Monthly Briefings

January 2012 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for January 2012. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Warm Saline Enhances Shoulder Tendinitis Treatment

TUESDAY, Jan. 31 (HealthDay News) -- The use of a warm saline solution improves outcomes and reduces procedure time for patients undergoing double-needle ultrasonography (US)-guided percutaneous treatment for rotator cuff calcific tendinitis (RCCT), according to a study published in the February issue of Radiology.

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Disc Degeneration More Likely in Overweight, Obese Adults

MONDAY, Jan. 30 (HealthDay News) -- Overweight and obese adults are significantly more likely to have lumbar disc degeneration compared with those who have a normal body mass index (BMI), according to a study published online Jan. 27 in Arthritis & Rheumatism.

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Unemployed Have Poorer Mental and Physical Health

TUESDAY, Jan. 24 (HealthDay News) -- Unemployed adults are about half as likely to have health insurance as employed individuals; have poorer mental and physical health, regardless of their insurance status; and are less likely to receive needed medical care and prescriptions, according to a January data brief issued by the National Center for Health Statistics.

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HealthGrades IDs Notable Hospitals for Clinical Excellence

TUESDAY, Jan. 24 (HealthDay News) -- The top 5 percent of U.S. hospitals has more than a 30 percent lower risk-adjusted mortality across 17 procedures and diagnoses, compared with other hospitals, according to the 10th annual HealthGrades Hospital Quality and Clinical Excellence study published online Jan. 24.

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Recent Shift in Indication for Total Elbow Arthroplasty

TUESDAY, Jan. 24 (HealthDay News) -- The most common indication for total elbow arthroplasty in New York State changed from inflammatory conditions in 1997 to trauma in 2006, with revision and complication rates remaining high, according to a study published in the Jan. 18 issue of The Journal of Bone & Joint Surgery.

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Chlorhexidine Erases More of Preoperative Skin Markings

MONDAY, Jan. 23 (HealthDay News) -- Use of a chlorhexidine-based solution for preoperative skin marking is associated with more erasure of skin markings than an iodine-based alternative, according to a study published in the Jan. 18 issue of The Journal of Bone & Joint Surgery.

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Effects of Severe, Childhood Brain Injury Long Lasting

MONDAY, Jan. 23 (HealthDay News) -- There is a high risk of persisting deficits following severe, childhood traumatic brain injury (TBI), according to a study published online Jan. 23 in Pediatrics.

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Lamina Closure Has No Long-Term Impact in Laminoplasty

MONDAY, Jan. 23 (HealthDay News) -- Lamina closure has no significant impact on the long-term surgical outcomes of laminoplasty performed for cervical myelopathy, according to a study published online Jan. 12 in Spine.

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Neuromodulators Reduce Pain in Rheumatoid Arthritis

FRIDAY, Jan. 20 (HealthDay News) -- Neuromodulators are superior to placebo for reducing pain in patients with rheumatoid arthritis (RA), but treatment is associated with adverse events; whereas muscle relaxants show no benefit for improving pain in RA, according to two reviews published online Jan. 18 in the Cochrane Database of Systematic Reviews.

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Study IDs Optimal Interval Between Bone Density Tests

WEDNESDAY, Jan. 18 (HealthDay News) -- The recommended bone mineral density (BMD) screening interval is approximately 16 years for postmenopausal women with normal BMD, 4.5 years for women with moderate osteopenia, and one year for women with advanced osteopenia, according to a study published in the Jan. 19 issue of the New England Journal of Medicine.

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Rates of Post-Arthroplasty Symptomatic VTE Identified

WEDNESDAY, Jan. 18 (HealthDay News) -- The rates of postoperative symptomatic venous thromboembolism (VTE) are 1.09 percent after total or partial knee arthroplasty (TPKA) and 0.53 percent after total or partial hip arthroplasty (TPHA), according to a review published in the Jan. 18 issue of the Journal of the American Medical Association.

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Increase in Incidence of Knee Arthroplasty in Finland

WEDNESDAY, Jan. 18 (HealthDay News) -- The incidence of total knee arthroplasties (TKAs) and unicondylar knee arthroplasties (UKAs) increased in Finland from 1980 to 2006, with most of the increase occurring in those aged 50 to 59 years, according to a study published online Jan. 17 in Arthritis & Rheumatism.

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Juvenile Arthritis Disease-State Cut-Off Values Established

TUESDAY, Jan. 17 (HealthDay News) -- Using the Juvenile Arthritis Disease Activity Score (JADAS), disease-state cut-off values have been established for pediatric patients with juvenile idiopathic arthritis (JIA), according to research published online Jan. 9 in Arthritis & Rheumatism.

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Tool Predicts Improved Function After Hip Arthroplasty

TUESDAY, Jan. 17 (HealthDay News) -- Preoperative patient characteristics and radiographic assessment can be used to predict expected functional improvement for patients undergoing total hip arthroplasty (THA), according to a study published online Jan. 9 in Arthritis Care & Research.

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Comorbidities Affect Hospital Costs After Hip Fracture

TUESDAY, Jan. 17 (HealthDay News) -- For older Americans with hip fracture, the presence of comorbidities is associated with increased cost of hospitalization, according to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery.

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Preoperative Tracheal Exercise Cuts Post-Op Dysphagia

MONDAY, Jan. 16 (HealthDay News) -- For patients with multiple-level fusion after anterior spinal surgery, postoperative dysphagia can be reduced by use of preoperative tracheal/esophageal traction exercise (TTE) treatment, according to a study published online Jan. 5 in Spine.

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Hyaluronic Acid Similar to Placebo for Ankle Arthritis

MONDAY, Jan. 16 (HealthDay News) -- A single intra-articular injection of hyaluronic acid was no more effective in treating osteoarthritis of the ankle than an injection of normal saline solution, according to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery.

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Increased Pathologic Fracture Risk in Staph Osteomyelitis

MONDAY, Jan. 16 (HealthDay News) -- Children with osteomyelitis secondary to Staphylococcus aureus infection have increased risk of pathologic fracture, according to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery.

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Surgery Beats Non-Op Care for Intervertebral Disc Herniation

FRIDAY, Jan. 13 (HealthDay News) -- Surgery is more effective than nonoperative treatment for patients with intervertebral disc herniation (IDH), with marital status, joint problems, and symptom trend at baseline identified as significant modifiers of treatment effect, according to a study published in the Jan. 15 issue of Spine.

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U.S. Health Care Expenditure Still Unevenly Distributed

FRIDAY, Jan. 13 (HealthDay News) -- Health care expenditure in the United States is still unevenly distributed, with 1 percent of the population accounting for approximately 20 percent of expenditure in 2008 and 2009, according to a January statistical brief published by the Agency for Healthcare Research and Quality (AHRQ).

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Thromboprophylaxis Rate Low for Knee Arthroplasty in Taiwan

FRIDAY, Jan. 13 (HealthDay News) -- Pharmacologic thromboprophylaxis for Taiwanese patients undergoing total knee arthroplasty (TKA) is very low, at 2.2 percent, which may correlate with the low incidence of post-surgery venous thromboembolism (VTE), according to a study published in the January issue of the Journal of Thrombosis and Haemostasis.

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Surgical Techniques Affect Outcome in Scoliosis Surgery

FRIDAY, Jan. 13 (HealthDay News) -- For patients with adolescent idiopathic scoliosis (AIS), eight factors correlate significantly with maintenance of kyphosis, according to a study published online Jan. 5 in Spine.

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Patients Give High Marks to Ankle Replacement Surgery

THURSDAY, Jan. 12 (HealthDay News) -- Patients who undergo Scandinavian Total Ankle Replacement (STAR) arthroplasty for treatment of end-stage arthritis report significant intermediate to long-term improvement in pain, function, and quality-of-life scores, according to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery.

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Physical Activity in Work or Leisure Tied to Lower MI Risk

THURSDAY, Jan. 12 (HealthDay News) -- Physical activity during work or leisure time is associated with a significantly lower risk of myocardial infarction (MI), according to a multinational study published online Jan. 11 in the European Heart Journal.

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SPECT-CT Is Good Predictor of Response to Vertebroplasty

WEDNESDAY, Jan. 11 (HealthDay News) -- Positive bone single photon emission computed tomography-computed tomography (SPECT-CT) images are useful as predictors regarding which patients will experience clinical improvement following percutaneous vertebroplasty (PV) for vertebral fractures, according to a study published in the December issue of The Spine Journal.

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CDC: 2010 Saw Decrease in Age-Adjusted Death Rates

WEDNESDAY, Jan. 11 (HealthDay News) -- From 2009 to 2010, age-adjusted death rates decreased and life expectancy increased, according to a Jan. 11 report published by the U.S. Centers for Disease Control and Prevention.

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Conscious Sedation Feasible for Ambulatory Spine Procedures

TUESDAY, Jan. 10 (HealthDay News) -- Conscious sedation in the ambulatory interventional spine setting is associated with a low rate of adverse events comparable to that observed with local anesthesia alone, according to a study published in the December issue of The Spine Journal.

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Back Pain Intensity Not Linked to Extent of Muscle Damage

MONDAY, Jan. 9 (HealthDay News) -- The intensity of exercise-induced low back pain is not statistically associated with the magnitude of spinal muscle damage in the lumbar erector spinae, according to a study published in the December issue of The Spine Journal.

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Rilonacept Reduces Gout Flares During Acute Urate Lowering Rx

MONDAY, Jan. 9 (HealthDay News) -- The use of rilonacept significantly reduces gout flare-ups in the first few months following initiation of urate-lowering therapy (ULT), according to research published online Jan. 4 in Arthritis & Rheumatism.

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Hand Bone Loss Predicts Radiographic Progression in RA

FRIDAY, Jan. 6 (HealthDay News) -- Hand bone loss during the first year of treatment of rheumatoid arthritis (RA) is associated with a high likelihood of radiographic progression, but it is not associated with long-term patient-reported outcomes, according to a study published in the January issue of Arthritis Care & Research.

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Poorer Leg Muscle Quality Associated With Knee OA

FRIDAY, Jan. 6 (HealthDay News) -- Muscle quality is significantly poorer in a biracial group of older patients with radiographic knee osteoarthritis (RKOA), regardless of their pain status, according to a study published in the January issue of Arthritis Care & Research.

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In-Hospital, 30-Day Standardized Mortality Measures Differ

THURSDAY, Jan. 5 (HealthDay News) -- The mean risk-standardized mortality rates (RSMRs) differ for in-hospital and 30-day models, with wide variability across U.S. hospitals, according to a study published in the Jan. 3 issue of the Annals of Internal Medicine.

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Formula Diet Aids Weight Loss, Nutritional Gains in Obese

THURSDAY, Jan. 5 (HealthDay News) -- A 16-week formula-based diet program significantly improves the nutritional status and bone health in obese patients with osteoarthritis, according to a study published online Dec. 21 in the European Journal of Clinical Nutrition.

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Spinal Manipulation Superior to Medication for Neck Pain

THURSDAY, Jan. 5 (HealthDay News) -- For patients with acute and subacute nonspecific neck pain, symptoms improved with spinal manipulation therapy (SMT), medication, and home exercise, but spinal manipulation was found to be the most effective method for both short-term and long-term pain relief, according to a study published online Jan. 2 in the Annals of Internal Medicine.

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Donor Bisphosphonate Use OK With Demineralized Bone Matrix

WEDNESDAY, Jan. 4 (HealthDay News) -- Demineralized bone matrix (DBM) derived from donors who used bisphosphonates is safe and effective in its ability to induce bone formation, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

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Epidural Steroids Temporarily Up Blood Glucose in Diabetes

TUESDAY, Jan. 3 (HealthDay News) -- Epidural steroid injections (ESIs) significantly increase the blood glucose levels in patients with diabetes mellitus, but the effect lasts less than two days, according to a study published in the Jan. 1 issue of Spine.

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Traditional, Disease Risk Factors ID'd in SLE Osteoporosis

TUESDAY, Jan. 3 (HealthDay News) -- For patients with systemic lupus erythematosus (SLE), the etiology of osteoporosis is multifactorial, encompassing traditional risk factors and SLE-related factors; and there is an increased fracture risk, according to a review published in the January issue of Arthritis Care & Research.

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Standardized Count Practices Reduce Retained Surgical Items

MONDAY, Jan. 2 (HealthDay News) -- Implementation of quality improvement strategies to standardize count practices can reduce the incidence of unintentional retained surgical items (RSIs) in operating rooms (ORs), according to a study published in the January issue of the AORN Journal.

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