A Reminder about What Orthopaedic Surgeons Should Not Do

The Choosing Wisely campaign seeks to bring more awareness to tests and procedures that should be discussed between physicians and patients. The campaign was spearheaded by the ABIM Foundation, and the American Academy of Orthopaedic Surgeons (AAOS) partnered with the campaign to develop a list of the five things physicians and patients should question.

  1. Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.
  2. Don’t use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief.
  3. Don’t use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.
  4. Don’t use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.
  5. Don’t use post-operative splinting of the wrist after carpal tunnel release for long-term relief.

The list was developed after review of approved clinical practice guidelines and included input from specialty society leaders.

6 thoughts on “A Reminder about What Orthopaedic Surgeons Should Not Do

  1. Good forum to bring these issues up for education and discussion. Perhaps we should also compile a list of important evidence based “do’s” such as DO order “weight bearing as tolerated” for all elderly patients after hip fracture surgery.

  2. This topic remains controversial even among experts. There has been no definitive consensus regarding its use for knee DJD Even if patient improvement is at times from a placebo effect, use of glucosamine/chondroitin may be appropriate as it is unethical to use placebos in practice. It seems very dogmatic to make a blanket recommendation against its use.

  3. This seems like really interesting information for orthopaedic patients and physicians should know. Tip #4 was very insightful. My mother has symptomatic medial compartment osteoarthritis in her knee, so it’s very important for her to know about what her doctor shouldn’t be doing. I’ll be sure to inform her that her doctor shouldn’t use lateral wedge insoles to treat her knee.

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