Tackling shoulder instability with bone loss: Arthroscopic graft-and-fill techniques appear promising

Mary Ann Porucznik

The best way to treat the unstable shoulder with a bony defect hasn’t been determined yet, but presentations at the 26th Annual Meeting of the Arthroscopy Association of North America (AANA) are providing clues about what works. The arthroscopic treatment of anterior shoulder instability has improved, and surgeons are seeing higher rates of clinical success.

Second Look

In case you missed these news items the first time around, AAOS Now gives you a second chance to review them. Stay current by subscribing to Headline News, the AAOS thrice-weekly online update of news of interest. Headline News brings you the latest on clinical, socioeconomic, and political issues, as well as important announcements from AAOS. Subscribe to Headline News at www.aaos.org/news/news.asp Federal probe into device makers nears conclusion.

Arthroscopic bursectomy works for stubborn trochanteric bursitis

Mary Ann Porucznik

Patients whose chronic recalcitrant trochanteric bursitis does not respond to nonsurgical interventions now have a choice. According to the presentation made by Champ L. Baker, MD, and R. Vaughan Massie, MD, arthroscopic bursectomy appears to be an effective and viable alternative to open bursectomy.

Arthroscopic treatment for elbow osteoarthritis reduces pain, improves motion

Mary Ann Porucznik

Débridement and capsular resection provides good outcomes An evolving technique, presented during the Arthroscopy Association of North America’s annual meeting, addresses three main pathologic processes involved in primary degenerative arthritis of the elbow. According to first author Julie E. Adams, MD, “Loss and fragmentation of cartilage lead to loose body formation. Reactive bone and cartilage formation give rise to osteophytes.

Surgical treatment of rotator cuff provides better pain relief, function

Mary Ann Porucznik

Although both nonsurgical and surgical treatments are effective, a matched comparison study shows surgical treatment yields superior results Many patients with rotator cuff disease do just fine with nonsurgical treatment that includes administration of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and physical therapy. Likewise, surgical treatment—including acromioplasty and rotator cuff repair—has also been found effective for most patients who receive it.

Build—don’t break—communication during patient hand-offs

Harold W. Rees, MD; Norman A. Johanson, MD

“Breakdowns in communication” were cited as the second leading cause of medical errors in orthopaedic practice, according to a 2005 survey of AAOS members conducted by the Patient Safety Committee.1 These communication lapses accounted for 26 percent of all reported errors. Obstacles to good communication involve both individual and systemic problems.

Clinical performance measures depend on physician input

Kenneth L. Moore, MD

AAOS brings expertise in measure development to Physician Consortium for Performance Improvement Ever since the Institute of Medicine (IOM) published its landmark book To Err is Human: Building a Safer Healthcare System, awareness and development of clinical quality measures in medicine have increased. As Harvey Fineberg, MD, PhD, MPH—then the IOM’s president—said, “The only way to know whether the quality of care is improving is to measure performance.”

NCQA launches back pain recognition program

Jill Elaine Hughes, MA

Diagnosis and treatment of back-pain–related conditions make up a large component of many orthopaedic practices. As shown in the accompanying “Facts about back pain,” the economic impact of low back pain is extremely high and represents a significant component of rapidly rising healthcare costs. Although a strong clinical evidence base for treating both acute and chronic back pain exists, substantial quality gaps remain.

To report or not to report?

Kenneth L. Moore, MD

The NCQA Back Care Recognition Program may be a good idea—but do we need another reporting activity? One of the most common ailments that orthopaedists see—and often feel overwhelmed by—is low back pain. Most of us believe that we do a good job of making appropriate treatment decisions for patients with low back pain. But we often make these decisions based on our years of experience or what we were taught in medical school.

Upcoming Orthopaedic Meetings of Interest

Listed below are upcoming meetings through September 2007 that may be of interest to orthopaedic surgeons. For more information, contact the source listed. July 12-15 AOFAS 23rd Annual Summer Meeting Westin Harbour Castle, Toronto, Ontario, Canada Web site: www.aofas.org July 12-15 AOSSM Annual Meeting Telus Convention Centre, Calgary, Alberta, Canada Web site: www.aossm.org July 18-21 Western Orthopaedic Association 71st Annual Mtg. Hotel Del Coronado, San Diego, Calif.

Articular cartilage defects: Emerging technologies are changing the treatment landscape

Mary Ann Porucznik

Microfracture, osteochondral transplants, and implantation of cultured autologous chondrocytes help repair, replace, and regenerate tissue The goals of treating articular cartilage lesions haven’t changed, but the treatment techniques themselves have evolved in recent decades, according to a master lecture presented by Nicholas A. Sgaglione, MD, at the Arthroscopy Association of North America meeting in San Francisco last month.