AAOS Now, November 2017
Two-stage Exchange Arthroplasty and the Antibiotic Holiday
Study results presented at the Musculoskeletal Infection Society (MSIS) annual meeting indicate that the duration of the antibiotic-free period often associated with two-stage exchange arthroplasty—the current gold standard for treating periprosthetic joint infection (PJI) following total joint arthroplasty—does not significantly affect reinfection rates following reimplantation.
Next-generation Sequencing: The Next Step in Identifying Infections?
Next-generation sequencing (NGS) is a DNA-sequencing technology that has revolutionized genomic research, reducing both the time and costs involved. "The cost to sequence one gigabase of DNA in 2000 was $230; to sequence the same amount of DNA today costs just $1," said Javad Parvizi, MD, FRCS, during his presentation at the 2017 annual meeting of the Musculoskeletal Infection Society. Dr.
EWI XII Highlights Joint Learning
The 12th Extremity War Injuries Symposium (EWI)—hosted by the AAOS, the Orthopaedic Trauma Association, the Society of Military Orthopaedic Surgeons, and the Orthopaedic Research Society—was held earlier this year. EWI XII focused on the lessons of war and how the military and civilian trauma communities can move forward together, based on joint learning.
FDA Guidances on Physician-Directed Use
The U.S. Food and Drug Administration (FDA) has issued several guidances—documents that outline the agency's current thinking about regulatory policy—concerning physician-directed use of medical devices. Before a guidance is finalized, the agency releases a draft guidance to solicit feedback from stakeholders. In January 2017, the FDA issued two new draft guidances, using a question/answer format.
Hip Fracture Guidelines: Evidence Over Experience
One way or another, we as orthopaedic surgeons all practice EBM. The question for each of us is whether the "E" represents Evidence-based or Experience-based Medicine. Some of us may be dogmatic in our approach, rigidly adhering to experienced-based medicine; others of us are neophytes looking for guidance. Regardless of our personal situation, familiarity with clinical practice guidelines (CPGs) and appropriate use criteria (AUCs) can benefit us as surgeons and our patients as well.
Form and Function
The modernist architecture principle "form follows function" promotes the idea that a building design should reflect how it would be used. It's a useful, if imperfect, analogy for understanding cell polarity—a certain cellular form is required for that cell's function. The architecture of growth plates requires well-regulated cell polarity.
AAOS Approves the Re-evaluation of Clinical Performance Measure #109
Warren Dunn, MD, chair of the AAOS Performance Measures Committee, is pleased to announce that the AAOS Board of Directors recently approved the re-evaluation of clinical performance measure #109 – Osteoarthritis: Function & Pain Assessment (OAFP). This cross-cutting, process, and clinician-level measure can be reported by clinicians via administrative claims or a registry.