AAOS: Five Unnecessary Orthopedic Procedures

Does the doctor always know best? A recent release by the American Academy of Orthopaedic Surgeons (AAOS) suggests that the answer may be “not always.” Through its participation in the “Choose Wisely” campaign, the American Academy of Orthopaedic Surgeons has released a list of five procedures, commonly proscribed by orthopedic surgeons that research has found to be of little value to patients. They are:

1. Routine ultrasound screening to check for deep vein thrombosis in hospital patients after hip and knee replacement surgery, if they do not have symptoms of a blood clot
2. Needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief
3. Glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee
4. Lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee
5. Postoperative splinting of the wrist after carpal tunnel release for long-term relief.

Joshua J. Jacobs, M.D., president of AAOS, explained that: “Identifying tests, procedures or treatments that show little to no value not only helps our patients by preventing unnecessary care, but will end up saving health care dollars.” According to the release, the AAOS is participating with more than 30 medical organizations in releasing similar lists in an effort to encourage medical professionals to follow evidence-based guidelines. Jacobs hopes that his organization’s “participation in the Choosing Wisely campaign will help shape patient-physician dialogue.”

Research has shown that there are many reasons why doctors fail to follow evidence-based guidelines. They include not knowing about them, being in disagreement with them, working at a place that does not encourage or support change, or not being motivated to change.