2024 Course Descriptions & Learning Objectives
Prosthetic Joint Infection | Gerald Aggrey, MD
Overview of diagnosis and management of prosthetic joint infection.
Learning Objectives
- Review updated diagnostic criteria for prosthetic joint infection.
- Differentiate between acute and chronic prosthetic joint infection.
- Review management options once infection is identified.
Surgical Timing in Poly Trauma Patients | Dane Brodke, MD
This talk will review the key considerations and guidelines for the timing of surgical interventions in polytrauma patients with orthopaedic injuries. Balancing factors such as patient stability, injury severity, and resource availability will be discussed. Strategies for prioritizing and sequencing procedures in these complex scenarios will be presented.
Learning Objectives
- Understand the physiologic impact of polytrauma and the concept of damage control orthopaedics.
- Recognize key factors influencing surgical timing decisions in polytrauma patients.
- Learn a framework for prioritizing and planning surgical interventions for orthopaedic injuries in the polytrauma setting.
Complex Trauma | Mackenzie Cook, MD
This talk will discuss key points of contact between trauma surgeons and orthopaedic surgeons with a focus on key decisions in the first 72-96 hours to stage reconstruction and resuscitation.
Learning Objectives
- Understand the goals of damage control surgery for thoraco-abdominal bleeding.
- Describe the challenges of complex TBI management in the ICU and how this will impact orthopedic reconstruction timing.
- Describe the damage control approach to resuscitation and determination of physiologic stability for operative intervention.
Young Femoral Neck Fractures: what’s new and what’s controversial? | Graham DeKeyser, MD
This talk will review young femoral neck fractures treatment, implants, and technical tips for success.
Learning Objectives
- Understand current controversies in young FNF treatment, including: implant choice, approach considerations and fixation timing.
- Discuss surgical techniques to achieve quality reductions of young FNFs.
- Give opportunity for discussion regarding treatment of these complex injuries.
Distal Femur Multicenter Prospective RCTs In Process: DIFFIR & DISIDE | Graham DeKeyser, MD
Presentation of two multicenter, prospective RCTs ongoing at OHSU with the potential implications for future treatment of distal femur fractures.
Learning Objectives
- Discuss the increasing incidence of geriatric distal femur fractures, the associated mortality and the high rates of nonunion.
- Understand the clinical question attempting to be answered by DIFFIR study.
- Understand the clinical question attempting to be answered by DISIDE study.
Bone Health and Osteoporosis | Joann Deutsche, NP
This talk will present practical bone health/osteoporosis educational topics and interventions that can be integrated into fragility fracture care during follow-up visits.
Learning Objectives
- Review the scope of people affected by poor bone health/osteoporosis, and the current state of fragility fracture care.
- Understand the importance of formally diagnosing osteoporosis at discharge and how that will open the door for ongoing treatment and management.
- Understand the importance of osteoporosis awareness/education, and the role of the orthopaedic provider.
Getting “Hip” to Inpatient Zoledronic Acid – Fragility Fracture Treatment During Hip Fracture Admission | Katie Drago, MD
This session will unpack the barriers to osteoporosis treatment after fragility fracture and highlight the opportunity to include bone health and fracture prevention in hip fracture admission.
Learning Objectives
- Review the secondary fragility fracture risk faced by older hip fracture patients.
- Consider the current state of care for secondary fragility fracture prevention and barriers experienced by patients.
- Explore a newer approach to embedding secondary fracture prevention into hip fracture admission that capitalizes on multi-specialty care teams.
Age Friendly Health Systems: A Framework for High Value Care for Older Adults | Katie Drago, MD
Health systems are not always set up to meet the unique needs of older adults. Patients are reliant on staff to have the knowledge to deliver high quality care leading to missed opportunities and hospital related harms like falls, delirium and adverse medication reactions. Best practices are known and supported by evidence but rarely implemented or sustained. Age Friendly Health Systems (AFHS) is an evidence-based interprofessional framework for high value care for older adults across clinical settings that is straightforward and effective at improving care for all older adults. This session will overview AFHS, the 4Ms and benefits to patients, providers and systems.
Learning Objectives
- Detail the current state of hospitalization impact and outcomes for older adults, particularly those living with frailty and other geriatric syndromes.
- Familiarize Ortho providers and teams with the Age Friendly Health Systems nationwide improvement initiative and highlight successful approaches to implementation.
- Deliver a call to action for Orthopedists across settings to adopt AFHS and the 4Ms as part of high value care for older adults.
Pre-Operative Evaluation of the Hospitalized Patient | A. Shams Helminski, MD
This session is designed to familiarize Orthopedic Surgeons with medical pre-operative evaluation of hospitalized patients. The content is specifically geared to better understand time involved, allowing for better operative planning. Additional focus will be placed on ways to effectively provide collaborative management.
Learning Objectives
- Understand the goal of pre-operative risk assessment and optimization.
- Review standard components of pre-operative evaluation.
- Identify opportunities for collaboration between Orthopedists and Hospitalists.
The American Joint Replacement Registry; The Past, Current and Future | Ryland Kagan, MD
Created in 2009, the American Joint Replacement Registry (AJRR) has grown to be the world’s largest registry of hip and knee replacement data by annual procedural count. The AJRR contains data on over 3 million procedures from hospitals, ambulatory surgery centers, and private practice groups in all 50 states and the District of Columbia. By collecting and reporting data, the AJRR provides actionable, evidence-based information to guide physicians and patient decision-making to improve care. This talk will provide a history and background of the AJRR registry, compare and contrast the AJRR to other international registries or big data research, introduce the Registry Analytics Institute (RAI) and explore benefits of participation with the registry. Specific focus will illustrate the unique attributes of the AJRR, educate surgeons on the process of collaboration with the RAI, and provide a framework on how to apply AJRR annual report information into their practices.
Learning Objectives
- Develop a historical background understanding how the AJRR was developed.
- Be able to compare and contrast the strengths and weaknesses of AJRR with other US and International registries.
- Understand benefits of participation with the AJRR and how you can get your institution involved.
Spinopelvic Trauma | Jonathan Kark, MD
Lumbopelvic instability, particularly in trauma patients, involves a disruption in the normal biomechanical relationship between the lumbar spine and pelvis, often resulting from fractures, dislocations, or severe ligamentous injuries. This course will provide a brief overview of radiologic findings of lumbopelvic instability in trauma patients and surgical management strategies of this condition.
Learning Objectives
- Identify radiographic findings consistent with junctional instability.
- Surgical planning with orthopaedic trauma teams.
- Surgical strategies for management of fractures.
PT after Orthopaedic Trauma: When, Where, and How | Jonathan Kirsch, PT, DPT
This course will overview the history and evolution of Physical Therapy care following a trauma. During covid, telehealth became a very important mechanism of care delivery for many patients. This new approach allowed improved access to care for appropriate patients for a variety of patients. This course will discuss importance of quick access to care and outcomes associated with in-clinic care versus telehealth versus hybrid. It will also discuss emerging technologies that will further evolve future care for these patients.
Learning Objectives
- Overview how Physical Therapy has been delivered over time and with Trauma.
- Overview on impact time to care for patient outcomes.
- Describe various delivery methods of care today with pros/cons.
- Barriers to Physical Therapy following an injury.
Commonly Missed or Mistreated Pediatric Fractures | Heather Kong, MD
A brief review of common pediatric fractures that may be treated by general orthopedists, their pitfalls and potential long-term sequelae.
Learning Objectives
- Discuss pediatric fracture malunions with minimal remodeling potential.
- Increase awareness of commonly missed injuries with long-term morbidity.
- Reinforce the importance of investigating concerns for non-accidental trauma.
Immunologic Precision Typing At-Risk Fractures to Predict Nonunion | Kelly Leguineche, PhD Candidate
Severe tibia fractures are prone to a chronic condition of failed bone healing called non-union, with rates between 10-15%. Immune dysregulation may be an important underlying cause of bone non-union with the potential to be detected far earlier than radiograph-based diagnosis allows. Traumatic bone injuries ignite an intense inflammatory response at the site of injury and in the peripheral blood. The early inflammatory response is a critical stage of healing, but severe trauma can lead to excessive or aberrant immune responses, which can be life threatening and may also compromise regenerative processes. A growing body of preclinical studies, including in the Guldberg Musculoskeletal Research lab, find strong correlations between immune biomarkers and eventual healing outcomes. We recently begun enrolment on a clinical study performing temporal peripheral immune monitoring of patients with open tibia fracture. Predictive models for fracture non-union based on circulating immune biomarkers would provide a much needed minimally invasive method to detect at-risk patients.
Learning Objectives
- Describe complicated immune responses to severe musculoskeletal trauma.
- Summarize current progress in developing predictive models for bone nonunion based on circulating biomarkers.
- Discuss ongoing clinical study monitoring peripheral blood and local tissue immune biomarkers for nonunion risk-stratifying patients with open tibia fracture.
What has been done to successfully recruit diversity into ortho? | Elizabeth Lieberman, MD, Andrea Herzka, MD and Sudeep Taksali, MD
This is a three-physician panel featuring Dr. Lieberman (arthroplasty, private practice), Dr. Herzka (sports medicine, academic), and Dr. Taksali (foot and ankle, hospital employed). This course explores the strategies and initiatives that have successfully increased diversity within orthopedic surgery, highlighting the importance of a diverse workforce in improving patient care and outcomes. Participants will examine case studies, best practices, and ongoing challenges in recruiting underrepresented groups to the field. The course will also cover the role of mentorship, outreach programs, and institutional policies in creating a more inclusive environment in orthopedic surgery.
Learning Objectives
- Introduce the importance of diversity in orthopaedic surgery.
- Participants will learn about successful programs and initiatives that have effectively recruited and retained diverse talent in orthopedic surgery.
- Participants will understand the positive impact that increased diversity has on patient outcomes, team dynamics, and the overall healthcare environment.
- Participants will be equipped to develop and implement actionable strategies within their institutions to improve diversity in orthopedic surgery.
Wireless Sensors in Orthopaedic Care | Keat Ghee Ong, PhD
This course provides a quick overview of wireless sensors in orthopaedic care, followed by introducing a new implantable sensor for peri- and post-operative monitoring of orthopaedic surgeries. The operating mechanism and preliminary performance of the sensor, as well as plans of using the sensor and data to improve patient outcomes will also be described and discussed.
Learning Objectives
- Provide a quick overview of wireless sensors used in orthopaedic care.
- Introducing a new implantable sensor for peri- and post-operative monitoring of orthopaedic surgeries.
- Discuss the need and potential impact of using sensors and sensor data to improve patient outcomes.
Distal Radius Fractures: Treatment Tips & Tricks | Robert Orfaly, MD, MBA
Review treatment of simple through complex distal radius fractures.
Learning Objectives
- Review indications for operative and nonoperative treatment.
- Review surgical options.
- Discuss tips for treating complex fracture deformity.
Upper Extremity Fracture Case Presentations | Robert Orfaly, MD, MBA
Distal radius and proximal humerus fracture cases will be presented with audience discussion of treatment options.
Learning Objectives
- Discuss basic principles and different opinions in treatment algorithms.
- Debate pitfalls of different treatment.
- Review results of chosen treatment in specific cases.
Management of the Spine and Extremity Injured Patient | Travis Philipp, MD
This talk will focus on general principals of management of patients with both spine and extremity traumatic injuries. Geared more towards a general orthopaedic audience, prehospital, initial stabilization and management principals will be discussed.
Learning Objectives
- Discuss initial stabilization and management for patients presenting with both spine and extremity injuries.
- Review time-to-surgery recommendations for various injuries.
- Discuss the importance of open communication between spine and orthopaedic surgeons when managing this polytrauma patients.
Challenges to Survive Your Weekend of Call | Daniel Sheeran, MD
Discuss topics encountered when on call: open fractures, what can wait until morning, and temporizing vs definitive fixation.
Learning Objectives
- Describe my understanding and approach to problems encountered on call.
- Review current literature that addresses this topic.
- Review case examples and answer questions.
Non-Operative Management of Hip Fractures: Palliative Approaches and Indications for Non-Surgical Treatment | Sudeep Taksali,MD
Provide an exploration of palliative and non-operative care strategies for managing hip fractures in frail elderly patients. Participants will learn to identify appropriate candidates for non-surgical treatment, understand the indications and contraindications for palliative care, and develop comprehensive care plans that focus on quality of life. The course will cover evidence-based practices, ethical considerations, and interdisciplinary approaches in managing these complex cases.
Learning Objectives
- Identify Indications: Participants will be able to identify the clinical indications and patient characteristics that suggest non-operative management of hip fractures.
- Develop Care Plans: Participants will learn to develop individualized, multidisciplinary care plans focusing on pain management, mobility, and quality of life for patients undergoing palliative care for hip fractures.
- Ethical Considerations: Participants will understand the ethical considerations involved in choosing non-operative care, including discussions with patients and families about goals of care and end-of-life decision-making.
2024 AAOS Update | Paul Tornetta III, MD, PhD
This course will provide an overview of the current state of AAOS.
Learning Objectives
- Educate participants on the status of the current AAOS Strategic Plan and future efforts to update the plan.
- Quantify the value of AAOS Membership.
- Share information on key initiatives of the AAOS, including, education, membership, research and quality, Resident Orthopaedic Core Knowledge (ROCK), PAC status and maintenance of certification (MOC).
Intertrochanteric Fracture Update | Paul Tornetta III, MD, PhD
Update on the new knowledge of IT fractures.
Learning Objectives
- Nail vs plate data.
- Perioperative management.
- Long vs short nails.
Peri-prosthetic Distal Femur Fractures | Paul Tornetta III, MD, PhD
Options for management of periprosthetic fractures.
Learning Objectives
- Decision making in periprosthetic fractures.
- Understanding Implant choices.
- Recognizing knee implants.
Physician Burnout Listening Tour ‘24: Smell the Toast! | Ron Turker, MD
An introduction to my project as a Fellow of a international healthcare advocacy group, The Patient Revolution. A year-long listening tour specifically targeting physician burnout. This is primarily a narrative project: Story in—Story out. How are you feeling? Would you be willing to share your story?
Learning Objectives
- Inform my colleagues about the work of The Patient Revolution (an international healthcare advocacy group.
- Recruit those physicians who are willing to share their ideas and stories. What’s working? What is not?
- Introduce the concept that the head-down-status-quo approach to healthcare reform is making our patients, ourselves, and our country sicker.
Pediatric Ortho Trauma: An Owners Manual | Ron Turker, MD
A guide to common peds ortho trauma that we can all feel comfortable handling. We’ll review cases that require little more than common surgical techniques that all orthopedic surgeons already have at their disposal. And we’ll discuss which cases truly need a more experienced surgeon.
Learning Objectives
- Re-introduce pediatric trauma cases to those who don’t often see children.
- Discuss triage: when to send and when to keep.
- Discuss the false malpractice narrative and stigma surrounding the care of children.
Pediatric Trauma: When should things be sent up the chain? | Anna van der Horst, MD
A discussion of common pediatric trauma diagnoses of the lower extremity with a focus on femur fractures and distal tibia physeal fractures, when non-pediatric orthopedic surgeons can treat them, when to refer to a pediatric specialist, and common complications that can be seen acutely and long-term.
Learning Objectives
- Review treatment for pediatric femur fractures for all age groups.
- Review treatment for pediatric femoral neck fractures.
- Review treatment for pediatric distal femur fractures.
- Review treatment for distal tibia physeal fractures.
Periprosthetic Distal Femur Fractures: Is anything too distal to nail? | Noelle Van Rysselberghe, MD
This talk reviews the literature on treatment options for periprosthetic distal femur fractures, with an emphasis on fixation constructs such as retrograde intramedullary nailing vs locked plating.
Learning Objectives
- Understand the pros and cons of various treatment options for periprosthetic distal femur fractures.
- Understand the evidence (or lack thereof) informing construct selection (i.e. retrograde nail vs lateral locking plate, dual plate and nail-plate combinations).
- List some of the technical challenges associated with retrograde intramedullary nailing of extreme distal periprosthetic distal femur fractures, as well as some techniques which can help mitigate those.
What can a non-peds Ortho surgeon do?—Supracondylar Humerus | Brandon Wilkinson, MD
Discussion on the appropriate diagnosis, initial and definitive management of pediatric supracondylar humerus fractures.
Learning Objectives
- Discuss appropriate injury assessment and diagnosis.
- Discuss timing of treatment.
- Management of “pulseless” fracture.
Leveraging Implantable Strain Sensors to Improve Femoral Fracture Healing | Kylie Williams, PhD Candidate
Implantable strain sensors developed by the Ong and Guldberg lab from the Knight Campus enable real-time tracking of fixation plates strains with potential to inform surgical decisions, postoperative management, and physical therapy after ORIF. Preclinical data have demonstrated that (1) fixation plate strains can predict bone healing outcomes before radiographic evidence, (2) rehabilitation of higher intensity increased local strains and regenerated femurs to intact strength and (3) fixation plate strains only decrease overtime if bridging occurs. These labs are now working on commercializing a clinical version of this technology through NIH SBIR funding mechanisms.
Learning Objectives
- Understand the key elements of our implantable strain sensors.
- Discover clinical-relevant data our sensors have provided over the last four years.
- Learn about our preclinical femoral fracture model relevant to the field of ortho-trauma surgery.
Transfer Etiquette | Kimberly Workman, MD
This course is designed to enhance the knowledge and skills of orthopedic surgeons and healthcare providers involved in patient transfers between facilities. This session will cover key aspects of transfer etiquette, including effective communication strategies between sending and receiving physicians and hospitals, the legal implications of the Emergency Medical Treatment and Labor Act (EMTALA), and how to streamline processes to ensure optimal patient outcomes. Participants will leave with a clearer understanding of how to navigate complex transfer scenarios while maintaining regulatory compliance and fostering collaboration across institutions.
Learning Objectives
- Demonstrate effective communication techniques between sending and receiving hospitals to ensure smooth and timely transfers of orthopedic trauma patients.
- Explain the key components of EMTALA as it relates to orthopedic trauma transfers, and how to ensure compliance while minimizing legal risks.
- Consider implementing standardized transfer protocols that improve patient outcomes and efficiency within the orthopedic care continuum.
- Recognize common barriers to effective patient transfers and strategize methods to overcome these challenges.
When to Refer: Sub-Specialist Perspective/Preference | Natalie Zusman, MD
An overview of commonly encountered pediatric orthopaedic trauma that would be best served by referring to a tertiary/quaternary center. The focus of the presentation is post-traumatic complications that need to be anticipated.
Learning Objectives
- Recognize pediatric orthopaedic trauma conditions that should be considered for transfer.
- Discuss complications associated with the aforementioned conditions.
- Increase communication between pediatric orthopedists and possible referring orthopaedist.
