AAOS Now, JanFeb 2007
E. Amory Codman
Codman considered father of evidence-based medicine by William J. Mallon, MD E. Amory Codman was born the year that Stanley went to find Dr. Livingston (1869) and died as Hitler was overrunning much of Europe (1940). During his lifetime, X-rays were discovered and anesthesia became a reality, and he died just as the antibiotic era was upon us. To most modern orthopaedists he is simply a name attached to the triangular harbinger of osteosarcoma, or to shoulder pendulum exercises.
What does evidence-based practice mean to you?
What does evidence-based practice mean? How does a surgeon practice evidence-based orthopaedics? Although surgeons have always used evidence obtained from the surgical literature to make clinical decisions, evidence-based practice means using the “best available evidence” in caring for patients. Best available evidence comes from well-designed, appropriately-conducted studies. Studies, however, vary in quality. Levels of Evidence are one measure of study quality.
What shall we do with the wounded?
Extremity War Injuries II focuses on development of clinical treatment principles More than 20,000 U.S. service men and women have been wounded in the ongoing wars in Iraq and Afghanistan. Approximately 70 percent of these injuries are musculoskeletal in nature, mostly resulting from exploding devices. In January 2006, the AAOS, the Orthopaedic Trauma Association (OTA), and the military cosponsored the Extremity War Injuries: State of the Art and Future Directions (EWI) symposium.
Clinical guidelines strengthened by evidence-based practice
Formal development of clinical practice guidelines has been part of the U.S. healthcare system in various forms and from various sources for more than three decades. Initially, such guidelines were condemned by organized medicine and physicians alike as intrusive into the physician-patient relationship and for promoting a “cookbook” approach to medical care that restricts individualized, innovative care and clinical practices.
Developmental Biology in Orthopaedics kicks off research symposia series
During the next four years, the AAOS will be sponsoring a series of cutting-edge topical symposia, supported by the National Institutes of Health through a multi-year R-13 grant. The first, “Developmental Biology in Orthopaedics” (DBO) was held this past October in Toronto, Ontario, Canada.
Linking chondrosarcoma to angiogenesis
For more than a decade, I have focused my laboratory research on one of the most difficult cancers to cure—chondrosarcoma. This bone cancer, composed of malignant cartilage cells, has presented a formidable scientific challenge.
The role of hypoxia in cartilage development
An increasing body of evidence strongly suggests that low oxygen tension is not only a component of many human disorders including cancer, heart attack and stroke, but it is also important in normal fetal development and cell differentiation. At the AAOS sponsored Developmental Biology in Orthopaedics symposium, I had the opportunity to present my research on how the hypoxia inducible factor -1a (HIF-1a) regulates differentiation of the limb bud mesenchyme and joint development.