Today’s Top Story
AAOS Board approves AUCs on CTS and SMOAK.
The AAOS Board of Directors has approved new Appropriate Use Criteria (AUC) for the management of carpal tunnel syndrome (CTS) and the surgical management of osteoarthritis of the knee (SMOAK). The AUCs provide specific diagnostic criteria, complementing and building upon existing AAOS clinical practice guidelines, “Management of Carpal Tunnel Syndrome” and “Surgical Management of Osteoarthritis of the Knee.” “Appropriate Use Criteria for the Management of Carpal Tunnel Syndrome” provides 135 diagnostic scenarios to assist orthopaedic surgeons and other clinicians in determining whether a patient has CTS, and if so, the optimal treatment—from non-operative, such as a splint or a steroid injection, to surgery. “Appropriate Use Criteria for the Surgical Management of Osteoarthritis of the Knee” looks at three types of surgical treatment—total knee arthroplasty (TKA), unicompartmental knee arthroplasty, and realignment osteotomy—and the scenarios for when each is appropriate. View the CTS AUC…
View the SMOAK AUC…
View all AAOS AUCs…
Other News
Study: Smoking linked to increased risk of complication following shoulder arthroplasty.
According to a study published in the January issue of the Journal of Shoulder and Elbow Surgery, smoking may increase risk of complication following total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA). The research team reviewed information on 1,834 primary TSAs and RSAs across 1,614 patients (814 smokers, 1,020 nonsmokers). Overall, complications occurred in 75 shoulders (44 smokers, 31 nonsmokers). The research team notes that smoking was associated with lower periprosthetic infection-free survival rates and overall complication-free survival rates compared to nonsmoking. In addition, both current and former smokers were at increased risk of periprosthetic infection in comparison with nonsmokers, and current smokers showed a higher risk of postoperative fracture compared to both former smokers and nonsmokers. Read the abstract…
Study: What factors are linked with problematic healing following surgical treatment of atypical femoral fracture?
A study published in the Dec. 7 issue of The Journal of Bone & Joint Surgery examines surgically controllable factors related to healing time following operative treatment of complete femoral fractures associated with long-term use of bisphosphonates. The authors reviewed data on 99 patients (109 fractures) surgically treated for a complete atypical femoral fracture and with a documented history of bisphosphonate therapy. They observed that 76 fractures (69.7 percent) displayed osseous union within 6 months after index surgery and 33 fractures (30.3 percent), showed delayed union or nonunion. Overall, supra-isthmic fracture location, femoral bowing of ≥10° in the coronal plane, and a lateral/medial cortical thickness ratio of ≥1.4 were predictive of problematic healing but were uncontrollable factors. Iatrogenic cortical breakage around the fracture site and a ratio of ≥0.2 between the remaining gap and the cortical thickness on the anterior and lateral sides of the fracture site were controllable predictive factors linked with problematic healing. Read the abstract…
Study: Botulinum toxin treatment may improve function and reduce pain for plantar fasciitis patients.
According to a study published in the January issue of the journal Foot & Ankle International, treatment with incobotulinumtoxinA (IBTA) may help improve foot function and pain for patients with plantar fasciitis. The researchers conducted a randomized, double-blinded, placebo-controlled trial of 50 patients with plantar fasciitis who received an injection of either IBTA (n = 25) or saline (n = 25) in the affected foot. At 6-month follow-up, they found that mean Foot and Ankle Ability Measures increased from 36.3 to 73.8 in the IBTA cohort and from 35.9 to 40.9 in the placebo cohort. In addition, mean pain score decreased from 7.2 to 3.6 in the IBTA group and from 8.4 to 7.9 in the placebo group. At 12-month follow-up, the IBTA group maintained significantly better function and pain than the placebo group, and no patients in the IBTA group and 3 patients in the placebo group had undergone surgery for recalcitrant plantar fasciitis. Read the abstract…
AHA, FAH urge caution in ACA replacement process.
In a letter to President-elect Donald Trump, the American Hospital Association (AHA) and the Federation of American Hospitals (FAH) urge caution in repeal of the Affordable Care Act (ACA) before a suitable replacement is enacted. The organizations cite information from two reports that project the financial impact of ACA repeal without replacement. The first report estimates that ACA repeal without replacement would cost hospitals $165.8 billion from 2018 to 2026. The second report projects that hospitals would lose $289.5 billion in inflation updates if payment cuts under the ACA are not restored. “Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care, decimate hospitals’ and health systems’ ability to provide services, weaken local economies that hospitals help sustain and grow, and result in massive job losses,” the letter states. Read the letter (PDF)…
Read the reports (PDF)…
Study: Small study suggests running may help reduce knee inflammation.
Findings from a pilot study published in the December issue of the European Journal of Applied Physiology suggest that running may help reduce inflammation in the knee joint. The researchers examined synovial fluid (SF) and serum samples of six recreational runners before and after 30-minute running and control sessions. They found no changes in serum or SF cytokine concentration in the control condition. However, from pre- to post-run, the researchers found that the cytokine GM-CSF decreased from 10.7 pg/ml to 6.2 pg/ml, and IL-15 showed a trend for decreasing concentration. Overall, changes in IL-15 concentration negatively correlated with the mean number of foot strikes during the run. Finally, the control condition induced a decrease in serum cartilage oligometrix matrix protein (COMP) and an increase in SF COMP, while the run induced an increase in serum COMP and a decrease in SF COMP. Read the abstract…
Last call: Committee positions closing soon!
A number of openings on the AAOS Committee Appointment Program website are closing Dec. 16. Act now to apply for the following positions:
- AAOS Emergency Medical Services Program Product Line (Series editor—designee)
- Communications Cabinet (one member-at-large)
- Content Committees (four members—generalist)
- Council on Education (Board preparation course chair; chair—designee)
- Hip & Knee Content Committee (Vice chair)
Learn more and submit your application…(member login required)
