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Category: Orthopedics | Monthly Briefing

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December 2011 Briefing - Orthopedics

Last Updated: January 02, 2012.

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

Use of Propofol Saves Time Compared to Midazolam/Ketamine

FRIDAY, Dec. 30 (HealthDay News) -- Procedural sedation with propofol accelerates patient management in emergency departments, and saves time in comparison with midazolam/ketamine sedation, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

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Ankle Position Reduces Gap in Ruptured Achilles Tendon

THURSDAY, Dec. 29 (HealthDay News) -- Ultrasound assessment reveals that maximum ankle equinus alone significantly improves the gap distance after acute Achilles tendon rupture, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

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Near Normal Function Seen in Secondary Hip Osteonecrosis

THURSDAY, Dec. 29 (HealthDay News) -- Children with osteonecrosis of the hip, secondary to the treatment of developmental dysplasia of the hip, have no marked physical disability, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

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Study Assesses Fusion Failure After Anterior Screw Fixation

WEDNESDAY, Dec. 28 (HealthDay News) -- Risk of fusion failure following anterior odontoid screw fixation increases with both delays in surgery and fracture gaps larger than 2 mm, according to a study published in the Jan. 1 issue of Spine.

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Perceptions of Inappropriate Care Prevalent Among ICU Staff

TUESDAY, Dec. 27 (HealthDay News) -- Perceptions of inappropriate care are prevalent among intensive care unit (ICU) clinicians in Europe and Israel, according to a study published in the Dec. 28 issue of the Journal of the American Medical Association.

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Risk Factors for Post-Spinal Fusion Visual Loss Identified

TUESDAY, Dec. 27 (HealthDay News) -- Significant risk factors for ischemic optic neuropathy (ION) after spinal fusion surgery include male gender, obesity, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and lower percent colloid administration, according to a study published in the January issue of Anesthesiology.

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Medical Team Training Program Cuts Surgical Morbidity Rate

WEDNESDAY, Dec. 21 (HealthDay News) -- The Veterans Health Administration Medical Team Training (MTT) program is associated with a significant decrease in the annual surgical morbidity rate, according to a study published in the December issue of the Archives of Surgery.

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Trauma Quality Indicators Linked to Clinical Outcomes

WEDNESDAY, Dec. 21 (HealthDay News) -- Several of the American College of Surgeons Committee on Trauma (ACSCOT) quality indicators have significant associations with in-hospital mortality and the composite outcome of death or major complications, according to a study published online Dec. 19 in the Archives of Surgery.

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Majority of Practitioners in U.K. Advise Time Off for Back Pain

WEDNESDAY, Dec. 21 (HealthDay News) -- Despite guidelines for the clinical management of patients with low back pain (LBP) that encourage patients to stay active and return to work, the majority of practitioners advise patients to take a break from work to recover, according to a study published in the December issue of Pain.

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Vitamin D, Calcium Found to Cut Fracture, Cancer Risk

TUESDAY, Dec. 20 (HealthDay News) -- Vitamin D supplementation can reduce the risk of fracture and cancer; and although there is a biological association between vitamin D deficiency and cardiovascular disease (CVD), there is no evidence that vitamin D supplementation prevents CVD, according to two reviews published in the Dec. 20 issue of the Annals of Internal Medicine.

Abstract - Chung
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Abstract - Greevy and Williams
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Physician Opinions on Benefits of Open Visit Notes Vary

MONDAY, Dec. 19 (HealthDay News) -- Primary care physicians (PCPs) have varied opinions about open access to doctors' notes; and most users of a personal health record (PHR) system are interested in sharing access to their information, according to two studies published in the Dec. 20 issue of the Annals of Internal Medicine.

Abstract - Walker
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Abstract - Zulman
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Training Improves Physical Function After Hip Replacement

FRIDAY, Dec. 16 (HealthDay News) -- For patients with osteoarthritis who undergo total hip arthroplasty (THA), a walking skill training program performed three to five months after THA improves physical functioning, according to a study published online Dec. 14 in Arthritis Care & Research.

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Concurrent-, Staged-Bilateral Knee Arthroplasty Compared

THURSDAY, Dec. 15 (HealthDay News) -- Simultaneous-bilateral arthroplasty is associated with reduced incidence of periprosthetic joint infection and malfunction, and with increased cardiovascular risk, compared with staged-bilateral arthroplasty, according to a study published in the Dec. 7 issue of The Journal of Bone & Joint Surgery.

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Some RA Remission Criteria Underestimate Foot Synovitis

THURSDAY, Dec. 15 (HealthDay News) -- For patients with rheumatoid arthritis (RA), remission criteria based on 28 joint counts underestimate foot involvement, compared with criteria which assess full joint counts, according to a study published online Dec. 1 in Arthritis & Rheumatism.

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Ankle Dorsiflexion Improves After Plantar Flexor Surgery

THURSDAY, Dec. 15 (HealthDay News) -- For children with cerebral palsy, ankle plantar flexor lengthening surgery results in significantly improved passive ankle motion, strength, selective motor control, and improved dorsiflexion during the swing phase, according to a study published online Dec. 7 in The Journal of Bone & Joint Surgery.

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Liberal Transfusion Nonsuperior Post-Hip Fracture Surgery

WEDNESDAY, Dec. 14 (HealthDay News) -- A liberal blood transfusion strategy (maintenance at a threshold of 10 g/dL hemoglobin) is not superior to a restrictive strategy (transfusion at symptoms of anemia or <8 g/dL hemoglobin) for reducing death and inability to walk independently after hip fracture surgery, according to a study published online Dec. 14 in the New England Journal of Medicine.

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MRI Has Limited Impact on Epidural Steroid Decisions

WEDNESDAY, Dec. 14 (HealthDay News) -- For patients with lumbosacral radiculopathy who are clinical candidates for epidural steroid injections (ESI), magnetic resonance imaging (MRI) does not improve treatment outcomes, and only marginally influences physicians' decision making, according to a study published online Dec. 12 in the Archives of Internal Medicine.

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More Pain in Erosive OA Than OA/Inflammatory Arthritis

WEDNESDAY, Dec. 14 (HealthDay News) -- Patients with erosive osteoarthritis (EOA) have significantly more pain and more functional impairment than those with osteoarthritis (OA) or inflammatory arthritis, according to a study published online Dec. 2 in Arthritis & Rheumatism.

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Pediatric Football-Linked Risk Factors for Stroke Explored

WEDNESDAY, Dec. 14 (HealthDay News) -- Several factors, including repeated head or neurological injury and obesity, may contribute to the risk of stroke among young football players, according to a study published in the December issue of the Journal of Child Neurology.

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Autologous Blood Donation Tied to Pre-Op Anemia, Blood Loss

WEDNESDAY, Dec. 14 (HealthDay News) -- Preoperative autologous blood donation (PABD) during posterior lumbar spinal surgery is associated with preoperative anemia and a lower transfusion threshold than allogeneic blood use, according to a study published in the Dec. 15 issue of Spine.

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Similar Outcomes for Walking, Traditional Hip Spica Casts

WEDNESDAY, Dec. 14 (HealthDay News) -- A single-leg walking hip spica cast is as effective as a traditional hip spica cast for the treatment of low-energy femoral shaft fractures in young children, and reduces the care burden for the family, according to a study published in the Dec. 7 issue of The Journal of Bone & Joint Surgery.

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Myotonic Muscular Dystrophy Tied to Increased Cancer Risk

TUESDAY, Dec. 13 (HealthDay News) -- Patients diagnosed with myotonic muscular dystrophy (MMD) are at an increased risk of developing cancer, according to a study published in the Dec. 14 issue of the Journal of the American Medical Association.

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Infection Prevention Up in VA, Non-Federal Hospitals

TUESDAY, Dec. 13 (HealthDay News) -- From 2005 to 2009, there was a significant increase in the use of hospital-acquired infection (HAI) prevention practices in non-federal and Veterans Affairs (VA) hospitals, according to a study published online Dec. 6 in the Journal of General Internal Medicine.

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Higher Level of Wear in Pseudotumor Hip Revisions

TUESDAY, Dec. 13 (HealthDay News) -- The hip resurfacing implants of patients who undergo revision for pseudotumors have significantly higher linear, volumetric, and edge wear rates than implants of patients who undergo revision for other reasons, according to a study published in the Dec. 7 issue of The Journal of Bone & Joint Surgery.

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Electroacupunture Reduces Pain in Whiplash Patients

FRIDAY, Dec. 9 (HealthDay News) -- Use of electroacupuncture is associated with a significant reduction in pain intensity in whiplash patients, but the reduction is probably not clinically significant, according to a study published in the Dec. 15 issue of Spine.

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Factors Affecting Micro-RNA Detection Accuracy Identified

FRIDAY, Dec. 9 (HealthDay News) -- Accurate detection and quantitation of circulating microRNAs (miRNAs) is affected by inherent differences in plasma samples, methods used for their collection and analysis, and the presence of specific inhibitors in plasma, according to a study published online Dec. 9 in the Journal of Molecular Diagnostics.

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Leisure-Time Physical Activity Low in Adults With Arthritis

THURSDAY, Dec. 8 (HealthDay News) -- The prevalence of U.S. adults reporting no leisure-time physical activity (LTPA) fell between 1989 and 2002, but has held steady at 25 percent since then; it is possible that subgroups, such as adults with arthritis, have hindered further reduction, according to research published in the Dec. 9 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Knee Asymmetries Identified Early in Unilateral Hip OA

THURSDAY, Dec. 8 (HealthDay News) -- For patients with unilateral hip osteoarthritis (OA), loading and structural asymmetries appear in the contralateral knee early in the disease course, when the knees are asymptomatic, according to a study published in the December issue of Arthritis & Rheumatism.

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Physical Activity Laws Impact School Activity Opportunities

WEDNESDAY, Dec. 7 (HealthDay News) -- Schools located in areas with laws encouraging 150 minutes/week of physical education (PE) are more likely to have the required exercise time, and schools in locales requiring daily recess are more likely to have a 20 minute daily recess, according to a study published online Dec. 5 in the Archives of Pediatrics & Adolescent Medicine.

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Bisphosphonate Use Ups Knee, Hip Implant Survival

WEDNESDAY, Dec. 7 (HealthDay News) -- Bisphosphonate use in patients undergoing total knee or hip arthroplasty is associated with significantly longer implant survival and time to revision, according to a study published online Dec. 6 in BMJ.

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HLA-B27 Prevalence in United States Calculated

TUESDAY, Dec. 6 (HealthDay News) -- In the first large-scale study on the prevalence of HLA-B27 reactivity in the general population, roughly 6 percent of the population was found to be positive for HLA-B27, and it was more common in non-Hispanic whites and appears to decrease in prevalence with age, according to recent research published online Dec. 2 in Arthritis & Rheumatism.

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Medical Students Fail to ID Hand Hygiene Indications

MONDAY, Dec. 5 (HealthDay News) -- Medical students who are about to start the clinical phase of their education have a lack of knowledge regarding the correct indications for hand disinfection, according to a study published in the December issue of the American Journal of Infection Control.

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C. difficile Infection Ups Duration of Hospital Stay

MONDAY, Dec. 5 (HealthDay News) -- Hospital-acquired infection with Clostridium difficile (C. difficile) significantly and independently lengthens the duration of stay in the hospital, according to a study published online Dec. 5 in CMAJ, the journal of the Canadian Medical Association.

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Similar Running Economy for Older, Younger Runners

MONDAY, Dec. 5 (HealthDay News) -- The running economy (RE) of older competitive distance runners does not differ from that of their younger counterparts, according to a study published in the November issue of the Journal of Strength and Conditioning Research.

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Total Disc Replacement, Spinal Fusion Reach Surgical Goals

FRIDAY, Dec. 2 (HealthDay News) -- Surgical goals are reached for most patients undergoing spinal fusion or total disc replacement (TDR) for chronic low back pain (CLBP) that is assumed to be discogenic, but this is not correlated to clinical outcome, according to a study published in the November issue of The Spine Journal.

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Time of Operation Not Linked to Postoperative Mortality

FRIDAY, Dec. 2 (HealthDay News) -- The timing of general surgery and the moon phase are not associated with 30-day mortality after surgery, according to a study published in the December issue of Anesthesia & Analgesia.

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Most Non-Mobile Spinal Mets Patients Walk Post-Surgery

FRIDAY, Dec. 2 (HealthDay News) -- The majority of nonambulatory patients with epidural spinal metastasis become ambulatory postoperatively, according to a study published in the November issue of The Spine Journal.

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Early Post-Op Complications Identified in Rett Syndrome

FRIDAY, Dec. 2 (HealthDay News) -- A high rate of early postoperative medical complications is seen among patients with Rett syndrome (RS) undergoing spinal fusion, according to a study published online Nov. 19 in Spine.

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Risk Factors ID'd for Pressure Ulcers in Prolonged Surgery

THURSDAY, Dec. 1 (HealthDay News) -- Pressure ulcer development during surgical procedures that last more than three hours is significantly related to the type of positioning device, table surface, skin assessment, and gender; with use of a foam pad and a lower day-one Braden score significantly predictive of pressure ulcers, according to a study published in the December issue of the AORN Journal.

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Anticoagulant Self-Monitoring Safe Option for Suitable Patients

THURSDAY, Dec. 1 (HealthDay News) -- Self-monitoring and self-management of oral coagulation is associated with a significant reduction in thromboembolic events and is a safe option for suitable patients of all ages, according to a review published online Dec. 1 in The Lancet.

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Global Postural Alignment Parameters Tied to Spinal Pain

THURSDAY, Dec. 1 (HealthDay News) -- Global alignment parameters, but not local spinopelvic features, are associated with low back, neck, and thoracic spine pain among adolescents before the age of attainment of peak height velocity (PHV), according to a study published online Nov. 19 in Spine.

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