Published 5/1/2013

Choosing Wisely A Good Idea

I was excited to see that the AAOS is playing an active role in the Choosing Wisely Campaign. MED Solutions, where I work as associate medical director, emphasizes cost-saving measures that are saving the healthcare industry millions of dollars. I am looking forward to learning more about the five evidence-based recommendations that the Academy is making. 
Walter W. Wheelhouse, MD

Franklin, Tenn.

Misleading advertising?
I am writing about a recent advertisement for non-narcotic pain pumps (AAOS Now, February 2013).

As a medicolegal consultant for pain pump litigation on behalf of plaintiffs. I read this advertisement with great interest as I looked to find the disclosure that pain pumps cause chondrolysis and that this pump should be used for nerve blocks/regional anesthesia.

The ad gives statistics about time to discharge home, pain scores, and fewer side effects without disclosing the location of the pain pump. In the fine print, an “inherent risks” statement encourages readers to “refer to the product labeling” and states that “failure to follow the product labeling could directly impact patient safety.” This is a veiled statement; the directions for use on the product website include a warning about chondrolysis.

I believe this advertisement is misleading and encourages orthopaedic surgeons to use pain pumps in the shoulder despite the clear risk of chondrolysis with intra-articular use. To my knowledge, this pain pump does not have FDA approval for use in the shoulder joint. I hope that the orthopaedic community sees the numerous published articles regarding chondrolysis and is not mislead by this type of advertising.
Benjamin Busfield, MD

Antioch, Calif.

Kinesio tape
The editorial on kinesio tape (
“Kinesiology Tape My Foot...or Shoulder...or Head.....,” AAOS Now, November 2012) made me smile. I loved your facial taping; it’s a pity it did not work.

As a pediatric physiotherapist, I have seen some amazing effects of this tape in children (I can say from my clinical experience that this tape works)—not in all cases, of course, but it certainly has potential.
Esther de Ru, PPT
Málaga, Spain

Setting Now Straight
welcomes reader comments and efforts to “set AAOS Now straight.” We reserve the right to edit your correspondence for length, clarity, or style. Send your letters to the Editor, AAOS Now, 6300 N. River Rd., Rosemont, IL 60018; fax them to (847) 823-8033; or e-mail them to