News Updates

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.

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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.”

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Preterm, low birth-weight babies may need new hips in adulthood

Source: Science Daily

Researchers from Australia report that low birth weight and preterm birth are linked to increased risk for osteoarthritis (OA)-related hip replacements in adulthood. The findings also indicate that low birth weight and pre-term babies were not at greater risk of knee arthroplasty due to OA as adults.

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Pacira Pharmaceuticals Inc. announces new data on the use of EXPAREL to treat postsurgical pain following total knee arthroplasty

Source: Medical News Today

Pacira Pharmaceuticals, Inc. has announced results of an independent, physician-initiated study designed to evaluate the difference in postsurgical pain and opioid consumption between patients who received EXPAREL versus a multi-drug analgesic cocktail for pain management following total knee arthroplasty (TKA). The data, presented at the annual meeting of the American Association of Hip and Knee Surgeons (AAHKS), found that patients treated with EXPAREL reported significantly lower patient-perceived pain scores and morphine sulfate equivalence consumption, and reported higher satisfaction with pain control and overall experience, compared with patients who received the multi-drug analgesic cocktail.

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Acoustic technique developed to detect knee osteoarthritis

Source: Medical News Today

A revolutionary medical technique using sound waves to identify osteoarthritis in the knee has been developed by researchers.

The UK is leading this new field of health research based on listening to the sounds emitted by the body.

Microphones are attached to the knees of patients, and the high frequency sound waves emanating from their knees are measured as they stand up. These acoustic emissions are interpreted by computer software to give information about the health of the patient’s knee.

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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.

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Exercise, Physical Therapy May Help Ease Pain of Arthritis

Source: Health Day

Regular exercise and physical therapy may benefit people with hip and knee arthritis, new research suggests.
The study included 206 people with hip and knee osteoarthritis, average age 66, who were divided into two groups. One group received usual care, while the other group had regular exercise, physical therapy or both added to their standard care.

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Embracing the brace

Source: Daily Rx

Knees are only meant to bend forward and backward. If a knee pops and locks up with major pain, something serious is going on there, and it’s most likely an ACL injury.

The injuries often need surgery to reconstruct the ligament, followed by therapy to help rehabilitate the knee.

It does not lower pain, protect from reinjuring the knee or improve the stability of the knee. Rather, braces add an unnecessary expense to the recovery. Vitamins and other supplements also don’t help in the healing process.

Beginning physical therapy shortly after surgery, ideally within a few days after, can bring great outcomes for patients.

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Does rehab help before joint replacement?

Source: Daily Rx

Before going through knee replacement surgery, patients often do some rehab for their aching joint. That is, they try to improve pain and function before surgery. But does this pre-surgery rehab improve outcomes?

According to recent research, pre-surgery rehabilitation seemed to do little to improve pain, function and motion after knee replacement surgery.

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More magnesium, less arthritis

Source: Daily Rx

What you put in your body can affect your risk of disease, even your risk of osteoarthritis. If you’re trying to prevent this “wear-and-tear” type of arthritis, you may want to eat more almonds and spinach.

Eating more magnesium – a mineral found in many green vegetables, beans and nuts – it may lower the risk of knee osteoarthritis.

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Most damage, most gain in knee replacement

Source: Daily Rx

If you have knee osteoarthritis, you can take steps to prevent permanent damage. For those with the damage done, joint replacement surgery may relieve pain and boost knee function.

Osteoarthritis patients with the most joint damage before surgery may be the most likely to benefit from total knee replacement.

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MRI may spot arthritis unseen by X-ray

Source: Daily Rx

Osteoarthritis happens when joints and joint tissues wear down over time. Usually, doctors use X-ray imaging to see this joint damage. But another imaging technique may give doctors a better picture.

Magnetic resonance imaging (MRI) spotted many signs of knee osteoarthritis in patients that had no signs of knee osteoarthritis in X-ray images.

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Cartilage made from stem cells

Source: Medical Breakthroughs

Using pluripotent stem cells, a team of Duke Medicine researchers has engineered cartilage. The findings suggest that induced pluripotent stem cells (iPSCs) may be a viable source of patient-specific articular cartilage tissue.

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ORIF prevented need for later THA in acetabular fracture patients

Source: Healio.com

Long-term follow-up showed that open reduction and internal fixation successfully treated displaced acetabular fractures in patients without the need for subsequent total hip arthroplasty, according to this study.

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Study confirms socioeconomic value of hip protectors, joint arthroplasty

Source: Healio.com

Researchers in a recent issue of Orthopedic Research and Review have concluded that medical devices, such as hip protectors and total joint arthroplasty implants, are cost-effective and significantly improve patients’ lives, confirming their socioeconomic value.

“Orthopedic devices such as knee and hip implants or hip protectors have the potential to improve people’s lives. They allow for greater flexibility, faster return to an active, independent lifestyle and reduced risk of future fractures to name but a few benefits,” Yves Verboven, executive director at the European Health Technology Institute for Socio-Economic Research (EHTI), stated in a press release.

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Quit the bottle to build happy bones

Source: Daily Rx

Avoiding alcohol combined with regular exercise can help men build the bones lost from alcoholism, a new study has found.

The amount of osteocalcin, which is a protein in the bones and teeth, increased over the eight-week period as men continued to avoid alcohol.

This means that there was a “higher rate of bone formation during continuous abstinence,” the authors said in their study.

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Global efforts necessary to prevent fragility fractures due to osteoporosis

Source: Medical News Today

The International Osteoporosis Foundation (IOF) has released a new report, revealing approximately 80 percent of patients treated in clinics or hospitals following a fracture are not screened for osteoporosis or risk of future falls. Left untreated, these patients are at high risk of suffering secondary fractures and facing a future of pain, disfigurement, long-term disability and even early death.

The report ‘Capture the Fracture – A global campaign to break the fragility fracture cycle’ calls for concerted worldwide efforts to stop secondary fractures due to osteoporosis by implementing proven models of care.

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New hip replacement technique offers faster recovery with less pain

Source: Medical News Today

A new hip replacement strategy, an anterior approach technique, allows the patient to experience less pain, have a quicker recovery, and improved mobility.

The majority of hip replacement surgeries are done using other techniques because many hospitals do not yet offer the anterior approach. However, people are becoming increasingly aware of its benefits. Within the next 5 to 10 years, Dr. Rees believes that it will become the primary technique.

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Marco lecture proves robotic knee replacement surgery has leg up on traditional methods

SourceMarco News.com

Buechel, an orthopedic surgeon at Physicians Regional Healthcare System, is on the cutting edge of robotic joint replacement, having performed 439 robotic knee surgeries or about 5 percent of all such surgeries worldwide. He also teaches other doctors the technique.

Errors occur with traditional partial knee replacements, Buechel said, because doctors are not as likely to place implants into the knee joint with complete accuracy. The robotic system pinpoints alignments to within one millimeter and one degree, he asserted.

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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.

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Can surgery help you stay in the game?

SourceBoston.com

Demand for knee and hip replacement rises–

Arthritic knee crimping your tennis game? Toss it out and get a new one.

Demand for joint replacement surgery, once confined largely to patients well past retirement age, has been growing rapidly among a class of people doctors have dubbed the “young actives’’ – those in the 45 to 64 age group who are determined to stay fit.

Still, even with the rise of obesity and longer lives, public health researchers say the rate of joint replacement failures requiring revisions is about 1 percent a year, mostly in the relatively younger patients who “outlive’’ the 10-to-20-year working life spans of their replacement joints. And as technique and technology have improved, the rates of infection, dislocations, and other complications have declined.

But she added a note of caution. “What we could expect to see in the future is the people in the 45-to-64-year-old category coming back to get revisions’’ – new knee replacements in second surgeries. With any luck, the second implants could be better.

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Untreated varicose veins put patients at greater DVT risk following THA

SourceHealio

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.

“Overall patients should consider having their varicose veins treated prior to undergoing total hip arthroplasty (THA) in an attempt to reduce DVT [deep vein thrombosis],” Anahita Dua, MD, of Brookfield, Wisc., said at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting, here.

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Hip resurfacing: The metal-on-metal bearing material is not the problem

SourceHealio

MoM hip resurfacing is not a new technology any more, and the devices that have been approved by the FDA after sufficient clinical trials have been available for more than a decade. It is important to avoid making statements about a procedure based on the poor results of subsequent designs which were still in their experimental (non-FDA approved) phase.

Many have written off MoM HRA, and this is unfortunate because superb results have been achieved with several devices in several centers for the young and active patient. The MoM bearing, unlike polyethylene of first generation devices, is not the problem. It is a treatment option for arthritis that is worth pursuing and improving. It just makes sense to save the head and neck, and adhere to a fundamental tenet of orthopedics espoused by our forebears — save bone.

It is my fervent desire to improve surgeon and patient education and emphasize that there are techniques to solve the problems associated with MoM hip resurfacing. Charles Kettering said, “The world hates change, yet it is the only thing that has brought progress.”

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ACR approves standardized measures to determine RA disease activity

SourceHealio

A working group organized by the American College of Rheumatology has analyzed more than 60 disease activity measures for rheumatoid arthritis and recommended six measures that can be applied in clinical practice, according to a press release. The analysis by the Rheumatoid Arthritis (RA) Clinical Disease Activity Measures Working Group apppear in Arthritis Care & Research.

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Hip dysplasia can be reliably diagnosed by ultrasound at 6 months

SourceMedical News Today

Developmental dislocation (dysplasia) of the hip (DDH) is a common congenital condition in which a child’s upper thighbone is dislocated from the hip socket. The condition can be present at birth or develop during a child’s first year of life. Plain radiography (X-rays) has long been the gold standard screening modality for this condition in 6-month-old children, despite concerns over exposing very young children to ionizing radiation.

Ultrasound provided good quality images with 100 percent diagnostic correlation to the X-rays in all patients. Ultrasound is a reliable alternative imaging method to X-rays for DDH screening in 5-to-7 month old children.

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Synovial fluid tests with leukocyte esterase strips improved periprosthetic joint infection detection

SourceOrthosupersite

A prospective cohort study showed that leukocyte esterase reagent strips can play an important role in the rapid diagnosis of periprosthetic joint infection when following patients after total joint arthroplasty.

“LE [leukocyte esterase] is a very accurate test for diagnosing PJI [periprosthetic joint infection],” Parvizi said at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting, here.

LE at 2-plus had 100% positive predictive value and 100% specificity. I am not aware of a single test in our armamentarium today that carries the same specificity and positive predictive value,” he said, noting the strips, which are commercially available, cost about 25 cents each and can detect PJI in about 1 minute.

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Knee replacement may lower a patient’s risk for mortality and heart failure

Sourcee! Science News

New research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) highlights the benefits of total knee replacement (TKR) in elderly patients with osteoarthritis, including a lower probability of heart failure and mortality.

There were significant positives in the osteoarthritis TKR group: the risk of mortality was half that of the non-TKR group and the congestive heart failure rate also was lower, at three, five and seven years after surgery. There was no difference in diabetes rates among both groups. Depression rates were slightly higher in the TKR group during the first three years after surgery, though there was no difference at five and seven years.

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Early study suggests nanodiamonds safe for implants

SourceSciencedaily

In the race to create longer-lasting and less-painful artificial joints, University of Alabama at Birmingham researchers are exploring whether nanodiamond coatings can reduce wear on joints made of metal alloys. The work is important because, according to the American Academy of Orthopedic Surgeons, more than 418,000 knee replacements and 328,000 hip replacements are performed in the United States each year; the numbers are expected to balloon as the nation’s population ages.

Joint wear generates debris that can cause pain, limit mobility and hasten joint failure. Debris particles from metal surfaces are absorbed by scavenging immune cells called macrophages, which then secrete chemicals that cause swelling and pain. This inflammation turns on bone-eating cells near implants, and bone-loss increases the likelihood implants will break loose and require a second surgery.

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