Orthopedic medicine resources commonly referenced by physicians include major clinical practice guidelines, fracture-risk tools, therapeutic updates, landmark clinical trials, and patient-reported outcome measures. The following 10-item framework reflects selected resources that inform musculoskeletal care.
- American Academy of Orthopaedic Surgeons (AAOS) Management of Osteoarthritis of the Knee Guideline — The AAOS guideline provides evidence-based recommendations for the treatment of knee osteoarthritis in adult patients. The guidance addresses nonpharmacologic and pharmacologic interventions as well as operative procedures less invasive than knee arthroplasty.
- AAOS Management of Hip Fractures in Older Adults Guideline — The AAOS guideline provides evidence-based recommendations for the diagnosis, treatment, and postoperative management of hip fractures in patients aged 65 years and older. The guidance is intended to support the clinical decision-making process.
- American College of Rheumatology/American Association of Hip and Knee Surgeons Optimal Timing of Elective Hip or Knee Arthroplasty Guideline — The guideline provides evidence-based recommendations on the timing of elective hip and knee arthroplasty among patients with moderate-to-severe osteoarthritis or advanced osteonecrosis with secondary arthritis who have not responded to nonoperative treatment. The guidance addresses factors that may influence surgical timing and patient-important outcomes, including pain, function, infection, hospitalization, and mortality at 1 year.
- AAOS Management of Rotator Cuff Injuries Guideline — The AAOS guideline provides evidence-based recommendations for the diagnosis, treatment, and postoperative management of rotator cuff injuries in adult patients.
- Fracture Risk Assessment Tool (FRAX) — The Fracture Risk Assessment Tool estimates a patient's 10-year probability of hip fracture and major osteoporotic fracture by incorporating clinical risk factors and femoral neck bone mineral density when available.
- FRAME Trial — The phase 3 FRAME trial evaluated romosozumab in postmenopausal women with osteoporosis. Compared with placebo, romosozumab was associated with fewer new vertebral fractures at 12 months, which was maintained following transition to denosumab at 24 months.
- Endocrine Society Pharmacologic Management of Osteoporosis Guideline — The Endocrine Society guideline provides recommendations for the pharmacologic management of osteoporosis in postmenopausal women. The guidance recommends assessing fracture risk to inform treatment decisions and recommends incorporating patient preferences, nutrition, lifestyle measures, and fall prevention into osteoporosis management alongside pharmacologic therapy.
- METEOR Trial — A multicenter randomized controlled trial compared arthroscopic partial meniscectomy followed by postoperative physical therapy with a standardized physical therapy regimen in patients aged 45 years or older with a meniscal tear and imaging evidence of mild-to-moderate knee osteoarthritis. Researchers found no statistically significant difference in functional improvement between the treatment groups at 6 months and 12 months. Thirty percent of those assigned to physical therapy underwent surgery within 6 months.
- Acute Achilles' Tendon Rupture Trial — A randomized controlled trial compared nonoperative treatment, open repair, and minimally invasive surgery in adult patients with acute Achilles' tendon rupture. At 12 months, changes in Achilles' tendon Total Rupture Score, physical performance, and patient-reported physical function were similar among the three groups. Tendon rerupture occurred more frequently with nonoperative treatment, whereas nerve injuries were reported more often following surgical treatment.
- Patient-Reported Outcomes Measurement Information System (PROMIS) — The Patient-Reported Outcomes Measurement Information System is a National Institutes of Health (NIH)-funded initiative that provides validated patient-reported outcome measures for clinical research and practice. The system includes instruments that assess physical, mental, and social health in adult and pediatric patients across the general population and among patients with chronic conditions.
Sources: AAOS, Arthritis Care & Research, FRAX, The New England Journal of Medicine, The Journal of Clinical Endocrinology & Metabolism, NIH
