AAOS Now, August 2020
NIH Provides Guidance Summary on the Use of Corticosteroids
Injectable and oral corticosteroids are commonly used to reduce inflammation and manage pain in patients with musculoskeletal disease. Concerns regarding the use of injectable and oral corticosteroids in musculoskeletal care come from guidelines for systemic steroid use in patients being treated for active COVID-19 disease, such as those from the National Institutes of Health (NIH). Within the guidelines, the NIH provides evidence-based recommendations “against the routine use of systemic corticosteroids for the treatment of mechanically ventilated patients with COVID-19 without acute respiratory distress syndrome (ARDS).” For “mechanically ventilated adults with COVID-19 and ARDS, there are insufficient data to recommend either for or against corticosteroid therapy in the absence of another indication.”
Presidential Symposium Illustrates Academy Registry Successes, Paths to Value
At the 2020 Presidential Symposium, titled “Successful MSK Care in the New Age: It’s All About Value and Outcomes,” 2019–2020 President Kristy L. Weber, MD, FAAOS, noted that during her past service as chair of the Committee of Research and Quality, she had come to perceive that “quality and value in patient care are at the core of what we do as doctors and surgeons.”
True Progress in Orthobiologics Requires That We Police Ourselves and Each Other
The orthobiologic product segment now represents 10 percent of the worldwide orthopaedic marketplace, with 2019 sales exceeding $5 billion worldwide. Sadly, however, there are far too many cases where companies have improperly side-stepped the FDA, misguided clinicians, and defrauded not only the surgeon community but also the general public and other federal agencies as well. Fortunately, AAOS is now dedicating more resources and focus to the topic of biologic product development and responsible clinical use. Formation
New AUC Provides Tool for Screening for Psychosocial Risk Factors After Trauma
In June, the AAOS Board of Directors approved the release of a new set of Appropriate Use Criteria (AUC) designed to guide orthopaedic surgeons and other clinicians in determining appropriateness of early screening for psychosocial risk and protective factors in patients with adult orthopaedic trauma.
Two Million and Counting: AJRR Reaches Major Milestone
The Academy’s Registry Program celebrated a major marker of progress in June when the American Joint Replacement Registry (AJRR), the cornerstone of AAOS’ Registry Program, reached and surpassed its two millionth hip and knee procedure with the input of data from Mayo Clinic in Rochester, Minn.
AAOS’ Systematic Review on Management of SSI in Orthopaedic Surgery
Surgical site infections (SSIs) continue to be a daunting challenge for modern healthcare systems, with an estimated 1.0 percent to 2.5 percent annual incidence of SSIs after total joint arthroplasty (TJA) alone. The Centers for Disease Control and Prevention (CDC) defines an SSI as “an infection that occurs after surgery in the part of the body where the surgery took place. SSIs can sometimes be superficial infections involving the skin only. Other SSIs are more serious and can involve tissues under the skin, organs, or implanted material.”