AANA celebrates 25 years of achievement

Despite successes, AANA leaders foresee challenges and discussed how to overcome them.

Issue: July 2006

HOLLYWOOD, Fla. – When introduced in the United States, arthroscopy experienced slow adoption and was regarded in medical academic circles as “unlikely to succeed.”

That all began to change in 1981 – 17 years after arthroscopy emigrated from Japan to North America. In August of that year, members of the North American Chapter of the International Arthroscopy Association (IAA) converted to the Arthroscopy Association of North America (AANA) as a society to educate surgeons in arthroscopy.

“Television [monitors] had adapted to arthroscopy and had become the standard way to do the procedure,” John B. McGinty, MD, AANA’s inaugural president, said at the Arthroscopy Association of North America 25th Annual Meeting.

John B. McGinty, MD [photo]
John B. McGinty

“Endoscopic techniques were starting to be used in joints other than the knee. Demand for arthroscopy and arthroscopic surgery was overwhelming. It was obvious that some form of organized leadership was needed to provide the necessary information and education of these burgeoning skills,” said McGinty, who is a past chief medical editor of Orthopedics Today.

Looking back

AANA held its first annual meeting at the Drake Hotel in Chicago on May 5, 1982. During the meeting, members approved the bylaws and articles of incorporation and set the annual dues at $150. The next year, AANA established the $100 assessment research grant program with an annual goal of $500,000, which McGinty said has long since been surpassed.

Through the ensuing years, AANA prospered, although not without enduring difficulties, McGinty said. For example, in 1985, AANA negotiated with FlightSafety International and the state of Massachusetts to build a learning center for skills education and arthroscopy simulators in North Haven, Mass.

“In spite of two years of efforts … the efforts fell through, largely because of the [learning center’s] remote location and the failure of promised support from the governor of Massachusetts,” McGinty said.

AANA eventually partnered with the American Academy of Orthopaedic Surgeons (AAOS) and opened a learning center in 1994 in Rosemont, Ill. In 2000, the learning center expanded, forming its own board of directors, and became financially separate from AANA and the AAOS, McGinty said.

In 1989, AANA experienced financial hardship but recovered through a fund drive and with support from industry leaders. The society’s members started a second fund drive for the learning center in 2001.

Over the years, arthroscopy evolved in the United States both medically and academically. “The value of information gained to arthroscopy became so obvious to the universities that they were forced to change their residencies,” McGinty said.

“Once television [monitors] became the mode of control of endoscopic procedures in orthopedics, arthroscopy rapidly spread to other specialties and was the major contributing factor to the development of minimally invasive surgery in all surgical specialties.”

Like any organization, AANA faces new challenges, such as educating patients, future medical education, government regulations and pay-for-performance.

“As arthroscopists, we can be proud, creating one of the … major advancements in orthopedics and having influenced the entire surgical field,” James C.Y. Chow, MD, AANA president, said in his presidential address. “With our success, there are always repercussions. As a growing organization, we are facing new challenges.”

One challenge, he said, is false advertisement, which could lead to unreasonable expectations from the patient. Chow added: “AANA’s great path in front of us is how to educate the general public and deliver our message: What is arthroscopy about?”

The bottom line

Leslie S. Matthews, MD [photo]
Leslie S. Matthews

Although AANA remains financially stable, Chow reminded everyone to keep their eye on the bottom line, which allows the society to support research and provide education to members and other qualified individuals.

“Last year, a task force was formed [to explore] the possibilities of AANA’s financial independence,” Chow said. “Transformation of their ideas to reality takes time, planning, patience and persistence.”

Another issue: AANA succeeded in making arthroscopy the preferred procedure for some orthopedic surgeries; therefore, open surgery declined in some teaching institutions. New and young orthopedists need to understand how to perform open surgery so they can explore a joint and surrounding structures when needed.

“Maybe we should start thinking about teaching both open [surgery] and arthroscopy in the residents’ course,” Chow said.

He also urged the attendees to help set guidelines for quality control in pay-for-performance.

“If we don’t assist in setting the guidelines, they will be set for us,” Chow said.

Douglas W. Jackson, MD [photo]
Douglas W. Jackson

AANA has been instrumental in introducing arthroscopy around the world, and many members pioneered “motor skills education” in orthopedics, Chow said. In addition to making a place for arthroscopy in joint disorder treatment, AANA provided a forum for arthroscopists to share ideas and techniques with their peers, added Leslie S. Matthews, MD, Orthopedics Today Arthroscopy section editor.

“[AANA’s] greatest challenge has been to maintain its leadership position in fostering research, surgeon education and patient care,” Matthews told Orthopedics Today. “It is my view that the association has been more than up to that task.”

Now, “It will be challenging to continue the past momentum and accomplishments for another 25 years,” said Douglas W. Jackson, MD, Orthopedics Today chief medical editor and a key member of AANA.

“AANA will remain relevant as long as it oversees new applications and developments involving the use of the arthroscope,” Jackson told Orthopedics Today.