Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for June 2009. 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.
Protein Growth Factor Used in a Quarter of Spinal Fusions
TUESDAY, June 30 (HealthDay News) -- A sharp increase in the use of bone-morphogenetic protein (BMP) growth factor in spinal fusion since 2002 is associated with an increase in the complication rate for anterior cervical fusion and increased hospitalization charges, according to a study in the July 1 Journal of the American Medical Association.
Knee Replacement Increases Functional Status
MONDAY, June 29 (HealthDay News) -- In elderly patients with knee osteoarthritis, those who undergo total knee arthroplasty have significantly improved functional outcomes compared to those who forgo the surgery, according to a study published in the July issue of Medical Care.
CT-Myelogram Still Useful in Diagnosing Spinal Disorders
MONDAY, June 29 (HealthDay News) -- Although MRI has become the standard tool for assessing patients with degenerative cervical spinal disorders, postmyelographic computed tomography (CTM) can still provide useful diagnostic information, according to a study published in the July issue of the Journal of Spinal Disorders & Techniques.
Age, Education Affect Post-Sick Leave Transition to Disability
FRIDAY, June 26 (HealthDay News) -- In adults with musculoskeletal disorders who had a lengthy sickness-related work absence, their age, diagnosis, and socioeconomic factors predicted their transition to disability pension in following years, according to research published in the June 15 issue of Spine.
Different Epidural Injections May Relieve Low Back Pain
FRIDAY, June 26 (HealthDay News) -- Caudal epidural injections (CEIs) with local anesthetic, with or without steroids, may help patients with low back pain, but the steroids may help provide faster relief, according to research published in the June 15 issue of Spine.
Aquatic Exercise May Be Helpful for Low Back Pain
FRIDAY, June 26 (HealthDay News) -- Exercising in water may be particularly beneficial for people with chronic low back pain, according to research published in the June 15 issue of Spine.
Spinal Cord Stimulation Viable in Deployed Military Personnel
THURSDAY, June 25 (HealthDay News) -- Spinal cord stimulation (SCS) may be a viable approach to treating military personnel with chronic pain who wish to continue overseas deployments, according to research published in the July issue of Anesthesia & Analgesia.
Americans Paying for More of Their Health Care Costs
WEDNESDAY, June 24 (HealthDay News) -- Out-of-pocket costs are rising for Americans with health care coverage, including premiums, deductibles and copayments, according to a new June 23 report from the U.S. Department of Health & Human Services.
Monitoring May Be Unnecessary After Bisphosphonate Treatment
WEDNESDAY, June 24 (HealthDay News) -- Postmenopausal women treated with a potent bisphosphonate should not undergo bone mineral density monitoring within the first three years of starting treatment because such tests can give misleading results, according to a study published online on June 23 in BMJ.
Secondary Causes for Low Bone Mineral Density Common
TUESDAY, June 23 (HealthDay News) -- Many postmenopausal breast cancer survivors may have secondary causes of low bone mineral density that are potentially treatable, according to research published online on June 22 in the Journal of Clinical Oncology.
Total Knee Arthroplasty Found Cost-Effective
TUESDAY, June 23 (HealthDay News) -- Among Medicare patients, total knee arthroplasty is cost-effective, especially when performed at high-volume hospitals, according to a study published in the June 22 issue of the Archives of Internal Medicine.
President Signs Tobacco Law, Acts on Medicare Coverage
MONDAY, June 22 (HealthDay News) -- President Barack Obama moved on two health care fronts today, signing new legislation to regulate tobacco industry marketing and announcing an agreement with the nation's pharmaceutical companies to reduce the cost of prescription drugs for Americans on Medicare who find themselves in the so-called "doughnut hole" coverage gap.
Platelet Glue May Not Improve Spinal Fusion Rates
MONDAY, June 22 (HealthDay News) -- Using platelet glue, which comprises platelet gel and fibrin glue, does not improve the outcome of instrumented posterolateral lumbar fusion, according to a study published in the June issue of the Journal of Spine Disorders & Techniques.
Reinforced Infection Control Needed to Combat H1N1
MONDAY, June 22 (HealthDay News) -- Infection control messages aimed at health care workers should be reinforced in an effort to reduce the spread of novel influenza A (H1N1) virus, according to a study published in the June 19 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
Scoliosis Surgeries May Compromise Pulmonary Function
MONDAY, June 22 (HealthDay News) -- In patients with adolescent idiopathic scoliosis, surgical approaches that violate the chest wall are associated with a significant but temporary decline in pulmonary function, according to a study published in the June issue of the Journal of Spinal Disorders & Techniques.
Oxygen-Ozone Injections May Help Lower Back Pain
FRIDAY, June 19 (HealthDay News) -- Intramuscular paravertebral injections of oxygen and ozone may be helpful in relieving acute low back pain, according to research published in the June 1 issue of Spine.
Bone Disease, Rheumatoid Arthritis Connection Complex
FRIDAY, June 19 (HealthDay News) -- In postmenopausal women with rheumatoid arthritis, hip bone mineral density appears to be associated with focal erosions, but the relationship is not significant after controlling for other variables. However, the relationship appears to be stronger in certain subgroups of patients, according to a study published in the June issue of Arthritis & Rheumatism.
Advances Seen in Biologic Therapies for Disk Disease
FRIDAY, June 19 (HealthDay News) -- Biologic therapies show great potential for treating patients with degenerative disk disease, but more research is needed to establish their safety and efficacy before they can be widely used, according to a study published in the June issue of the Journal of Spinal Disorders & Techniques.
Glove Perforation Raises Odds of Surgical Site Infection
THURSDAY, June 18 (HealthDay News) -- Surgical glove perforation significantly increases the risk of surgical site infection in procedures where surgical antimicrobial prophylaxis is not applied, according to a study published in the June issue of the Archives of Surgery.
Individual Mandate for Health Insurance Affordable and Fair
WEDNESDAY, June 17 (HealthDay News) -- Reforming the health insurance market so that all individuals are required to obtain at least a minimum amount of health insurance would eliminate the problem of adverse selection that the current system enables insurers to avoid, according to a perspective published online June 17 in the New England Journal of Medicine.
Spinal Approaches Linked to Similar Pain Outcomes
WEDNESDAY, June 16 (HealthDay News) -- In older patients with osteoporotic vertebral fractures, conservative treatment may be associated with similar improvements in pain as percutaneous vertebroplasty, according to research published in the June 1 issue of Spine.
Bariatric Surgery May Lead to Back Pain Improvements
MONDAY, June 15 (HealthDay News) -- The substantial weight loss resulting from bariatric surgery may be associated with moderate improvements in pre-existing low back pain in the following year, according to research published in the June issue of The Spine Journal.
Discoblock Effective for Back Pain Diagnosis
MONDAY, June 15 (HealthDay News) -- Pain relief after an injection of bupivacaine rather than pain provocation after injection of contrast medium into the painful disc is a useful tool to diagnose discogenic lower back pain, and patients have better outcomes after spinal surgery, according to a study in the June 1 issue of Spine.
Sweeping Medical Reforms Lack Medical Liability Element
MONDAY, June 15 (HealthDay News) -- Three approaches to medical reform currently under discussion in the United States all have pros and cons, and questions remain over whether or not the reform package should include changes to the medical liability system, according to an article published online June 15 in the New England Journal of Medicine.
Bill Giving FDA Authority Over Tobacco on Way to President
FRIDAY, June 12 (HealthDay News) -- Legislation giving the U.S. Food and Drug Administration (FDA) regulatory control over tobacco products is headed to the White House for President Obama's signature, as health organizations continue to applaud the action.
Intervention Effective for Workers With Back Pain
FRIDAY, June 12 (HealthDay News) -- A workplace intervention for workers on sick leave due to nonspecific low back pain is most effective for older workers and those with previous sick leave, according to a study in the May 20 issue of Spine.
Spinal Disc Degeneration Common in Elderly
FRIDAY, June 12 (HealthDay News) -- Most elderly adults show signs of degenerative disc disease regardless of whether they have chronic low back pain, although individuals with chronic low back pain tend to have more severe disc disease, according to a study in the May 20 issue of Spine.
Senate Approves Bill Giving FDA Authority Over Tobacco
THURSDAY, June 11 (HealthDay News) -- The U.S. Senate has passed a measure that would give the U.S. Food and Drug Administration (FDA) broad authority over the advertising, sale, and manufacture of tobacco products, an action that is being applauded by the American Medical Association, among others.
Distal Radial Fracture Rates Vary Across the Nation
MONDAY, June 8 (HealthDay News) -- The rate of distal radial fractures varies widely by sex, age, race, and geographic region, and the type of treatment also varies by age and region, according to a study published in the June issue of the Journal of Bone & Joint Surgery.
Surgery Improves Spondylolisthesis Outcomes
MONDAY, June 8 (HealthDay News) -- In patients with degenerative spondylolisthesis and associated spinal stenosis, those who are treated surgically have significantly better outcomes after four years than those who are treated nonoperatively, according to a study published in the June issue of the Journal of Bone & Joint Surgery.
Medications Reduce Postmenopausal Fracture Risk
FRIDAY, June 5 (HealthDay News) -- In postmenopausal women with osteoporosis, teriparatide and raloxifene may significantly reduce the risk of vertebral fractures, according to a study published in the June 1 issue of the Journal of Bone & Joint Surgery.
Location of Pain May Affect Spinal Surgery Outcome
FRIDAY, June 5 (HealthDay News) -- Patients undergoing decompression surgery to treat spinal stenosis are likely to have a worse outcome if their preoperative pain in the back is bad relative to pain in the legs or buttocks, according to a study published in the May 15 issue of Spine.
Tai Chi May Be Modestly Effective for Arthritis Patients
FRIDAY, June 5 (HealthDay News) -- In patients with arthritis, Tai Chi appears to be modestly effective at reducing pain and tension and improving disability, physical performance, and quality of life; but in people with other types of musculoskeletal pain, its effects are unclear, according to a study published in the June 15 issue of Arthritis & Rheumatism (Arthritis Care & Research).
Active Patients Get Better Outcome From Fusion
FRIDAY, June 5 (HealthDay News) -- Isthmic spondylolisthesis patients who undergo fusion have a better outcome if they are working prior to surgery, and male gender and regular exercise also contribute to a more favorable outcome, according to a study published in the May 15 issue of Spine.
Many U.K. Trained Doctors Stay in National Health Service
WEDNESDAY, June 3 (HealthDay News) -- The majority of domestic medical students in Britain work in the National Health Service (NHS) after graduation, as do the majority of doctors from overseas who go to the country for training, with men and women choosing similar career paths, according to a study published online June 3 in BMJ.
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