The American Academy of Orthopaedic Surgeons (AAOS) released the updated Evidence-Based Clinical Practice Guideline for the Management of Rotator Cuff Injuries in August 2025. The guideline provides 25 recommendations and 4 consensus statements across diagnosis, treatment decision-making, biologic interventions, and postoperative rehabilitation, with the strength of each recommendation graded according to the quality of supporting evidence. The updated guideline highlights several key advances, including establishing CT as an important adjunctive imaging modality, providing specific recommendations on repair strategies for high-grade partial-thickness rotator cuff tears, and clearly restricting the use of platelet-rich plasma and marrow stimulation in rotator cuff repair, as well as limiting the application of prolotherapy in the treatment of full-thickness rotator cuff tears. In addition, the guideline emphasizes the potential benefits of early mobilization in patients with small to medium-sized tears.
Surgical management of osteoarthritis of the knee: evidence based guideline contains 38 recommendations pertaining to the preoperative, perioperative, and postoperative care of patients with knee osteoarthritis (KOA) who are considering surgical treatment. Compared with the domestic consensus on diagnosis and treatment for KOA, this clinical practice guideline (CPG) prepared by the American Academy of Orthopedic Surgeons (AAOS) has some advantages in terms of methodology selection and recommendation. Therefore, it is necessary for us to interpret this CPG to speed up the understanding and dissemination of the CPG. The ultimate aims are to: ① strengthen the standardization and understanding of surgical treatment of KOA; ② enhance the understanding of clinicians for this CPG in treating KOA; ③ speed up the development of guideline development methodologies in China; ④ provide methodological guidance for the development of CPG based on the current situation in China.
In November 2025, the American Academy of Orthopaedic Surgeons (AAOS) released the updated Clinical Practice Guideline for the Management of Acute Compartment Syndrome (ACS). This guideline addresses key issues including early diagnostic strategies, surgical decision-making, and perioperative management, presenting 8 recommendations and 7 consensus statements. A systematic interpretation highlights the core recommendations regarding the diagnostic value of biomarkers, the important role of compartment pressure monitoring, surgical decision-making, and wound management. A major update is the upgrade of the recommendation for early fixation of long bone fractures in ACS patients with associated fractures from expert consensus to a limited recommendation. Compared with the Chinese Guideline for Early Diagnosis and Treatment of Acute Compartment Syndrome (2020 edition), there were three key similarities and differences. Diagnostic strategy: both guidelines value compartment pressure monitoring, but the Chinese guideline emphasizes its diagnostic role, whereas the AAOS guideline focuses on its utility in dynamic monitoring to help rule out ACS. Biomarkers: Chinese guidelines suggests that serum lactate, serum cardiac troponin, and myoglobinuria may serve as indicators of traumatic ACS; the AAOS guideline only recognizes myoglobinuria, serum troponin, and, in specific contexts, femoral venous lactate as having adjunctive value, and explicitly states that serum biomarkers should not be used as the basis for fasciotomy decision-making in late or missed ACS. Treatment: both guidelines emphasize that once the diagnosis is confirmed, early fasciotomy should be performed. The AAOS guideline provides a reference for Chinese clinicians to improve early recognition and standardized management of ACS.