The AAOS expanded list includes the following five recommendations:
- Avoid routine use of Continuous Passive Motion (CPM) after knee replacement.
- Avoid routinely performing arthroscopy with lavage and/or debridement in patients with a primary diagnosis of symptomatic osteoarthritis of the knee.
- Do not transfuse asymptomatic postoperative hip fracture patients with a hemoglobin higher than 8g/dl.
- Avoid routine use of therapy following carpal tunnel release.
- Avoid routine use of opioids for treatment of knee osteoarthritis, hip osteoarthritis, low back pain, or rotator cuff injury.
“As orthopaedic surgeons, our duty to our patients is to restore mobility and improve their quality of life through evidence-based, high-quality treatment,” said Joseph A. Bosco III, MD, FAAOS, AAOS President. “Our Healthcare system is rapidly transforming into a value-based model. The Choosing Wisely initiative encourages orthopaedic surgeons and clinicians across a variety of specialties to carefully consider the value proposition of the tests and procedures they provide. Understanding the value of interventions enables surgeons to make evidence-based decisions about the most appropriate care – all while maintaining a two-way conversation with their patients.”
The Academy’s Choosing Wisely list was expanded after careful consideration and review, using the most current evidence about management and treatment options. AAOS routinely develops evidence-based clinical guidelines and appropriate use criteria as valuable tools to advance the physician-patient communications process and enhance the diagnosis and treatment of musculoskeletal conditions. Each of the recommendations now included on the list came out of those clinical practice guidelines.
“Clinicians and patients all across the United States – and now the world – are engaging in conversations about avoiding unnecessary care thanks to the efforts of medical specialty societies like the AAOS,” said Richard J. Baron, MD, president and CEO of the ABIM Foundation. “The content of the AAOS Choosing Wisely list will help further these conversations and better the future of orthopaedic patient care.”
Since the launch of the Choosing Wisely campaign in 2012, it has covered more than 600 tests and procedures that the specialty society partners say are overused and may be inappropriate, and that physicians and patients should discuss. More than 80 national medical specialty societies have released recommendations, and dozens of regional health collaboratives and consumer partners have joined the conversations about appropriate care.
To learn more, visit www.ChoosingWisely.org.