Revolutionary treatments, latest surgical techniques slated for Specialty Day 2007

Revolutionary treatments, latest surgical techniques slated for Specialty Day 2007

By Carolyn Rogers

Twenty years ago, the nascent Council of Musculoskeletal Specialty Societies (COMSS) proposed a plan to dedicate one day of every AAOS Annual Meeting exclusively to specialty society programs. The following year—during the 1987 AAOS Annual Meeting—10 specialty societies gathered for the first-ever “Specialty Day.”

That tradition will continue at the AAOS Annual Meeting in San Diego, with 13 organizations of the Board of Specialty Societies (BOS/COMSS) presenting their own educational programs at “Specialty Day 2007” tomorrow.

World-renowned experts in every orthopaedic discipline will share innovative surgical techniques, debate controversial topics, and update the nearly 8,000 attendees on the latest advances in orthopaedic research. The following is just a sample of the numerous “hot topics,” state-of-the-art techniques and up-to-the-minute research that will be presented at Specialty Day 2007.

Correcting deformities through “guided growth”

New techniques involving manipulation of the growth plate, enabling “guided growth,” are the focus of the Pediatric Orthopaedic Society of North America’s (POSNA), morning symposia.

“For decades, the growth plate has been a wilderness to avoid,” says Peter M. Stevens, MD, POSNA program chair. “The mainstay of scoliosis correction, therefore, has been bracing, often followed by multilevel instrumentation and fusion—very invasive surgery that permanently stiffens the spine.

“Similarly, the gold standard for correcting angular deformities of the extremities has been invasive osteotomy—requiring stable fixation and often a cast. This is also a draconian approach, fraught with potential errors,” Dr. Stevens adds.

Fortunately, new, less-invasive techniques are now a credible option.

“Tissue engineering is a hot topic now in medicine and orthopaedics,” he says. “The potential to correct deformities in vivo, by controlling and redirecting the chondrocytes of the growth plate, is an exciting frontier.”

As researchers gain a better understanding of the workings of the growth plate, “new techniques have evolved that enable orthopaedists to change the angle of growth—thus correcting deformities without having to fuse the spine or cut and reset the long bones,” Dr. Stevens says.

World-renowned experts will assess the current knowledge and compare various guided growth techniques during the two morning symposia—“Spinal Growth and Modulation (Fusionless)” and “Extremity Growth and Modulation.”

Topics to be addressed in POSNA’s afternoon sessions include subtalar alignment and instability, and treatment of the adolescent knee and hip.

Trauma course targets community surgeons

The Orthopaedic Trauma Association (OTA) is reaching out to community surgeons with its Specialty Day program: “Outside the box: Non-academic medical center trauma.”

“As a specialty, we need to recruit and retain more surgeons on the nation’s emergency room panels,” says Michael J. Bosse, MD, OTA president. “The OTA recognizes this obligation and the critical importance of the community surgeon. Most fractures are cared for in community hospitals.”

That’s why OTA has targeted its program to the non-academic, non-Level 1 trauma center surgeon, he says.

“Major topics will include malpractice risks in trauma care, strategies for developing a viable trauma system in a community hospital, and issues that typically confront today’s trauma surgeon—obese patients and ‘how good is good enough,’” Dr. Bosse adds.

Update on emergency hand surgery

Advances in the management of traumatic conditions of the upper extremity are advancing rapidly. For its Specialty Day program, the American Society for Surgery of the Hand/American Association for Hand Surgery (ASSH/AAHS) will present “Trauma and reconstruction in the upper extremity: Evidence-based care in 2007,” using a practical, case-based format.

“The essential focus of the meeting is to update the practicing orthopaedic surgeon on the most current treatment options for patients presenting in an emergency situation,” says David S. Ruch, MD, chair of the ASSH/AAHS program.

Internationally-renowned speakers have been selected for their specific expertise in a given topic, Dr. Ruch says. Topics include fractures of the clavicle, proximal humerus, elbow and distal radius. Ideal repairs of peripheral nerve and tendon injuries will also be presented.

The ASSH/AAHS program is not simply an “update,” Dr. Ruch adds.

“In keeping with [ASSH President] Dr. Richard Gelberman’s focus on evidence-based medicine, all of the presentations will provide the highest level of evidence to support the recommended treatment,” he says.

Finally, in an effort to define current standards of care, Dr. Ruch adds, “Audience members will be provided with ample time, as well as floor microphones, to interact with the speakers.”

Changes afoot at AOFAS program

The American Orthopaedic Foot & Ankle Society (AOFAS) has made several adjustments to its Specialty Day program, which is designed to expand the overall care provided by the practicing orthopaedist.

For one thing, the society has invited a large number of international surgeons to participate in this year’s program.

“Each symposium will feature at least one international surgeon,” says Christopher W. DiGiovanni, MD, AOFAS program chair. “Physicians in other countries often think about orthopaedic problems differently and take a different approach to treatment. We believe it’s important to cross-fertilize ideas from here and abroad.”

To facilitate that interaction and allow more time for audience participation, AOFAS has shorted the time allotted to individual panel members.

“We’re trying to shift the focus of the meeting from what the panelists think is important to discuss to what the audience wants to talk about,” said Dr. DiGiovanni.

AOFAS is also devoting time to orthopaedic conditions that are rarely discussed and are poorly understood—such as how to approach osteochondral lesions of the talus, surgical options for hallux rigidus, and the subtle cavus foot, says Dr. DiGiovanni.

“These conditions are very common in a foot-and-ankle surgeon’s office, but are reasonably controversial in terms of how they are best treated,” he says. “Leading experts will discuss these conditions and the treatment options in detail.”

Several talks on minimally-invasive surgical techniques for the foot and ankle, which will be presented in a debate format, are also on the schedule.

Sports medicine research

The meeting of the American Orthopaedic Society for Sports Medicine (AOSSM) will focus on recent research in the field, says James P. Bradley MD, AOSSM program chair.

“We’ve assembled a number of leading researchers to discuss the ‘hot topics’ in orthopaedic sports medicine,” he says.

Program highlights include symposia on articular cartilage restoration and the latest techniques in posterior cruciate ligament (PCL) surgery. Other scientific sessions and symposia will focus on anterior cruciate ligament (ACL) reconstruction, the rotator cuff, shoulder instability, the elbow, biceps lesions and more.

The AOSSM program also will feature Q&A sessions, spotlights on surgical techniques, current concepts, clinical insights and debates.

“This will be a very well-rounded meeting, touching on both clinical and basic science topics in orthopaedic sports medicine,” Dr. Bradley says.

New arthroscopic techniques

Highlights of the 40-plus sessions to be presented at the Arthroscopy Association of North America (AANA) Specialty Day program include a discussion of biologic enhancements for regeneration of cartilage and ligament in knees, as well as a session on using silk scaffold to grow a new ACL, says Nicholas A. Sgaglione, MD, AANA Education Committee chair.

Other AANA hot topics include a discussion of arthroscopic interposition graft in the treatment of shoulder arthritis, a presentation on knotless rotator cuff repair, and a demonstration of the latest in computer-guided knee ligament surgery.

Update on difficult primary THA

Comprised of 11 symposia, the American Association of Hip and Knee Surgeons (AAHKS)/Hip Society program offers up-to-date information on the treatment of hip problems—including difficult primary total hip arthroplasty (THA) cases, non-arthroplasty options, a discussion of complication management, the current thinking on bearing surfaces, and an update on revision THA.

“This year’s hot topics include updates on hip resurfacing, the use of computer-assisted navigation in THA and video demonstrations of the latest surgical techniques,” says Douglas Dennis, MD, Hip Society program chair.

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