August 2002 Bulletin

In the News

AAOS asked to join pain management panel

The American Academy of Orthopaedic Surgeons (AAOS) has been invited to participate on a Pain Management Expert Panel being convened jointly by the American Medical Association, the Joint Commission on Accreditation of Healthcare Organizations and the National Committee for Quality Assurance. The primary purpose of the panel is to develop recommendations on a set of performance measures for pain management with a focus on cancer, arthritis and back pain. These measures will be used to evaluate the delivery of services across the continuum of care including practitioners, provider organizations and health plans. James S. Breivis, MD, of San Francisco, will represent the perspectives of the AAOS in this project.

"Find a Surgeon" feature expands

The "Find a Surgeon" feature of the AAOS web site will soon be enhanced to allow visitors to search the databank of AAOS member orthopaedic surgeons by treatment specialty, anatomical specialty and age. This feature will be launched on Sept. 1, 2002, when "Find a Surgeon" will also be renamed "Find an Orthopaedist." Links to "Find an Orthopaedist" can be found on both the Web site’s home page and on the patient education section, Your Orthopaedic Connection. Thousands of consumers visit Your Orthopaedic Connection each month and many of these individuals are looking for a surgeon to consult. "Find an Orthopaedist" will give them an easy way to find surgeons in their communities who specialize in caring for the orthopaedic condition for which they need treatment. Members who are interested in being listed in the databank under these additional designations need to declare the anatomical areas, age groups, and treatment specialties that they handle; this is entirely voluntary. Unless they have specifically requested otherwise, all Fellows are currently listed in the data bank by name and geographic location. They can enhance their listing by going to the Service Requests area of the Member Services section of the Web site and select the additional listing categories noted above. Or, for the next month or so, they can also click on "What’s New" on the site’s main splash page. The direct link is:

OREF seeks surgeon input on the use of DVT prophylaxis

The Orthopaedic Research and Education Foundation (OREF) is seeking input from orthopaedic surgeons about usage of deep vein thrombosis DVT) prophylaxis in their total hip and total knee arthroplasty patients. OREF encourages orthopaedists to take a few minutes to respond to the on-line survey, posted on OREF’s website at The results of this survey should be of significant interest and benefit to the orthopaedic community, as DVT continues to be an important patient safety issue confronting the orthopaedists in their practice. Please take a few minutes to visit the OREF web site, and respond to this important survey. Deadline for responding is September 13, 2002. For more information, please contact Judy Sherr at

CMS to expand Medicare coverage of NMES

The Centers for Medicare and Medicaid Services (CMS) announced that it intends to expand Medicare coverage of Neuromuscular Electrical Stimulation (NMES) to assist people with spinal cord injuries in walking. Since 1984 NMES has been covered for treatment of disuse atrophy where the nerve supply to the muscle is intact and where other non-neurological reasons for disuse are causing atrophy. All other uses of NMES were not covered. To ensure that only patients who can utilize and benefit from these devices receive them, Medicare intends to cover the use of NMES for walking for those persons with intact lower motor units (L1 and below), with at least six-month post recovery spinal cord injury and restorative surgery, without hip and knee degenerative disease and no history of long bone fracture secondary to osteoporosis, who have demonstrated a willingness to use device long-term, who have completed regular sessions of physical therapy with the device over a period of three months, who can bear weight on their lower and upper extremities, maintain an upright posture independently, transfer independently, and stand for at least three minutes. Other factors are patients who possess high motivation and commitment and cognitive ability to use such a device for walking, demonstrate hand and finger function to manipulate the controls, and demonstrate brisk muscle contraction in response to NMES and have sensory perception of electrical stimulation sufficient for muscle contraction. Also, the goal of therapy must be to train SCI patients on the uses of NMES/FES to achieve walking, not to reverse or retard muscle atrophy.

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