On April 16, 2018 the Canadian Orthopaedic Association announced the release of five new orthopaedic recommendations of tests, treatments or procedures to question. These five new recommendations are in addition the orthopaedic list previously released, making the list Ten Things Physicians and Patients Should Question in Orthopaedics.

The five new recommendations include:

• Don’t use arthroscopic debridement as a primary treatment in the management of osteoarthritis of the knee.
• Don’t order a knee MRI when weight-bearing x-rays demonstrate osteoarthritis and symptoms are suggestive of osteoarthritis as the MRI rarely adds useful information to guide diagnosis or treatment.
• Don’t order a hip MRI when x-rays demonstrate osteoarthritis and symptoms are suggestive of osteoarthritis as the MRI rarely adds useful information to guide diagnosis or treatment.
• Don’t prescribe opioids for management of osteoarthritis before optimizing the use of non-opioid approaches to pain management.
• Don’t routinely request pathological examination of tissue from uncomplicated primary hip and knee replacement surgery undertaken for degenerative arthritis.

See Ten Things Physicians and Patients Should Question in Orthopaedics to view the full list, including a rationale and references for each recommendation.

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