Why Evidence-Based Medicine? - American Academy Of Orthopaedic Surgeons

Main Category: Bones / Orthopaedics
Article Date: 12 Mar 2010 - 1:00 PST

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Evidence based practices, such as clinical practice guidelines advance medicine and can help serve as a roadmap for medical practitioners. Clinical practice guidelines can also serve as a reference tool for patients. Actively engaged in this practice since 2007, the American Academy of Orthopaedic Surgeons (AAOS) will discuss three recently adopted guidelines at its 2010 Annual Meeting.

"By creating evidence-based guidelines, the AAOS is being responsible," stated Kristy L. Weber, MD, chair of the Academy's Council on Research, Quality Assessment, and Technology. "These guidelines are done in a systematic fashion, and are credible and transparent," she added.

Dr. Weber will serve as the moderator of a media briefing entitled "Evidence-Based Medicine and AAOS Guidelines" and be joined by Randy R. Bindra, MD, Ilya Voloshin, MD, and Mark Glazebrook, MD as they each present recently adopted AAOS Guidelines. This briefing occurs on Thursday, Mar.11, 2010 in the Morial Convention Center, Room 206, at 8:30 a.m.

"The cost of medical care is rising astronomically," added Dr. Weber, "and specialty medicine, like orthopaedics, needs to use evidence whenever available to justify clinical practice and procedures. Clinical practice guideline creation is a step towards evidence-based medicine, and part of the national focus on healthcare quality. This will not be going away any time soon."

The featured guidelines include:

-- Treatment of Distal Radius Fractures

A distal radius (wrist) fracture - one of the most common fractures in the body - usually occurs as a result of a fall. For example, a fall may cause someone to land on his or her outstretched hands, breaking the larger of the two bones in the forearm, near the wrist. In 2007, more than 261,000 people visited the emergency room due to a distal radius fracture. One key question that needs to be answered in future research is whether surgeons should perform the same operations and use the same fixation methods for older patients as they do for younger patients.

-- Treatment of Achilles Tendon Rupture

The Achilles tendon is the thick, fibrous tissue connecting the muscles along the back of the calf to the heel bone. It is one of the strongest tendons in the body, so a rupture can be quite disabling. An acute rupture of the Achilles tendon is an injury commonly treated by orthopaedic surgeons. Statistically, Achilles tendon rupture is more common in males in their 30s and 40s. Yet today, more people remain active as they age, so it is very common to see this injury in all age groups.

-- Treatment of Glenohumeral Joint Osteoarthritis

This major joint in the shoulder - the ball and socket joint - is sometimes affected by osteoarthritis, causing pain, loss of function, and reduced quality of life. Shoulder replacement surgery has been routinely performed since the 1970s for patients with advanced osteoarthritis of the shoulder. The guideline offers a review of total shoulder arthroplasy and hemiarthroplasty as treatment options.

Editor's Note: All AAOS guidelines are developed by AAOS physician volunteer work groups with research staff guidance and based upon a systematic review of the current scientific and clinical information on accepted approaches to treatment and/or diagnosis. The entire process includes peer review by internal and external AAOS committee and non-orthopaedic societies, public commentaries and final approval by the AAOS Board of Directors.

Disclaimer: Treatment decisions should be made in light of all circumstances presented by the patient. Treatments and procedures applicable to the individual patient rely on mutual communication between patient, physician, and other healthcare practitioners.

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American Academy of Orthopaedic Surgeons