Osteoporosis: Steroid Danger
10-million Americans have osteoporosis and 18-million more are at risk. The bone disease leads to an increase in fractures in the hip, spine and wrist accounting for one-point-five million painful fractures each year and one woman's harrowing story of recovery is inspiring.
Link possible between oral contraceptive use, ACL injury in females
Researchers from Denmark have uncovered a potential link between oral contraceptive use and instances of ACL injuries that required surgical intervention in women. The researchers evaluated 4,497 women who were treated operatively for an ACL injury between July 2005 and December 2011 and 8,858 age-matched, uninjured controls.
Prompt, appropriate medical care for dislocated shoulder injuries
Source: Science Daily
Prompt and appropriate treatment of a dislocated shoulder -- when the head of the upper arm bone is completely knocked out of the shoulder socket -- can minimize risk for future dislocations as well as the effects of related bone, muscle and nerve injuries, according to a literature review.
Mind over matter: Can you think your way to strength?
Source: Science Daily
Regular mental imagery exercises help preserve arm strength during 4 weeks of immobilization, researchers have found. Strength is controlled by a number of factors -- the most studied by far is skeletal muscle. However, the nervous system is also an important, though not fully understood, determinant of strength and weakness. In this study, researchers set out to test how the brain's cortex plays into strength development.
Shoulder arthroplasty for treatment of infected shoulder had low risk of reinfection
Shoulder arthroplasty can be performed for the treatment of the sequelae of an infected shoulder with low risk of reinfection, according to study results.
Twenty-four shoulders underwent shoulder arthroplasty for postinfectious glenohumeral arthritis between 1977 and 2009. Researchers monitored 23 shoulders for a minimum of 2 years or until reoperation and documented complications and clinical and radiographic results at the most recent follow-up.
'Therapy car' helps orthopedic patients avoid falls
Source: Science Daily
A “therapy car” is being used by physical and occupational therapists to help patients recovering from hip and knee replacement surgery simulate getting in and out of a real vehicle without falling or injuring themselves.
Concurrently, Virginia Mason's application for a patent on this invention is being reviewed by the United States Patent and Trademark Office.
THA outcomes, surgeon volume effects can be effectively managed
Studies dating back nearly 20 years have shown a correlation between surgeon volume and the rate of complications in total hip arthroplasty, with higher-volume surgeons yielding lower complication rates.
“There are a fair number of studies now that establish pretty clearly that volume matters — independent of the volume done by the hospital,” said Jeffrey N. Katz, MD, MSc, professor of medicine and orthopedic surgery at Harvard Medical School and Brigham & Women’s Hospital in Boston.
New frailty test predicts risk of poor outcomes in elderly patients
Source: Science Daily
A simplified frailty index created by surgeons at Wayne State University School of Medicine in Detroit, Mich., is a reliable tool for assessing risk of mortality and serious complications in older patients considering total hip and knee replacement procedures, according to new study findings presented at the 2014 Clinical Congress of the American College of Surgeons.
As more seniors stay healthier longer, elective operations such as hip and knee replacements are becoming more common. Traditionally, a person's eligibility for surgery has been based largely upon biological age. In recent years, however, a person's level of frailty (under-stood as a general decline in functional status) has come to be recognized as an independent risk factor for adverse health outcomes.
Ankle Replacements of the Future
It’s a surgery that is becoming increasingly more common. Ankle replacements usually are needed because of a bad accident or arthritis. But artificial ankles have come a long way and not all of them are the same.
David Sander believes he is a walking medical marvel and told Ivanhoe, “It’s really a miracle.”
The miracle is that he's walking at all after he slipped on an icy city sidewalk in the middle of winter. Sander said, “I lifted up my leg and my foot was backwards, and I said to myself oh my god.”
After his initial surgery David knew it would eventually come to a replacement, his cartilage was gone leaving him with painful, debilitating arthritis. But he worried failure rates were high for artificial ankles.
Chronic kidney disease increases prosthetic joint infection rates after TJA
Patients with stage 1, 2 or 3 chronic kidney disease may have a higher rate of prosthetic joint injection after total joint arthroplasty, according to study results.
Researchers retrospectively reviewed electronic medical records for 377 patients with stage 1 to 2 kidney disease with 402 patients who had stage 3 chronic kidney disease. All patients underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2004 and 2011.
Patients with stage 3 chronic kidney disease had a greater rate of overall mortality compared with patients with stage 1 to 2 chronic kidney disease, according to the researchers.
When adjusted for comorbid disease, the researchers found no significant increases in joint infection, readmission or early revision between patients with stage 1 to 2 chronic kidney disease compared with patients with stage 3 chronic kidney disease.
Compared with patients with end-stage renal disease, dialysis and kidney transplant, overall incidence of infection was high but much less in chronic kidney disease patients.
In a subgroup analysis, the significant difference in mortality rate persisted between the stage 1 to 2 group vs. the stage 3 group in patients who had undergone THA, but not in patients who had undergone TKA, according to the researchers.
Study results showed a slightly lower rate of 90-day readmission in patients with stage 1 to 2 chronic kidney disease who underwent TKA than in patients with stage 3 chronic kidney disease, whereas 90-day readmission was slightly higher in the THA subgroup.
Antibiotic cement during primary TKA may not decrease infection rates
Judicious risk-stratified usage of antibiotic cement during primary total knee arthroplasty may not decrease infection at 1 year, according to study results. Researchers retrospectively reviewed data for 3,292 patients who underwent primary total knee arthroplasty (TKA). Patients were grouped into cohorts based on whether their surgery involved plain or antibiotic cement, or if they were high-risk patients who received antibiotic cement, and infection rates were compared between the cohorts.
Study results showed a 30-day infection rate of 0.29% in cohort 1, 0.2% in cohort 2 and 0.13% in cohort 3.
Infection rates in all cohorts increased at all time points, with 6-month rates at 0.39% in cohort 1, 0.54% in cohort 2 and 0.38% in cohort 3, and 1-year rates at 0.78% in cohort 1, 0.61% in cohort 2 and 0.64% in cohort 3. However, no statistically significant between-group differences in infection rates were seen at any of the time intervals studied, according to the researchers.
Older patients still fastest-growing demographic for TKA
Despite total knee arthroplasty becoming more prevalent in patients younger than 65 years of age, the main demographic of growth is still among patients older than 65, according to recent study data.
Researchers compared 1999 to 2008 U.S. census data for individuals 18 to 44 years old, 45 to 64 years old, and 65 years and older and the number of total knee arthroplasties (TKAs) performed annually in each age group. Per-capita incidence rates were calculated, and the growth rate in all demographics was determined.
Approximately 305,000 TKAs were performed beyond the number predicted by population growth alone in 2008. Patients older than 65 years of age represented the largest growing cohort, as 151,000 recorded TKA procedures and a per-capita growth rate from 5.2 to 9.1 procedures per 1,000 individuals was observed. Per-capita growth rate also increased from 1.4 to 3.3 procedures per 1,000 individuals among patients 45 to 64 years old.
TKAs were found to have increased 234% during the span of this study, from 264,000 in 1999 and approximately 616,000 in 2008, with fewer than 48,000 of the additional procedures able to be explained by population increase, according to the researchers.
Multiple predictors of unstable syndesmotic SER ankle fractures identified
Fracture height, medial joint space and bone attenuation were determined to be useful predictors of unstable syndesmotic SER-type ankle fractures, according to a study.
The retrospective study included 191 patients who underwent surgical fixation of SER-type ankle fractures. Age, sex and mechanism of injury (ie, low- or high-energy trauma), as well as radiographs and CT imaging scans, were reviewed for all patients. Researchers performed binary logistic regression analysis to identify all predictors of unstable syndesmotic injuries.
Overall, 38 patients (19.9%) had a concurrent unstable syndesmotic injury. Age, sex, mechanism of injury, fracture height, medial joint space and bone attenuation were significantly different between stable or unstable syndesmotic patients, according to the researchers.
Through binary logistic analysis, the researchers found that fracture height, medial joint space and bone attenuation were significant factors contributing to unstable syndesmotic injuries.
Cutoff values for predicting unstable syndesmotic injuries on CT scans were fracture height of 3 mm or larger and medial joint space of 4.9 mm or larger; cutoff values on radiograph were fracture height of 7 mm or larger and medial joint space of 4.5 mm or larger.
Disclosure: The authors have no relevant financial disclosures.
New approach to total knee replacement spares muscle, decreases pain
Source: The Daily Progress
Total knee arthroplasty, also known as total knee replacement, is one of the most commonly performed orthopedic procedures. According to the American Academy of Orthopedic Surgeons, as of 2010, more than600,000 total knee replacements were being performed annually in the United States. The number of total knee replacements performed annually in the U.S. is expected to grow by 673 percent to 3.48 million procedures by 2030.
To start, a rigorous preoperative optimization process is now in place to help minimize the risk of complications after surgery. Patients also attend a joint education class to be advised of what to expect before, during and after the surgery. Studies have shown that these educational classes improve patient outcomes.
Semi-constrained implant improves revision knee arthroplasty outcomes
Use of a semi-constrained implant in revision knee arthroplasty produced acceptable implant survival and functional outcomes during the long-term follow-up period, according to study results.
Identifying risk factors for ACL re-injury
Source: Medical News Today
Re-tearing a repaired knee Anterior Cruciate Ligament (ACL) happens all too frequently, however a recent study being presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting suggests that identification and patient education regarding modifiable risk factors may minimize the chance of a future ACL tear.
Autografts may improve ACL reconstructions
Source: Medical News Today
Anterior Cruciate Ligament (ACL) reconstructions occur more than 200,000 times a year, but the type of material used to create a new ligament may determine how long you stay in the game, say researchers who presented their work at the Annual Meeting of the American Orthopaedic Society of Sports Medicine (AOSSM).
High success rates seen for combined meniscal, ACL repair
Concurrent meniscal and ACL repair has shown high rates of success, according to a presenter here.
Researchers evaluated 235 patients from the Multicenter Orthopaedic Outcomes Network (MOON) who underwent both unilateral primary ACL reconstructions and concurrent meniscal repair between 2002 and 2004. Of the meniscal repairs, 154 were medial, 72 were lateral and nine underwent both.
Validated patient-oriented outcome data (KOOS, WOMAC) scores, Marx activity scores and IKDC scores were recorded at 2 and 6 years follow-up. Failure of meniscal repairs was determined by subsequent ipsilateral repair.
“This represents the largest cohort combining meniscus repair and ACL reconstruction follow-up for a minimum of 6 years,” Robert W. Westermann, MD, said during the American Orthopaedic Society for Sports Medicine Annual Meeting.
Overall, 86% of meniscal repairs were successful at 6-year follow-up; of these, 86.4% were medial meniscal repair, 86.1% were lateral meniscal repairs and 77.8% were in cases where both were repaired, according to Westermann.
Of the 33 repair failures, nine (27.3%) were related to revision ACL surgery. On average, medial meniscal repairs failed sooner than lateral repairs (2.1 years vs. 3.7 years).
KOOS Symptoms, KOOS Pain, KOOS KRQOL, WOMAC Pain, and IKDC values all improved significantly when comparing baseline scores to 6-year follow-up, according to Westermann. Marx Activity levels gradually declined from time of injury to 6-year follow-up. — by Christian Ingram
Reference:Westermann RW. Paper #44.Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.
Disclosure:Westermann has no relevant financial disclosures.
Risk factors identified for little league shoulder
As cases of Little League Shoulder (LLS) occur more frequently, the need for additional information about the causes and outcomes of the condition has become clear. Researchers presenting at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting shared new data identifying associated risk factors, common treatment options and return to play.
NFL players return to the game after stabilizing shoulder surgery
Shoulder instability is a common injury in football players but the rate of return to play has not been regularly determined following surgery. A new study, discussed at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting, details that return rates for NFL players is approximately 90 percent no matter what the stabilization procedure (open vs. arthroscopic).
Obesity may be driving increasing need for knee and hip replacements in steadily younger patients
The impact of being overweight has far reaching health implications — implications that may be taking a toll at an earlier age.
In a new study, researchers found that packing on the pounds may be setting the stage for total knee or hip replacement at increasingly younger ages.
Further, the scientists found that being overweight or obese had a greater impact on the knee than the hip.
In 'tennis elbow' tendon stimulation is the key to repair
Source: Medical News Today
New data presented at the European League Against Rheumatism Annual Congress (EULAR 2014) show that ultrasound-guided injections of growth factors-containing platelet-rich plasma (PRP) are no more effective in treating recently developed epicondylitis than injections of saline.
Elbow surgery risk may be increased by early entry to Major League Baseball
Source: Medical News Today
The common elbow surgery made famous by Major League Baseball (MLB) pitcher, Tommy John, definitely does its job to return pitchers to the mound, but risks for having the surgery may be able to be recognized earlier in a player's career, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting. The study was the largest cohort of MLB pitchers, to date, that have undergone UCL reconstruction.
Ankle replacement becomesmore common to relieve severe arthritis pain
Source: Science Daily
Arthritis can cause terrible pain, making activities of daily living difficult, if not impossible. While most people are familiar with knee and hip replacement surgery for debilitating arthritis in these joints, ankle replacement is another procedure that's on the rise for people suffering from severe ankle pain.
Although ankle fusion traditionally has been the standard treatment, improvements in implant design have prompted more orthopedic surgeons and their patients to consider ankle replacement to relieve pain and restore function, according to Jonathan Deland, MD, co-chief of the Foot and Ankle Service at Hospital for Special Surgery in New York City.
What Patients Need to Know About Revision Surgery After Hip or Knee Replacement
Hundreds of thousands of hip and knee replacement surgeries are performed in the United States each year, and they are highly successful in eliminating pain, restoring mobility and improving quality of life.
Over the past two years, Dr. Westrich has seen a sharp increase in the number of people coming in for a second hip or knee replacement, called a revision surgery. When the implant wears out or another problem develops, people often need a second surgery in which the existing implant or components are taken out and replaced.
Dr. Westrich says patients should be aware of warning signs that there may be a problem, such as pain that comes on suddenly or trouble getting around. They also may have decreased range of motion. Anyone with a joint replacement experiencing these symptoms should see their doctor immediately, Dr. Westrich adds.
Multidisciplinary treatment can help with pain after TKA or THA
Multidisciplinary pain treatment has been shown in a recent study to one way to aid patients following total knee arthroplasty and total hip arthroplasty procedures.
In the study, investigators found that multidisciplinary pain treatment (MPT) “has beneficial short-term and mid-term effects on subjective pain intensity, physical capability and depression levels in patients with persistent pain after joint arthroplasty,” lead author Christian Merle, MD, MSc, and colleagues, wrote.
Merle and colleagues conducted a retrospective study that followed 40 patients (mean age 62 years) with persistent unexplained pain following total knee arthroplasty (TKA) or total hip arthroplasty (THA) that previous treatments were unable to rectify. The procedures were performed between April 2007 and April 2010.
The evaluations, which were done before MPT, after 3 weeks of MPT and at 32 months mean follow-up, focused on the patients’ pain intensity, physical capability and psychological status, according to the study.
All the scores used showed a significant improvement at the completion of MPT over the baseline pain scores. At 32 months’ follow-up, pain intensity, physical capability and depression levels deteriorated slightly, but were significantly better than at baseline.
The results showed 79% of the 34 patients available for final follow-up reported a reduction in pain on the Numeric Rating Scale of 0.5 to 5.0 points. All patients reported pre-MPT NSAID use, 41% of patients continued to use NSAIDs and15% of them reported using opioids after 32 months.
Because MPT helps to alleviate unexplained pain following TKA and THA, Merle and colleagues noted in the study it may help patients avoid exploratory revision surgery.
Overuse Injuries, Burnout in Youth Sports Can Have Long-Term Effects
As an emphasis on competitive success in youth sports has led to intense training, frequent competition and early single sport specialization, overuse injuries and burnout have become common. Given these concerns, the American Medical Society for Sports Medicine (AMSSM) has released a new clinical report that provides guidance to physicians and healthcare professionals who provide care for young athletes.
Improper way of working out may do more harm than good
Source: News Medical
With the coming of the new year, many people will vow to get in shape after overindulging during the holidays. However, not knowing the proper way to work out might do more harm than good.
Nearly 500,000 workout-related injuries occur each year. One reason is people want to do too much too fast and overuse their muscles. These injuries occur gradually and are often hard to diagnose in the bones, tendons and joints. Another reason is poor technique during weight and other training.
Bio-Inspired Robotic Device Could Aid Ankle-Foot Rehabilitation
A soft, wearable device that mimics the muscles, tendons and ligaments of the lower leg could aid in the rehabilitation of patients with ankle-foot disorders such as drop foot, said Yong-Lae Park, an assistant professor of robotics at Carnegie Mellon University.
Park, working with collaborators at Harvard University, the University of Southern California, MIT and BioSensics, developed an active orthotic device using soft plastics and composite materials, instead of a rigid exoskeleton. The soft materials, combined with pneumatic artificial muscles (PAMs), lightweight sensors and advanced control software, made it possible for the robotic device to achieve natural motions in the ankle.
Study: Patients with femoral neck fractures have more complications after uncemented hemiarthroplasty
The use of uncemented hemiarthroplasty is associated with more hip reoperations and mechanical complications for patients with femoral neck fractures compared to patients who are treated using cemented hemiarthroplasty, according to a recently published data.
Using the PERFECT database, researchers identified 25,174 patients in Finland who were treated with hemiarthroplasty (HA) for a femoral neck fracture from 1999 to 2009. Using the unique personal identification number of each patient, data on comorbidities, the use of residential care and deaths in this population were extracted from the Finnish Health Care Register. Primary outcome measures included mortality, while secondary outcomes included reoperations, complications, readmissions and treatment times.
Researchers found patients who have an uncemented HA showed lower postoperative mortality during the first postoperative days. However, there were no significant differences in mortality for the patients at 1 week and 1 year after surgery. Patients treated with uncemented HA showed more mechanical complications, re-arthroplasties and femoral fracture operations during the first 3 months after surgery.
Program allows young visitors to experience orthopaedics up close
Source: UT Southwestern Medical Center
Less than 7 percent of orthopaedic surgeons in the U.S. are women, according to data from the American Academy of Orthopaedic Surgeons. It is a statistic that Dr. Katherine Coyner, Assistant Professor of Orthopaedic Surgery at UT Southwestern Medical Center, is trying to change.
Painful Frozen Shoulder Generally Resolves, But Return To Mobility Takes Time
Source: The Vancouver Sun
Nearly a decade has passed since Lynne Robson's first encounter with frozen shoulder. But she remembers in exquisite detail the limitations it imposed and the pain it caused her.
Pulling on a winter coat was excruciating. Robson could only wear clothing with front closures, because reaching behind her back to hook a bra, for instance, required a range of movement she no longer had. Blow-drying her hair — pretty much a requirement for a TV reporter, which Robson was at the time — was impossibility.
Rotator Cuff Tears
Source: Medical Observer
This Update looks at the anatomy, assessment and management of rotator cuff tears.
The rotator cuff is a set of tendons that surround the humeral head and seat the head in the glenoid which in turn allows overhead function. They are crucial tendons and commonly injured. The most commonly injured of the four tendons is the supraspinatus, particularly, at its insertion into the greater tuberosity on the humeral head.
How To Know If Shoulder Pain Might Be Rotator Cuff Disease
A positive painful arc test and a positive external rotation resistance test in a patient with shoulder pain has a high likelihood of being rotator cuff disease (RCD). And a positive lag test (external or internal rotation) likely means a full-thickness rotator cuff tear.
That's according to a meta-analytic review of relevant studies. Dr. Job Hermans from Erasmus Medical Center, Rotterdam, the Netherlands and colleagues say they did the analysis to identify the most accurate clinical examination findings for RCD.
Combating Sports-Related Concussions: New Device Accurately And Objectively Diagnoses Concussions From The Sidelines
Source: Science daily
In the United States there are millions of sports-related concussions each year, but many go undiagnosed because for some athletes, the fear of being benched trumps the fear of permanent brain damage, and there is no objective test available to accurately diagnose concussions on the sidelines.
Balance tests are a primary method used to detect concussion. The current means of scoring these tests relies on the skill of athletic trainers to visually determine whether or not a concussion has occurred.
Women More Likely To Tear ACL Due To 'Knock Knees'
Source: Medical News Today
Researchers say that women are nearly four times more likely to suffer from a tear to the ACL (anterior cruciate ligament) in the knee than men, but that it may be prevented by a different "landing strategy."
ACL injuries are defined as a tearing of the anterior cruciate ligament inside the knee joint. The injury causes the knee to swell, and the joint becomes too painful to bear weight.
These injuries are very common in sports where the participants are required to do many "jump stops and cuts." This includes basketball, soccer, tennis and volleyball.
Surgeons Successfully Use Suture Bridge Technique For Achilles Tendon Reattachment
A suture bridge technique with bone anchors to reattach the Achilles tendon in cases of insertional Achilles tendinosis resulted in no postoperative ruptures at the 24-month follow-up. Ninety-seven percent of patients successfully performed the single heel rise test at the final postoperative visit.
Running is in the knees and ankles
A lot of hardcore runners have proper running form on the mind. Another concern they may have is foot posture. Does foot posture make a difference in staying injury-free?
A recent study found that runners with pronated feet, or feet that fall slightly inward towards the middle of the body, were less likely to get injured while running than people with other kinds of feet.
Omega-3 fatty acids may help reduce risk of hip fracture in postmenopausal women
The risk of hip fractures in postmenopausal women may be reduced through consuming more omega-3 polyunsaturated fatty acids, according to a study published in the Journal of Bone and Mineral Research.
“We don’t yet know whether omega-3 supplementation would affect results for bone health or other outcomes,” Tonya Orchard, PhD, RD, LD, from Ohio State University, stated in a press release. “Though it is premature to make a nutrition recommendation based on this work, I do think this study adds a little more strength to current recommendations to include more omega-3s in the diet in the form of fish, and suggests that plant sources of omega-3 may be just as important for preventing hip fractures in women.”
Women with lupus seem at higher risk for hip fractures
Women with lupus the autoimmune disease that can damage skin, joints and organs also are at higher risk of a hip fracture known as a cervical fracture, new research from Taiwan suggests.
Dr. Shu-Hung Wang, of the Taipei Veterans General Hospital, and his colleagues evaluated nearly 15,000 adults 90 percent of them women who had lupus. They followed them for an average of six years. During that time, 75 suffered a hip fracture. Of those, 57 were cervical fractures of the hip; the other 18 were trochanteric fractures of the hip
After elbow surgery, successful long-term results enjoyed by baseball players
Source: Medical News Today
Baseball players undergoing ulnar collateral ligament (UCL) surgery are able to return to the same or higher level of competition for an extended period of time, according to research presented at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting in Chicago, IL.
"Previous studies showed successful return to play after UCL surgery, but we were also able to evaluate each athlete's career longevity and reason for retirement," commented lead author, Daryl C. Osbahr, MD of MedStar Union Memorial Hospital in Baltimore. "These players typically returned to play within a year of surgery and averaged an additional 3.6 years of playing time, a significant amount considering the extensive nature of this surgery in a highly competitive group of athletes. They also typically did not retire from baseball secondary to continued elbow problems."
Sports injuries strike again
Sports are a great way for kids to get exercise and have fun. But sometimes young athletes get hurt. Many sports injuries are mild and heal on their own. Others — such as knee ligament tears — may be more serious and require surgery.
Athletes who have had surgery to repair knee ligament tears are more likely to experience another knee ligament tear than uninjured athletes, according to a recent study.
Knee replacement often beneficial for RA: study
The common belief that rheumatoid arthritis patients don't benefit from knee replacement surgery as much as those with the more common osteoarthritis has been challenged by the findings from a pair of studies by New York City scientists.
Different options for shoulder replacement
Question: I am considering having my shoulder replaced. What questions should I be asking my doctor?
Answer: The decision to replace your shoulder joint is a very serious one. The most important factor in choosing a surgeon is their experience.
A study that was published out of Duke University in 2004 demonstrated that the risk of a post-operative complication was reduced by more than 50 percent when surgeons performed a high volume of shoulder replacements in a high-volume hospital, compared to surgeons and hospitals performing relatively few of these procedures. This high volume is typical of shoulder fellowship-trained surgeons.
Shoulder surgery may make sense for young patients: research
Source: MD India
According to research presented today at the American Orthopedic Society for Sports Medicine's (AOSSM) Annual Meeting in Chicago, IL, arthroscopic bankart repair surgery is a cost-effective approach for patients suffering their first shoulder dislocation.
"We based our conclusions on a Markov model, which takes into account how surgery affects the patient's recovery in relation to the actual costs of medical treatment," commented Ryan P. Donegan, MD, MS, from Dartmouth-Hitchcock Medical Center in Lebanon, NH. "For surgery to be cost-effective in this model, expenses must be under $24,457, the probability of re-dislocation must be under 7 percent, and the quality of life rating must not fall below 0.86. Our research showed surgical costs of $11,267, probability of re-dislocation at only 4 percent and quality of life rating of 0.93 - numbers suggesting surgery is a good investment for these patients."
Better posture can help ease shoulder pain from impingement
Shoulder pain from impingement occurs frequently as the rotator cuff tendons and sometimes a bursal sac get pinched under the roof of the shoulder blade or the acromion. People with a downward slope of the acromion, or who have developed bone spurs from arthritis in the adjacent acromioclavicular (AC) joint, are more susceptible to developing such impingement.
The mechanism causing this disorder may be a gradual or sudden elevation of the ball of the shoulder joint, squishing the described soft tissues against the acromion roof. The rotator cuff muscles are responsible for keeping the ball of the shoulder joint down and away from the roof as we elevate the arm.
Distal radial fractures heal by direct woven bone formation
Descriptions of fracture healing almost exclusively deal with shaft fractures and they often emphasize endochondral bone formation. In reality, most fractures occur in metaphysealcancellous bone. Apart from a study of vertebral fractures, authors have not found any histological description of cancellous bone healing in humans. The histology suggests that cells in the midst of the marrow respond to the trauma by direct formation of bone, independently of trabecular surfaces.
No Time to Hesitate Before Hip Surgeryl
Older adults who take a bad fall or blow to the hip might need to act quickly. If the hip's fractured, there's no time to delay.
A study recently presented at a conference found that delaying surgery to treat a fractured hip more than two days increased the odds of dying by about 10 percent.
Patients rave about anterior hip replacement, but it's not right for all
Source:Tampa Bay Times
Ann Elias knew something was wrong when her much-loved tennis games produced more pain than pleasure. X-rays showed the source of her discomfort — enough damage to her hip joint to warrant hip replacement surgery. But the 71-year-old put it off for more than two years after friends shared frightening stories about the long, painful recovery from hip surgery done in the conventional way, through an incision made on the back side of the body.
For instance, with the anterior approach there is less danger of the new ball joint popping out of its socket in the six weeks or so after surgery. "Medicare estimates that 2 to 3 percent of all (hip replacement) patients nationally have dislocation" with the standard surgery, Cooper said. "With anterior, it's 0.2 percent."
Patients physically more active than ever before and after hip implantations
The proportion of patients physically active before and after a hip implantation increased in the last decade by 14%, Swiss researchers reported at the EFORT Congress in Istanbul. The sustainable success of hip replacements was confirmed in a recent long-term study which nevertheless cautioned against excessive physical activity.
Embrace the Knee Brace
It's been established that braces for the knees can provide relief from pain and protection from injury. But until now, not much was known on whether knee braces can pinpoint pain in the kneecap.
Knee braces can ease pain from osteoarthritis specifically in the kneecap, according to a study recently presented at a conference.
The findings show that the brace is a step forward from relying on painkillers and reducing the chances of needing joint surgery, according to researchers.
Working Out The Wobbly Knees
General exercise programs improved pain levels and stability in the knees just as well as exercises that target that joint in patients with unstable knees, a recently published study found.
About 78 percent of the knee-specific exercise group and 77 percent of the general exercise group reported their knee symptoms remained stable or improved six months after the exercise programs. The researchers found that activity limitations, knee instability and pain decreased in both groups by about 20 to 40 percent.
Youth football concussions occurred mostly during games, not practice
Children playing tackle football are more likely to sustain a concussion during games and not practice, according to recent study results published in The Journal of Pediatrics.
No Gym Necessary: 4 Anywhere-Exercises
Quit the gym. Or rather, if the 40 or 50 bucks you shell out each month for a membership is shrinking your wallet, remember that folks have been exercising since long before the days of ellipticals and spin classes. Many exercises can be done just about anywhere, any time. Squats in the office; push-ups as the pasta cooks; lunges during "Game of Thrones"—there's no need to pay cash for these moves, just cold, hard calories. Below, five fitness experts with a collective six-pack of 30 abs (don't think about the math too hard) dole out their favorite exercises that require no gym, no trainer and barely any equipment.
I became an orthopaedic surgeon because...
Source: A Nation in Motion
As a former college basketball player I saw first hand the devastation that a season ending injury can cause. I was also fortunate enough to see the skill of a surgeon that can "repair your broken parts," and the motivation it takes for an athlete to rehab successfully to return to the game they love. I feel I can relate to athletes of all ages and help them accomplish their goals and get them back to their active lifestyles.
Breakthrough In Arthritis Research
Source: Medical News Today
Researchers at Western University have made a breakthrough that could lead to a better understanding of a common form of arthritis that, until now, has eluded scientists.
According to The Arthritis Society, the second most common form of arthritis after osteoarthritis is "diffuse idiopathic skeletal hyperostosis" or DISH. It affects between six and 12 percent of North Americans, usually people older than 50. DISH is classified as a form of degenerative arthritis and is characterized by the formation of excessive mineral deposits along the sides of the vertebrae in the neck and back. Symptoms of DISH include spine pain and stiffness and in advanced cases, difficulty swallowing and damage to spinal nerves. The cause of DISH is unknown and there are no specific treatments.
Stop elbow pain before it’s chronic
Source: The Province
One body part where there are a number of common issues is the elbow joint. Terms like tennis elbow and golfer’s elbow get thrown around regularly when people have pain in their elbows.
Related conditions, like carpal tunnel syndrome, also involve the elbow joint and muscles of the forearm.
One of the problems with elbow injuries is that this area is constantly in use. People with elbow pain commonly list simple activities like typing, driving, writing, shaking hands or turning doorknobs as movements that aggravate their condition.
New hip replacement approach offers multiple benefits
Source: Daily Republic
It’s no fun walking around with an ailing hip; anyone with severe arthritis knows that kind of pain all too well. For years, orthopedic surgeons have been performing total hip replacements when less invasive options don’t provide the desired results.
The bottom line for those who have hip pain that significantly interferes with their quality of life is that there’s no need to suffer. If non-operative treatments don’t provide the long term relief, hip replacement or resurfacing may be the answer.
Vitamin D no help for arthritis in the knee
Source: Medical News Today
Adults with osteoarthritis in the knees who take vitamin D supplements did not show an improvement in pain relief or cartilage loss, according to a new study published in JAMA.
ACL therapy can get started a few days after surgery to jumpstart healing
In healing the ACL, therapies that focus on range-of-motion, strength and getting back to normal function are beneficial in the process, a new study has found.
Fewer injuries occur and more concussions are diagnosed in high schools with athletic trainers
Where there are athletic trainers, there are lower rates of injury overall in high schools, a new study presented at a conference has found.
This study's findings mean athletic trainers can show the proper way to exercise and treat an injury.
Association between lack of sleep and teen sports injuries
Hours of sleep per night were significantly associated with a decreased likelihood of injury, according to the study results. In addition, the higher the grade levels of the athlete, the greater the likelihood of injury - 2.3 times greater for each additional grade in school. Gender, weeks of participating in sports per year, hours of participation per week, number of sports, strength training, private coaching and subjective assessments of "having fun in sports" were not significantly associated with injury.
Barefoot Running: Yeah or Nay?
Runners have worn footwear and gone barefoot while running to avoid injury.
The barefoot running trend has gained popularity over the last decade, but scientists are unsure whether this is a good or bad thing. A recent study showed that it is less about whether a runner is wearing shoes and more about how they are running.
Young Athletes: Injuries and Prevention
High profile events like the Olympics bring the hope that witnessing and celebrating dedicated athletes at the top of their game, will inspire young people to take up sport and physical activities that help them develop confidence, lead more satisfying lives, and not least, secure long-term health by reducing their risk for developing chronic illness like diabetes, obesity, cancer and cardiovascular diseases.
But unfortunately, if they don't take appropriate measures, young athletes can instead, end up in pain, on a different path to poor health, due to avoidable sport injury.
Experts offer tips to help keep fall sports injury free
Fall sports such as soccer, football and volleyball are in high gear and players need to take steps to prevent injuries, experts say.
Deep abdominal muscle activation lessens lower back pain
Source: News Medical
Improving transversus abdominis slide appears to be associated with clinically important long-term pain reduction in people experiencing lower back pain, researchers report.
Sports medicine physician recommends two high-tech tools to enhance patient care
Source: News Medical
Research shows that the average person only retains 15 to 20 percent of what he or she is told during a medical appointment. According to Matt Roth, MD, associate medical director for ProMedica Sports Care, when patients have the opportunity to view actual images of their anatomy and diagnosis, their understanding and retention improves.
Beginning Runners Naturally Develop More Economical Gait
Runners naturally develop a more economical running style over time, according to research published in the official journal of the American College of Sports Medicine. This study, in the September edition of Medicine & Science in Sports & Exercise®, demonstrates that after completing a 10-week running program, participants had improved running economy by 8.4% through a self-optimization process.
Stay safe while skiing, snowboarding with your family
Going down the slopes with your kids is a great way to spend family vacations. But make sure you also keep safety in mind while skiing and snowboarding.
Autograft hip reconstruction provides good outcomes for athletes
A common, painful hip condition in elite athletes may be able to be repaired with an improved surgical technique, according to researchers presenting their work at the American Orthopaedic Society for Sports Medicine's Annual Meeting in Baltimore, Maryland.
Common shoulder injury treated non-surgically may increase chances of return-to-play
Surgically repairing a painful shoulder injury in baseball players known as a SLAP tear (superior labral) varies widely and often doesn't allow for return to play at the same level as before the injury. However, researchers presenting their findings at the American Orthopaedic Society for Sports Medicine's Annual Meeting in Baltimore, Maryland suggest that nonsurgical treatment may be more beneficial.
Study suggests new screening method for sudden death in athletes
A new study suggests that echocardiography be included as part of screenings to help identify student athletes with heart problems that could lead to sudden death.
Trampoline Advice Issued By Orthopedic Surgeons
Source - MedicalNewsToday
"Although trampolines can be fun for both kids and adults, they pose a high risk for injuries, especially when two or more people jump at one time. Orthopedic surgeons recommended that trampolines not be used in home environments or in outdoor playgrounds because of the high risk of injuries from this activity."
The AAOS has created an audio public service message as well as a position statement regarding trampoline safety in order to prevent injuries sustained from trampolines, rather than treat them.
In children with ACL injuries, surgery delay can cause irreparable meniscus tears
Source - MedicalNewsToday
For children aged 14 and under, delaying reconstructive surgery for anterior cruciate ligament (ACL) injuries may raise their risk of further injury, according to a new study by pediatric orthopaedic surgeons. If surgery occurs later than 12 weeks after the injury, the injury may even be irreparable.
ACL injuries have increased among children and young adults in recent years, possibly because of increased participation in high-level sports such as football, skiing, lacrosse, hockey and soccer, all of which place a high demand on the knees, where the ACL is located.
Pediatricians sound alarm on overuse sports injuries
Source - ScienceDaily
Children are prone to sport-specific trauma to the growth plates. For example, dancers, skaters and cheerleaders are vulnerable to ankle damage, while baseball and football players tend to injure their shoulders and elbows. Runners suffer shin pain and knee problems, while gymnasts are prone to wrist damage from repetitive weight bearing.
"The combination of repetitive use and skeletal immaturity puts these youngsters at high risk for injuries, some of them long-lasting, so it is really important that young children have whole-body conditioning and engage in a variety of athletic activities rather than one sport," Valasek says.
Sprained ankles can be complicated—and misdiagnosed
Source - HealthNewsDigest
Ankle sprains may be one of the most common injuries, but they’re also commonly misdiagnosed. That’s because the two major types of sprained ankles—high ankle sprains and lateral ankle sprains—often look the same, even though they affect entirely different ligaments. Surgeons are taking a closer look at the treatment of ankle sprains at the Annual Scientific Conference of the American College of Foot and Ankle Surgeons in San Antonio this week.
The less common type—a high ankle sprain—is often mistaken for a lateral sprain. Misdiagnosis can delay getting the right treatment—and that can impair recovery.
Thromboprophylaxis ‘not supported’ for ankle fracture surgery
Source - MedwireNews
Venous thromboembolism (VTE) is rare in patients who undergo ankle fracture surgery, say researchers who believe that routine use of thromboprophylaxis is unnecessary in this population. Pelet et al therefore conclude that, in the absence of evidence, thromboprophylaxis use is not supported for patients undergoing ankle fracture surgery.
New company enters market to use vitamin E to extend life of hip, knee implants
Source - Marco News.com
Vitamin E isn't an antioxidant just for your skin and nails anymore — it's expanding to joint implants.
Zimmer, a company also based in Warsaw, is seeking FDA approval to offer its own version.The concept is that the natural antioxidant in vitamin E can prevent wear of the polyethylene, or plastic, components of implants. Many cup liner components for hip implants are made of the plastic and the same goes for plastic knee bearings in knee replacements.
The vitamin is blended in during the manufacturing process and makes the material denser to better handle stress, said Tim Gardener, product director for hip products with Zimmer.
'30-year knee' lasts twice as long as most knee replacements
Source — 9News.com
In the U.S., the number of knee replacements has doubled in the last decade. More than 600,000 Americans had knee replacement surgeries in 2009, with the fastest growing segment under the age of 65. More than 4.7 percent of those over the age of 50 already have knee replacements.
Given Dietrich's age, 71, and his good health, Xenos recommended a Legion Total Knee, or as some surgeons call it, a "30-year knee." Research has suggested the Total Knee, built with an oxinium metal alloy, deteriorates at a rate about half as fast as most traditional cobalt chromium alloy knee replacements.
Ankle replacement rapidly on the rise
Source - MarketWatch
Arthritic hips and knees are replaced all the time--but did you know that arthritic ankles can also be replaced? In fact, ankle replacements in the U.S. more than doubled last year, thanks in part to technological advances in ankle implants (prostheses). Surgeons are discussing this burgeoning procedure at the Annual Scientific Conference of the American College of Foot and Ankle Surgeons (ACFAS) in San Antonio, Texas.
Total ankle replacement surgery--also called ankle arthroplasty--involves replacing the damaged joint with an artificial joint. The procedure greatly improves function for people who cannot perform everyday activities without experiencing severe pain. Rheumatoid arthritis, osetoarthritis and previous injuries are the most common causes of this pain.
Prevent back, neck and shoulder pain from prolonged sitting and bad posture
Source - Natural News. com
Back, neck and shoulder pain is the natural result of prolonged sitting at work behind a computer, as is bad posture. This can cause headaches and excessive tension in neck, shoulders, arms, forearms, wrists, back, hips, thighs and legs.
Preventing back and neck pain while sitting is not an exact science as there are many differing opinions on the subject. However, there are some common denominators on which most chiropractors and other medical professionals agree:
Untreated varicose veins put patients at greater DVT risk following THA
Source - Orthosupersite
As the search continues for methods to reduce deep vein thrombosis and pulmonary embolism risk in patients undergoing total joint arthroplasty, researchers have found increased rates of deep vein thrombosis within 90 days of undergoing total hip arthroplasty among patients with untreated varicose veins.
ACL reconstruction delay in children may lead to higher rates of associated knee injuries
Source: Medical News Today
Kids treated more than 150 days after an Anterior Cruciate Ligament (ACL) injury have higher rates of other knee injuries, including medial meniscal tears, say researchers presenting at the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day in San Francisco, CA.
The study also demonstrated a relationship of age with children more than 15 years old having a higher rate of medial femoral chondral injury. Neither gender nor sport played during injury was found to be associated with an increased rate of injury in the study.
Monitored heart bracelets may prevent sudden death in sport
Source: Science Daily
The use of heart bracelets connected via ICT (Information and Communication Technologies) to a system of tracking and monitoring could prevent cases of sudden death in sports activities. It could also enable an early detection of cardiac abnormalities, the prevention of certain muscle injuries and the improvement in health care times to the athlete.
The possibility of sudden death can begin to take shape with cardiac abnormalities detectable until 60 minutes before cardiac arrest occurs. The use of these bracelets enables to control these anomalies, and other aspects such as cardiac abnormalities generated by the consumption of doping substances, thus improving the completeness and reducing the costs of today's sport controls.
Women have more knee ligament injuries than men due to geometry, not gender
Source: Science Daily
Research recently published in the Journal of Bone and Joint Surgery (JBJS), compared magnetic resonance imaging (MRI) scans of male and female athletes with non-contact anterior cruciate ligament (ACL) injuries with those of athletes who participated in similar, at-risk sports but without a history of ligament injury.
The study found that most of the women (those who had ACL injuries and those who did not) and only the ACL-injured men shared a common geometry on the outside of their knee joint: The upper part of their shin bone at the joint (tibial plateau) was much shorter and more rounded. This may help to explain why women have an ACL injury rate that is two-to-five times greater than that of men.
Treating ankle sprains
Source - abc Health News
According to estimates from orthopedic surgeons, 25-thousand people a day experience an ankle sprain. "The most common ankle injury is the lateral ankle sprain, which is spraining the ligaments on the outside of the ankle," Dr. Brian Donley of the Cleveland Clinic said. Lateral sprains are frequent in sports and the most common type seen in emergency rooms. A more serious sprain can involve a tear or happen higher in the ankle
It's the amount of stretching or tearing of the ligament that determines the pain. But whether mild, moderate or severe, the first response should be R-I-C-E. "The initial treatment that's important for both sprains is what we like to call the RICE method: Rest it, Ice it, put Compression on it, and elevate it and that's essential for both types of sprains," Donley said.
Rehabilitation prior to arthroscopic rotator cuff repair yields range of motion benefits
Source — ORTHOSuperSite
Preoperative rehabilitation programs for arthroscopic rotator cuff repair patients were found effective for increasing postoperative range of motion, but only during the first 3 weeks of recovery, according to a study presented at the 8th Biennial ISAKOS 2011 Congress.
From their study of 168 patients, Seyahi and colleagues found that while results of the preoperative rehabilitation program in the first 3 weeks after surgery were associated with greater improvement in range of motion (ROM) vs. those patients who completed only regular postoperative rehabilitation, there were no significant differences between the two groups’ functional outcomes at the 12 week and 12.4 month follow-ups.
Some seniors at greater risk of falls and hip fractures due to undiagnosed neurological disorders
Hip fractures are a common cause of morbidity and mortality in elderly patients. Cervical myelopathy is a common neurological condition that can diminish balance and coordination. Undiagnosed neurological disorders may predispose patients to falls and fractures. Screening for cervical myelopathy should be standard care for all hip fracture patients, to reduce the risk for additional falls and fractures.
Source — Medical News Today