The research fueling new programs at Dr. Andrew Bush's practice


Many orthopedic surgeons are involved with research alongside their clinical practices. Andrew Bush, MD, of Central Carolina Orthopaedic Associates in Sanford, N.C., is using his research to explore a new fracture treatment in private practices.

Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

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Please send responses to Carly Behm at by 5 p.m. CST, Wednesday, Feb. 23, 2022.

Editor's note: Responses were edited for style and clarity.

Question: What orthopedic research are you currently involved in? Have there been any interesting findings?

Dr. Andrew Bush: I am currently retooling my orthopedic surgery practice and am developing a bone health and fracture prevention program. As part of that program, I have implemented the use of a dedicated ultrasound unit to determine axial BMD measurements similar to a DXA. However, the REMS unit (radiofrequency echographic multispectrometry) is a system that does not use ionizing radiation and can measure bone density, as well as bone quality.

In a presentation at the recent Orthopaedic Research Society meeting, the research group presented a poster that summarized the findings of a five-year longitudinal study that compared DXA-derived BMD to REMS-derived BMD and REMS-derived bone quality assessment for predicting the likelihood that a patient will or will not sustain a fragility fracture. In that study with 700 participants, the REMS-derived assessment of bone quality proved to be the most sensitive and specific — it was the best predictor of those who fractured and those that did not.

In our private practice setting, we are currently assessing interoperator accuracy, as well as the usefulness of this unit in a private practice setting.

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