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February 2011 Briefing - Orthopedics

Last Updated: March 01, 2011.

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for February 2011. 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.

Tranexamic Acid Lowers Post-Op Blood Loss in Neck Surgery

MONDAY, Feb. 28 (HealthDay News) -- Tranexamic acid (TXA) used in cervical laminoplasty significantly reduces perioperative blood loss, mainly through reduced postoperative bleeding, according to a study published online Feb. 1 in Spine.

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Necrotizing Fasciitis Pathogen Can Predict Urgency

MONDAY, Feb. 28 (HealthDay News) -- Necrotizing fasciitis caused by Vibrio vulnificus progresses faster and is more clinically fulminant than infections caused by Staphylococcus aureus, according to a study published in the Feb. 2 issue of The Journal of Bone & Joint Surgery.

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Diabetes Affects Outcomes of Spine Surgery

FRIDAY, Feb. 25 (HealthDay News) -- Patients with diabetes who undergo surgery for spine problems experience less improvement compared to those without diabetes, according to research published in the Feb. 15 issue of Spine.

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Return to Work Delayed After Lumbar Fusion

THURSDAY, Feb. 24 (HealthDay News) -- Lumbar fusion surgery is associated with poor return to work (RTW) status, as well as increased disability, opiate use, reoperations, and complications, according to research published in the Feb. 15 issue of Spine.

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Equations Predict Quadriceps Strength in Knee Osteoarthritis

THURSDAY, Feb. 24 (HealthDay News) -- Predictive equations can be used to assess maximal quadriceps strength in individuals who have osteoarthritis in a knee joint, according to a study published in the February issue of Arthritis Care & Research.

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Staging Spine Surgery Linked to Increased Morbidity

WEDNESDAY, Feb. 23 (HealthDay News) -- Circumferential spine fusion surgery that is performed in two stages on different days may expose patients to increased morbidity and mortality, compared to same-day surgeries, according to a study published online Feb. 4 in Spine.

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Nitroglycerin Strengthens Bones in Older Women

WEDNESDAY, Feb. 23 (HealthDay News) -- Nitroglycerin ointment appears to increase bone mineral density (BMD) and decrease bone resorption in postmenopausal women when administered daily, according to research published in the Feb. 23 issue of the Journal of the American Medical Association.

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Prolonged Bisphosphonate Use Tied to Fracture Risk

TUESDAY, Feb. 22 (HealthDay News) -- Bisphosphonate therapy lasting more than five years is associated with an increased risk of subtrochanteric or femoral shaft fractures in older women, according to a study published in the Feb. 23 issue of the Journal of the American Medical Association.

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Kyphoplasty Effective for Vertebral Fractures

MONDAY, Feb. 21 (HealthDay News) -- Balloon kyphoplasty appears to be a safe and effective means for reducing pain and improving function in cancer patients with vertebral compression fractures (VCFs), according to research published online Feb. 17 in The Lancet Oncology.

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Preoperative MRI Detects Spinal Injuries

MONDAY, Feb. 21 (HealthDay News) -- More than 90 percent of adult patients with cervical spinal cord injury without radiographic abnormality (SCIWORA) have signs of spinal cord injury that are identified by preoperative magnetic resonance imaging (MRI), which give an indication of symptom severity and prognosis, according to a study published online Feb. 1 in Spine.

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Low Pay for New Female Doctors Tied to Gender, Not Job

MONDAY, Feb. 21 (HealthDay News) -- In 2008, male physicians who were newly trained in New York State made an average of $16,819 more than newly trained female physicians, compared to a $3,600 difference in 1999, according to a study published in the February issue of Health Affairs.

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Hip Synovial Chondromatosis Leads to Joint Space Widening

THURSDAY, Feb. 17 (HealthDay News) -- Joint space widening persists after surgery for primary synovial chondromatosis of the hip, but it does not appear to influence clinical results, according to a study published in the Feb. 2 issue of The Journal of Bone & Joint Surgery.

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New U.S. Report on the Nation's Health 2010 Released

WEDNESDAY, Feb. 16 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention's National Center for Health Statistics' 34th annual report, presenting the latest information on health status and determinants, utilization of health care, health care resources, expenditures, and a special feature on death and dying, was published Feb. 16.

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Thoracic Spine Screw Shift May Endanger the Aorta

WEDNESDAY, Feb. 16 (HealthDay News) -- Thoracic pedicle screws, used in surgical correction of scoliosis, may shift over time due to structural failure of bone, making the aorta susceptible to irritation or penetration from laterally oriented or breached screws, according to a study published in the Feb. 1 issue of Spine.

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Most Recalled Medical Devices Given Lenient Approval

TUESDAY, Feb. 15 (HealthDay News) -- The majority of medical devices recalled from 2005 to 2009 for risk of serious health hazard or death were approved by the less strict 510(k) process intended for devices considered low or moderate risk, according to a study published online Feb. 14 in the Archives of Internal Medicine.

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Obesity, Arthritis Shorten Quality-Adjusted Life-Years

TUESDAY, Feb. 15 (HealthDay News) -- A substantial number of quality-adjusted life-years are lost due to knee osteoarthritis and obesity, with a disproportionate number of black and Hispanic women affected, according to a study published in the Feb. 15 issue of the Annals of Internal Medicine.

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Researchers Explore Nature of Difficult Clinical Encounters

MONDAY, Feb. 14 (HealthDay News) -- Both patients and physicians can bring qualities to a clinical encounter that result in its being perceived as difficult, and patients involved in these types of encounters have worse short-term outcomes, according to research published online Jan. 25 in the Journal of General Internal Medicine.

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Increase Seen in Pediatric Running Injuries

MONDAY, Feb. 14 (HealthDay News) -- A growing number of children are injuring themselves while running, suggesting a need for scientific, evidence-based research to create guidelines that will help reduce pediatric running-related injuries, according to a study in the February issue of Clinical Pediatrics.

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Teens Prefer Pedicle Screw Result Over Hybrid Construct

MONDAY, Feb. 14 (HealthDay News) -- Adolescent patients undergoing surgery for scoliosis report improved postoperative appearance when all pedicle screws are used versus less costly hybrid constructs, according to a study published in the Feb. 1 issue of Spine.

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Joint Effusions Signal Possible Lyme Arthritis

MONDAY, Feb. 14 (HealthDay News) -- Children with joint effusions in a Lyme-endemic area of the Northeastern United States may have Lyme arthritis, especially if there is knee involvement, according to a study published in the Feb. 2 issue of The Journal of Bone & Joint Surgery.

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Addison's Disease Is a Risk Factor for Hip Fracture

FRIDAY, Feb. 11 (HealthDay News) -- Clinically diagnosed and undiagnosed cases of Addison's disease (AD) are associated with hip fractures in patients aged 30 years or older, with the highest risk in women aged 50 years or younger, according to a study published online Jan. 19 in the Journal of Internal Medicine.

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Sagittal Balance Not Improved With Anterior Lumbar Support

FRIDAY, Feb. 11 (HealthDay News) -- Sagittal spinal balance outcomes do not appear to differ among patients who undergo anterior lumbar interbody fusion (ALIF) with posterolateral lumbar fusion (PLF) or PLF alone, and lumbar lordosis and type of lordosis correlate with outcomes, according to a study published in the Feb. 1 issue of Spine.

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Shunt Increases Infection Risk in Scoliosis Surgery

THURSDAY, Feb. 10 (HealthDay News) -- The presence of a ventriculoperitoneal shunt is a significant risk factor for developing a wound infection following surgery for neuromuscular scoliosis, according to a study published in the Feb. 1 issue of Spine.

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Same Results From Paper or Electronic Health Surveys

THURSDAY, Feb. 10 (HealthDay News) -- Outcomes obtained from hip replacement patient health questionnaires are the same, whether completed on paper, touch screen, or online, according to a study published in the Feb. 2 issue of The Journal of Bone & Joint Surgery.

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Public Sector Plays Big Role in Drug Research

WEDNESDAY, Feb. 9 (HealthDay News) -- Public-sector research institutions (PSRIs) appear to play a bigger role in drug discovery than was previously thought, contributing to the discovery of about 10 to 20 percent of drugs approved for new drug applications since 1990, according to research published in the Feb. 10 issue of the New England Journal of Medicine.

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Surgery Reduces Leg Pain More Than Low Back Pain

TUESDAY, Feb. 8 (HealthDay News) -- Surgical treatment improves leg pain more than low back pain in patients with degenerative spondylolisthesis (DS) and spinal stenosis (SpS), according to a study published in the Feb. 1 issue of Spine.

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More Radiation in Minimally Invasive Than Open Surgery

MONDAY, Feb. 7 (HealthDay News) -- Surgeons are exposed to significantly more radiation during minimally invasive lumbar microdiscectomy compared to traditional open microdiscectomy, according to a study published in the Feb. 1 issue of Spine.

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Conflict of Interest Reporting Varies Among Spine Meetings

FRIDAY, Feb. 4 (HealthDay News) -- There is a lack of uniformity among disclosure policies of various medical associations, and confusion regarding what relationships need acknowledgement results in variability in the reporting of financial conflicts of interest in clinical research, according to research published in the January issue of The Spine Journal.

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Bone Mass, Bone Formation Reduced in Quiescent Crohn's

WEDNESDAY, Feb. 2 (HealthDay News) -- Bone analysis reveals a reduction in bone mass characterized by trabecular thinning and bone loss caused by reduced bone formation in patients with quiescent Crohn's disease (CD), according to a study published in the January issue of Gastroenterology.

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Imaging for Low Back Pain Often Useless, Harmful

TUESDAY, Feb. 1 (HealthDay News) -- For most patients, routine imaging for low back pain is an expensive intervention that may do more harm than good, according to a clinical guideline published in the Feb. 1 issue of the Annals of Internal Medicine.

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