Avis de convocation à la séance de travail de la Réunion annuelle 2008

La séance de travail de la Réunion annuelle aura lieu le jeudi 5 juin à 10 h 15 au salon 301A du Centre des congrès de Québec.

The Advanced Practice Physiotherapist in Orthopaedic Care

Alice B. Aiken, PhD, PT
Assistant Professor
School of Rehabilitation Therapy
Queen's University
Kingston, ON

Care for persons with orthopaedic problems can be complex. Usually the first health care contact for such a condition is the family physician. More than 60% of the people who suffer from orthopaedic problems will seek attention from their family physician¹ who will typically treat the patient with anti-inflammatory medications and advice on rest². However, family physicians may lack the background knowledge and sufficient contact time to comprehensively manage orthopaedic conditions, and patients may not respond to conservative treatment, leaving referral to a specialist as the typical course of action.

Note de la rédaction :

Vous trouverez ci-après le premier d'une série d'articles qui seront publiés dans les prochains numéros du Bulletin de l'ACO. Ces articles abordent quelques-unes des questions les plus importantes auxquelles est confrontée l'orthopédie actuellement : les adjoints au médecin et ressources humaines en santé; les temps d'attente pour les interventions orthopédiques autres que les arthroplasties de la hanche et du genou; le champ d'activité; les relations avec l'industrie, la place du privé et du public; et ainsi de suite. Dans le cadre de cette série, nous recueillerons le point de vue de membres exerçant dans tout le pays. Si vous souhaitez participer à cette initiative et transmettre votre point de vue à nos lecteurs, veuillez communiquer avec Doug Thomson ( Cet e-mail est protégé contre les robots collecteurs de mails, votre navigateur doit accepter le Javascript pour le voir ), aux bureaux de l'ACO.

Notre premier article de la série est une entrevue avec le D^r Ted Rumble, de North York, en Ontario.

Emil H. Schemitsch, MD, FRCSC
Rédacteur en chef 

Tournés vers l'avenir :
trois choses dont la profession aurait bien besoin

Doug Thomson
Directeur
Association Canadienne d'Orthopédie

Dennis Jeanes
Collaboration spéciale
Association Canadienne d'Orthopédie

Quand on lui demande ce qu'il pense de l'évolution du milieu de travail et de l'avenir de l'orthopédie, l'orthopédiste Ted Rumble, de Toronto, commence par établir la question fondamentale dans le domaine : « Ce qui me préoccupe surtout, c'est que la pénurie chronique d'orthopédistes nous empêchera de répondre aux besoins de la population et entraînera le surmenage chez les orthopédistes partout au pays. Au fil des ans, nous avons perdu beaucoup des gens que nous avons formés parce qu'ils ne pouvaient pas trouver un travail convenable au Canada. Nous ne pouvons vraiment pas nous permettre de perdre encore des orthopédistes de cette façon. »

Bone and Joint Canada
Expands its Mandate

James P. Waddell, M.D., FRCSC
Coordinator, Canadian National Action Network
For the Bone and Joint Decade

Bone and Joint Canada, the "action arm" of the Bone and Joint Decade in this country addressing access to care for hip and knee replacement patients, has been extremely active in the past few months. We have been actively engaged in discussions with orthopaedic surgeons, hospital administration and government officials from Nova Scotia to help develop a programme for the province to address the current wait times for total joint replacement. There has been significant enthusiasm amongst all three parties about the proposals and we hope that our efforts will continue to be favourably received in that province.

Orthopaedic Oncology
sub-specialty forms new society

Doug Thomson
Executive Director
Canadian Orthopaedic Association
Dennis Jeanes

Special to the Canadian Orthopaedic Association

The last time osteosarcoma made headlines was about 30 years ago, when Terry Fox started out from Halifax on his legendary run across Canada. The lack of profile since is hardly surprising, given that this rare cancer (that would famously claim Fox's life in 1981) has an annual incidence rate of roughly one in a million.

Introduction
Cuff tear arthropathy is a devastating condition, which has been traditionally difficult to treat. Drs. Darren Drosdowech and Jeremy Hall will debate the pros and cons of using a reverse total shoulder arthroplasty versus a hemiarthroplasty for this pathology.

In Defense of Primary Reverse Total Shoulder Arthroplasty for Rotator Cuff Tear Arthropathy

Darren S. Drosdowech, M.D., FRCSC
Hand and Upper Limb Centre
St Joseph's Health Centre
University of Western Ontario
London, ON,

The Problem
Patients with rotator cuff tear arthropathy (RCTA) most often present with painful arthritis combined with loss of active forward elevation (AFE) secondary to a massive rotator cuff tear. The principles defining surgical treatment of end-stage RCTA are:

Hemiarthroplasty for Cuff Tear Arthropathy

Jeremy Hall, M.D., FRCSC
Toronto, ON

Cuff Tear Arthropathy
Arthritis in association with rotator cuff tears was first observed and described in 1853 by Professor Adams of the University of Dublin¹. Charles Neer later explained the clinical entity of cuff tear arthropathy and its pathomechanics in 1977². Patients with this condition are plagued with pain and limited function. Cuff tear arthopathy challenges our understanding of the shoulder and is often difficult to treat surgically with success (Figure 1).

 The Swedish Knee Arthroplasty Register

Otto Robertsson M.D., PhD.
The Swedish Knee Arthroplasty Register

The Swedish Knee Arthroplasty Register (SKAR) was started in 1975 and is thus the oldest national arthroplasty register. It was initiated by interested orthopaedic surgeons who realized a combined effort would be needed to assemble knowledge about this then relatively new procedure.

The Swedish Hip Arthroplasty Register

Johan Kärrholm, M.D. PhD
Professor in Orthopaedics,
Head of the Swedish Hip Arthroplasty Register

Göran Garellick, M.D., PhD
Peter Herberts, M.D., PhD
Department of Orthopaedics,
Sahlgrenska University Hospital
Sweden

In 1977 a pilot study was initiated to record all primary and revision hip arthroplasties in Swedish hospitals. Experiences from this study resulted in the Swedish Hip Arthroplasty Register founded in 1979. From the very beginning, all individual revision arthroplasties were identified with a social security number. Demographic data, details about surgical technique, implant used, operating unit and the type and history of the previously used implant or implants were recorded. Until 1992 data about primary hip arthroplasties were recorded on a hospital basis. This meant that it was not possible to connect each individual implant to a social security number which resulted in some uncertainties in the outcome analyses. Implant survival was calculated by use of information from other governmental register and statistically based models¹. In a thorough evaluation it did; however, turn out that the recorded results were valid⁶. From 1992, all primary total hips were also recorded in more detail. This meant that each surgical procedure could be connected to patient demographics, type of incision, a specific implant and technique of fixation. In 1999 the recording was further expanded by including more details about the implants. Information about sizes, offset, and implant materials became available. These registers cover the entire country i.e. all public and private hospitals in Sweden participate.

Scottish Arthroplasty Project

Mr. Gavin C.A. Wood
MBChB, FRCS,
Royal Infirmary Edinburgh

Mr. Colin Howie FRCS
Consultant Surgeon
Royal Infirmary Edinburgh

The Scottish Arthroplasty Project (SAP) was established in 1999 with the following aims.

• To instigate change through continual feedback.
• To set individual results in a local and national context.
• To use outcomes which the public could identify with (death, dislocation, infection, DVT/PE and re-operation).

The Canadian Joint Replacement Registry: Gaining Momentum

Robert B. Bourne, M.D., FRCSC
London, ON

The Canadian Joint Replacement Registry (CJRR), operated through the Canadian Institute for Health Information (CIHI), serves as Canada's leading source of information on hip and knee replacement surgeries. The CJRR captures national data on elective primary and revision hip and knee replacement surgeries and subsequent patient outcomes. The goal of the CJRR is to improve the quality of care in clinical outcomes of joint replacement recipients in Canada.

The Australian Orthopaedic Association National Joint Replacement Registry

Professor Stephen E. Graves
Director
AOA National Joint Replacement Registry

The Australian Joint Replacement Registry is owned and managed by the Australian Orthopaedic Association and is fully funded by the Australian Federal Government. The Registry commenced data collection from a small number of hospitals in September 1999. It then underwent a staged implementation to all remaining hospitals nationally. This was completed in mid 2002. All hospitals, both government and private, undertaking joint replacement surgery, contribute data to the registry. This totals almost 300 hospitals nationwide. There is 100% surgeon participation.

Section spéciale sur la Réunion annuelle de Québec

Pierre Mercier, MD, FRCSC
Président du Comité organisateur
Réunion annuelle 2008, à Québec

Nous sommes impatients de vous voir tous à Québec en juin pour la Réunion annuelle conjointe de l'American Orthopaedic Association (AOA) et de l'Association Canadienne d'Orthopédie (ACO), qui promet d'être des plus formidables.

A Québec City and Area Overview

The Québec City and Area tourist region is a living historical illustration of a people unique to this continent, strong and proud of their Aboriginal, French, and British ancestry. Québec City, Côte-de-Beaupré, Île d'Orléans, as well as the Jacques-Cartier and Portneuf communities are included in the Greater Québec Area territory.

In 2008, come celebrate!

On July 3, 1608, Samuel de Champlain founded a settlement at Kébec, an Algonquin word meaning "place where the river narrows." In doing so, he established what would become the first permanent French settlement in North America and one of the world's most enchanting cities. From January to October 2008, Québec City will be pulling out all the stops to celebrate its 400^th anniversary, and we want you at the centre of it. Come celebrate with us and make our joie complete!

Activités et visites
Ce programme est provisoire. Veuillez consulter le programme final pour confirmer la date et l'heure des activités. Des changements seront périodiquement apportés au site Web de la Réunion annuelle, à http://www.aoacoa2008.org/.

Réservations de voyage

Québec (Québec)

En 2008, la ville patrimoniale de Québec célèbrera le 400^e anniversaire de sa fondation, et vous êtes invité aux célébrations! Québec a de tout, pour tous les goûts : de ses boutiques locales et de sa gastronomie classiquement québécoise à ses nombreux festivals et activités extérieures. La région s'enorgueillit d'un patrimoine culturel et architectural sans pareil, dont ses fortifications et ses rues piétonnières en pavés arrondis, qui lui donnent un cachet unique en Amérique du Nord. Venez visiter les plaines d'Abraham et le Vieux-Québec, une destination touristique désignée joyau du patrimoine mondial par l'UNESCO. Pour de plus amples renseignements sur la ville de Québec, veuillez consulter les sites http://www.quebecregion.com/ ou http://www.monquebec2008.com/.

Parce que nous le pouvons!
La durabilité par la promotion de la santé et la prévention des maladies

Angelique Berg
Directrice générale
Fondation Canadienne d'Orthopédie

Le D^r Kevin Orrell, président du conseil d'administration de la Fondation Canadienne d'Orthopédie, a été un témoin privilégié de l'influence que peuvent avoir les campagnes de marketing social sur la santé publique. « Lorsque j'ai commencé ma carrière en orthopédie il y a 19 ans, se souvient-il, il n'était pas rare de traiter des patients blessés dans un accident lié à l'alcool. » Le D^r Orrell, chef du département de chirurgie orthopédique du Cape Breton Regional Health Care Complex, à Sydney (Nouvelle-Écosse), ne croit pas avoir vu un seul patient blessé dans ce type d'accidents pendant les Fêtes. C'est assez extraordinaire.

Open Access Orthopaedics

Myles Clough, M.D., FRCSC
Kamloops, BC

One of the most common questions asked at informatics workshops across the world is how to get free access to journal articles. Orthopaedic surgeons recognize that ‘the literature' is one of the most valuable information resources and are getting increasingly frustrated at the difficulties and cost of access. One cannot afford to subscribe to all the interesting journals and one cannot afford the $25 price of access to a single article. There used to be only three useful ways to obtain free access, 1) to belong to a major medical library which has most of the journals online, 2) to do a Google search for the title (inside quotes) in case the full text has been posted somewhere or 3) to send an e-mail to the author requesting a copy. Now there is a fourth - to join the pressure groups demanding Open Access and wait until the battle is won. It won't be very much longer.