Education: The Mission of The American Journal of Orthopedics

Our Mission is stated at the beginning of every issue and on our website: "The primary goal of The American Journal of Orthopedics is to provide timely, practical, and readable technical information of the highest caliber to the orthopedic surgeon involved in the everyday practice of orthopedics."

This lofty goal is, I believe, all about continued education, which is one of the primary purposes of our major professional society, the AAOS, and our certification organization, The American Board of Orthopaedic Surgery. We, at AJO, take our Mission Statement very seriously and have assembled an outstanding publication staff and Editorial Board that include many nationally and internationally recognized leaders in the field of orthopedic surgery, who work in concert to provide "unbiased, comprehensive, and clinically relevant review articles, original studies, case reports, and practical department features."

AJO has made great efforts to offer a variety of formats to accomplish our Mission. These include our concept of Focus Issues wherein a monthly journal will concentrate on a particular field of clinical interest. For example, this February issue is focused on the shoulder and elbow, and includes
three informative studies on topics that are currently clinically relevant to shoulder/elbow surgeons.

Garzon-Muvidi and colleagues from Johns Hopkins University describe the unfortunate outcome of an 85-year-old patient who died as a result of sepsis following infection in the shoulder from revision reverse prosthesis surgery (see page 84). While the 90-day mortality following shoulder arthroplasty is extremely low—0.25% to 0.58%, according to one study cited in the paper—to my knowledge, this was the first report of a case where mortality was directly related to a complication of the reverse prosthesis. The authors justifiably recommend that all "risks, benefits, and potential complications should be discussed thoroughly with patients considering this procedure."

A second study by Petrera and colleagues from the University of Toronto Orthopaedic Sports Medicine, report their experience using fresh glenoid osteochondral allograft in the treatment of posttraumatic posterior subluxation of the shoulder associated with glenoid bone loss (see page 78). Posterior glenoid defects in the posterior shoulder instability are quite uncommon, but the authors describe a case report with excellent two-year follow-up results using fresh osteochondral allograft to reconstruct the posterior glenoid bone deficiency. This is an excellent description of a technique that addresses an uncommon, yet challenging orthopedic condition and that can be a useful procedure for a shoulder surgeon to consider.

A third paper in this issue, is a retrospective study on the effectiveness of acellular human dermal allograft as a bridging device for massive irreparable rotator cuff tear reconstruction by Venouziou and colleagues from the Interbalkan Medical Center in Thessaloniki, Greece (see on page 63). The authors describe their indications and technique for the use of allograft and closing persistent defects of massive rotator cuff tears. Successful treatment of massive rotator cuff tears in the relatively young and active patient (average age, 54.6 years in the study) is one of the unsolved dilemmas confronting shoulder surgeons. While many studies have reported poor outcomes when attempting to use interpositional graft material, these authors describe very good outcomes (American Shoulder and Elbow Scores improving nearly 50 points following surgery, on average) using the air technique. While additional studies are needed to confirm and duplicate the outcomes of this promising report, shoulder surgeons certainly have something to learn from this paper.

Other formats embraced by AJO to enhance education include our 5 Points Series by acknowledged experts in their fields, or practice management series, expansion into electronic publishing on our website, timely e-mail advancements, and co-sponsoring of the successful Emerging Techniques in Orthopedics meeting held anually in Las Vegas, as well as audiocasts/webcasts, and conference news coverage. It is our hope that all of these efforts enhance our Mission— to further the education of our readers and, consequently, improve care for our patients. ◾

Author's Disclosure Statement: The author reports no actual or potential conflict of interest in relation to this article.