The annual meeting of the American Academy of Orthopaedic Surgeons was held from Feb. 7 to 11 in San Francisco and attracted approximately 30,000 participants from around the world. The conference highlighted recent advances in the diagnosis and management of musculoskeletal conditions, with presentations focusing on joint fractures, osteoarthritis, and other musculoskeletal injuries as well as factors impacting joint replacement procedure outcomes.
In one study, Seth Leopold, M.D., of the University of Washington School of Medicine in Seattle, and colleagues found that anxiety but not "catastrophizing" predicted postoperative pain levels and pain medication use in men but not in women after total knee replacement.
"We used validated questionnaires to assess patients' anxiety levels and their tendency to catastrophize; we gave patients these questionnaires before surgery. We then evaluated their pain experiences after knee replacement surgery. We used the same approaches to anesthesia, surgery, and aftercare," Leopold said. "We found that women described more pain than men, especially in the day or two after the surgery, and their level of satisfaction with pain management was correspondingly lower. We found that catastrophizing -- or at least the tools we used to assess it -- did not predict pain after surgery in men or women."
The investigators also found that older women reported less pain than younger women or men; and men whose baseline anxiety levels were higher described more postoperative pain, but this finding did not hold true for women.
"Our study suggests that men with higher anxiety levels and younger women may be at particular risk for higher levels of postoperative pain, and that these groups may benefit from targeted efforts to prevent pain," Leopold added.
In another study, Patricia Franklin, M.D., of the University of Massachusetts Medical School in Worcester, and colleagues evaluated the benefits of incorporating a known self-care support program into the rehabilitation phase of routine care after a total joint replacement procedure.
"We randomized patients to this self-care support program to receive telephone counseling or no counseling. The patients who received telephone counseling had a coach call them once per week to discuss how to incorporate daily activity and the importance of physical activity as well as what types of pain to be concerned about and what types of pain are normal with recovery after surgery," Franklin said. "We found that everyone who took part in the telephone counseling was actively engaged. We also found that patients who had high pre-surgical emotional well-being took part in higher levels of activity with telephone counseling. In addition, patients who had low or poor emotional health, but no other medical conditions saw an improvement in activity with telephone counseling."
Harlan Amstutz, M.D., of the University of California in Los Angeles, and colleagues found that the rate of revisions increased in individuals who had undergone treatment with a hip resurfacing approach and engaged in high impact activity.
Patients who had undergone treatment with a hip resurfacing approach filled out a questionnaire to provide insight into hip cycle per day; impact activity; and activity frequency, duration, and intensity. The investigators used a scoring system and evaluated these patients over a 10-year follow-up period.
"We found that the revision rate increased among individuals who engaged in high-impact activity that scored above 50, which typically included running more than three miles per day. This was not necessarily surprising to us but what was surprising was the degree and extent of activity that these patients were able to engage in, which was pretty positive," Amstutz said. "We also found that cyclers tended to need fewer revisions than those who were runners and engaged in more impact activity."
AAOS: Prevalence of U.S. Total Knee Replacements ~5 Percent
FRIDAY, Feb. 10 (HealthDay News) -- Prevalence estimates show that approximately 4.7 percent of the U.S. population aged 50 years or older currently has an intact primary total knee replacement (TKR), according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from Feb. 7 to 11 in San Francisco.
AAOS: Defensive Medicine Prevalent in Orthopedics
THURSDAY, Feb. 9 (HealthDay News) -- Almost all orthopedic surgeons report practicing defensive medicine, with costs per surgeon estimated at $100,000 per year, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from Feb. 7 to 11 in San Francisco.
AAOS: Platelet-Rich Plasma Effective for Plantar Fasciitis
TUESDAY, Feb. 7 (HealthDay News) -- For patients with severe chronic plantar fasciitis refractory to traditional non-operative management, treatment with platelet-rich plasma (PRP) injection is significantly more effective than cortisone, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from Feb. 7 to 11 in San Francisco.
AAOS: Unemployment Rate Tied to Orthopedic Trauma Volume
TUESDAY, Feb. 7 (HealthDay News) -- Economic factors impact orthopedic trauma volume, with the unemployment rate for the previous year being the best predictor of volume, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from Feb. 7 to 11 in San Francisco.
AAOS: Female Soccer Athletes at Risk for Female Triad
TUESDAY, Feb. 7 (HealthDay News) -- Female soccer athletes are at risk for delayed menarche, irregular and/or missed cycles, and stress fractures, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from Feb. 7 to 11 in San Francisco.
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