Orthopedic News
Battling Bone Spurs
They are known to be painful and to interfere with the movement of a joint. But bone spurs-common in older adults-often are benign. If you are over 60, chances are good that you have a bone spur, though you may not yet realize it, according to local orthopedic surgeons.
A bone spur-the creation of extra bone-is the result of inflammation, stress, pressure or damage. "It's the body's response to wear and tear on the joints," said Loiy Mustafa, M.D., an orthopedic surgeon at Capital Orthopaedic Specialists, P.A. with privileges at Doctors Community Hospital in Lanham. Bone spurs are found in joints as well as in places where tendons and ligaments attach to bone. In seniors, a bone spur most often occurs when there is degeneration of a joint due to osteoarthritis, Mustafa said.
Device developed for running shoes that prevents injuries
Source: Science Daily
A prototype running shoe has been designed with an integrated device that improves training management and prevents injuries. The device consists of a microelectronic measuring system capable of gathering biomechanical parameters that characterize the runner's technique during a race. This information is wirelessly transmitted to the runner's mobile phone and a mobile phone application provides real-time feedback, including level of performance and suggestions to change the running pattern or to stop running in case of detecting a high risk of injury.
Prehabilitation Could Help Knee and Hip Replacement Patients Recover
Source: Daily Rx
With the number of total knee and hip replacements on the rise, doctors are looking for ways to reduce the amount of care needed after surgery. Prehabilitation (physical therapy before surgery) could help patients recover faster and save money.
Rehabilitation following knee or hip replacement is the standard of care. The physical therapy is designed to help patients adjust to new joints and strengthen muscles.
A new study found that physical therapy before the joint replacement surgeries reduced the need for rehab after the surgery.
Intra-articular tranexamic acid benefitted TKA patients without increased risk of DVT, PE
Source: Healio
Among patients who underwent total knee arthroplasty, intra-articular tranexamic acid significantly reduced total blood loss, drainage, reduction of hemoglobin and the need for transfusion without increasing the incidence of deep venous thrombosis and pulmonary embolism, making it safe and efficacious, according to study results.
Through a search of various databases for relevant randomized, controlled trials, researchers included seven studies comprising 622 patients. The researchers calculated mean difference in total blood loss, risk ratio for transfusion and complication rate in the tranexamic acid-treated group vs. the placebo group.
Study shows trends in total hip arthroplasty implant usage from 2001 to 2012
Source: Healio
From 2001 to 2012, total hip arthroplasty implant usage trends favoredcementless fixation, metal-on-polyethylene or ceramic-on-polyethylene bearings, modular acetabular cups and large diameter femoral heads, according to study results.
Researchers analyzed 105,291 total hip arthroplasty (THA) procedures to evaluate trends in implant utilization from 174 hospitals throughout the United States.
Most dislocated hips placed within ‘safe zone’ during THA, study finds
Source: Healio
DALLAS — During their minimum 2-year follow-up, researchers here reported a 1.9% rate of subsequent dislocation after total hip arthroplasty in a contemporary practice and noted 58% of these cases had an acetabular socket position within the Lewinnek safe zone.
“Most contemporary total hip arthroplasties that dislocate are within the Lewinnek safe zone,” Matthew P. Abdel, MD, said during his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “Cup position for some patients certainly lies outside this safe zone. Most importantly, new technologies will need better targets to hit prior to them being clinically relevant or economically feasible.”
Researchers found better cup, stem survival after early THA
Source: Healio
Patients who underwent early total hip arthroplasty experienced better 10-year cup and stem survival compared with patients who underwent late total hip arthroplasty, according to study results.
Researchers searched the Medline databases from January 1990 to January 2014 and retrieved 19 articles reporting on the management of posttraumatic arthritis of the hip following acetabular fractures with the use of late total hip arthroplasty (THA), as well as articles where acetabular fractures were treated with early THA. In all, the researchers assessed THA outcomes following acetabular fracture in 654 patients.
New techniques shorten recovery time in hip, knee replacements
Source: nwitimes.com
It wasn't too long ago that patients who underwent a hip replacement or knee surgery spent nearly a week in the hospital and months in rehab.
Today, more patients find themselves at home just days after surgery and back at work within weeks.
Results show link between pain sensitization and chronic pain after TKRL
Source: Healio
Widespread preoperative pain sensitization may be associated with chronic pain after total knee replacement, according to results published in Osteoarthritis and Cartilage.
These findings suggest that further investigation is warranted into the role of preoperative pain sensitization in predicting chronic postsurgical pain,” Vikki Wylde, BSc (Hons), PhD, and colleagues wrote in their study. “Larger studies, in which other known risk factors are assessed and controlled for, are needed to establish the sensitivity and specificity of preoperative measures of pain sensitization in the prediction of chronic pain after [total knee replacement] TKR.
Fifty-one patients who underwent TKR for osteoarthritis participated in a preoperative Quantitative Sensory Testing (QST) session where researchers assessed their pain thresholds for knee and forearm pressure (PPT) and heat (HPT). The investigators compared preoperative median QST thresholds to thresholds they obtained from a database of 50 individuals without knee pain.
One year after TKR, patients’ preoperative median WOMAC scores significantly improved from 40 points to 90 points, and 29% had a WOMAC score of less than 75 points. Researchers found the patients’ median preoperative knee and forearm PPTs were significantly lower vs. the healthy individuals.
While Wylde and colleagues found no correlation between preoperative HPTs or knee PPTs and 1-year WOMAC scores, they observed a small but statistically significant correlation between the preoperative forearm PPTs and 1-year WOMAC scores. When they grouped patients by low and high preoperative forearm PPTs, the low PPT group reported significantly worse 1-year WOMAC pain scores compared to the high PPT group.
Sports Injuries Strike Again
Source: dailyRx
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.
Knees Buckling Under Pressure
Source: dailyRx
Your body weight and your job may be putting considerable pressure on your knees. This pressure could lead to a medical condition called knee osteoarthritis.
A recent study found that having a higher body mass index (a measure of height and weight) and living a more active lifestyle were both associated with a higher risk of knee osteoarthritis.
Knee Replacement Often Beneficial for RA: Study
Source: WebMD
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.
Omega-3 fatty acids may help reduce risk of hip fracture in postmenopausal women
Source: Healio
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
Source: MedlinePlus
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.
A New Approach to Hip Surgery
Source: The New York Times Health
Larry Kufel had always been an active man, tall and rangy, who worked out regularly and picked up basketball games at the gym. But age was taking a toll on his joints, and it had become clear that he needed a hip replacement.
“It got to the point, if I did any exertion, even getting out of a chair, it felt like the muscle was tearing away from the bone,” he recalled.
Smoking is bad to the bone
Source: Daily Rx
The body is designed to heal after breaking a bone. But it may not be designed to heal a broken bone while processing cigarette smoke and nicotine.
A recent study looked at the differences between smokers and non-smokers when healing from a broken bone. Results showed that smokers took several extra weeks to heal from a fracture.
Smokers also had higher odds of the fracture not healing properly.
Cartilage damage helps detect osteoarthritis?
Source: ivanhoe.com
Osteoarthritis is the most common joint disorder and affects about one-third of older adults. New research suggests that cartilage damage from exercise may aid in early detection of osteoarthritis.
"We discovered that GAG-depleted tissue is most vulnerable to high rates of loading and not just the magnitude of the load. This finding suggests that people with early degradation of cartilage, even before such changes would be felt as pain, should be careful of dynamic activities such as running or jumping,” Grodzinsky was quoted as saying.
A new approach to hip surgery
Source: The New York Times Health
Larry Kufel had always been an active man, tall and rangy, who worked out regularly and picked up basketball games at the gym. But age was taking a toll on his joints, and it had become clear that he needed a hip replacement.
The procedure that Mr. Kufel received is called anterior hip replacement. The surgeon makes the incision at the front of the hip instead of through the buttocks or the side of the hip. This approach permits the doctor to reach the hip socket without cutting through major muscle groups. Proponents claim that the procedure results in less pain and fewer complications for patients than standard hip replacement.
Hip surgery flip! Direct Anterior Hip Replacement
Source: ivanhoe.com
The numbers are sky-rocketing. There were more than 300 thousand total hip replacements in 2010, that’s up 135 thousand compared to just ten years earlier. As more and more people need help to relieve the pain, there’s an option that’s becoming popular with patients and surgeons.
“It’s a less invasive approach,” Stefan Kreuzer, MD, associate professor at Memorial Hermann Hospital, told Ivanhoe.
He went through the front of her leg to get to her hip, instead of the more traditional technique of going through the back.
The doctor says the normal post-operative restrictions on hip movements do not apply to patients who undergo direct anterior hip replacement. He tells us it great for most people in need of a hip replacement, including highly active patients. The doctor is currently training surgeons from around the world on the technique.
New technique revolutionizing hip-replacement surgery
Source: palmbeachpost.com
“It’s a ‘micro-invasive’ technique,” says Grandic.
And it offers myriad advantages over other techniques.
“All muscles, tendons, ligaments and soft tissue are spared, and the hip socket is never twisted into unnatural positions during surgery,” Grandic explains.
Thus, he says, patients experience little or no post-operative discomfort; are able to walk immediately, with no restrictions; and are usually discharged from the hospital within 24 to 48 hours.
Quit smoking and enjoy that new hip
Source: Daily Rx
Total hip replacement and smoking cigarettes just don’t mix. That's because smoking can cramp the healing process. Even quitting just before surgery is better than not quitting at all.
Researchers recently studied a group of patients who had undergone total hip replacement surgery.
Patients who were current smokers had higher rates of infection, pain and loosened hip joints, which had to be corrected with a second surgery, compared to non-smokers.
New surgery makes hip replacement easier
Source: charlotteobserver.com
The surgery is extensive. It involves removing the joint – the damaged bone and cartilage – and replacing it with prosthetic parts made of metal, plastic or ceramics. Typically, surgeons enter the joint from the rear, which requires cutting through muscle and cartilage. But a relatively new procedure enables surgeons to enter from the front and only stretch the muscles aside, avoiding the cutting and minimizing pain and recovery time. Those who use this anterior technique say the benefits are substantial.
Knee osteoarthritis patients have improved knee loads when using specialized mobility shoe
Source: Daily Rx
When patients with knee osteoarthritis are walking, their knees may jut out to the side. Shoes that imitate barefoot walking can help with that.
A recently published study found that wearing a "mobility" shoe keeps the knee joint more aligned in knee osteoarthritis patients.
Using flat, flexible footwear can significantly reduce knee loading in patients with the joint condition, according to researchers.
ACL surgery techniques using double versus single bundle ligaments provide equal stability
Source: Daily Rx
Surgery for a blown anterior cruciate ligament (ACL) inside the knee is becoming more and more common. New techniques to perform the surgery are on the rise across the country.
Damaged ACLs that were replaced using a double-bundle technique during surgery were as stable as patients who received the single-bundle technique, according to a study presented at a conference.
In double-bundle, the new ligament has two parts whereas the single bundle just has one.
Total knee replacements for juvenile idiopathic arthritis last for decades in most patients
Source: Daily Rx
People typically think knee replacement surgery is only for older adults with arthritis. But the surgery is also used for young patients when joint damage has become severe.
Recently, researchers found knee replacements did not last as long in young patients with juvenile idiopathic arthritis (JIA) as they do in older osteoarthritis patients.
Still, the procedure can be a life-changer for many patients with JIA – a painful disease that affects children.
In patients with JIA, about 92 percent of knee replacements lasted 10 years and a little over 75 percent lasted 20 years.
Patients with diabetes at no greater risk for infection or other complications after total knee replacement
Source: newsroom.aaos.org
Patients with diabetes were no more likely to suffer infection, deep vein thrombosis(a deep vein blood clot) or other complications following total knee replacement(TKR) than patients without diabetes, according to new research published online today, in advance of its publication in the March 2013 Journal of Bone and Joint Surgery (JBJS).
Which knees need the knife?
Source: Daily Rx
Jeffery Katz, MD, of Orthopedic and Arthritis Center for Outcomes Research Brigham and Women's Hospital, Boston, and colleagues led the study to determine if patients with a meniscal tear and knee osteoarthritis had better outcomes with surgery plus physical therapy or just physical therapy.
Return-to-work rate high after knee replacement
Source: webmd.com
Getting back to work after knee-replacement surgery is a big concern for people contemplating the procedure. Now, a new study shows that most people return to work after a total knee replacement -- even those with physically demanding jobs.
"We are now reaching a population that is younger and actively working. Most have very arthritic knees and expect to go back to work," Orozco said. Better implant materials that support more weight, improved surgical techniques that spare muscle, and better post-surgery patient care plans -- including pain management and physical therapy -- have increased the popularity of knee replacement in recent years, he said.
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