Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for July 2010. 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.
Lumbar Motion Norms Vary by Race, Age in Women
FRIDAY, July 30 (HealthDay News) -- Age has an effect on the degree of lumbar flexion and extension that is possible for a woman, as does race on the degree of extension, thus creating a need for new normative values for these categories, according to research published in the July 15 issue of Spine.
Transforaminal Steroid Shot Benefits Lumbar Radicular Pain
FRIDAY, July 30 (HealthDay News) -- Transforaminal injection of steroids appears to be a viable alternative to surgery for some patients with lumbar radicular pain caused by disc herniation, according to a study published online July 30 in Pain Medicine.
Exercise Adherence Helps Osteoarthritis Patients
FRIDAY, July 30 (HealthDay News) -- Greater adherence to home exercise and more physical activity in general appear to enhance the long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip and/or knee, according to research published in the August issue of Arthritis Care & Research.
Continuous Morphine Plus Injection Preemptive Pain Option
FRIDAY, July 30 (HealthDay News) -- Preemptive analgesia using continuous subcutaneous morphine combined with a single intrathecal injection of morphine (SI) in patients who undergo posterior lumbar interbody fusion provides a favorable analgesic effect and compares favorably with continuous subcutaneous morphine alone (SC), according to a study published in the July issue of the Journal of Spinal Disorders & Techniques.
Specialties See Modest Compensation Increases in '09
FRIDAY, July 30 (HealthDay News) -- Most medical specialties saw modest compensation increases in 2009, but many provider organizations are still operating at a substantial loss, according to the findings of the American Medical Group Association's (AMGA) 2010 Medical Group Compensation and Financial Survey.
Thiazolidinediones May Up Fracture Risk in Older Women
THURSDAY, July 29 (HealthDay News) -- In type 2 diabetes patients, thiazolidinedione (TZD) exposure is associated with an increased risk of fracture in women age 50 and older -- especially in higher doses -- and in men who are concurrently exposed to loop diuretics, according to research published online July 14 in the Journal of Clinical Endocrinology and Metabolism.
General Anesthesia May Up Surgical Site Infection Risk
THURSDAY, July 29 (HealthDay News) -- Patients who undergo a primary total hip or knee replacement procedure with general anesthesia have a higher risk of surgical site infection (SSI) than those who undergo the procedure with epidural/spinal anesthesia, according to a study published in the August issue of Anesthesiology.
Total Knee, Hip Replacement Tied to BMI Decrease
THURSDAY, July 29 (HealthDay News) -- After correcting for the natural weight gain expected with aging, many patients experience a decrease in weight and body mass index (BMI) after total knee or total hip replacement, according to research published in the June 1 issue of Orthopedics.
Scoliosis Patients May Have Worse Perceived Health Status
WEDNESDAY, July 28 (HealthDay News) -- People with adolescent idiopathic scoliosis (AIS) may have perceived mental and physical health that is moderately, albeit significantly, worse than those without the condition, according to twin-based research published in the August issue of Spine.
Range of Motion With Cervical Disc Replacement Studied
WEDNESDAY, July 28 (HealthDay News) -- The range of motion (ROM) resulting from cervical disc arthroplasty is associated with preoperative factors and factors related to the surgical procedure itself, according to a pair of studies published in the August issue of The Spine Journal.
Predictors for Long-Term Back Pain and Disability Evaluated
WEDNESDAY, July 28 (HealthDay News) -- For patients who miss work with low back pain (LBP), persistent disability and pain one year after treatment are associated with baseline pain intensity and degree of disability, diffuse tenderness, health anxiety and fear avoidance, little or moderate exercise, and having made a compensation claim, according to a study in the August issue of The Spine Journal.
Back Pain Diagnostic Blocks Delay Pain Relief, Add Cost
MONDAY, July 26 (HealthDay News) -- Performing one or more temporary diagnostic nerve blocks to establish arthritis as the cause of back pain before treatment with radiofrequency denervation results in unnecessary tests, delayed pain relief, and added cost, according to a study in the August issue of Anesthesiology.
Spine Surgery Rating System Found to Be Reliable
FRIDAY, July 23 (HealthDay News) -- The 15-point Spine Severity Score (SSS) rating system is a reliable tool for experts and non-experts alike to use for the triage of elective spine referrals, according to a study in the August issue of The Spine Journal.
Knee OA Can Be Predicted From MRI Findings Decade Earlier
THURSDAY, July 22 (HealthDay News) -- The type of subacute knee injury seen on magnetic resonance imaging (MRI) at initial examination can predict the features of knee osteoarthritis (OA) likely to develop in the years ahead, according to a study published online June 29 in Radiology.
Approaches for ACL Injuries Linked to Similar Outcomes
WEDNESDAY, July 21 (HealthDay News) -- Among young, physically active adults with acute anterior cruciate ligament (ACL) tears, rehabilitation with optional delayed ligament reconstruction is associated with similar outcomes as rehabilitation plus early reconstruction, and it reduces the rate of reconstruction, according to research published in the July 22 issue of the New England Journal of Medicine.
Regular High-Heel Use Linked to Lower Leg Differences
WEDNESDAY, July 21 (HealthDay News) -- Wearing high-heeled shoes over the long term leads to shortening of muscle fascicles in the calf as well as increased stiffness of Achilles' tendons, according to research published online July 16 in the Journal of Experimental Biology.
5.2 Percent of Residency Applicant Essays Plagiarized
TUESDAY, July 20 (HealthDay News) -- About 5 percent of the application essays to residency programs -- often referred to as the personal statement -- contain plagiarized material, according to research published in the July 20 issue of the Annals of Internal Medicine.
Surgical Residents' Fellowship Decisions Are Gender-Neutral
MONDAY, July 19 (HealthDay News) -- A surgery resident's decision to pursue fellowship training is largely due to a desire for clinical mastery and specialty activities regardless of gender, with lifestyle factors of only midrange importance and program size appearing more influential than gender, according to research published in the July issue of the Archives of Surgery.
Minimally Invasive Knee Arthroplasty Found Not Superior
FRIDAY, July 16 (HealthDay News) -- Minimally invasive total knee arthroplasty does not confer a significant advantage over a conventional approach, according to research published in the July 7 issue of the Journal of Bone & Joint Surgery.
High Acupuncture Expectations Not Linked to Outcomes
FRIDAY, July 16 (HealthDay News) -- In patients with chronic low back pain, having a positive predisposition toward acupuncture doesn't predict better outcomes, according to research published in the July 1 issue of Spine.
Quality of Internet Info on Sports Med Diagnoses Variable
FRIDAY, July 16 (HealthDay News) -- The quality of content and financial transparency of Internet health information related to orthopedic sports medicine diagnoses is highly variable, but Web sites displaying the HONcode seal are significantly more likely to score higher in both of these areas, according to research published in the July 7 issue of the Journal of Bone & Joint Surgery.
Pain and Depression Dim Work Expectations After Whiplash
FRIDAY, July 16 (HealthDay News) -- Among people who suffer whiplash-associated disorder (WAD) resulting from a car accident, those in the most pain and those with depression symptoms appear to have the lowest expectations of returning to work, according to a study in the July 1 issue of Spine.
Use of ACDF Spinal Fusion Procedure on the Rise
THURSDAY, July 15 (HealthDay News) -- Anterior cervical discectomy and fusion (ACDF) became more prevalent over a recent 15-year period, with the largest increase in utilization seen in patients aged 65 and older, according to research published in the July 1 issue of Spine.
High Levels of Satisfaction Seen for Lumbar Fusion in Elderly
MONDAY, July 12 (HealthDay News) -- Elderly patients can benefit from lumbar spinal fusion in terms of reduced leg and back pain, and age alone is not a contraindication, according to a study in the July 1 issue of Spine.
Gastric Acid Drugs May Increase Hip Fracture Risk
FRIDAY, July 9 (HealthDay News) -- The use of drugs that inhibit gastric acid is linked to a higher risk of hip fracture among patients; however, with proton pump inhibitors (PPIs) this appears limited to those who have at least one other fracture risk factor, according to research published in the July issue of Gastroenterology.
Wrist Fractures, Functional Decline Linked in Older Women
FRIDAY, July 9 (HealthDay News) -- Wrist fractures in older women can result in clinically important functional decline, according to a study published online July 8 in BMJ.
Qigong and Tai Chi Have Multiple Health Benefits
THURSDAY, July 8 (HealthDay News) -- The combined outcomes of 77 studies on Qigong and Tai Chi suggest that these practices have a positive effect on multiple areas of health and well-being, according to a review published in the July/August issue of the American Journal of Health Promotion.
Poor Health Literacy Not Major Factor in LBP Disability
THURSDAY, July 8 (HealthDay News) -- Beliefs about chronic low back pain (CLBP), as well as behaviors related to fear of pain, have more effect on disability than pain intensity or LBP health literacy, according to research published in the July issue of Pain.
Many Doctors in Specialties Other Than Their Early Choices
WEDNESDAY, July 7 (HealthDay News) -- Ten years after graduation, approximately one-fourth of doctors work in a specialty other than the one they chose in their third year post-graduation, according to research published online July 6 in BMJ.
Glucosamine Similar to Placebo in Treating Back Pain
TUESDAY, July 6 (HealthDay News) -- Compared with placebo, treatment with glucosamine is not associated with reductions in pain-related disability in people with chronic low back pain and degenerative lumbar osteoarthritis, according to a study in the July 7 issue of the Journal of the American Medical Association.
Review Updates Evidence on Osteoporosis Screening
TUESDAY, July 6 (HealthDay News) -- Screening methods are available to predict risk of osteoporotic fractures, and medications to reduce fractures are effective, but studies have yet to directly identify the effectiveness or potential harm of screening or establish ideal screening intervals, according to a review published online July 5 in the Annals of Internal Medicine.
Fifth of Medicare Patients With Spinal Stenosis Have Surgery
FRIDAY, July 2 (HealthDay News) -- About one out of five Medicare patients with lumbar spinal stenosis (LSS) receives surgery within three years of diagnosis, and there appears to be an association between the type of surgery provided and the point after diagnosis when surgery is carried out, according to research published in the July issue of The Spine Journal.
Report Addresses Physician Financial Conflicts in Care
THURSDAY, July 1 (HealthDay News) -- In a new report, the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that ensure financial relationships between physicians and industry do not result in conflicts of interest that influence patient care.
Weight Associated With Post-Surgical Disc Herniation
THURSDAY, July 1 (HealthDay News) -- Obese individuals who undergo lumbar microdiscectomy are much more likely than non-obese individuals to experience recurrent herniation of the nucleus pulposus (HNP), according to research published in the July issue of The Spine Journal.
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