Non-inferiority Trials for Orthopaedic Implants

S. Raymond Golish, MD, PhD; Paul A. Anderson, MD

An increasing trend in randomized controlled trials (RCTs), specifically those involving orthopaedic implants, is the use of non-inferiority trials. In these trials, a novel treatment is compared to a clinically established treatment to show that the effect of the novel treatment is not inferior to—or at least within a small margin—the effect of the established treatment.

Compensation and Satisfaction in Orthopaedic Surgery

Emily Curry, BA; Elizabeth Matzkin, MD

Income disparities between the sexes have existed for decades in practically all fields. With the second wave of feminism that began in the 1960s, workplace equality dramatically increased. Within medicine, however, a sex gap still exists, most prominently within the surgical specialties, such as orthopaedics. Even though women accounted for 49 percent of enrollees in medical school, only 5.7 percent of orthopaedic surgeons were women, according to the 2014 AAOS Member Census (Fig.1).

Customizing Patient Care with Rapid Prototyping

Karthikeyan E. Ponnusamy, MD; Hani Haider, PhD; Paul A. Anderson, MD; Ahmad Nassr, MD; Nicholas John Giori, MD

Additive manufacturing (three-dimensional [3D] printing) has many applications in orthopaedics, beyond its use in building models for preoperative planning and patient and resident education. For example, with the use of computer-aided design (CAD) software, 3D printing can be used to build custom instruments such as retractors and drill/saw guides.

Measuring Pediatric Treatment Outcomes

Jay D. Lenn

Patient feedback on treatment outcomes plays a critical role in both clinical practice and research. Questionnaires or rating scales provide information about symptoms, the effect of injuries on joint and muscle function, the effects on functional abilities and activities, and changes in any of these factors after treatment. One such patient-derived outcome assessment is a sports activity scale.

AAOS to Add Systematic Reviews to Evidence-based Products

David S. Jevsevar, MD, MBA

Beginning this year, the AAOS Evidence-based Quality and Value Committee (EBQV) will convene workgroups to produce and publish systematic reviews as part of its evidence-based program for orthopaedics. Since 2007, the AAOS has created and published clinical practice guidelines (CPGs) as part of this program. To date, the AAOS has published 17 CPGs, highlighting the efficacy of treatments and the current state of associated research literature.

Smoking Increases Wound Complications After TJA

Amber Blake

Should surgeons advise patients to quit smoking before undergoing total joint arthroplasty (TJA)? It’s a well-known fact that smoking is bad for overall health, increasing the chances of lung cancer, heart attack, and stroke. In a study presented at the 2015 Orthopaedic Research Society (ORS) annual meeting, Kyle Duchman, MD, and his team took a closer look at how smoking can lead to complications following TJA.

Interpreting Number Needed to Treat

Kevin Shea, MD; Jayson Murray, MA; ; Peter Shores, MPH

What is the number needed to treat (NNT)? How does it relate to orthopaedic practice and, ultimately, orthopaedic patient outcomes? Quite simply, the NNT tells how many patients would need to be treated to prevent one adverse outcome for a particular intervention. A perfect NNT would be 1; this would mean that for every person treated, there would be a reduction of one adverse outcome.

Ruptured Disks in Space

Amber Blake

For astronauts, being in outer space means adapting everyday tasks to a weightless environment. Once they return to earth, astronauts may find that they not only struggle to perform these same tasks, but they also face an increased risk of back pain and injury.

Kappa Delta, OREF Call for Manuscripts

The AAOS is soliciting manuscripts for the 2016 Kappa Delta Awards and the 2016 Orthopaedic Research and Education Foundation (OREF) Clinical Research Award. Up to two $20,000 Kappa Delta awards (Elizabeth Winston Lanier Award and Ann Doner Vaughan Award), one $20,000 Kappa Delta Young Investigator award, and one $20,000 OREF award will be bestowed, provided manuscripts of requisite quality are submitted.

What Is AAOS Doing About Performance Measures?

Joseph P. DeAngelis, MD; William Timothy Brox, MD

Joseph P. DeAngelis, MD, and William Timothy Brox, MD One of the cornerstones of current healthcare reform efforts is the attempt to measure the impact of implementing evidence-based guidelines in clinical practice. As the nation moves toward value-based healthcare delivery, these “performance measures” may provide the link that makes compensation proportional to performance. As physicians, we realize that neither regulators nor legislators should define these measures.

AJRR Attains New Milestones

Lori Boukas

The American Joint Replacement Registry (AJRR) is proud to announce that it has attained two major milestones in development as a national hip and knee joint replacement registry. In mid-May, AJRR welcomed its 500th participating hospital. As a national registry, the AJRR has orthopaedic representation from all 50 states and all types of medical institutions, including academic medical systems, smaller community hospitals, surgery centers, and private practice groups.