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  • 28 Nov 2023 10:42 AM | Anonymous

    From the American Academy of Orthopaedic Surgeons

    It is well-established that conventional cigarette smoking causes delayed healing of fractures and results in higher rates of nonunion. Nicotine exposure through smoking cigarettes may be more harmful than nicotine exposure through oral administration or nicotine patches, due to other harmful chemicals in the smoke. However, little is known concerning the effects on fracture healing of electronic cigarettes (e-cigarettes) that contain nicotine.

    A study presented at the AAOS 2023 Annual Meeting aimed to compare the effects of traditional cigarette smoke and e-cigarettes on fracture healing using a rodent model. The study found that although levels of cotinine (a nicotine metabolite) were lower in the e-cigarette group than in the group exposed to cigarette smoke, bone healing in the e-cigarette group was still compromised compared with the control (no nicotine) group.

    In the study, 48 adult male Sprague Dawley rats were randomly allocated to exposure to ambient air (control), regular cigarettes, or e-cigarettes. Researchers placed the latter two groups in a smoking chamber for 20 minutes twice daily.

    After 1 week of exposure, all animals were anesthetized and underwent surgery. The researchers created a transverse osteotomy in the midshaft of one femur, which was then stabilized surgically with an intramedullary Kirschner wire. All animals were treated with buprenorphine to reduce pain after surgery. Half of the animals were euthanized 3 weeks after fracture surgery, and the remaining animals were euthanized 6 weeks after surgery.

    Serum obtained at the time of euthanasia was used to measure cotinine levels. Bilateral femurs were harvested and imaged with contact radiographs and microCT. An orthopaedic traumatologist used a modified Radiographic Union Score for Tibia Fractures (mRUST) scoring system to evaluate both the contact radiographs and the microCT images of the fractured femurs in a blinded fashion. That surgeon also made an assessment of whether each femur was healed. The microCT images were segmented into three density ranges (unmineralized callus, mineralized callus, and cortical bone) and analyzed with BoneJ (an open-source bone-analysis plug-in technology) to determine the volume of tissue present in the three density ranges.

    Five animals (two in the control group, one in the cigarette group, and two in the e-cigarette group) were removed from analysis due to either inadequate fracture fixation or nontransverse fracture. Cotinine levels in the animals from the cigarette group were nearly twice the level of those in the e-cigarette group.

    The mRUST scores from contact radiographs correlated modestly but significantly with most measures from the microCT image analysis (r values ranged from 0.312 for cross-sectional area moment of inertia to 0.570 for medium-density tissue volume). After 3 weeks, there were significantly more animals in the control group (42.9 percent) who were classified via microCT as healed than in either the cigarette (0 percent) or e-cigarette group (0 percent).

    At 6 weeks, there were no differences among the three groups in terms of healing assessment, but the e-cigarette group had significantly higher measures of low-density tissue, indicating persistent soft callus volumes, explained Mark L. Prasarn, MD, FAAOS, of Memorial Hermann–Texas Medical Center, presenting author of the study. This finding raises the possibility that e-cigarette use “may be even more detrimental to fracture healing than conventional cigarettes,” Dr. Prasarn said.

    Addressing limitations of the study, Dr. Prasarn explained that although the investigators attempted to equalize the amount of time animals were exposed to cigarette smoke or e-cigarette vapors in the chamber, the finding of lower serum levels of cotinine in the e-cigarette group is likely attributable to the device they chose to investigate. “It is possible that other e-cigarettes dispense higher or lower amounts of nicotine than the one we used or that individuals using them draw more from them during each use or use them more frequently than regular smokers light up,” he said. “Additional studies are warranted to compare the effects of the two types of nicotine exposure on bone metabolism and healing. Studies in humans would also be beneficial.”

    Noting that e-cigarette use is increasing, especially among young people, and that the detrimental effects associated with nicotine use (whether from smoke or e-cigarette vapor) on bone healing are established, Dr. Prasarn said, “Physicians should counsel patients to discontinue using e-cigarettes after fractures, as well as conventional cigarettes, to avoid issues with healing.”

    Dr. Prasarn’s coauthors of “The Effects of E-cigarettes on Fracture Healing” are Ryan Tyler Anthony, MD; James F. Kellam, MD, FAAOS; and Glenn R. Rechtine II, MD, FAAOS.

    Visit aaos.org/ameducation to view an ePoster of this study or any AAOS 2023 Annual Meeting poster.

    Terry Stanton is the senior medical writer for AAOS Now. He can be reached at tstanton@aaos.org.

  • 2 Oct 2023 2:16 PM | Anonymous

    The Wisconsin Orthopaedic Society held their 2023 Annual Conference at the Madison Concourse Hotel, September 28-29, 2023.

    The conference featured Resident research presentations, Financial Planning advice, and a sub-specialty panel with speakers from UW Madison. The Annual Business Meeting celebrated WOS's accomplishments for the year and thanked the board members for their service to WOS and their work planning the event. 

    Thank you to all who attended, we hope to see you in 2024!

  • 28 Jun 2023 9:07 AM | Anonymous

    Doctor Day 2023 was a success with over 300 registered physicians, residents, and medical students!

    The group began their day at the beautiful Monona Terrace for a light breakfast and presentations on First Attendee Orientation, Communications/Media Training 101, Physician Wellness, and  a Legal Update. AMA President, Dr. Jesse Ehrenfeld, then joined as the keynote presenter. Following his presentation was a State Agency Roundtable and a Physicians Priority Issues Briefing. The group had a brief lunch and then headed down the street to the Capitol where physicians met with their legislators to discuss Doctor Day's priority issues: APRN Legislation and Extended Medicaid Coverage for New Moms. 

    The group reconvened at Madison's for some appetizers and drinks and to discuss how their visits went. Everyone was in good spirits and already looking forward to the next Wisconsin Doctor Day!

    WOS is a proud supporter of Wisconsin Doctor Day, read their position paper here. 

  • 22 Dec 2022 11:46 AM | Anonymous

    From Wisconsin Health News:

    The Medical Examining Board on Wednesday signed off on a draft of a rule on use of chaperones and other observers during sensitive patient exams. The proposal will now head to the governor's office and then the Legislature for their consideration.

    Jameson Whitney, an attorney for the Department of Safety and Professional Services, said the final version factors in comments from Legislative Council, public feedback and a meeting with the Wisconsin Hospital Association.

    Under the plan, the Medical Examining Board, when determining whether alleged misconduct occurred, could take into consideration the failure of a doctor to follow the rules established by their employer regarding chaperones or other observers in patient exams.

    Self-employed doctors or those practicing in practice settings that do not involve hospitals or employers will have to establish and comply with their own written procedures. They'd have to make those available and accessible to all patients likely to receive a non-emergency examination of the breasts, genitals or rectal area.

    The board couldn't find doctors in violation of the rule because a third-party didn't create a chaperone policy or allow its posting or notification.

    Another change to the rule clarifies that it's not intended to impose a requirement on any person or entity the board doesn't oversee. There are also modifications to the definition of chaperone, whom is chosen by the doctor, and observer, whom is chosen by the patient.

    Matthew Stanford, WHA general counsel, said those working on the rule reached "a good place ... that both will protect patients and provide a good framework for physicians" to know what's required and what's not.

    Previous attempts at drafting the rule ran into hurdles from doctor and hospital groups.

  • 15 Dec 2022 11:15 AM | Anonymous

    Wisconsin’s Doctor Day will take place on June 15, 2023. WI Doctor Day brings together physicians from every specialty and practice environment to meet with their legislators and advocate on health care issues affecting healthcare. The multi-specialty nature of Doctor Day makes it among the most unique advocacy events for physicians in the country.

    Physicians and medical students at all stages of their careers will once again join together in Madison to take part in policy breakout sessions, hear keynote presentations and participate in a briefing on the day's priority issues. Attendees will then participate in group visits with legislators and legislative staff at the Wisconsin State Capitol. The day will conclude with a Doctor Day reception where you’ll have the chance to connect socially with both friends and peers. 

    ​Whether you’re a seasoned veteran or brand new to the legislative process, attending Doctor Day will provide you advocacy tools and skills to make your voices heard. Continue to watch your email for updates on registration!

  • 14 Dec 2022 8:30 AM | Anonymous

    Join us September 28-29, 2023 at the Madison Concourse Hotel in downtown Madison, WI for the WOS 2023 Annual Conference. The conference will feature the latest updates in orthopaedic education, lectures, networking, and more! Continue to watch your email for updates on registration and hotel reservations.

    We need member input! We are actively looking for suggestions for topics and presenters for the 2023 conference. Please email your ideas and recommendations to wos@badgerbay.co

  • 14 Dec 2022 8:27 AM | Anonymous

    WOS welcomes new President, Jonathan Campbell, MD! Dr. Jonathan Campbell graduated summa cum laude with a Bachelor of Science degree in biology from the Ohio State University in Columbus, OH. He received his Doctor of Medicine from the Ohio State University College of Medicine in 2011. From 2011-2016, he was a resident in orthopaedic surgery at the Medical College of Wisconsin in Milwaukee, WI where he received the MCW Department of Orthopaedic Surgery John S. Gould MD Lectureship Outstanding Research Award. He then completed an Orthopaedic Sports Medicine Fellowship at the Minnesota Orthopaedic Sports Medicine Institute in Minneapolis, MN. Dr. Campbell joined the Department of Orthopaedic Surgery as an Assistant Professor in September of 2017.

  • 4 Nov 2022 11:48 AM | Anonymous

    WOS held their Annual Conference September 29-30, at the Ingleside Resort in Pewaukee, Wisconsin. It was their first in-person conference since Covid, and the turn out was great! The conference planning committee planned an excellent program that kept attendees engaged  through a lively Resident Jeopardy on Thursday night, along with two panel discussions on Friday, and other interactive talks.  A great lineup of speakers filled the program covering topics from Making Your Practice More Efficient to a Product Theater.  Thank you to all of our presenters, attendees, and exhibitors who were able to join us! 

  • 24 Mar 2022 12:32 PM | Anonymous

    If you have not yet renewed your WOS membership, now is the time to do so! The purpose of the Wisconsin Orthopaedic Society is to enhance the commitment of practicing orthopaedic surgeons in Wisconsin to stay current of information and advancements in the dynamic practice of modern orthopaedic surgery, to maintain the highest medical and ethical standards, and ultimately to optimize service and care to our patients. This is encouraged by our members and promoted by our educational and informative process.

    Renew your membership today by clicking on the "Join Us" tab! 

  • 24 Mar 2022 12:32 PM | Anonymous

    The WOS Annual Conference is approaching! The conference will take place from September 29-30, 2022 at the Ingleside Hotel in Pewaukee, Wisconsin. Reserve your room at the Ingleside by August 17, 2022 to receive the WOS group rate of $109 plus taxes and fees. Call the Ingleside directly at 262-547-0201 and request the WOS Annual Conference Room Block.

    Registration will open in May- watch your email for updates! 

Contact Us

563 Carter Court, Suite B
Kimberly, WI 54136
Tel: (920) 560-5633
Fax: (920) 882-3655
Email: WOS@badgerbay.co

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