AMA Guides® Newsletter - Issue Archive

Articles

1. Fifth Edition: the New Standard

   Christopher R. Brigham, James B. Talmage, Leon H. Ensalada

   Pages 1–7

   DOI: 10.1001/amaguidesnewsletters.2000.NovDec01

   Abstract

   The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is available and includes numerous changes that will affect both evaluators who and systems that use the AMA Guides. The Fifth Edition is nearly twice the size of its predecessor (613 pages vs 339 pages) and contains three additional chapters (the musculoskeletal system now is split into three chapters and the cardiovascular system into two). Table 1 shows how chapters in the Fifth Edition were reorganized from the Fourth Edition. In addition, each of the chapters is presented in a consistent format, as shown in Table 2. This article and subsequent issues of The Guides Newsletter will examine these changes, and the present discussion focuses on major revisions, particularly those in the first two chapters. (See Table 3 for a summary of the revisions to the musculoskeletal and pain chapters.) Chapter 1, Philosophy, Purpose, and Appropriate Use of the AMA Guides, emphasizes objective assessment necessitating a medical evaluation. Most impairment percentages in the Fifth Edition are unchanged from the Fourth because the majority of ratings currently are accepted, there is limited scientific data to support changes, and ratings should not be changed arbitrarily. Chapter 2, Practical Application of the AMA Guides, describes how to use the AMA Guides for consistent and reliable acquisition, analysis, communication, and utilization of medical information through a single set of standards.
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2. Impairment Tutorial: Rating Less Common Meniscal and Articular Cartilage Scenarios

   James B. Talmage, Robert H. Haralson

   Pages 13–14

   DOI: 10.1001/amaguidesnewsletters.2000.NovDec02

   Abstract

   The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, provides methods to rate knee injuries treated by partial or total menisectomy and also provides methods to rate knee injuries treated by partial or total menisectomy. Although accompanying tables permit impairment rating of most knee injuries, arthroscopy and new surgical procedures have permitted early diagnosis of osteochondral fracture defects that are not easily rated. A peripheral meniscal tear in the fascular part of the meniscus potentially is repairable, but impairment rating after treatment is challenging. If the only surgical procedure was meniscal transplantation and if preoperative radiographs demonstrate joint space narrowing that is sufficiently significant to rate as an impairment, the knee probably can be rated using the joint space narrowing measurement and Table 62. The AMA Guides is silent about rating the impairment when an osteochondral fracture has occurred. If, after time for healing and rehabilitation, the joint has limited motion, atrophy in supporting muscles, or joint space narrowing on radiographs, the rating for those problems probably will adequately describe the impairment. Long-term results of operations that attempt to repair the meniscal or articular cartilage are not known, and impairment rating after one of these procedures may change with time and the publication of additional studies.
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3. Erratum

   Pages 14–14

   DOI: 10.1001/amaguidesnewsletters.2000.NovDec03