OTW Staff

Articles by OTW Staff

BEAR at Six Years: Finally Ready for Prime Time?

Six-year BEAR results looked similar to hamstring ACLR, with higher hamstring strength.

Jun 15, 2026

The Cementless Tibia: A Viable Fixation Alternative

Two of the best knee surgeons duke it out over cemented versus cementless. After a full ten rounds, Indiana’s Meneghini pretty much earned a split decision against Penn’s Lee. Fellow Philadelphian, Bob Booth refereed one of the best Classic Debates. A must read.

Jun 22, 2020

The Primary Modular Tibia: Regardless of Age & BMI

The first question every arthroplasty surgeon asks is: “Given my patient’s age and BMI {body mass index}, what implant do I use?”. This debate is about how you answer that question. Hofmann v Berend and could one implant – the primary modular tibia—be a one size fits all? Check out this great debate.

Jun 2, 2020

Patella Resurfacing: Rarely, If Ever Necessary

Anterior knee pain is this very stubborn problem that bedevils every large joint surgeon. What role does resurfacing, or not resurfacing, the patella play? With Bob Booth moderating, Robert Barrack and Steven Haas energetically tackle this very timely and important subject in yet another Classic Debate.

May 28, 2020

The Tourniquetless TKA: A Miraculous Conversion

Ready to go tourniquetless? HSS’s Jose Rodriquez was not, until he looked at the data and listened to his mentor Chit Ranawat and had a miraculous conversion. Not so fast, says the inimitable Bob Booth. There’s an important place for the tourniquet in most cases. Great debate. Where do you stand?

May 1, 2020

Abdel v. Dennis: The Cup Cage Construct: Preferred Solution for Pelvic Discontinuity

These are tough, tough cases. The patient is distraught. Disabled. Pelvic discontinuity is the sticky issue. What to do? Mayo’s Abdel makes a strong case for a cup-cage construct. But Colorado’s Dennis counters effectively on behalf of a custom triflange. Who is right? To find out, read this excellent debate and discussion.

Mar 30, 2020

Garvin v. Padgett: Dual Mobility: First “Choice” for the High Risk Primary & Recurrent Dislocator

Hip instability, for any number of patient-specific or physician-specific reasons, is unacceptably high. Do you go for the larger head or dual mobility? Nebraska’s Kevin Garvin argues for dual mobility while HSS’ Padgett strenuously disagrees. Harvard’s Thornhill moderates this excellent and timely debate.

Feb 7, 2020

Jacobs v. Whiteside: Metal Sensitivity: A Clinical Bridge Too Far

Does metal allergy really exist? How prevalent is it? And what’s the diagnosis? Rush’s Joshua Jacobs debates the esteemed Leo Whiteside and, with help from Moderator Thomas Thornhill, come up with answers to those and other questions. It’s a great and illuminating discussion.

Jan 28, 2020

Hamilton v. Meneghini: The Anterior Approach: Better, Faster, Cost Effective

>> Yes, Virginia, there is something new to learn about the anterior hip approach. William Hamilton, whose hip practice is primarily direct anterior takes on Mike Meneghini, who speaks eloquently on behalf of the posterior approach. Has the pendulum in favor of anterior swung too far? You be the judge. Harvard’s Thornhill moderates.

Jan 24, 2020

O’Connor v. Lewallen: Patient Specific TKA Provides Improved Satisfaction

One of the best debates ever. Yale’s Mary O’Connor presents a compelling case for customized knee implants. But Mayo’s resident curmudgeon isn’t buying it. Mary had more studies in her arsenal. But Lewallen had the scars of experience. Who wins? You do. It’s a great debate.

Jan 9, 2020

Gustke v. Thornhill: Simulation Training: This is the Future?

Who would you trust more—a resident with predominately simulation training or a resident with predominately real patient training? It’s not a simple answer. Simulation may be the future, but there are some very important nuances to pay attention to. Great debate. Important reading.

Dec 19, 2019

Gehrke v Barrack: Ceramics Decrease the Incidence of Peri-Prosthetic Joint Infection

Are ceramic bearing surfaces less prone to infection? In this interesting debate, Gehrke points to registry and other data to suggest it might. Barrack counters, quite rightly, that association is not causation. Still, to use a bird analogy, canaries in the coal mine are also merely associative. Could this registry “noise” be a canary? Interesting debate.

Nov 15, 2019

Lee v. MacDonald: Ceramic-Ceramic: Pricey Longevity for the Young Active Patient?

Are ceramic-on-ceramic bearings durable enough to justify cost, squeaking and malposition risk? “Yes” says University of Penn’s Gwo Chin-Lee. “No” says the inimitable Steven MacDonald from University of Western Ontario. This crackling debate is moderated by Mayo’s Dan Berry. Check it out.

Nov 5, 2019

Garbuz v. Engh: Ceramic Heads Should Be Used in All Patients

Are ceramic heads worth the cost? Donald Garbuz, who uses ceramic heads every time, says yes. Anderson Engh, says no, it’s not worth the cost. And there are excellent reasons for both conclusions. Who wins this debate? You might be surprised at the answer.

Oct 21, 2019

Lachiewicz v. Sculco: Dual Mobility: “Everyman’s” Choice for High Risk & Recurrent Dislocation

She’s an elderly patient with recurrent dislocations. Use a constrained liner or dual mobility? Lachiewicz champions dual mobility while HSS’ Sculco makes a case for constrained liners. Who wins? You be the judge.

Sep 6, 2019

Abdel v Hamilton: Simultaneous Bilateral Anterior Hips: Double Trouble

Double trouble or an obvious surgery? Would you try a bilateral anterior hip surgery? Bill Hamilton from Anderson Institute does and he’s delighted with it. Mayo’s Abdel is not nearly no sanguine. Not at all. For him, it’s an unnecessarily risky procedure. Interesting debate for sure.

Aug 23, 2019

Trousdale v. Sculco: Porous Metal Cones: Optimal Solution for Bone Deficiency

In your tough knee revision cases with significant bone loss, is it time for a $4,000 cone or do you reach for bulk allograft? Mayo’s Trousdale says ‘cone’ while HSS’s Sculco says allograft most of the time. Who wins this great debate? You be the judge.

Aug 14, 2019

Lewallen v Hofmann: The Cemented All Poly Tibia: Regardless of Age & BMI

Are you only using all-poly tibias for older patients? In this debate Mayo’s Lewallen puts up the argument that all-poly is “ok” all the time. Aaron Hofmann pushes back and by the end of this debate, both senior surgeons reach a consensus. Another stellar debate.

Aug 6, 2019

Meneghini v. Padgett: Posterior Stabilized Knee Designs: Vestigial Organs

A classic debate updated and revisited. Squaring off is Mike Meneghini who maintains that the cam-post is obsolete and Doug Padgett, who counters with “Michael, you are absolutely wrong!” Check out this enjoyable and informative debate.

Jul 27, 2019

Gustke v. Thornhill: The Cementless Knee: The Emergent Game Changer

>> Is the cementless knee an emergent game changer? Probably not according to this terrific debate. The jury is still out. But new materials in the R&D pipeline could tip the scales in favor of cementless. Hear Drs. Gustke and Thornhill dissect this very timely topic.

Jul 12, 2019

Romeo v. Cordasco: OA in a 60-Year-Old: Stemless Trumps Stemmed Implants

>> Is the stemless shoulder implant a triumph of technology over reason…or the wave of the future? Tony Romeo is thinking stemless while Frank Cordasco says it’s a bit too early, the data is not so strong. Who wins? You be the judge.

Jul 11, 2019

Sperling v Jobin: Severe Glenoid Bone Loss in a 70-Year-Old: Reverse is the Way to Go

Elderly patients with severe glenoid bone loss. Do you go anatomical or is this a good set of circumstances for a reverse shoulder arthroplasty? Mayo’s Sperling is all about going in reverse while Dr. Jobin sticks with an anatomical approach. It’s a great debate.

Jul 5, 2019

Galatz v. Flatow: Four-Part Fx’s in an Active 65-Year-Old: Reverse is the Preferred Treatment

Reverse shoulder surgeries have skyrocketed but is it the preferred treatment for patients with 4-part fractures? Dr. Galatz says “yes” while her colleague Dr. Flatow argues persuasively in favor of other options including non-operative care. Very informative debate.

Jun 7, 2019

Gehrke v Haddad: The Hinge: Prerequisite Solution for the Infected TKA

>> To hinge or not to hinge the knee. At Gehrke’s ENDO-Klinik in Hamburg, the decision in 99% of relevant cases is to hinge. But at Haddad’s University College in London, not so much. Can the Brits learn something from the Germans or vice versa? You be the judge.

May 24, 2019

Thornhill v. Springer: Measured Resection Trumps Gap Balancing in TKA

Mind the gap. Or measured resection. Or both? The esteemed Thomas Thornhill from Harvard butts heads with fellow West Virginian (by marriage) Bryan Springer from OrthoCarolina over this issue of Gap Vs Measured Resection. Prepare for a master course from two of the best.

May 13, 2019

Abdel v. Schmalzried: The Cementless Knee: Emergent Game Changer

Cemented or Uncemented? That is the question. Whether it is the elderly patient with fixation needs or the younger active patient, where do you stand on this question? Mayo’s Abdel and Joint Replacement Institute’s Schmalzried tackle this very important subject in an even better debate.

May 6, 2019

Dunbar v. Lewallen: Kinematic Alignment Optimizes Patient Outcome

Here’s one of the most controversial total knee reconstruction topics there is. Kinematic Alignment vs. Neutral Mechanical Alignment. The sparks fly a little, but mostly this debate between Dunbar and Lewallen, moderated by Mayo Clinic’s Daniel Berry, sheds a tremendous amount of light on this very important subject.

Apr 30, 2019

Haas v. MacDonald: Robotic Assisted TKA: The Future Is Now

Robotic assist for total knee arthroplasty or tried and true navigation? HSS’ Steven Haas debates Western Ontario’s Steven MacDonald and argues that, yes, the million dollar robotic assist devices make you a better surgeon. Read this timely debate.

Apr 8, 2019

Walter v. Nam: Medial Pivot Designs Avoid the Need for Ligament Balancing

When William Walter from Waverton, Australia, took on Denis Nam from Rush in Chicago over medial pivot knee designs, one of the best, classic debates broke out. For ANY joint arthroplasty surgeon, this is a must-read debate about implants and knee balancing.

Feb 21, 2019

Meneghini v. Padgett: Posterior Stabilized Knee Designs: Vestigial Organs

Posterior Stabilized or Cruciate Retaining? Have designs progressed to the point where cruciate retaining deserves more support? Meneghini is a strong “yes” while HSS’ Padgett sticks with the post. Who won their case? You be the judge.

Jan 22, 2019

Della Valle v. Sculco: Dual Mobility Cups: The Emergent Solution for Recurrent Dislocation

She’s a 60-year-old patient, she’s frantic because her total hip dislocated. She has trunnion problems; her abductor mechanisms are compromised and she’s at ultra-high risk for instability. Do you go dual mobility or constrained liner? This debate has answers.

Jan 11, 2019

Gross v. Berend: The Cup Cage Construct: Preferred Solution for Pelvic Discontinuity

Pelvic discontinuity and acetabular disasters. With Mayo Clinic’s Daniel Berry moderating, Allan Gross from Toronto and Keith Berend from New Albany break down the issues and solutions in a masterful discussion. Ultimately, this is a question of customized procedure vs customized implant.

Dec 31, 2018

Dorr v. Taunton: The Mini-Posterior Approach: Evidence Over Eminence

Has the Hype over anterior total hips obscured the time-tested value of the mini-posterior approach? Absolutely! Says USC’s Larry Dorr. Not so fast says Mayo Clinic’s Michael Taunton. It’s a lively debate and really exposes the need for better long-term data.

Nov 28, 2018

Parvizi v. Barrack: Ceramics Decrease the Incidence of Peri-Prosthetic Joint Infection

Could your choice of bearing surface affect your risk of peri-prosthetic joint injection? “Yes” says Rothman Institute’s Parvizi. “No” says the Knight Professor of Orthopedic Surgery, Robert Barrack. It’s a great debate. You don’t want to miss it. Here it is.

Nov 13, 2018

Walter v. MacDonald: Ceramic-Ceramic: Articulations of Longevity for the Young Active Patient

Ceramic-on-ceramic components have such low wear rates that, in theory, they could last 40 years. But at what cost? The debate is on with Australia’s William Walter speaking in favor and Canada’s Steven MacDonald taking the opposite view. And yes, squeaking hips was addressed.

Nov 1, 2018

Trousdale v. Engh: Ceramic Heads Should Be Used in all Patients

Cobalt chrome or ceramic? Cost or corrosion? Two lions of the debating stage start off in one direction but then veer into a more vital and relevant discussion. This is a great ‘debate’ by Mayo’s Trousdale, Anderson Institute’s Engh as moderated by Harvard’s Thornhill.

Oct 26, 2018

Gehrke v. Sculco: Routine Use of Antibiotic Bone Cement in Primary TJA is Justified

Periprosthetic joint infection is a catastrophic problem but is avoiding catastrophe reason enough to justify routine use of antibiotic bone cement? This debate tackles both that issue and differences between U.S. and European approaches. Very informative.

Oct 19, 2018

Lachiewicz v. Callaghan: Dual Mobility Cup: Emergent Standard for Recurrent Dislocation

Dual Mobility Cup or Restrained Liner? When it comes to revision cases, the battle lines are clearly drawn between Paul Lachiewicz from Duke University and John Callaghan from University of Iowa. The winner? The audience attending this excellent debate.

Oct 8, 2018

OTW Streaming from NASS 2018

Orthopedics This Week streams the latest in navigation, cervical and robotic technology from the floor of NASS 2018.

Oct 2, 2018

Flatow v. Sperling: Lateralization in Reverse TSA: Bone Graft & Long Stem Outdistances Metal

This debate is a must read for every surgeon doing reverse shoulder procedures. This master course by Flatow and Sperling delivers detailed and time-tested advice on fixation, bone loss and blending bone graft with metal. Really exceptional discussion.

Sep 10, 2018

Krishnan v. Lederman: OA in a 50-year-old: Stemless TSA Trumps Resurfacing Arthroplasty

To Stem or Not to Stem, that is the question—for shoulder arthroplasty. Arguing in the affirmative is Butch Krishnan from Baylor, opposing him is Evan Lederman from the University of Arizona. Very timely debate with many practical tips for every shoulder surgeon.

Aug 13, 2018

Levine v. Warner: Four-Part Shoulder FX in an Active 70-Year-Old: Reverse Is Overkill

Reverse shoulder or hemiarthroplasty surgery for the active, tennis playing 70-year old? As this debate illustrates, that’s a provocative question. Harvard’s Jon Warner squares off with North Dakota’s favorite son, Bill Levine to tease out the answer. Great debate.

Aug 6, 2018

Barrack v. Lombardi: The Tourniquetless TKA: Let It Bleed

Tourniquets are employed approx. 15,000 times a day. But how, for how long and in which cases make ALL the difference. Three old hands – Thomas Thornhill from Harvard, Robert Barrack from Wash U and Adolph Lombardi from New Albany – give a master class in this classic debate.

Jul 27, 2018

Haddad v Ranawat: The Medial Stabilized Knee: The “Post-Cam” Replacement

Has knee arthroplasty hit a 15-20% patient dissatisfaction wall? If so, could a solution be hiding in an older technology, the Freeman medial pivot approach? Fares Haddad says that it might while Chit Ranawat argues the opposite. Welcome to a very lively debate.

Jul 20, 2018

Trousdale v. Mullaji: Knee Navigation: Lost in Space

Computer-assisted total knee arthroplasty has its proponents and its critics. In this debate two of the most accomplished and articulate total knee surgeons debate the value and efficacy of computer assist devices in the OR. Tremendous and very timely discussion.

Jul 12, 2018

Abdel vs. Lee: The Cementless Knee: An Emergent Game Changer

Cementless hips is well established. But in knees? Matthew Abdel from the Mayo Clinic contends that the time is here for cementless knee arthroplasty. Gwo-Chin Lee makes the obvious point that knees aren’t hips. Of course, there’s so much more. This is a great debate.

Jul 8, 2018

Sculco v. Nam: Neutral Mechanical Alignment: Stickin’ With the One That Brung Ya

Twenty percent of knee patients, give or take, are not happy with their new knees. Assuming the implant is surviving long term, is this persistent issue due to alignment problems, unreasonable expectations or all of the above and more? Peter Sculco and Denis Nam tackle these thorny issues in this week’s excellent debate.

Jul 2, 2018

Barrack v. Haas: Patella Resurfacing: Rarely, if Ever, Necessary

Twenty percent of knee replacement patients are not happy with their total knee replacements. What role could patella resurfacing (or not) play? Two giants of knee replacement, Robert Barrack and Steven Haas, tackle this very critical topic.

Jun 8, 2018

Meneghini v. Hamilton: Posterior Stabilized Knee Designs: Vestigial Organs

Do total knee replacements render the PCL a vestigial organ—as in, it’s lost its original function? If so, is that clinically relevant? Two giants of large joint replacement surgery wade in on this core issue and point out that updated implant designs and materials may well have resolved this debate.

May 22, 2018

Pagnano v. Lombardi: The Bi-Cruciate Retaining Knee: A Bridge Too Far

Back to the future with bi-cruciate retaining knee? A trio of Italians tackle this intriguing subject with Mayo Clinic’s Pagnano taking the affirmative, Mt. Carmel’s Lombardi disagreeing and HSS’ Sculco refereeing.

May 16, 2018

Trousdale v. Hofmann: The Cemented All Poly Tibia in the Active < 60 Patient

Cemented all poly tibias are certainly something to consider for the active, under 60-year-old patient. In this well-reasoned debate, arguments emerged in favor of all poly but questions about versatility in the long-run—particularly in revision situations—were also articulated.

May 4, 2018

Whiteside v. Callaghan: The Cementless TKA: It’s About Time

Two Hall of Famers debate one of the great questions in large joint reconstruction—cemented or cementless. Both of these guys have forgotten more than most surgeons know. So, take notes. This is a great debate.

Apr 16, 2018

Ranawat v. Dunbar: Neutral Mechanical Alignment: Stickin’ With the One that Brung Ya!

What percentage of your knee patients ‘look good, feel bad’? If its 18%, you’re typical. Why? One reason may be over reliance on neutral alignment. That heretical thought was forcefully and brilliantly raised in this remarkable debate between Chit Ranawat and Michael Dunbar. If ever there was a MUST READ debate, this is it.

Apr 10, 2018

Lombardi v. Schmalzried: Ceramic-XLPE in Patients <60: The New Standard

Ceramic with cross-linked polyethylene, is this the new standard for patients under 60 years of age? Adolph Lombardi from New Albany, Ohio’s Mt. Carmel Surgical Hospital says yes. But Tom Schmalzried from Los Angeles isn’t so sure. After reading this debate, what will you think?

Mar 1, 2018

Gross v. Abdel: Avoiding Instability: The Transtrochanteric Approach

>> Ready for a great discussion on a tough subject? This may well be the “meatiest” CCJR debate yet. Gross and Abdel tackle the always interesting subject of removing the greater trochanter for difficult primary or revision hips. Trousdale masterfully moderates. One of the best CCJR’ debates.

Feb 26, 2018

Stulberg v. Dorr: The Short Stem: Proven Solution for ALL Primary Hips

No shortage of important considerations when it comes to the short stem. David Stulberg and Larry Dorr, through the miracle of Seth’s debate format, uncover and review the most important pluses and minuses regarding short stems for primary hip arthroplasty.

Feb 6, 2018

Brooks v. MacDonald: Why Cut Off Your Head? Resurface It Instead

Resurfacing or replacement? This was not even close. Three guesses as to which debater won this contest—and the first two guesses don’t count. This sharply fought contest pits Cleveland Clinic’s Peter Brooks against University of Western Ontario’s Steven MacDonald. BC’s Clive Duncan referees.

Jan 18, 2018

Berend v. Lieberman: The Outpatient THA: A Paradigm Change

Outpatient total hip arthroplasty or inpatient. Berend says outpatient is a paradigm shift and represents the future of arthroplasty. Lieberman notes, quite correctly, that outpatient is not for every patient and simple aphorisms don’t serve either the patient or the surgeon well. Excellent debate on this timely subject.

Jan 11, 2018

Rodriguez v. Springer: The Anterior Approach: Better, Faster, Safer

>> Finally, a fair, balanced, fact-based and experiential debate about anterior hip surgery. Not for everyone. Not for every patient. Has clear advantages…for a short while. But is that what hip arthroplasty is all about? Short term outcomes? No spin zone here. One of the best anterior hip debates yet.

Jan 5, 2018

Lee v. Padgett: Ceramic-Ceramic Bearings in Patients <60 Assures Longevity

Has cross linked polyethylene put wear and tear to bed as an issue? Can younger patients expect a poly hip to last 20 or 30 years or longer? Not likely says Gwo-Chin Lee and he makes a case for ceramics. Doug Padgett counters with 13-year data. Excellent debate.

Dec 26, 2017

Whiteside v. Parvizi: Intra-Articular Antibiotic Irrigation Has a Role in Revision Arthroplasty

Two giants of orthopedics Leo Whiteside and Javad Parvizi go head to head on the topic of antibiotic irrigation. Whiteside says it’s the only way to go. Parvizi says dilute Betadine and new CDC guidelines will do just fine, thank you. It’s a great debate!

Sep 26, 2017

Lachiewicz v. Callaghan: Dual Mobility Obviates the Need for Constrained Liners in Revision THA

Recurrent dislocations, total hip revisions—for whatever reason—these are tough problems. Is a dual mobility articulation a better answer than constrained liners? Lachiewicz and Callaghan go head to head over this hot topic. Who wins? You do. This debate is timely and highly instructive.

Sep 13, 2017

Hamilton v. Haddad: The Anterior Approach: Better, Faster, Cheaper

After articles in The New York Times, The Wall Street Journal and The Washington Post, it’s no wonder that the anterior hip approach is the fastest growing new THA approach in decades. But is it really better, faster, cheaper? Maybe not. This is the debate EVERY hip surgeon should read diligently.

Aug 25, 2017

Berend v. Meneghini: Liposomal Bupivacaine Injectables: Game Changers in Pain Management

The #1 game changer in large joint arthroplasty has been the shift from inpatient surgery to better pain control and outpatient surgery. Liposomal bupivacaine is the poster child of this shift, but is it worth the extra $300? Michael Berend and Michael Meneghini debate this question in an absolutely stellar review of the latest data.

Aug 18, 2017

Barrack v. Lombardi: Patella Resurfacing: Rarely, if Ever Necessary

Popular overseas but less so in the United States. Barrack debates Lombardi over patella resurfacing. Is it really necessary? And, if so, when? This is a solid point counter-point debate with plenty of data to chew on. Another classic CCJR debate.

Jul 11, 2017

Caretalk Tackles Insurer M&A: Dead yet?

Top healthcare blogger, John Driscoll, talks with David Williams (Health Business Group) about the end of health insurance merger mania, the climbing price of drugs, high-risk pools and more.

Jul 6, 2017

Trousdale v. MacDonald: The Cemented All Poly Tibia in the Active <60 Patient

Would you use an all poly tibia in the active patient under 60 years old? Of course you should, says Robert Trousdale from the Mayo Clinic. No way! Says Steven MacDonald from the University of Western Ontario. Younger patients have higher revision rates with an all poly tibia. Who wins this great debate? You be the judge.

Jun 16, 2017

Haddad v. Pagnano: Simultaneous Bilateral TKA: Are They Safe, Effective & Cost-Efficient?

Deep down, do you broadly agree with bilateral total knee arthroplasty? Mr. Haddad thinks so but Dr. Pagnano vigorously disputes that in a spirited and highly informative debate. It’s all about risk and return. Enjoy this great exploration of a key question.

May 3, 2017

Hofmann v. Callaghan: Gentleman’s Varus Alignment Optimizes TKA Function

Accuracy is everything. This week’s debate is all about varus alignment. If you aim for 3 degrees do you actually get 5 or 6? Or is that a lame argument given today’s computerized navigation tools? Hofmann and Callaghan go six rounds on this timely issue.

Apr 13, 2017

Gustke v. Schmalzried: Cementless TKA: As Older Patients Become Younger

Cementless implants…new and improved or just new and unproven? This week’s debate pits Thomas Schmalzried against Kenneth Gustke in a lively discussion of the cemented versus uncemented implants. Let the games begin!

Mar 28, 2017

Galatz v. Crosby: Biceps Long Tendon: Pain Generator Requiring Tenodesis in TSA

OK, everyone agrees tenodesis is the way to go for TSA. But with no prospective, randomized clinical trials regarding the long head of the biceps after total shoulder arthroplasty there remain too many questions. Which, of course, results in a spirited debate between Galatz and Crosby.

Feb 16, 2017

Flatow v Seitz: Optimal Glenoid Fixation Requires Cement

Excellent debate this week. While both debaters agree that metal backed shoulder implants fail, the battle lines are clearly drawn when it comes to uncemented tantalum versus cemented poly. Evan Flatow and Bill Seitz give us an outstanding debate and review this week with Thomas Thornhill moderating.

Jan 12, 2017

Romeo v Sperling: Moderate OA in Patients <50: Best Treated with Arthroscopic Debridement

This is a very challenging problem. Young people with severe shoulder problems. Arthroplasty or arthroscopy? In this debate, the nuances are in full display. This is one of CCJR’s best. Congrats to Seth Greenwald for this excellent program.

Dec 16, 2016

Lewallen v. Hofmann: The Cemented All-Poly Tibia: An Affordable Care Act Solution

All-poly tibia is a very cost effective alternative and, says David Lewallen, M.D., should be part of every knee surgeon’s armamentarium. BUT, newer modular designs and metal backed trays give today’s surgeon more versatility, counters Aaron Hofmann, M.D. This is an essential debate and a must read for every orthopod.

Dec 12, 2016

Lonner v. Haas: Patella Resurfacing: Rarely if Ever Necessary

This week’s Orthopaedic Crossfire® debate tackles the sometimes contentious subject of patella resurfacing. Jess Lonner says it is rarely, if ever, necessary. Steven Haas finds a slew of meta studies that say otherwise. Who wins? You be the judge.

Nov 14, 2016

Jones v. Berend: The Tourniquetless TKA: Let It Bleed

To tourniquet or to not tourniquet, that is the question. Dickey Jones says “Let it Bleed”. Keith Berend fights mightily to defend a near defenseless position. But at the end of the day, the winner, it seems, is tranexamic acid. Get ready to read one of the most unusual CCJR debates yet. Have fun folks.

Nov 3, 2016

The Use of Stems in Complex Primary TKA: Necessary & Sufficient

To stem or not to stem, that is the question when faced with a specifically complex primary or revision knee arthroplasty because of deformity or instability. New Zealander Kelly Vince gives the pro-stem case while HSS’ Thomas Sculco shows himself to be a stem-less kind of guy. Who wins? The reader. Another truly excellent and informative debate from CCJR.

Oct 25, 2016

Nam v Lombardi — Patient Specific Instrumentation: Added Cost & Unproven Value

Patient specific instrumentation: added cost with no proven value or an evolving technology to raise outcomes and improve OR efficiencies? This very timely debate pits two great surgeon/scientists against each other and in the process sheds light and understanding on this critical issue.

Aug 31, 2016

Gehrke v. Haidukewych: Mega Prosthesis for Distal Femoral Peri-Prosthetic Fx’s

OK, it’s a distal femoral peri-prosthetic fracture. Do you reach for the locking plates, the screws or the intramedullary nails? Or do you opt for a mega prosthesis? This week’s Orthopaedic Crossfire® debate tackles this excellent subject with ENDO-Klinik’s Gehrke choosing the big implant and Orlando Health’s Haidukewych going ORIF. Who wins? You judge.

Aug 5, 2016

Thienpont v. Ranawat—UKA: The Gold Standard for Medial Compartment Disease

Unicompartmental Knee or Total Knee? What’s not to like about preserving natural kinematics, lower infection rate and good post op range of motion? But can the patient live with higher revision rates? Dr. Thienpont argues for Uni while Dr. Ranawat takes the counter position. Great and timely debate this week.

Jul 23, 2016

Berend v. Dunbar: Outpatient TJA: “Drive-Thru” Surgery

Same day total knee arthroplasty is the siren song of large joint reconstruction. Michael Berend has performed over 2, 000 knee arthroplasties with 98% of these folks going home the same day and recommends it strongly. Michael Dunbar points out that these are select patients in a tightly controlled environment. Hard to duplicate especially with heavier, more diabetic and older patients. Read this very interesting debate here.

Jul 7, 2016

Gonzalez Della Valle v. Gross: Extensive Acetabular Bone Loss: Impaction Grafting, a Preferred Solution

Acetabular bone loss and impaction grafting, for which patients is it good strategy, which patients is it a ‘no-way’ strategy and is it overly technique dependent? Alejandro Gonzalez Della Valle and Allan Gross, with Daniel Berry moderating, tackle this important and impactful (pun intended) subject.

Jun 24, 2016

Haidukewych v. Su: ORIF for Displaced Femoral Neck Fx’s in the 50-60 Year Old Patient

Open reduction internal fixation or total hip arthroplasty for younger (50-60 years old) patients with displaced femoral neck fractures? This week’s debate pits George Haidukewych against Edwin Su. Who wins? You do…with an outstanding debate.

Jun 16, 2016

Lee v. Schmalzried: Ceramic-Ceramic THA in Patients <60: A New Standard

Is the use of ceramic-on-ceramic in young patients the new standard of care? Yes, says Lee. In fact c-on-c has better wear, is more reliable and provides more options. Not so fast says Schmalzried. Survivorship and function are no better, there is a squeaking and fracture risk. Who wins this debate? You be the judge.

May 20, 2016

Hozack v. Haddad: The Anterior Approach: Better, Faster, Cheaper

Anterior hip arthroplasty. Is it really better, faster and cheaper or is that mere marketing hype? This week’s debate pits William J. Hozack, M.D. against Fares Haddad, M.B., F.R.C.S. with Paul Lachiewicz moderating on this hot topic. Who wins this most entertaining debate? You be the judge.

Apr 10, 2016

Sculco v. MacDonald: Dual Mobility: An “Every Man’s” Choice for Primary THA

Did Tom Sculco get the short straw in this dual mobility THA debate against Steven MacDonald? At one point Moderator Thornhill offered to shield Dr. Sculco from MacDonald’s expected onslaught of data. What really happened? Here’s a clue: Australian Registry! And not much blood on the floor.

Mar 29, 2016

Jacobs v. Murphy: Distal Neck Modularity in Primary THA: The Bridge Too Far

Corrosion, adverse tissue reaction, fracture and Australian Registry data. Jacobs and Murphy stir all those concepts up into a hot gumbo of data and case studies. This debate serves up the facts behind distal neck modularity. Bottom line, these guys were for it before they were against it.

Mar 21, 2016

De Smet v. Dunbar: Metal-On-Metal Hip Resurfacing: An Option for Right Patient & Surgeon

Metal on Metal Hip Resurfacing—YES! It is an option for the right patient and surgeon. De Smet v. Dunbar dive into this very interesting, CCJR debate.

Mar 10, 2016

Barrack v. Kwong: Mobile Pump DVT Prophylaxis: Just Say No to Drugs

Forty years ago Charnley raised the issue of pulmonary embolism risk. This remains a significant concern for surgeons. This excellent debate from CCJR brings us fully up to date on the latest thinking, studies and advice.

Feb 3, 2016

Murphy v Maloney: Ceramic on Ceramic THA in Patients <60: A New Standard

Does a patient’s age determine whether to use ceramic-on-ceramic THA? As we saw with the excellent 2013 CCJR debate regarding ceramic-on-ceramic, this is a popular topic. This year Stephen Murphy reminds us that “ceramic-on-ceramic bearings have excellent results” while William Maloney points out that they are not a standard of care and can squeak. Lieberman moderates yet another terrific CCJR debate.

Jan 14, 2016

Haidukewych v Su: ORIF for Displaced Femoral Neck Fx’s in the <60 Active Patient

The incidence of femoral neck fractures continues to increase. What’s the best approach for the under 60 patient? George Haidukewych makes the case for open reduction internal fixation (ORIF) while Edwin Su counters with arthroplasty. Who wins? We think the reader.

Dec 18, 2015

Della Valle v Callaghan: Dual Mobility Obviates the Need for Constrained Liners in Revision THA

Dual mobility is the new kid on the block for total hip arthroplasty but it’s not for everyone. John Callaghan reminds us that the constrained liners can work well, especially in older patients while Craig Della Valle argues that constrained liners have metal rings that can break. What’s the right answer? This week’s debate may have found it. Read on.

Dec 3, 2015

Beaule v Maloney: The Anterior Tabled Approach: First Among Equals

“Are you doing the anterior approach?” According to Bill Maloney, that’s the most common patient question he gets. But not everyone should follow the anterior siren song. Paul Beaule makes a strong case for the benefits of the anterior approach while Dr. Maloney reminds us that the learning curve is steep. This may be one of the most important debates of the year.

Nov 8, 2015

MacDonald v Meneghini: Femoral Head Materials: No Difference in Outcomes

Cobalt chrome or ceramic heads? Steven MacDonald takes the position that there is NO difference between the two in outcomes while Michael Meneghini is very persuasive saying that outcomes are clearly better with cobalt chrome. Who wins this outstanding debate? With mounting evidence of corrosion from cobalt chrome, this is a timely debate.

Oct 22, 2015

Barrack v Pagnano: Patient Specific Cutting Blocks: Of Unproven Value

Patient Specific Instrumentation (PSI), unproven value or next new thing for knee replacement surgery? Dr. Barrack says he’s tried it and it didn’t improve outcomes or value. Dr. Pagnano counters by saying that in his experience PSI lowers stress in the OR and is valuable for certain hospitals. Another timely and important debate from CCJR.

Oct 19, 2015

Lewallen v Whiteside: The All Poly Tibia in Younger Patients: An Affordable Care Act Alternative

All poly tibia knees? Really? Get ready to be surprised. Says David Lewallen MD “Poly designs are cost effective and an excellent solution for a subset of patients.” Taking the opposite point of view is Leo Whiteside MD saying; “Well David, I wish I could agree with you but then we’d both be really wrong.” Welcome to an especially fun and informative debate.

Sep 27, 2015

Patella Resurfacing: Rarely, if Ever Necessary

According to Robert Barrack, M.D.” There are about five things that can happen when you resurface a patella and four of them are bad.” Not so, says Wayne Paprosky, M.D. in this spirited CCJR debate. “I say resurface the patella” With modern techniques and instruments “Just go ahead and resurface the patella. Why not finish the job?” Who wins this debate? You be the judge.

Sep 19, 2015

Kwong vs Pagnano — The Cementless TKA: Lifetime Guarantee on Parts & Labor

“I believe that we are on the threshold of the cementless total knee coming of age, ” says Louis Kwong. Not so fast counters Mark Pagnano, “It’s my contention that in 2015 cemented fixation remains the gold-standard for total knee arthroplasty fixation.” Who’s right? In this spirited debate it’s truly hard to tell.

Sep 10, 2015

Haddad vs Sculco — Is TKA the Answer for Medial Compartment Arthritis?

Why replace the total knee when your patient only has medial arthritis? Fares Haddad goes toe-to-toe with Thomas Sculco over TKA versus UNI when the issue is medial compartment arthritis. Is TKA the only tried and true solution? You be the judge.

Aug 31, 2015

Measured Resection Trumps Gap Balancing in TKA

Them’s fighting words! Measured resection or gap balancing in total knee arthroplasty. Aaron Hofmann M.D. makes a strong case for measured resection but Bryan Springer M.D. counters effectively for gap balancing. Who earns an “A”? You be the judge.

Aug 20, 2015

Reverse Shoulder or Not? Crosby and Gobezie Debate Contained Cuff Arthropathy

Lynn Crosby: “When treating cuff tear arthropathy with loss of acromial-humeral distance; pain with or without activity; good deltoid tone and strength, reverse is the best option. Not so fast, says Reuben Gobezie: “Don’t do these reverse replacements on patients who have these types of tears because they have pre-op range of motion greater than 90. It is not a good outcome.” Who wins this great debate? You decide.

Aug 7, 2015

Cement That Shoulder? John W. Sperling and William H Seitz, Jr. Debate

In the Crossfire this week is a very sticky topic—cementing that shoulder replacement. Says John W. Sperling “If we look over all the literature one can see that cement fixation is frankly not necessary.” Not so fast says William H. Seitz, Jr., “Cement has become the gold standard and there are new designs and new techniques and we also have new techniques for cementing as well.” It’s a lively and informative debate, for sure.

Jul 23, 2015

Burkhead vs. Romeo Over Hill-Sachs Lesion for Shoulder Repair

To Surface Replace or Not to Surface Replace. That is the question. Buz Burkhead and Anthony Romeo debate fiercely the advisability of shoulder surface replacements when there is a Hills-Sachs lesion. It’s a spirited intellectual tussle which we think you’ll enjoy immensely.

Jul 16, 2015

FDA Trips Up High Flying MiMedx

On August 28, 2013, the FDA sent an unwelcome and surprising letter to Georgia-based allograft supplier MiMedx Group, Inc., informing them that one of their allograft products, EpiFix, did not meet the requirements for an allograft and therefore was being sold without the required FDA clearance or approval. The letter, otherwise known as an “Untitled [&hellip;]

Sep 9, 2013

Spine World Loses Luminary: Harry Herkowitz, M.D.

On June 9, 2013 the orthopedic world was jolted by the sudden loss of Harry N. Herkowitz, M.D., the much-loved chairman of Orthopaedic Surgery at Beaumont Hospital in Royal Oak, Michigan. Dr. Herkowitz, who was 65 years old, is survived by his wife Jan, son Seth (Laura) and daughter Rachael (Michael – fiancé).

Jun 12, 2013