Position Statement

Credentialing in the Use of Specialized Instrumentation in Orthopaedics

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

The use of specialized orthopaedic instrumentation is an intrinsic part of the practice of orthopaedic surgery, and constitutes an integral portion of the curriculum in orthopaedic graduate and continuing medical education. The proliferation of this specialized instrumentation and the rapid introduction of new and emerging technology have raised concerns from many parties. Questions involve the best methods of education regarding the instrumentation, the best means and methods of demonstrating familiarity with the indications, contraindications and techniques associated with its use, and confusion regarding the proper locus and responsibility for the "credentialing" of orthopaedists regarding the use of new technology.

Several manufacturers have recently initiated requirements regarding education in the use of their technology that approximate a credentialing activity. The American Academy of Orthopaedic Surgeons (AAOS) is concerned about this trend and its implications for orthopaedics.

The AAOS believes:

1. The use of specialized orthopaedic instrumentation by an orthopaedic surgeon should be based upon the surgeon's educational exposure to the use of the instruments as well as its indications and contraindications in clinical application.
2. The source of an appropriate educational experience in the use of new instrumentation should not be limited by the manufacturers to themselves or any one provider, nor should the sales or availability of such instrumentation be linked to a single source of education. An appropriate education regarding the use of such instrumentation may vary depending upon the stage of training of the orthopaedist and his/her existing skills, and the interests and capability of the sponsor for the educational activity.
3. The delineation of clinical privileges for orthopaedic surgeons should continue to be the responsibility of local hospitals, and be based upon a thorough assessment of the surgeon's orthopaedic knowledge, skills, and experience.

© July 1990 American Academy of Orthopaedic Surgeons
This material may not be modified without the express written permission of the American Academy of Orthopaedic Surgeons^®.

Position Statement 1105

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