Spotlight is on specialty societies today

By Kathleen Misovic

The 19th Annual Orthopaedic Specialty Day is in full swing today, giving orthopaedic surgeons the opportunity to learn the latest surgical techniques and earn CME credits within 13 subspecialty areas. The programs are being sponsored by the member organizations of the Board of Specialty Societies (BOS/COMSS).

On-site registration is available from 7:30 a.m. to 4:30 p.m. at the McCormick Place Convention Center. The programs will be held in various sites throughout the center.

AOFAS
Realizing that the early bird gets the worm, the American Orthopaedic Foot and Ankle Society (AOFAS) meets in room S105ABCD beginning at 7 a.m. for a 20-minute Early Bird Symposium, followed by a welcome from AOFAS President James Brodsky, MD.

The meeting will feature a total of six symposia sessions. Highlights include a video symposium on new surgical techniques for fundamental foot and ankle procedures, and an interactive symposium on surgical decision making. Surgeons will also debate the different methods to integrate evidence-based practice in foot and ankle sports injuries.

Stuart L. Weinstein, MD, past president of the AAOS, will discuss the challenges of liability reform. Presidential guest speakers Richard L. Cruess, MD, and Sylvia R. Cruess, MD, of the Center for Medical Education at McGill University, will discuss professionalism and medicine’s social contract with society.

After lunch, the effect of selective COX-2 inhibition on tendon healing, the feasibility and safety of using continuous sciatic nerve block for pain control after outpatient foot and ankle surgery, and difficulties encountered with deformity correction in total ankle arthroplasty will be examined. Afternoon symposia will look at the science, rationale and reimbursement behind shockwave therapy, and minimally invasive foot and ankle fracture fixation.

The AOFAS meeting will conclude with a 10-minute business meeting.

AOSSM
The American Orthopaedic Society for Sports Medicine (AOSSM) meeting in Lakeside E354B begins promptly at 7:55 a.m. with a welcome from William A. Grana, MD, MPH, society president, and Mark E. Steiner, MD, program chair.

The day will feature of 10 scientific sessions: healing, posterior cruciate ligament, anterior cruciate ligament (ACL) graft choice, ACL graft placement, hip, suprascapular nerve and labral cysts, meniscus allograft, osteotomy, rotator cuff repair and shoulder instability. Each session will feature several presentations on the topic.

During the session on healing, for example, the effect of common analgesics on the healing rat patellar tendon, and the role that NSAIDs, nitroglycerin patches and extracorporeal shock treatments have on healing will be examined. Several session include a question-and-answer period.

From 3 p.m. to 5:30 p.m. the AOSSM will join with the American Shoulder and Elbow Surgeons (ASES) for a joint session. After a welcome from W.Z. Burkhead Jr., MD, ASES program chair, and Dr. Steiner, the joint session will include a current concepts panel on managing the in-season collision athlete with shoulder instability and two surgical technique spotlights, as well as a case presentation on superior labrum anterior posterior (SLAP) tears. A point/counterpoint session will look at whether orthopaedists are overtreating elbow instability.

The joint session will conclude with two sessions on golf, looking at the biomechanics and muscle activity used during a golf swing, and offering tips on how to activate muscle patterns to improve golf scores.

ASES
David M. Dines, MD, immediate past president of the ASES, will start the program with a welcome at 7:30 a.m. in Lakeside E353ABC. Papers to be presented focus on six topics: rotator cuff, elbow, arthroplasty, acromioclavicular joint, trauma and instability.

The program will also feature three symposia, on reverse shoulder arthroplasty, mid-shaft clavicle fractures and nerve complication about the elbow. Two how-to-videos will demonstrate techniques on capsular release for stiff shoulder following cuff repair and single incision biceps.

At 3 p.m. members will attend the joint session with the AOSSM described above.

ASSH
Controversies and complications in upper extremity surgery is the theme of the American Society for Surgery of the Hand (ASSH)/American Association for Hand Surgery meeting, being held in S406AB. ASSH President David M. Lichtman, MD, welcomes members at 8 a.m., followed by the first session titled, “The Elbow—the Unforgiving Joint.” The controversies section of the session will explore “Making the stiff elbow move.” The complications section will discuss approaches to failed ligament reconstruction for elbow instability and the young arthritic elbow.

Three more sessions will follow: peripheral nerve reconstruction, repair and reanimation; distal radius; and the wrist. In the distal radius session, participants will look at the issues involved in a smashed distal radius fracture and determine if fixation and approach type matter. They will also examine the role of acute arthrodesis.

At the end of the program, course participants should have a better understanding of controversies and complications in hand and upper extremity procedures, and how to approach them.

AANA

A session on instability detailing bone defects in unstable shoulders and potential complications in arthroscopic instability repair will start off the Arthroscopy Association of North America (AANA) meeting, which begins at 8 a.m. in Lakeside E354A with a welcome by AANA President James C. Y. Chow, MD, and Education Chairman Richard L. Angelo, MD. The program will feature three other sessions before lunch: rotator cuff, hip arthroscopy and miscellaneous topics.

After lunch, members will look at classic approaches and recent innovations in meniscus repair in the articular cartilage/meniscus session. Another miscellaneous session will include a technique spotlight on arthroscopic proximal realignment/media retinacular placation. A session on ligament insufficiency will feature a point/counterpoint debating whether the double-bundle technique offers a more reliable ACL reconstruction, with Freddie H. Fu, MD, speaking on the pro side, and Bernard R. Bach Jr., MD, speaking on the con side.

The meeting will conclude with a session looking at new techniques that are “on the horizon,” such as the future promise of articular cartilage, and early results of arthroscopic acetabular labral repair.

FSA
The Federation of Spine Associations (FSA) is comprised of the Cervical Spine Research Society (CSRS), the North American Spine Society (NASS), the American Spinal Injury Association (ASIA) and the Scoliosis Research Society (SRS). Each of the participating associations will present one section during the day.

The program begins at 7:55 a.m. in room S103ABCD with a welcome breakfast and program report by program chair Bruce V. Darden II, MD. This will be followed by the CSRS section, which features an update on cervical disc arthroplasty and discussions on autograft and allograft.

The NASS section, beginning at 10:05 a.m., will focus on disc salvage symposium. Discussions include disc arthroplasty results rationale, appropriate patient selection for the procedure, the complications of disc arthroplasty, conservative treatment of the failed disc arthroplasty patient, and other topics.

A lunchtime debate on the good and bad features of motion sharing technologies will follow and NASS will continue its section with a focus on cervical and lumbar disc arthroplasty. K. Daniel Riew, MD, will discuss why cervical arthroplasty is a viable alternative to fusion in the setting of symptomatic myelopathy, and Rick C. Sasso, MD, will discuss why cervical arthroplasty should never be used in the setting of symptomatic cervical myelopathy.

Richard D. Guyer, MD, will discuss why lumbar disc arthroplasty has been extremely successful since the procedure was approved by the Food and Drug Administration (FDA), and Todd Albert, MD, will discuss why it hasn’t been as successful as expected.

After the NASS session, ASIA and SRS will present their sections. The ASIA section will examine classification of cervical spine injuries, and the SRS session will focus on attaining balance in adult spinal deformity surgery.

Hip Society/AAHKS
Minimally invasive surgery (MIS) will be a hot topic at the Hip Society/American Association of Hip and Knee Surgeons (AAHKS) program, which will be held in room S100A. The program begins at 8 a.m. with opening comments by Hip Society president James D’Antonio, MD. The first symposium will look at topics involving young adult hip, such as cemented total hips in patients younger than 50.

Eight other symposia are scheduled: bearing surfaces (such as ceramic on ceramic and metal on metal), periprosthetic bone loss, deep vein thrombosis (DVT), femoral neck fractures, revision surgery, and minimally invasive surgery. In addition, the Hip Society awards will be presented and Richard Coutts, MD, will present a summary of research society proceedings.

The MIS symposium will cover patient selection and various surgical approaches, such as the mini-anterior approach and the mini-posterior vs. two incision approach. It will also explore the management of peri-operative pain, look at a comprehensive approach to rehabilitation and discuss measurable and clinically relevant outcomes.

Knee Society/ AAHKS
A popular offering from the Knee Society/American Association of Hip and Knee Surgeons (AAHKS) program promises to be the symposium on computer-assisted and minimally invasive total knee replacements. It will examine the use of computers as teaching tools in knee replacement surgery as well as the use of computer-assisted surgery in difficult total knee reconstruction.

Several surgeons will explain their approaches to MIS knee replacement: Giles R. Scuderi, MD, will discuss the mini-quadriceps split, Steven B. Haas will focus on the mid-vastus approach and Mark W. Pagnano, MD, will explain why he prefers the sub-vastus approach.

The program begins at 8 a.m. in S100BC with a welcome by Russell E. Windsor, MD, Knee Society president, and Joseph C. McCarthy, MD, AAHKS president. A symposium titled “Improving the basics in total knee replacement (TKR): Difficult deformities” will look at severe valgus and varus deformities as well as extraarticular deformity. A symposium on DVT prophylaxis in total knee replacement will look at rationale for the use of low-molecular weight heparin and warfarin in treating blood clots.

Other symposia will cover optimizing flexion in TKR, wear in total knee replacement, burning issues in revision knee surgery, and pearls on avoidance and treatment of intraoperative and postoperative complications.

During the meeting, the Knee Society will present the papers that received the Mark Coventry, Chitranjan Ranawat and John Insall awards.

LLRS
David S. Feldman, MD, and David W. Lowenberg, MD, program chairs for the Limb Lengthening and Reconstruction Society (LLRS): ASAMI-North America, have a full program planned, beginning at 8 a.m. in S503AB. Some of the topics to be discussed in the morning include the use of OP-1 in the treatment of long bone nonunions and the treatment of failed tibial plateau fractures. Treatment strategies for failed supracondylar femur fractures will also be explored.

After lunch, members will regroup to talk about joint distraction in the hip, knee, upper extremity/elbow and foot/ankle. Other topics for the afternoon include: multiaxial correcting, congenital pseudoarthrosis of the tibia and amputation.

MSTS
An expert witness testimony presentation at 1:30 p.m. will highlight the Musculoskeletal Tumor Society (MSTS) meeting in S504ABC. Moderated by Terrance D. Peabody, MD, the lecture, “The top 10 ways to stay out of court!” will explore appropriate testimony for standards of care in orthopaedics. Audience participation is encouraged.

The MSTS program begins at 7 a.m. with a business meeting, followed by opening remarks by William G. Ward, MD, MSTS president, and Brian McGrath, MD, program chairman. Next, a panel discussion on soft tissue sarcoma will feature a presentation on oncologic laboratory targeted therapies in soft tissue sarcoma.

Other topics of discussion will include an update on osteosarcoma, a debate on the role of resection in metastatic cancer and indications for rotationplasty in the young child. Dempsey S. Springfield, MD, and Franklin H. Sim, MD will debate “Aggressive enchondromas exist” vs. “All painful cartilage tumors are malignant.”

The program will end with the MSTS version of the game show Jeopardy, moderated by Mark T. Scarborough, MD. Audience participation is strongly encouraged.

ORA
“The Iraq War Experience: Limb Amputation” will be discussed during a symposium at the Orthopaedic Rehabilitation Association (ORA) meeting, which begins at 7 a.m. in S502AB. The symposium will also feature battlefield injury and field triage, treatment considerations and outcomes for upper arm amputations, and prosthetic options and usage for below elbow amputation. New surgical techniques and future developments in lower limb amputation will be explored, as well as prosthetic advances.

ORA President David A. Fuller, MD, will conduct the breakfast business meeting. Scientific sessions begin at 8:10 a.m., with the presentation of the Jacquelin Perry Award to Sudheer Reddy, MD, Sharat Kusuma, MD, and Mary Ann Keenan, MD, for their research on the cost-effectiveness of surgical intervention for cerebrospastic equinovarus deformity. The session will also include a discussion of surgical treatment of crouched gait in adults with cerebral palsy.

A symposium on the denervated upper limb will look at the history, evaluation and treatment options of brachial plexus injury and the principles and challenges of nerve transfer, among other topics.

OTA
The Orthopaedic Trauma Association (OTA) meeting focuses on “Tips, tricks, pearls and evidence for managing common fractures.” The meeting begins at 7:50 a.m. in S102ABCD with a welcome by OTA President Paul Tornetta III, MD. Alternative surgical approaches for complex fractures (with video) will begin at 9 a.m. The session will look at the anterolateral approach to pilon fractures, percutaneous approaches to the distal femur, open approaches to the distal radius and the extensile approach to the elbow.

In a session on evidence-based solutions for common problems, George J. Haidukewych, MD, with discuss whether open reduction/internal fixation or replacement is best for active elderly patients with displaced femoral neck fractures. Alan L. Jones, MD, will discuss whether amputation or salvage is best for mangled tibia fractures.

Guest speaker Sigvard T. Hansen Jr., MD, will discuss post-traumatic reconstruction of the foot and ankle. His speech will be followed by a symposium on locked plating, which will include a practical guide on the timing of fracture and dislocations.

The program will end with a series of debates on operative versus non-operative care in distal 1/3 humerus fractures, the use of plates or nails in proximal tibia fractures and primary closure versus repeat debridements in open fractures.

POSNA
From ethics and medical liability to tumor treatments and prosthetis, the Pediatric Orthopaedic Society of North America (POSNA) program will be filled with information to help members improve both their careers and their patient care.

The meeting begins at 7:55 a.m. in room S501ABCD with a welcome by POSNA President David Aronsson, MD. Next, Andrew King, MD, will moderate a symposium on management strategies and their ethical considerations. The symposium will include a look at ethics in orthopaedic surgery by Jeanne L. DelSignore, MD, chair of the AAOS Ethics Committee, as well as various treatment options and compliance issues.

An instruction course on practice management will look at marketing a pediatric orthopaedic practice. A second symposium will look at medical liability and the AAOS Professional Compliance Program, with remarks by Peter J. Mandell, MD, chair of the Committee on Professionalism.

After a session on marketing a pediatrice orthopaedic practice conducted by Erick Berkowitz, PhD, attendees will be given a fracture quiz; the results will be announced at the end of the day.

A series of debates will be held in the afternoon. Topics include: “Closed Femur Fractures in School-aged Children: External Fixator vs. Internal Fixation”; “Scheuermann’s Kyphosis in the Adolescent: Treat or Not?”; “Subluxed/Dislocated Hips in the Quadriplegic CP: Reduce/Reconstruct vs. Salvage” and “Adolescent Bunions: Ignore/Avoid/Delay Treatment vs. Aggressive Surgical Treatment.”


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