Shoulder

[I fix partial thickness rotator cuff tears]
[I ignore partial thickness rotator cuff tears]

[My subacromial decompression includes partial acromial resection]
[My subacromial decompression is typically only a bursectomy]

[I perform subacromial decompression arthroscopically]
[I perform open subacromial decompressions]

[I fix four part proximal humerus fractures]
[I treat four part proximal humerus fractures with joint replacement]

[Displaced clavicular fractures should be treated operatively]
[Closed treatment for displaced clavicular fractures is best]

[First time shoulder dislocation in young athletes should be treated surgically]
[First time shoulder dislocation in young athletes should be treated non-operatively]

[Recurrent anterior shoulder instability should be treated with open surgical techniques]
[Recurrent anterior shoulder instability can be treated with open arthroscopic techniques]

Elbow

[I fix displaced radial head fractures]
[Displaced radial head fractures should be treated with a prosthesis]

[Recalcitrant lateral epicondylitis should be treated with surgical debridement]
[Lateral epicondylitis is not a surgical disease]

[Ulnar nerve transpositions must be submuscular]
[Ulnar nerve transpositions need not be submuscular]

[Distal biceps tendon repairs are best done with single techniques]
[Distal biceps tendon repairs are best done with two techniques]

[Pediatric supracondylar fractures need same day (or night) treatment]
[Pediatric supracondylar fractures may be deferred tothe next day with no harm to patients]

Wrist

[A TFCC "tear" seen on MRI and concordant pain is an indication for surgery]
[TFCC "tears" are seen on MRI so randomly that their presence should not contribute to surgical decision making]

[An EMG prior to operating on carpal tunnel syndrome is mandatory]
[An EMG prior to operating on carpal tunnel syndrome is optional]

[Carpal tunnel syndrome is caused by repetitive use]
[Carpal tunnel syndrome is not caused by repetitive use]

Cervical Spine

[Epidural steroid injections are useful treatments for cervical radiculopathy]
[Epidural steroid injections for cervical radiculopathy are costly and risky wastes of time]

[An EMG prior to decompression for cervical radiculopathy is mandatory]
[An EMG prior to decompression for cervical radiculopathy is optional]

Thoracic Spine

[Surgery for scoliosis is a cosmetic operation primarily]
[Surgery for scoliosis is a physiological operation]

[Bracing idiopathic scoliosis meaningfully alters the natural history of disease]
[Bracing idiopathic scoliosis imposes many burdens on patients without altering the natural history of disease]

Lumbar Spine

[Lumbar disc replacements are good for patients]
[Lumbar disc replacements are good for implant manufacturers and health care providers]

Hip and Pelvis

[Avascular necrosis of the femoral head without collapse should be treated with decompression]
[The natural history of avascular necrosis of the femoral head without collapse is not improved by decompression]

[Primary hip replacement should be performed via an anterior approach]
[Primary hip replacement should be performed via a lateral anterior approach]
[Primary hip replacement should be performed via a posterior approach]

[Suspected sepsis of a total hip replacement should be evaluated with an aspiration despite the possible risk of infecting a clean joint]
[Suspected sepsis of a total hip replacement should NOT be evaluated with an aspiration because of the possible risk of infecting a clean joint]

[Displaced femoral neck fracture in older patient is best treated by hemiarthroplasty]
[Displaced femoral neck fracture in older patient is best treated by total hip arthroplasty]
[Displaced femoral neck fracture in older patient might deserve an attempt of reduction and internal fixation]

[I perform prophylactic pinning of the contralateral side in patients with a slipped capitol femoral epiphysis]
[Prophylactic pinning of the contralateral side in patients with a slipped capitol femoral epiphysis is often not worth the costs and risks]

[slipped capitol femoral epiphysis should be pinned in situ]
[slipped capitol femoral epiphysis should be reduced prior to pinning]

Femur

[I recommend reaming when treating open femoral fractures with IM nails]
[Reaming when treating open femoral fractures with IM nails should be avoided]

[The best starting point for inserting a femoral nail is the piriformis fossa]
[The best starting point for inserting a femoral nail is the greater trochanter]

Knee

[I retain the PCL when doing a knee replacement]
[I sacrifice the PCL when doing a knee replacement]

[ACL reconstruction surgery can improve knee homeostasis]
[ACL reconstruction surgery improve stability just enough to let patients go out and really damage their knees]

[Anterior knee pain can be a surgical disease]
[Realignment procedures for anterior knee pain further upset knee homeostasis]

[Double bundle anterior cruciate ligament reconstruction is more physiologic]
[Double bundle anterior cruciate ligament reconstruction is a solution in search of a problem]

[The best graft for anterior cruciate ligament reconstruction is an autograft patellar tendon]
[The best graft for anterior cruciate ligament reconstruction is an autograft hamstring tendon]
[The best graft for anterior cruciate ligament reconstruction is an allograft]

Ankle

[Total ankle replacements are ready for prime time]
[Total ankle replacements are inferior to fusion]

[Operative treatment for Achilles tendon rupture is almost always the standard of care]
[There is a large role for non-operative treatment for Achilles tendon rupture]

Foot

[I will operate on bunions even if the patient intends to continue using ridiculous shoes]
[Operating on bunions if the patient intends to continue using ridiculous shoes enables bad behavior]

[Avulsion fractures of the fifth metatarsal are best treated with immobilization and full weight bearing]
[Avulsion fractures of the fifth metatarsal are best treated with immobilization and non-weight bearing]
[Avulsion fractures of the fifth metatarsal are best treated with benign neglect]

Economic Issues

[Consulting fees to surgeons are entirely appropriate]
[Consulting fees to surgeons are often bribes in disguise]

[Participation in Medicare is a moral responsibility]
[Participation in Medicare is entirely optional]

[Orthopedic surgeons are overpaid]
[Orthopedic surgeons are underpaid]

Policy

[Maintenance of certification is helpful to the public]
[Maintenance of certification is will keep CME providers in business without helping the public]

[The 80 work week will improve the training of doctors]
[The 80 work week will harm the training of doctors]

[There are few female orthopedic surgeons because of discrimination]
[There are few female orthopedic surgeons because of a lack of interest]
[The number of female orthopedic surgeons is not a datum policy members should care about]

Ethics

[It is okay to accept gifts from industry]
[It is unethical to accept gifts from industry]

[Advertising by orthopedic surgeons is benign and should be only loosely regulated]
[Advertising by orthopedic surgeons has pernicious effects and should be curbed]

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