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By Quanjun "Trey" Cui, MD
VOS Newsletter Editor
Glucosamine and Chondroitin,
Do They Really Work?
Evidence supporting the use of glucosamine and chondroitin is scant, anecdotal. A landmark study funded by the National Institutes of Health (NIH) in 2006, and involving more than 1,500 patients with knee OA, found virtually no benefit from the therapy using glucosamine and chondroitin. In his recent article published in AAOS Now, Terry Stanton has concluded with the following statements:
- Glucosamine and chondroitin, classified as food supplements and not regulated by the FDA, are substances that occur naturally in cartilage.
- Common forms of glucosamine are sulfate and hydrochloride, while chondroitin is typically a sulfate; it is possible that the sulfate component acts as a pain modulator.
- Early laboratory and clinical studies showed promise for glucosamine and chondroitin, but a large NIH-funded trial cast doubt on their efficacy, and subsequent studies have had similar findings.
- Glucosamine and chondroitin are considered safe for most people, and many physicians do not discourage their use if the patient thinks they are beneficial.
Read more at: http://www.aaos.org/news/aaosnow/sep12/cover2.asp
Work Place Stress and Burn Out:
Taking Care of Yourself ?
- Accept that time and age change a person, as well as his or her personal goals, priorities, and bedside manner. Take time to examine what is important to you now – and how that differs from earlier in your career. Use this knowledge to frame what is important to you, as a physician and an individual, so you can incorporate it in your daily work.
- Perfectionism is a well-known trait among surgeons. Striving for perfection is admirable, but can cause a great deal of stress.
- Related to this, how much of your stress is self-imposed rather than related to external factors? Understand whether you need to ask yourself or your organization for permission to change.
- Once you better understand your needs and the environmental factors that cause the most stress, start to look at specific tactics that can free up or rearrange time for other priorities and needs.
- Scheduling and time management – Are there ways to utilize your time more efficiently? Consider setting aside specific blocks of time for specific responsibilities.
- Delegation – Are there noncritical or lower priority tasks that can be done by or shared with others? Can ancillary staff do some paperwork or charting, or take care of patient-related appointments or communications?
- Protected time – How can you carve out time that is respected and protected for breaks? Everyone needs time to refresh and reflect, but struggling to find and maintain that time can create more stress.
- Resolving issues – If issues with staff or colleagues are resulting in conflict or other work issues (operational or process issues, policies, or resource allocation) and contributing to a stressful environment, how can they be resolved? Who in your organization is responsible for facilitating discussions and implementing solutions? Is there a way to provide input in a manner that is professional and receive feedback on results?
Read full article at: http://www.aaos.org/news/aaosnow/sep12/managing4.asp
Simulation Training in
Orthopaedic Surgical Education
New methods for developing surgical skills are on the rise. Traditionally, residents honed their surgical skills in the operating room under the tutelage of senior orthopaedic surgeons. Due in part, however, to the rapid evolution of orthopaedic surgical techniques, today’s residents are expected to acquire more complex and diverse surgical skills in less time than their predecessors. As a result, alternative teaching methods – such as simulation training – are increasingly becoming a part of resident training. A review of simulation-based orthopaedic surgical skills training – from cadaver models and synthetic bones to software tools and computerized simulators – appeared in the July issue of the Journal of the AAOS.
Read more at: http://www.jaaos.org/content/20/7/410.full http://www.aaos.org/news/aaosnow/aug12/clinical8.asp
