1. Metal-on-metal hip replacements. The U.K.’s Medicines and Healthcare Products Regulatory Agency notice on the increased revisions for MoM hip replacements increased awareness of the implant in the United States. AAOS released a statement alerting members about patient safety concerns with the implant.
2. Clinical Practice Guidelines. The AAOS released clinical practice guidelines on the diagnosis of periprosthetic joint infection of the hip and knee to focus on increasing diagnostic accuracy before surgery. The organization also released a clinical practice guideline recommending against the use of vertebroplasty to treat osteoporotic spinal compression fractures. Kyphoplasty was given a weak recommendation.
3. Platelet-rich plasma. The use of PRP still has not been proven effective by clinical studies, although it remains a hot topic of debate among orthopedic surgeons. Some studies have shown that the injections could produce beneficial results. AAOS Now plans on holding a PRP forum in 2011.
4. SLAP repair. Superior labral anterior to posterior procedure has come under scrutiny after some allege that the procedure is overused. Orthopedists must be able to distinguish between pathologic SLAP lesions and incidental degeneration of the labrum.
5. Pain pumps and chondrolysis. Controversy surrounding pain pumps and the development of postarthroscopic glenohumeral chondrolysis has increased as several lawsuits were filed over the past year.
6. Healthcare reform. Many believe the Patient Protection and Affordable Care Act doesn’t curtail the rising healthcare costs or improve the quality of care, according to the report. The reform does provide funding for comparative effectiveness research, studies on improving quality of care and the transition to electronic medical records. However, it doesn’t address tort reform or fix the Medicare Sustainable Growth Rate formula.
7. Independent physicians. Orthopedic surgeons are trending toward hospital employment or joining large practices. The decrease in reimbursements and cost to comply with government regulations is leading many surgeons to this decision, according to the report.
8. Off-label use. Off-label use of products, especially pharmaceuticals, made headlines this past year accusing the companies of promoting drugs for unapproved uses.
9. Disclosures. Disclosures of a physician’s relationship with device companies have been controversial this year, as many new companies will be forced to disclose their relationships with surgeons. AAOS unveiled an online disclosure program this past year that can be searched by anyone.
10. Volunteering in Haiti. Many orthopedic surgeons have spent time over the past year providing orthopedic services to underprivileged patients and earthquake victims. AAOS processed many volunteer applications and provided information to many interested physicians.
Read the AAOS Now story about the top stories in orthopedics for 2010.
Read other coverage on AAOS:
– AAOS: Statistics on Holiday Decorating-Related Orthopedic and Spine Injuries
– AAOS: 6 Coding Tips for Rehabilitative Services
– AAOS Physicians Discuss Treatment for Dupuytren Contracture
