rate in patients treated with CMNs versus RNs. The retrospective cohort study was presented at the AAOS 2019 Annual Meeting by Austin Heare, MD, of Regions Hospital, St. Paul, Minn.
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Little Benefit for Akin Osteotomy in Hallux Valgus Surgery Beyond the Cosmetic
A study presented at the AAOS Annual Meeting looking to gauge the added value of Akin osteotomy in hallux valgus corrective surgery has found no benefit to the procedure, such as improved function, beyond a more appealing aesthetic result. Although the Akin phalangeal osteotomy is commonly utilized to enhance the clinical appearance of the great toe in hallux valgus surgery, it is unclear whether this additional procedure also improves postoperative patient-reported outcomes.