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Canadian Orthopaedic Association Annual Meeting 2012 Coverage

The 67th Annual Meeting of the Canadian Orthopaedic Association was held from June 8 to June 10, 2012, in Ottawa, Ontario, Canada. Below are summaries of the research reported at the meeting.

Tailoring Patient Decision Aids to Address Their Concerns
A survey of more than 1,900 orthopedic surgery patients has given Toronto researchers a better understanding of why patients are unwilling to have surgery. The information will be used to develop better decision aids - tailored to patients' needs - which, ideally, will improve knowledge, enable better patient-surgeon communication and save time.

Fragility Fracture Prevention Begins in the Clinic
Programs to prevent a second fragility fracture have succeeded in increasing the number of patients sent home from the fracture clinic with treatment for osteoporosis, attendees heard at the Canadian Orthopaedic Association annual meeting. The programs, located at various locations in Ontario and in Montréal, also attempt to educate patients on osteoporosis.

Where Have All the Orthopedic Surgery Jobs Gone?
Orthopedic surgery residents are facing a diminishing job market, thanks to more orthopedic residency spots, fewer retirements and limited health care resources to create new jobs. Cutting residency spots is one solution, but changing the way care is delivered is another option.

Clear Policies Advocated for Managing Infected Physicians
Physicians need to advocate for clear, arm's-length policies concerning colleagues who test positive for blood-borne pathogens, attendees at the Canadian Orthopaedic Association (COA) annual meeting in Ottawa were told.

Minor Perioperative Adverse Events Significantly Affect Length of Stay
Perioperative adverse events that required no or minor treatment significantly increased the length of hospital stay - by an average of five days - researchers from the universities of Ottawa and Toronto have found.

Readmission for Total Joint Replacements Mostly Due to Infection, Not Failure to Cope
Researchers in Hamilton, Ont., have concluded that discharge planning following total joint replacement is better than they thought. This is because only 5.3% of readmitted patients returned because of "failure to cope" among 95 patients readmitted to hospital within a month after joint replacement surgery.

Patients with Atypical Femoral Fractures Have Different Bone Structure, May Respond to Teriparamide
Investigators in Toronto are trying to figure out what causes atypical femoral fractures and how they should be treated. These subtrochanteric and diaphyseal femoral fractures are rare, occur with no or mild trauma and are a source of prodromal pain. The long-term use of bisphosphonates has been found to increase the risk of these fractures.

Obese Patients with Osteoarthritic Knees Benefit from Training on Antigravity Treadmill
Obese patients with knee osteoarthritis have less pain and better quality of life after exercising twice a week on a treadmill that reduces the amount of weight placed on the knee, a study from the University of Manitoba has shown.

Hip Resurfacing Failures Can Be Prevented with Proper Patient Selection
A review of 2,773 hip resurfacings done in 11 Canadian centres (2001-08) shows femoral neck fracture is the main reason resurfacings fail and require revision. Male patients with larger femoral head diameter had the lowest rate of resurfacing failures.

Anterior Cruciate Ligament Preservation Surgery Results in Better Outcomes
Patients who had anterior cruciate ligament (ACL) reconstruction where the ligament was preserved had significantly better improvements in quality-of-life scores at one year compared to standard reconstruction surgery, researchers from the University of Calgary have demonstrated.

Predicting Who Will Heal after a Subacute Scaphoid Fracture
Researchers from the University of Western Ontario in London, Ont., have identified predictors that could help physicians determine whether a subacute scaphoid fracture will heal on its own after being immobilized in a cast or will need surgery.

Reconstructed Knees Have More osteoarthritis, but Long-Term Outcomes Are Good
A long-term study of patients who had anterior cruciate ligament (ACL) reconstruction showed reconstructed knees had more osteoarthritis than knees which had not been operated on. The good news is that three-quarters of patients reported positive outcomes in terms of symptoms and activities of daily life 12 years after knee reconstruction.

Web-Based Follow-up after Total Joint Arthroplasty Shows Promise
Early results from a randomized trial at London Health Sciences Centre, London, Ont., show a web-based follow-up after total knee or hip replacement is saving patients time, distance and travel-associated costs.

Hockey Forwards, Stronger Players Sustain More Injuries
The bigger, stronger guys in male collegiate hockey teams are more likely to sustain on-ice injuries, but it's not clear what can be done to prevent them getting hurt.

Putting Weight on Post-Op Hips Doesn't Affect Length of Hospital Stay
Older patients who did weight-bearing activities following surgery for hip fractures did not stay any longer in hospital than those who were restricted in how much they could bring to bear, Dr. Cai Wadden and colleagues from the University of Ottawa have found.

Hyperglycemia Common after Total Joint Replacement
A study that screened for diabetes patients who have had total joint replacement suggested 33% of them could have undiagnosed postoperative hyperglycemia or diabetes. The presence of untreated hyperglycemia has been shown to increase the risk of infection following joint replacement surgery.

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