AAOS Consensus Statements

Resolution – An official AAOS statement, usually dealing with a socio-economic or intra-orthopaedic issue. Binding on AAOS and Board of Directors. Not prepared using systematic review processes. Developed by BOC, BOS, BOD or Fellowship groups; adopted by the Fellowship. 

Disclaimer:  An AAOS Resolution is an official statement of policy, adopted by majority vote of the AAOS Fellowship casting ballots and binding on AAOS and Board of Directors  An AAOS Resolution is not a product of a systematic review, but rather Open Hearings and the opinions of AAOS Fellows.

Advisory Opinion – A statement adopted by the Board of Councilors (BOC) and/or Board of Specialty Societies (BOS) that makes a recommendation to the AAOS Board of Directors.  Prepared through a deliberative process described in the AAOS Bylaws.  Not prepared using systematic review processes.  Recommended by individual members of the Board of Councilors, state or regional orthopaedic societies, or orthopaedic specialty societies belonging to the BOS. 

Disclaimer: No disclaimer used.

Position Statement – An official AAOS statement, usually dealing with a socio-economic issue, designed for audience beyond orthopaedic surgery. Not prepared using systematic review processes. Developed by AAOS Committees or Councils; adopted by the Board of Directors.

Disclaimer:  This Position Statement was developed as an educational tool based on the consensus opinion of the authors. It is not a product of a systematic review process. Readers are encouraged to consider the information presented and reach their own conclusions.

Information Statement (formerly Advisory Statement) – An official AAOS statement on a clinical issue based on consensus and selected articles. Not prepared using systematic review processes. Developed by AAOS Committees or Councils; adopted by the Board of Directors.

Disclaimer:  This Information Statement was developed as an educational tool based on the consensus opinion of the authors. It is not a product of a systematic review process. Readers are encouraged to consider the information presented and reach their own conclusions.

AAOS Evidence-Based Statements

Technology Overview/Assessment – An AAOS statement that summarizes the findings of studies published as of a certain date. Does not assess or make recommendations for or against the use of a particular technology. Focus is on procedures or devices. Prepared using systematic review processes. Developed by interested AAOS or other groups; adopted by the Board of Directors. (being discontinued, effective 2011) 

Disclaimer:  This Technology Overview was prepared using systematic review methodology, and summarizes the findings of studies published as of [date] on [subject matter]. As a summary, this document does not make recommendations for or against the use of [subject matter]. It should not be construed as an official position of the American Academy of Orthopaedic Surgeons. Readers are encouraged to consider the information presented in this document and reach their own conclusions about [subject matter].

Clinical Practice Guideline – An AAOS statement on a clinical issue based on an assessment of the current scientific and clinical information and accepted approaches to treatment. Focus is on a disease, disorder or condition. Intended to guide clinical practice and serve as an information resource for medical practitioners; not intended as benefits determination documents. Prepared using systematic review processes. Developed by physician volunteer workgroup, under auspices of the AAOS Guidelines Oversight section of the Committee on Evidence-Based Quality and Value; adopted by the Board of Directors. 

Disclaimer:  This clinical practice guideline was developed by an AAOS physician volunteer Work Group based on a systematic review of the current scientific and clinical information and accepted approached to treatment and/or diagnosis.  This clinical practice guideline is not intended to be a fixed protocol, as some patients may require more or less treatment or different means of diagnosis.  Clinical patients may not necessarily be the same as those found in a clinical trial. Patient care and treatment should always be based on a clinician’s independent medical judgment, given the individual patient’s clinical circumstances.  

Appropriate Use Criteria – An AAOS statement on when the use of a procedure is appropriate, i.e., when the expected health benefits exceed the expected negative consequences by a sufficiently wide margin that the procedure is worth doing, exclusive of cost. Focus is on widely used procedures. Prepared using systematic review processes.   Developed by volunteer voting panels of physicians from multiple specialties and non-physicians, under auspices of the AAOS Appropriate Use Criteria Section on the Committee on Evidence-Based Quality and Value; adopted by the Board of Directors. 

Disclaimer:  This Appropriate Use Criteria was developed by panel of physicians from multiple medical specialties and non-physicians using a Delphi voting process, based on a review of published literature and/or relevant clinical practice guidelines. Appropriate Use Criteria are not intended to establish fixed protocols, as some patients may require more or less treatment or different means of diagnosis. Patient care and treatment should always be based on a clinician’s independent medical judgment, given the individual patient’s clinical circumstances. 

Performance Measures – An AAOS Statement on the metrics by which a healthcare provider’s or facility’s performance is compared with national benchmarks.  Focus is on measurable outcomes of evidence-based treatment recommendations.  Prepared using systematic review processes.  Developed by multi-disciplinary physician volunteer work group, under auspices of the AAOS Performance Measures Committee; adopted by the Board of Directors. 

Disclaimer: These Performance Measures and related data specifications were developed by the American Academy of Orthopaedic Surgeons (AAOS) through a multi-disciplinary physician work group and are based on a systematic review of published literature and/or relevant clinical practice guidelines to facilitate quality improvement activities by physicians.  These Performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. They are not intended to establish fixed protocols, but rather to serve as metrics by which a health care provider’s or facility’s performance may be compared with national benchmarks. Patient care and treatment should always be based on the clinician’s independent medical judgment, given the individual patient’s clinical circumstances.  These Performance Measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Performance Measures require a license agreement between the user and the AAOS.  Neither the AAOS nor its members shall be responsible for any use of the Performance Measures.   

AAOS Ethics and Professionalism Statements

Standards of Professionalism – An official AAOS statement that establishes the minimum, baseline standard of acceptable conduct for orthopaedic surgeons. Violations of an SOP may result in professional compliance actions against AAOS Fellows or Members found in violation. Not prepared using systematic review processes. Developed by BOC, BOS, BOD or Fellowship groups; adopted by the Fellowship. 

Disclaimer:  AAOS Standards of Professionalism (SOPs) establish the minimum standards of acceptable conduct for orthopaedic surgeons. Violations of any SOP may result in professional compliance actions against an AAOS Fellow or Member found in violation. Not prepared using a systematic review, SOPs are developed through a consensus process and are ultimately adopted as official AAOS statements by the two-thirds vote of the AAOS Fellowship casting ballots.

Opinion on Ethics and Professionalism – An official AAOS statement dealing with an ethical issue which offers aspirational AAOS advice on how an orthopaedic surgeon can best deal with a particular situation or circumstance. Not prepared using systematic review processes. Developed by the AAOS Ethics Committee; adopted by the Board of Directors. 

Disclaimer:  An AAOS Opinion on Ethics and Professionalism is an official AAOS statement dealing with an ethical issue, which offers aspirational advice on how an orthopaedic surgeon can best deal with a particular situation or circumstance.  Developed through a consensus process by the AAOS Ethics Committee, an Opinion on Ethics and Professionalism is not a product of a systematic review.  An AAOS Opinion on Ethics and Professionalism is adopted by a two-thirds vote of the AAOS Board of Directors present and voting.

AAOS Alerts

Patient Safety Alert – An AAOS statement electronically sent to all AAOS Fellows regarding an evolving issue of clinical importance (i.e., product recall). Frequently based on statements from government agencies (e.g., FDA, CDC) or from commercial companies. Not prepared using systematic review processes, but often based upon sentinel events. Developed by AAOS staff; approved by the Chair of the Patient Safety Committee and AAOS Medical Director prior to dissemination.    

Member Alert – An AAOS statement electronically sent to all AAOS Fellows regarding an evolving issue, usually related to a health policy or legal matter. Not prepared using systematic review processes. Developed by AAOS staff; approved by the Chair of the appropriate Council or committee and AAOS Chief Executive Officer prior to dissemination.   

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If the AAOS Board adopts an evidence-based statement, any previously adopted AAOS consensus statements (except for AAOS Resolutions) relating to the same topic shall be considered automatically rescinded.  If the evidence-based statement conflicts with an AAOS Resolution, the Board of Directors shall develop recommendations that the Fellowship amend or rescind the AAOS Resolution under Paragraph 10.4 of the Association Bylaws or Paragraph 6.4 of the Academy Bylaws. 

If known, the Board of Directors shall be advised of these inconsistencies prior to voting on the evidence-based statement.

Adopted:         September 2011

Revised:          March 2014

Revised:          March 2015