SMA News Digest (Summer 2014): V54, I2 | Page 40

CHOOSING WISELY CANADA 5 things orthopaedic surgeons and patients should question By the Canadian Orthopaedic Association 1 Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty. Since ultrasound is not effective at diagnosing unsuspected deep vein thrombosis (DVT) and appropriate alternative screening tests do not exist, if there is no change in the patient’s clinical status, routine post-operative screening for DVT after hip or knee arthroplasty does not change outcomes or clinical management. 2 Don’t use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief. The use of needle lavage in patients with symptomatic osteoarthritis of the knee does not lead to measurable improvements in pain, function, 50-foot walking time, stiffness, tenderness or swelling. 3 Don’t use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee. Both glucosamine and chondroitin sulfate do not provide relief for 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. In patients with