Published 11/1/2013

CPG Update

The latest clinical practice guideline (CPG), “The Treatment of Osteoarthritis of the Knee (OAK), Second Edition,” was approved in May and is available on the AAOS website. Articles on the guideline have appeared in the Journal of the AAOS (September), AAOS Now (June), and The Journal of Bone & Joint Surgery (Oct. 16). The OAK CPG has also been accepted by the national Guidelines Clearinghouse and the Guidelines International Network databases.

The AAOS Evidence-Based Medicine Unit has the following five CPGs in development:

  • Treatment of Anterior Cruciate Ligament (ACL) Injuries
  • Management of Hip Fractures in Elderly Patients
  • Early Detection and Non-Operative Management of Pediatric Developmental Dysplasia of the Hip (DDH)
  • Surgical Management of Osteoarthritis of the Knee (SMOAK)
  • Diagnosis and Treatment of Carpal Tunnel Syndrome (CTS)—guideline update

ACL and Hip Fracture CPGs
The guideline work groups have held their final meetings. They have developed recommendations, assigned ratings for each recommendation based on the best available evidence, and written rationales. Solicitation for peer review has begun and input received will be reviewed by the work group.

The research analyst for the DDH CPG has completed the appraisal of the evidence, and the guideline work group members have approved the included and excluded articles in the literature review. The DDH CPG work group members are scheduled to hold their final meeting this month to develop recommendations, assign ratings for each recommendation based on the best available evidence, and write rationales.

The SMOAK guideline work group held its introductory meeting in August. Results from the piloted topic suggestion survey were presented; a total of 41 patient responses and 80 clinician responses provided valuable input to the work group as they developed PICO(t) questions (research questions that include the following parameters—population, intervention, comparison, outcome, and time—and provide additional clarity in defining inclusion criteria for the literature review and evaluating the evidence). The work group also established search terms and defined the overall scope of the guideline at their introductory meeting.

The CTS CPG was originally adopted in 2007 and was partially updated in the Treatment of Carpal Tunnel Syndrome CPG in 2011. This edition will again combine both Diagnosis and Treatment of CTS and will replace both of the previous versions. Solicitation for work group members is complete and invitations to participate have been sent to members of the AAOS, relevant orthopaedic specialty societies, and external medical organizations to ensure multidisciplinary representation. The work group’s introductory meeting is scheduled for Feb. 1, 2014.

For more information on CPGs, visit www.aaos.org/guidelines