Dr. Tom Smith, D.O. – Orthopaedic Surgeon – Specializing in Hip and Knee Surgery Dr. Tom Smith, D.O. - Hip and Knee Surgeon : Westchester: (630) 790 1872
News and Events - Tom Smith, D.O. - Hip and Knee Surgeon

Arthroscopic Treatment of Hip Pain in Adolescent Patients With Borderline Dysplasia of the Hip: Minimum 2-Year Follow-Up

Source: Arthroscopy: The Journal of Arthroscopic and Related Surgery

This study shows favorable 2-year outcomes in adolescent patients with borderline dysplasia undergoing labral treatment and capsular plication. Outcomes in the borderline dysplastic patients were as good as those of a control group. Although adolescents with borderline dysplasia have traditionally been a challenging group of patients to treat, these results suggest that an arthroscopic approach that addresses both labral pathology and instability may be beneficial.

Read More


Total knee arthroplasty: analysis shows EXPAREL reduces length of hospital stay and improves discharge status compared to standard analgesic modality

Source: Medical News Today

Pacira Pharmaceuticals, Inc. has announced results of new data showing that EXPAREL® (bupivacaine liposome injectable suspension) infiltration compared to a standard analgesic regimen in patients undergoing total knee arthroplasty (TKA) significantly decreased the length of hospital stay and increased the likelihood that a patient would be discharged to their home rather than a care facility when released from the hospital.

Read More


Preventing long-term complications of an ACL tear

Source: Medical Xpress

A torn ACL (also known as the anterior cruciate ligament) is one of the most common knee injuries, with as many as 200,000 cases per year in the U.S. Young people under the age of 20 are at particular risk, in part because of participa

Read More


Higher rates of complications after THA found among patients with inflammatory arthritis

Source: Healio

Patients with inflammatory arthritis who underwent total hip arthroplasty experienced higher rates of complications compared with patients who had osteoarthritis, according to results.

Read More


Outcomes of Hip Arthroscopy in Competitive Athletes

Source: Science Direct

To evaluate the minimum 2-year postoperative clinical outcomes and the rate of return to sports in athletes who underwent capsular plication for the treatment of ligamentous laxity and/or borderline dysplasia during hip arthroscopy for the treatment of femoroacetabular impingement and labral pathology.

Read More


Yogurt consumption in older Irish adults linked with better bone health

Source: Science Daily

The largest observational study to date of dairy intakes and bone and frailty measurements in older adults has found that increased yogurt consumption was associated with a higher hip bone density and a significantly reduced risk of osteoporosis in older women and men on the island of Ireland, after taking into account traditional risk factors.

Read More


Use of off-label devices increased costs and length of stay in TJA

Source: Healio

Greater length of stay, admission costs, long-term complications risks and inpatient facility discharge likelihood was found among patients who underwent total hip or knee arthroplasty with an off-label prosthesis, according to results.

Read More


Imaging identifies cartilage regeneration in long-distance runners

Source: RSNA News

Using a mobile MRI truck, researchers followed runners for 4,500 kilometers through Europe to study the physical limits and adaptation of athletes over a 64-day period, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

Read More


BLOG: Hardware complications in revision ACL reconstruction take careful consideration

Source: Healio

Revision ACLR can pose a variety of surgical challenges. Evaluation of patient risk factors, prior surgical technique, prior tunnel placement, tunnel osteolysis, prior grafts utilized and implanted hardware must be considered prior to performing a revision ACLR case.

Read More


Patient factors, not procedure, linked with major complications after surgery for femoral neck fracture

Source: Healio

The risk of major postoperative complications after hemiarthroplasty or total hip arthroplasty for treatment of femoral neck fractures is influenced by patient factors, rather than choice of procedure, according to study results.

Read More


Outcomes of ACL Reconstruction With Fixed Versus Variable Loop Button Fixation

Source: Healio

Suspensory femoral fixation of anterior cruciate ligament (ACL) grafts with fixed loop button and variable loop button devices has gained popularity for ACL reconstruction. This study examined these 2 methods of fixation to determine their effect on graft laxity and patient-reported outcome scores.

Read More


In what ways do you think 3-D printing will become more utilized in the future?

Source: Healio

Three-dimensional printing has been available for several decades. However, the enthusiasm for use in hip and knee arthroplasties has only greatly increased in the past several years.

Read More


Femoral Component Revision of Total Hip Arthroplasty

Source: Healio

This article highlights the most common indications for revision after THA and offers recommendations for how to approach revision of the femoral component.

Read More


Morbidly obese, nonobese patients experienced similar outcomes after revision THA

Source: Healio

No differences found in incidence of complications or survivorship free of reoperation or rerevision.

Read More


Study finds predictors for ACL injury are dissimilar between male and female athletes

Source: Healio

Except for increased anterior-posterior knee laxity, results from this study indicated female athletes and male athletes were not similar with regard to predictors for first-time noncontact ACL injury.

Read More


Greater wound healing, renal complications found among TJA patients with gout

Source: Healio

Recently published results showed patients with gout who underwent total joint arthroplasty had greater wound healing and renal complications compared with patients without gout.

Read More


Primary hip arthroscopy yields improved patient-reported outcome scores

Source: Healio

Patients who underwent primary hip arthroscopy experienced greater improvement in patient-reported outcome scores at 2- year follow-up compared with patients who underwent revision arthroscopy, according to recently presented data

Read More


Study: Risk stratification protocol reduced rate of postoperative aggressive anticoagulation

Source: Healio

Recently published results showed 70% of patients who underwent total hip or knee arthroplasty avoided more aggressive anticoagulation after the use of a risk stratification protocol for venous thromboembolism.

Read More


More surgeon work effort found with revision vs primary THA

Source: Healio

Recently published results showed surgeon work effort increased for revision total hip arthroplasty, with substantially longer length of surgery and length of stay and more blood loss and complications, compared with primary total hip arthroplasty.

Read More


Effect of General Anesthesia on Preoperative Hip Range of Motion in Patients Undergoing Hip Arthroscopy

Source: Healio

Hip ROM does not change to a clinically significant extent with induction of general anesthesia. Small increases in external rotation in patients with FAI or acetabular dysplasia are within the standard error for ROM measurements.

Read More


Robotic Total Knee Arthroplasty: Surgical Assistant for a Customized Normal Kinematic Knee

Source: Healio

Robotic-assisted surgery aims to improve TKA by enhancing the surgeon's ability to optimize soft tissue balancing, reproduce alignment, and restore normal knee kinematics.

Read More


Study to evaluate outcomes of different hip replacement techniques using mobile gait analysis system

Source: News Medical Net

Researchers at Hospital for Special Surgery (HSS) have launched a pilot study using a portable gait analysis mat to determine early outcomes of several different hip replacement techniques. Gait analysis provides information about the way an individual walks.

Read More


Large variation found in 3-D UKA alignment analysis for femoral, tibial components

Source: Healio

Recently published results showed large variation in the rotational plane for both femoral and tibial components during 3-D unicompartmental knee arthroplasty component alignment analysis in the standing position, suggesting the importance of component positioning.

Read More


How a 3D printer could mean a breakthrough for joint-replacement surgery

Source: NJ.com

Since last summer, Ranganathan and his team — consisting of Jill Sharkey, a member of Rowan University's class of 2017, and Ridwan Murshed, a Rowan grad student from Bangladesh — have been working to develop new pieces that would administer controlled antibiotics into the body and prevent the need to open up patients a second or third time.

Read More


Knee Injections vs. Knee Replacement: What are My Options?

Source: Medical News Today

According to the Arthritis Foundation, over 50 million Americans have arthritis. The most common form of arthritis is osteoarthritis, which is a degenerative joint disease. Though it can occur in younger people, it often affects people 50 years of age and older.

Read More


A crisis in the treatment of osteoporosis

Source: Medical Xpress

The authors state: "While there are certainly controversies in the field of osteoporosis, there are also issues upon which there is complete or near-complete agreement: specifically, there is consensus that patients with hip fracture should receive pharmacological treatment to prevent additional fractures, as they are clearly at risk for recurrent hip or other osteoporotic fractures, and initiation of bisphosphonate therapy after hip fracture has been shown to reduce the risk of a second hip fracture."

Read More


Several independent risk factors for septic knee arthritis identified

Source: Healio

Compared with Lyme disease, septic arthritis was identified in pediatric patients younger than 2 years who have pain with short arc motion, C-reactive protein levels of greater than 4 mg/L and a patient-reported history of fever, according to results

Read More


What are the Risks of Knee Replacement Surgery?

Source: Medical News Today

Knee replacement surgery is a procedure carried out to treat a knee joint that has been worn down by osteoarthritis, a disease resulting from a breakdown of joint cartilage and the underlying bone.

Read More


Anterior vs. posterior: Does surgical approach impact hip replacement outcomes?

Source: Medical Xpress

The surgical approach to total hip replacement (THR)—either from the front of the body or the side/back (anterior versus posterior)— has no impact on outcomes six months after surgery, according to research presented today at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Read More


Total knee arthroplasty: analysis shows EXPAREL reduces length of hospital stay and improves discharge status compared to standard analgesic modality

Source: Medical News Today

Pacira Pharmaceuticals, Inc. has announced results of new data showing that EXPAREL® (bupivacaine liposome injectable suspension) infiltration compared to a standard analgesic regimen in patients undergoing total knee arthroplasty (TKA) significantly decreased the length of hospital stay and increased the likelihood that a patient would be discharged to their home rather than a care facility when released from the hospital.

Read More


TXA seen as less expensive treatment option for anemic patients undergoing TJA

Source: Healio

Investigators of this retrospective study found that for patients with preoperative anemia who underwent total joint arthroplasty, treatment with tranexamic acid and packed red blood cells was significantly less expensive than treatment with either IV iron supplementation or IV erythropoietin.

Read More


Reducing opioid use prior to joint replacement surgery linked to better outcomes

Source: Medical Xpress

The use of opioids (narcotic pain medication), often prescribed for chronic musculoskeletal pain, has skyrocketed in recent years with 98 percent of the world's opioid prescriptions filled in North America. Two research studies presented this week at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), link decreased opioid use prior to joint replacement surgery with improved patient satisfaction and outcomes, fewer complications, and a reduced need for post-surgical opioids.

Read More


New pain relief technique for ACL knee surgery preserves muscle strength

Source: Medical News Today

Anesthesiologists can significantly reduce loss of muscle strength in ACL knee surgery patients using a new pain management technique, a new study has found.

Read More


TXA safe and effective to reduce blood loss in joint replacement surgery, study finds

Source: Medical Xpress

Blood loss and the need for a blood transfusion are major concerns in joint replacement surgery, but a new use for an old drug is proving effective in reducing blood loss and transfusion rates, according to a study at Hospital for Special Surgery (HSS). The drug, tranexamic acid, or TXA, has been used for decades in heart surgery, to treat hemophilia and to stop excessive uterine bleeding.

Read More


Floseal Hemostatic Matrix may improve blood-loss control in TKA

Source: Healio

Use of Floseal Hemostatic Matrix in total knee arthroplasty safely provided improved control of blood loss and reduced the predicted probability of postoperative blood transfusion, according to study results.

Read More


Common hip issue in teens misdiagnosed as pulled muscle

Source: Science Daily

An athlete felt pain in his groin after a collision at the plate with an opposing player. He thought he had pulled a muscle, but it turns out he was suffering from a common condition seen in teens and young adults known as hip impingement.

Read More


Newer UKR prosthesis for patients with osteoarthritis achieved satisfactory results

Source: Healio

Patients who received a newer prosthesis similar to the Miller-Galante knee design showed significantly better Knee Society function scores than patients who had a long-used prosthesis to which it was compared. However, the two implants performed about the same at short-term follow-up, according to a presenter.

Read More


Highly cross-linked polyethylene bearings showed low revision rate, high survivorship after THA

Source: Healio

Total hip arthroplasty performed with first-generation annealed highly cross-linked polyethylene bearings in young, active patients showed 97% survivorship at 10 years and a low revision rate for wear-related failure.

Read More


New work on knee cartilage structure to aid better replacements and injury treatments

Source: Medical News Today

Fibrocartilage tissue in the knee is comprised of a more varied molecular structure than researchers previously appreciated, according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania and the University of Delaware. Their work informs ways to better treat such injuries as knee meniscus tears - treatment of which are the most common orthopaedic surgery in the United States -- and age-related tissue degeneration, both of which can have significant socioeconomic and quality-of-life costs. The team published their work this week online ahead of print in Nature Materials.

Read More


Tobacco use linked with more complications after ACL reconstruction

Source: Healio

Researchers of this database study discovered significantly higher rates of infection, venous thromboembolism and subsequent reconstruction within 90 days following arthroscopic-assisted anterior ACL reconstruction among patients who used tobacco compared with non-tobacco users.

Read More


Use of off-label devices increased costs and length of stay in TJA

Source: Healio

Greater length of stay, admission costs, long-term complications risks and inpatient facility discharge likelihood was found among patients who underwent total hip or knee arthroplasty with an off-label prosthesis, according to results.

Read More


Study supports efficacy of closed reduction, percutaneous fixation of crescent-fracture dislocations

Source: Healio

Recently published data highlight the safety and efficacy of closed reduction and percutaneous screw fixation for the treatment of crescent fracture-dislocation of the sacroiliac joint and indicate satisfactory function and radiographic outcomes with the procedure.

Read More


Imaging identifies cartilage regeneration in long-distance runners

Source: Medical News Today

Using a mobile MRI truck, researchers followed runners for 4,500 kilometers through Europe to study the physical limits and adaptation of athletes over a 64-day period, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

Read More


Study: Simultaneous bilateral TKA yielded higher complication rates vs unilateral TKA

Source: Healio

Compared with unilateral total knee arthroplasty, patients who underwent simultaneous bilateral total knee arthroplasty experienced an increased risk of overall complications, according to study results.

Read More


After hip-replacement surgery, medication use decreases

Source: Medical Xpress

A new study, published November 15, in the journal Pain provides information on the trajectories of prescription drug use before and after hip-replacement surgery—total hip arthroplasty (THA), one of the most common types of joint replacement surgery. Hip- replacement surgery is commonly followed by long-term reductions in the use of prescription drugs for pain and insomnia.

Read More


AAOS releases criteria for treating pediatric patients with knee osteochondritis dissecans

Source: Medical News Today

The American Academy of Orthopaedic Surgeons (AAOS) has released Appropriate Use Criteria (AUC) to assist in the treatment and rehabilitation of pediatric patients with osteochondritis dissecans of the femoral condyle, also known as OCDknee.

Read More


Speaker: No single ideal treatment for periprosthetic hip fractures

Source: Healio

Management of periprosthetic fractures should be dealt with on a case by case basis, according to a presentation here.

Read More


Many young, active patients reported pain after THA, surface replacement arthroplasty

Source: Healio

Regardless of whether patients underwent total hip arthroplasty or surface replacement arthroplasty, 40% of young and active patients in this study experienced pain around the hip following surgery.

Read More


Joint Surgery Predicted By Number Of Children And Use Of HRT

Source: Medical News Today

According to a study published in the Annals of the Rheumatic Diseases, women who have many children, usedhormone replacement therapy, and had early puberty are more likely to have surgery performed on their joints - especially on their knees.

Read More


Satisfactory results seen in revision THA with acetabular reinforcement, HA granules, autograft

Source: Healio

Using acetabular revision for loosening as an endpoint, investigators of this study found more than 90% acetabular component survival at 10 years among patients who underwent revision total hip arthroplasty for acetabular bone deficiency using a Kerboull-type acetabular reinforcement device to support hydroxyapatite granules and structural autograft.

Read More


Recommendations for patient activity after knee replacement vary among surgeons

Source: Healio

During recovery after knee replacement surgery, exercise is critical. After initial recovery, patients will want to resume more strenuous activities. In addition to exercise prescribed by a physical therapist, several studies have shown patients who participated in athletic activities prior to surgery will want to continue this practice after surgery. However, how much activity and how strenuous this activity should be remains unclear.

Read More


Higher rates of obesity seen over time in patients undergoing revision TKA

Source: Healio

DALLAS — Research presented here at the American Association of Hip and Knee Surgeons Annual Meeting found patients undergoing revision total knee arthroplasty have become significantly more at risk for obesity in recent years.

Read More


Study shows value of knee replacement surgery, other options

Source: Medical Xpress

People with knees worn out by arthritis will get more pain relief from joint replacement surgery, but it has more risks and there's a good chance that less drastic approaches also would help. That's the bottom line from the first study to strictly test other treatments against knee replacement, an operation done hundreds of thousands of times a year in the U.S.

Read More


High complication rates seen in obese adolescents after Bernese PAO

Source: Healio

Despite radiographic correction of acetabular dysplasia in obese adolescents after Bernese periacetabular osteotomy, complication rates were high, according to these study results.

Read More


Activity could help keep knees lubricated

Source: Science Daily

Cartilage is filled with fluid -- about 80% of the volume of the cartilage tissue -- that plays the essential roles of supporting weight and lubricating joint surfaces. Loss of this fluid, called synovial fluid, results in a gradual decrease in cartilage thickness and increase in friction, which is related to the degradation and joint pain of osteoarthritis. Since cartilage is porous, fluid is readily squeezed out of the holes over time. Yet the symptoms associated with osteoarthritis usually take decades to develop. Researchers have now proposed a mechanism that explains how motion can cause cartilage to reabsorb liquid that leaks out.

Read More


Differing pain control methods may offer similar outcomes in patients after unilateral TKA

Source: Healio

No significant differences in pain scores and mean morphine equivalent consumption were observed among patients who received either an intra-articular or periarticular injection of bupivacaine and morphine or a periarticular injection of liposomal bupivacaine to manage pain following unilateral total knee arthroplasty, according to a presenter here.

Read More


Prevalence of Total Hip and Knee Replacement in the United States

Source: JBJS

Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown.

Read More


The use of bisphosphonate drugs is associated with an increased risk of atypical hip fractures

Source: Medical News Today

The use of bisphosphonates, a group of drugs used to prevent hip breakages in women with osteoporosis, is associated with an increased risk of atypical fractures in this joint, understood as those that occur in less frequent locations. It has been established thus in the PhD thesis by Javier Gorricho-Mendívil, a graduate in pharmacy, and read at the NUP/UPNA-Public University of Navarre.

Read More


A 48-year-old woman with right knee pain

Source: Healio

A 48-year-old woman with a history of hypertension, rheumatoid arthritis treated with chronic prednisone, and a two-pack-per-week cigarette use, presented to clinic with 8 years of right knee pain. She had an intra-articular steroid injection with some relief 6 years ago. She denied any hip pain and uses a cane for ambulation.

Read More


The Changing Landscape of Joint Replacement

Source: ICJR

Faculty from a recent ICJR symposium discuss planning and implementation of an outpatient joint replacement surgery program.

The International Congress for Joint Reconstruction (ICJR) recently sponsored a CME symposium, accredited by Marshall University, designed to help orthopaedic surgeons understand the steps involved in planning and implementing an outpatient joint replacement surgery program.

Read More


The Learning Curve for The Direct Anterior Approach

Source: ICJR

Few joint replacement surgeons were exposed to the direct anterior approach for total hip arthroplasty during their residency and fellowship – which means they’ll need additional training if they want to offer this approach to their patients.

Read More


Researchers call for consideration of pre-injury status in ACL reconstruction evaluations

Source: Healio

Investigators who studied outcomes following ACL reconstruction said they believe patients’ pre-injury status has been overlooked in determining postoperative results.

Read More


Similar results seen for ACL reconstruction with autograft, hybrid graft

Source: Healio

Satisfactory and similar subjective and objective clinical outcomes were reported in a study of patients who underwent primary ACL reconstruction with either hybrid graft or autograft.

Read More


Findings suggest nonagenarians should be considered for THA

Source: Healio

Although results of this retrospective cohort study revealed more comorbidities in patients 90 years and older who underwent total hip arthroplasty compared with younger patients, nonagenarians had comparable rates of deep vein thrombosis, infection and pulmonary embolism. However, investigators cited the higher readmission rates of the oldest patients as need for closer postoperative follow-up.

Read More


Lima Corporate completes Zimmer-Biomet assets acquisition

Source: Healio

Lima Corporate announced the completion of the assets acquisition from Zimmer Holdings for the Zimmer Unicompartmental High Flex Knee and the Biomet Discovery Elbow System within the European Economic Area and Switzerland markets, as well as the Biomet Vanguard Complete Knee System for Denmark and Sweden.

Read More


Canal-to-Diaphysis Ratio as an Osteoporosis-Related Risk Factor for Hip Fractures

Source: Healio

Prevention of osteoporosis is essential to health, quality of life, and independence in the elderly. The accepted diagnostic method for evaluation of fracture risk after osteopenia and osteoporosis is the measurement of bone mineral density with dual-energy x-ray absorptiometry (DEXA). This method is limited because of its low accessibility, high capital costs, and low sensitivity. This study evaluated whether canal diameter is a reliable indicator as a major risk factor for hip fracture in the elderly.

Read More


Routine gait analysis may be a helpful guide for post-TKA rehabilitation

Source: Healio

Many patients who underwent total knee arthroplasty did not experience improvement in their gait relative to preoperative patients by 12 months postoperatively; however, use of routine gait analysis was helpful for guiding patients’ postoperative rehabilitation and may be useful for developing strategies for mobility improvement, according to researchers’ findings.

Read More


Nearly half of patients safe for discharge by postoperative day 2 after total joint arthroplasty

Source: Healio

Among patients who underwent total joint arthroplasty required to follow the Medicare 72-hour-stay rule, 47.88% were safe for discharge to a skilled nursing facility by postoperative day 2, according to results presented at the American Orthopaedic Association Annual Meeting.

Read More


Resident performance in knee arthroscopy may improve with cadaveric skills labs, simulators

Source: Healio

Residents who trained with cadaveric skills labs and simulators experienced improved performance in knee arthroscopy compared with residents who did not, according to results presented at the American Orthopaedic Association Annual Meeting.

Read More


TKA mechanical alignment more accurate on hip-knee-ankle radiograph vs. anteroposterior radiograph

Source: Healio

Standardized anteroposterior radiographs were insufficient for the accurate assessment of the mechanical alignment of total knee arthroplasty compared with hip-knee-ankle radiographs. Additionally, anteroposterior radiographs exaggerated the varus appearance of mechanical alignment in implants, according to study results.

Read More


Poorer outcomes observed for revision unicompartmental knee arthroplasty vs primary TKA

Source: Healio

Compared with primary total knee arthroplasty, revision unicompartmental knee arthroplasty was correlated with poorer outcomes; however, researchers theorized this may have been a result of poorer preoperative function.

Read More


Most patients able to safely drive 2 weeks after THA

Source: Healio

Most patients’ brake reaction time had returned to baseline level or better within 2 weeks of undergoing total hip arthroplasty, allowing the patients to be able to drive safely again, according to study results.

Read More


TOTAL FEMORAL ARTHROPLASTY FOR THE SALVAGED FEMUR

Source: ICJR

Complicated revision total hip arthroplasty (THA) and total knee arthroplasty (TKA), septic prosthetic failure, and periprosthetic femoral fractures seem to be increasing. The expanding applications for arthroplasty in younger patients coupled with their longer lifespan is translating into more revision procedures. In addition, with the increasing population of older patients  and the increasing number of THA and TKA procedures done in this population  prostheses are being used in more osteoporotic bone and the incidence of periprosthetic fractures is increasing.

Read More


Subclinical hyperthyroidism associated with an increased risk of hip and other fractures

Source: Science Daily

In an analysis that included more than 70,000 participants from 13 studies, subclinical hyperthyroidism was associated with an increased risk for hip and other fractures including spine. Subclinical hyperthyroidism is a low serum thyroid-stimulating hormone concentration in a person without clinical symptoms and normal thyroid hormone concentrations on blood tests.

Read More


University of Iowa team developing bioactive gel to treat knee injuries

Source: Medical News Today

Injectable gel encourages self-healing of cartilage Knee injuries are the bane of athletes everywhere, from professionals and college stars to weekend warriors. Current surgical options for repairing damaged cartilage caused by knee injuries are costly, can have complications, and often are not very effective in the long run. Even after surgery, cartilage degeneration can progress leading to painful arthritis.

Read More


Researchers find clues that may predict recovery outcomes following total hip replacement

Source: Medical Xpress

Surgery to replace the arthritic hip and knee joints is on the rise in the U.S., with more than 1.1 million replacement surgeries reported in 2009. While these surgeries improve pain, mobility and quality of life for most recipients, some patients are dogged by persistent muscular problems. Now, a cross-institutional team of researchers has found that a patient's susceptibility to muscle inflammation may be a measurable marker that can be used to predict how well that patient will recover from joint replacement surgery and to identify those patients who may be in need of a specialized rehabilitation plan.

Read More


An Anterior-based Muscle-sparing Approach to THA

Source: ICJR

A 66-year-old female who has acetabular protrusio and end-stage osteoarthritis of the right hip undergoes total hip arthroplasty through the ABMSparing approach. According to the authors, this approach avoids the complications of wound healing that can occur with an approach that crosses the hip flexion crease, as well as avoids cutting muscle.

Read More


What Is the Future of Mobile-bearing Acetabular Components?

Source: ICJR

Mobile-bearing acetabular components are a relatively new design option for total hip arthroplasty. The goal of these components, say the manufacturers, is to allow a better fit with the patient s anatomy, provide greater mobility, and create a stable hip that s less prone to dislocation.

Read More


Getting the perfect fit for artificial hips

Source: Medical News Today

When a patient receives a new hip, it is usually adjusted only approximately to leg length. Greater accuracy requires a more precise measuring process as well as adjustable implants. Now, a new type of measurement method coupled with a modular implant should allow orthopedic surgeons to precisely calibrate leg length after the operation so it matches its original length.

Read More


Walking on an incline could help people suffering from knee problems

Source: Medical Xpress

Incline walking on a treadmill could benefit people with knee osteoarthritis or knee replacements, says a new study from Ball State University.

Read More


Women fare better than men following total knee, hip replacement

Source: Medical Xpress

While women may have their first total joint replacement (TJR) at an older age, they are less likely to have complications related to their surgery or require revision surgery, according to a new study presented today at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). The findings contradict the theory that TJR is underutilized in female patients because they have worse outcomes then men.

Read More


Hip Fracture Patients: Nearly half have delirium, study suggests

Source: Science Daily

48 percent of hip fracture patients, age 65 and older, had delirium, or acute confusion, before, during and after surgery (perioperative), resulting in significantly longer hospital stays and higher costs for care, a new study concludes.

Read More


A hip and trunk training program for athletes reduces ACL injuries

Source: Medical Xpress

With the help of the Hockeyroos UWA researchers have developed a hip and trunk training program that could reduce the high rates of anterior cruciate ligament (ACL) injuries in all levels of sport.

Read More


One ACL Injury Might Mean More Down the Road

Source: DailyRx

Injuries are a potential risk athletic kids face. Concussions may be getting a lot of press lately, but injuries to the knee may be just as important.

A new study found that young athletes who needed ACL (anterior cruciate ligament) surgery were likely to re-injure their knees over a 15-year period.

Read More


Weight-loss surgery before joint replacement can improve outcomes in severely overweight patients

Source: Science Daily

Bariatric surgery prior to joint replacement is a cost-effective option to improve outcomes in severely overweight patients, research demonstrates. It is well-known that obesity takes a toll on one's health. Bariatric surgery and subsequent weight loss reduces the risk of heart disease, diabetes and even some forms of cancer. But before now, the effect of bariatric surgery on joint replacement outcomes was not known.

Read More


Freezing Knees, Stopping Pain

Source: Ivanhoe

More than 10-million Americans suffer from knee pain. Drugs and surgery can be a fix, but now, there's a better option for some patients and doctors are freezing away the pain! Sixteen-year-old Abbey Watson has been running her whole life.

Watson told Ivanhoe, "I did my first 5k when I was four years old!"

The cross country athlete has even gone to states. But recently, knee pain slowed her down.

Read More


Study: Hip replacement an excellent option to relieve pain in juvenile arthritis patients

Source: Medical News Today

Implant lasts at least 10 years in 85 percent of patients Hip replacement is often performed in patients with juvenile arthritis when their joints have been severely damaged by the disease. A study at Hospital for Special Surgery (HSS) finds that the procedure is an excellent option to alleviate pain and improve function in juvenile arthritis patients under age 35 when conservative treatments fail to provide relief.

Read More


Prevention of costly hip fractures should be a priority in UK

Source: Medical News Today

Hip fractures account for an estimated £1.1 billion in hospital costs annually; costs expected to increase dramatically with aging of the population

Read More


Floseal Hemostatic Matrix may improve blood-loss control in TKA

Source: Healio

Use of Floseal Hemostatic Matrix in total knee arthroplasty safely provided improved control of blood loss and reduced the predicted probability of postoperative blood transfusion, according to study results.

Read More


Common hip issue in teens misdiagnosed as pulled muscle

Source: ScienceDaily

An athlete felt pain in his groin after a collision at the plate with an opposing player. He thought he had pulled a muscle, but it turns out he was suffering from a common condition seen in teens and young adults known as hip impingement.

Read More


Osteoarthritis patients will benefit from jumping exercise

Source: Medicalxpress

Progressive high-impact training improved the patellar cartilage quality of the postmenopausal women who may be at risk of osteoporosis (bone loss) as well as at risk of osteoarthritis. This was found out in the study carry out in the Department of Health Sciences at University of Jyväskylä, Finland. The effects of high-impact exercise were examined on knee cartilages, osteoarthritis symptoms and physical function in postmenopausal women with mild knee osteoarthritis. The study was conducted in cooperation with the Central Finland Central Hospital and the Department of Medical Technology, Institute of Biomedicine in University of Oulu in Finland.

Read More


Study shows substantial benefits in obese patients after hip arthroscopy

Source: Healio

Although obese patients undergoing hip arthroscopy started with lower absolute scores preoperatively and ended with lower overall absolute postoperative scores, they showed substantial benefit from surgery, demonstrating a degree of improvement similar to non-obese patients, according to study results.

Read More


Early knee arthritis symptoms first felt when using stairs

Source: Medical news today

People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient- reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient- reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts. The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.

Read More


Hip protector saves you when you slip

Source: ScienceDaily

Are you well used to wearing studded shoes in winter? If so, you're probably ready for yet another step towards tackling the eternally icy winter streets: a hip protector.

Read More


Dislocating a hip after total hip replacement can be a traumatic experience

Source: Medical news today

Osteoarthritis of the hip is a degenerative joint disease that, besides being painful, also has a negative impact on mobility. An affected joint can be surgically replaced with an artificial prosthesis to alleviate pain and enhance mobility and quality of life. However, when the replacement hip is forced from its normal position-a so-called dislocation-these patients frequently experience injuries, undermining their trust in the artificial joint. Depending on the trauma that caused the dislocation, it may even be necessary to replace the prosthesis.

Read More


No adverse clinical outcomes found in patients with severe varus deformity after mini-midvastus TKA

Source: Healio

In patients with severe varus deformity of the knee, mini-midvastus total knee arthroplasty had no adverse clinical outcomes as a result of poor implant position, according to study results.

Read More


Alternative for pain control after knee replacement surgery

Source: ScienceDaily

Injecting a newer long-acting numbing medicine called liposomal bupivacaine into the tissue surrounding the knee during surgery may provide a faster recovery and higher patient satisfaction, a new study has found.

Read More


Osteoporosis: Steroid Danger

Source: Ivanhoe

10-million Americans have osteoporosis and 18-million more are at risk. The bone disease leads to an increase in fractures in the hip, spine and wrist accounting for one-point-five million painful fractures each year and one woman's harrowing story of recovery is inspiring.

Read More


Link possible between oral contraceptive use, ACL injury in females

Source: Healio

Researchers from Denmark have uncovered a potential link between oral contraceptive use and instances of ACL injuries that required surgical intervention in women. The researchers evaluated 4,497 women who were treated operatively for an ACL injury between July 2005 and December 2011 and 8,858 age-matched, uninjured controls.

Read More


Staying at Home for Knee Rehab

Source: dailyRx

After a knee replacement, there's no place like home for your physical therapy - or at least home may be just as good a place as a clinic to do your exercises. In a new study, knee replacement patients who followed a six-week, monitored exercise program at home showed similar progress to those who were in regular outpatient rehabilitation programs.

Read More


Hip Resurfacing: A Better Option for Some

Source: Ivanhoe

Every year, 330-thousand Americans undergo surgery to replace hip joints that have been damaged by age or overuse. After surgery most patients can go back to their normal activities but no running, no jumping and no high impact sports for some people who have been very physically active. Now, new research shows hip resurfacing may be the better option to get them back on their feet.

Read More


Study shows PRP has no effect on patients undergoing TKA

Source: Healio

Use of platelet-rich plasma had no evident effect on patients undergoing total knee arthroplasty, according to study results. Researchers randomly assigned 40 patients who were scheduled to undergo primary unilateral total knee arthroplasty (TKA) to be treated with platelet-rich plasma (PRP) or to a control group. Patients' hemoglobin (Hb) and hematocrit levels were documented before surgery and again on days 1, 7, 14 and 28 postoperatively, and estimated blood loss was calculated. The researchers also recorded and assessed the patients' C-reactive protein (CRP) levels, range of motion, pain levels, knee extension muscle strength, knee swelling, circumference differences, Knee Society Knee Score, Knee Society Functional Score and KOOS at various time points throughout the study.

Read More


EOS imaging obtains FDA approval for hipEOS, the first 3D stereoradiographic planning software for hip arthroplasty

Source: Medical News Today

EOS imaging, the pioneer in orthopaedic 2D/3D imaging, announced today that the U.S. Food and Drug Administration has approved hipEOS, a 3D hip arthroplasty planning software based on EOS stereo-radiographic 2D/3D imaging. hipEOS is the first offering of a software portfolio associated with the EOS imaging system. Developed by OneFit medical, an EOS imaging group company, the software enables surgeons to perform, using EOS unique stereo-radiographic 2D/3D low dose images, pre-surgical planning including hip implant selection and virtual positioning in functional, weight-bearing 3D. The software takes full advantage of the bias-free, real size 3D patient anatomical information obtained from the EOS exam to help physicians define implant size and visualize pre-operatively the restoration expected from a total hip arthroplasty prior to surgery. hipEOS received a CE Mark in March 2014.

Read More


EOS receives FDA approval for THA planning software

Source: Healio

EOS Imaging recently announced the FDA has approved hipEOS, the company's new 3-D planning software for total hip arthroplasty procedures. Designed with the intent to improve preoperative planning, hipEOS allows surgeons to test everything from hip implant selection to positioning in functional, weight-bearing 3-D based on the anatomical data specific to each patient. These data stem from the company's stereo-radiographic 2-D/3-D imaging and represent the first instance of a software portfolio offered with the EOS imaging system, according to a company press release. This improvement in planning via hipEOS is believed to aid surgeons in the accuracy of the restoration they anticipate following THA.

Read More


Most dislocated hips placed within ‘safe zone’ during THA, study finds

Source: Healio

DALLAS — During their minimum 2-year follow-up, researchers here reported a 1.9% rate of subsequent dislocation after total hip arthroplasty in a contemporary practice and noted 58% of these cases had an acetabular socket position within the Lewinnek safe zone.

“Most contemporary total hip arthroplasties that dislocate are within the Lewinnek safe zone,” Matthew P. Abdel, MD, said during his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “Cup position for some patients certainly lies outside this safe zone. Most importantly, new technologies will need better targets to hit prior to them being clinically relevant or economically feasible.”

Read More


Researchers found better cup, stem survival after early THA

Source: Healio

Patients who underwent early total hip arthroplasty experienced better 10-year cup and stem survival compared with patients who underwent late total hip arthroplasty, according to study results.

Researchers searched the Medline databases from January 1990 to January 2014 and retrieved 19 articles reporting on the management of posttraumatic arthritis of the hip following acetabular fractures with the use of late total hip arthroplasty (THA), as well as articles where acetabular fractures were treated with early THA. In all, the researchers assessed THA outcomes following acetabular fracture in 654 patients.

Read More


Prehabilitation Could Help Knee and Hip Replacement Patients Recover

Source: Daily Rx

With the number of total knee and hip replacements on the rise, doctors are looking for ways to reduce the amount of care needed after surgery. Prehabilitation (physical therapy before surgery) could help patients recover faster and save money.

Rehabilitation following knee or hip replacement is the standard of care. The physical therapy is designed to help patients adjust to new joints and strengthen muscles.

A new study found that physical therapy before the joint replacement surgeries reduced the need for rehab after the surgery.

Read More


Intra-articular tranexamic acid benefitted TKA patients without increased risk of DVT, PE

Source: Healio

Among patients who underwent total knee arthroplasty, intra-articular tranexamic acid significantly reduced total blood loss, drainage, reduction of hemoglobin and the need for transfusion without increasing the incidence of deep venous thrombosis and pulmonary embolism, making it safe and efficacious, according to study results.

Through a search of various databases for relevant randomized, controlled trials, researchers included seven studies comprising 622 patients. The researchers calculated mean difference in total blood loss, risk ratio for transfusion and complication rate in the tranexamic acid-treated group vs. the placebo group.

Read More


Acoustic technique developed to detect knee osteoarthritis

Source: Medical News Today

A revolutionary medical technique using sound waves to identify osteoarthritis in the knee has been developed by researchers.

The UK is leading this new field of health research based on listening to the sounds emitted by the body.

Microphones are attached to the knees of patients, and the high frequency sound waves emanating from their knees are measured as they stand up. These acoustic emissions are interpreted by computer software to give information about the health of the patient's knee.

Read More


Pacira Pharmaceuticals Inc. announces new data on the use of EXPAREL to treat postsurgical pain following total knee arthroplasty

Source: Medical News Today

Pacira Pharmaceuticals, Inc. has announced results of an independent, physician-initiated study designed to evaluate the difference in postsurgical pain and opioid consumption between patients who received EXPAREL versus a multi-drug analgesic cocktail for pain management following total knee arthroplasty (TKA). The data, presented at the annual meeting of the American Association of Hip and Knee Surgeons (AAHKS), found that patients treated with EXPAREL reported significantly lower patient-perceived pain scores and morphine sulfate equivalence consumption, and reported higher satisfaction with pain control and overall experience, compared with patients who received the multi-drug analgesic cocktail.

Read More


No functional differences found between short-, straight-stem THA implants
Source :
Healio

Recently published study data indicated short-stem and straight-stem implants for total hip arthroplasty exhibited no significant differences in functional outcome measures.

Researchers conducted a randomized, double-blinded study of 80 patients who underwent total hip arthroplasty (THA). Patients were grouped by whether their THA utilized a short-stem or conventional straight-stem implant. Radiological and functional outcomes were evaluated at 6 weeks postoperatively, and quality of life was quantified via Harris Hip Score, SF-36 and WOMAC scores.

No significant changes in offset differences were observed in either group from before surgery to after surgery. At final follow-up, no significant differences between groups were found in Harris Hip Score, SF-36 or WOMAC values, according to the researchers.

Comparison of long-term survival rates among both cohorts will help determine whether short stems are a viable alternative THA solution, the researchers concluded.

Read More


Chronic kidney disease increases prosthetic joint infection rates after TJA
Source :
Healio

Patients with stage 1, 2 or 3 chronic kidney disease may have a higher rate of prosthetic joint injection after total joint arthroplasty, according to study results.

Researchers retrospectively reviewed electronic medical records for 377 patients with stage 1 to 2 kidney disease with 402 patients who had stage 3 chronic kidney disease. All patients underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2004 and 2011.

Patients with stage 3 chronic kidney disease had a greater rate of overall mortality compared with patients with stage 1 to 2 chronic kidney disease, according to the researchers.

When adjusted for comorbid disease, the researchers found no significant increases in joint infection, readmission or early revision between patients with stage 1 to 2 chronic kidney disease compared with patients with stage 3 chronic kidney disease.

Compared with patients with end-stage renal disease, dialysis and kidney transplant, overall incidence of infection was high but much less in chronic kidney disease patients.

In a subgroup analysis, the significant difference in mortality rate persisted between the stage 1 to 2 group vs. the stage 3 group in patients who had undergone THA, but not in patients who had undergone TKA, according to the researchers.
Study results showed a slightly lower rate of 90-day readmission in patients with stage 1 to 2 chronic kidney disease who underwent TKA than in patients with stage 3 chronic kidney disease, whereas 90-day readmission was slightly higher in the THA subgroup.

Read More


Higher baseline expectations for TJR improved health-related quality of life, satisfaction
Source :
Healio

Health-related quality of life and satisfaction improved among patients who had higher expectations for total joint replacement at baseline compared with patients who had lower expectations, according to study results.

Researchers recruited 892 patients preparing for total joint replacement (TJR) of the knee or hip due to primary osteoarthritis. Before surgery and for 12 months afterward, patients completed questionnaires with five questions about expectations before surgery; an item to measure satisfaction; WOMAC and SF-12; and questions about sociodemographic information. The researchers performed general linear models and logistic regression analysis to determine the association of patients’ expectations at baseline with satisfaction and changes in health-related quality of life (HRQoL) 12 months after surgery.

Study results showed larger improvements in HRQoL at 12 months among patients who had higher pain relief or ability to walk expectations. WOMAC and SF-12 physical component summary domains also improved more among patients with high expectations regarding the ability to walk, interact with other and psychological wellbeing expectations, according to the researchers.
Patients with very high expectations on the SF-12 physical component summary regarding their ability to walk and with high or very high pain relief expectations on SF-12 mental component summary experienced better improvement compared with patients with low expectations, the researchers found.

The researchers also found patients who had high or very high daily activities expectations were more likely to be satisfied.

Read More


Older patients still fastest-growing demographic for TKA
Source :
Healio

Despite total knee arthroplasty becoming more prevalent in patients younger than 65 years of age, the main demographic of growth is still among patients older than 65, according to recent study data.

Researchers compared 1999 to 2008 U.S. census data for individuals 18 to 44 years old, 45 to 64 years old, and 65 years and older and the number of total knee arthroplasties (TKAs) performed annually in each age group. Per-capita incidence rates were calculated, and the growth rate in all demographics was determined.

Approximately 305,000 TKAs were performed beyond the number predicted by population growth alone in 2008. Patients older than 65 years of age represented the largest growing cohort, as 151,000 recorded TKA procedures and a per-capita growth rate from 5.2 to 9.1 procedures per 1,000 individuals was observed. Per-capita growth rate also increased from 1.4 to 3.3 procedures per 1,000 individuals among patients 45 to 64 years old.

TKAs were found to have increased 234% during the span of this study, from 264,000 in 1999 and approximately 616,000 in 2008, with fewer than 48,000 of the additional procedures able to be explained by population increase, according to the researchers.

Read More


TKA provides excellent outcomes after lower-extremity amputation
Source :
Healio

Although total knee arthroplasty is rare after lower-extremity amputation, it can provide excellent functional and clinical outcomes, according to study results.

Researchers reviewed 13 primary total knee arthroplasties (TKAs) in 12 patients with prior lower-extremity amputation, among which 12 TKAs were performed on the contralateral side of the amputated limb and one was performed on the ipsilateral side. Using clinical examinations and patient surveys, the researchers calculated preoperative and postoperative Knee Society scores. The study’s primary endpoint was failure, which was defined as revision for any reason. Average clinical follow-up occurred at 6.8 years.

The researchers observed improvement in Knee Society scores from 30.4 preoperatively to 88.5 following TKA with a prior contralateral amputation.

At final follow-up, radiographic evidence of aseptic loosening of the tibial components was observed in 23.1% of patients, and the researchers recommended augmentation of tibial fixation with a stem during TKA after contralateral amputation.

Read More


Regular physical activity improved patient satisfaction after TKA
Source :
Healio

Patients who participated in regular physical activity after undergoing total knee arthroplasty experienced improved satisfaction with their outcomes, according to study results.

Researchers evaluated physical activity profiles of 369 patients before and after total knee arthroplasty (TKA) using a questionnaire that contained the University of California — Los Angeles activity scale and types of sports activities. Using subgroup comparisons and partial correlation analyses, the researchers assessed the associations of socio-demographic features and postoperative functional outcomes with the physical activity levels, as well as the effects of regular physical activity on patient satisfaction with replaced knees.

Both before and after TKA, study results showed the three most common sports activities were walking, swimming and bicycling. Although the mean activity level remained similar after TKA, the frequency of moderate activity levels and moderate types of physical activities increased, according to the researchers.

The researchers also found higher postoperative activity levels reported by patients with higher postoperative function scores. However, socio-demographic factors were not associated with activity level. Overall, greater patient satisfaction was associated with regular physical activity.

Read More


Regional anesthesia for hip fracture surgery was not associated with increased 30 day mortality compared to general anesthesia
Source:
dailyRx

A hip fracture can mean surgery and a hospital stay. The type of anesthesia used in that surgery might affect the length of the hospital stay and recovery. Researchers compared the two types of surgical anesthesia in hip fracture patients and found that there was no difference in survival a month after surgery. Patients who had regional anesthesia had a slightly shorter hospital stay.

Read More


Prior TKR or revision THR causes increased periprosthetic fractures
Source:
Healio

Periprosthetic fractures are especially common in patients with prior total knee replacement or revision total hip replacement a decade after primary total hip replacement, according to study results.

Researchers identified 58,521 Medicare beneficiaries who had elective primary total hip replacement (THR) for non-fracture diagnoses between July 1995 and June 1996 and followed them using Medicare Part A claims data through 2008. Using ICD-9 codes, researchers identified periprosthetic femoral fractures occurring from 2006 to 2008. The incidence density method was used to calculate the annual incidence of periprosthetic femoral fractures, and Cox proportional hazards models were used to identify risk factors for periprosthetic fracture. The risk of hospitalization during the subsequent year was also calculated.

Overall, 55% of patients who had elective primary THR between July 1995 and June 1996 survived until January 2006, with 0.7% of these patients developing a periprosthetic femoral fracture between 2006 and 2008. The researchers found an annual incidence of periprosthetic fractures of 26 per 10,000 person-years among these individuals.

According to Cox proportional hazards models, patients had a greater risk of periprosthetic fracture after having a total knee replacement or a revision total hip replacement between the primary THR and 2006. The researchers found a three-fold higher risk of hospitalization in the subsequent year among THR patients who sustained periprosthetic femoral fracture compared with patients without fractures.

“These data will help clinicians as they portray to patients and their families the long-term concerns associated with living with a hip implant,” the researchers wrote. “The message is that periprosthetic fractures are relatively rare, though more frequent in patients with multiple implants. Further, these fractures are typically associated with the need for considerable subsequent medical care, as they are accompanied by a much greater risk hospitalization in the subsequent year than experienced by THR recipients who did not have hip fracture.”

Read More


Comparable readmission rates found for inpatient and outpatient TJA
Source:
Healio

Patients undergoing outpatient total joint arthroplasty had readmission rates, number of emergency room visits and patient satisfaction outcomes comparable patients who underwent inpatient procedures, according to a presenter at the American Academy of Orthopaedic Surgeons Annual Meeting.

“There has been a recent demand in outpatient total joint arthroplasty [TJA] stemming from better protocols, pain management and physical therapy,” Walter B. Beaver Jr., MD, medical director at OrthoCarolina in Charlotte, N.C., said. “The big question is, are there safety concerns with outpatient TJA? And more recently, there are concerns about penalties for readmission.”

According to Beaver and his colleagues, under the Patient Care and Affordability Act, Medicare is focusing on 30-day readmission rates for certain diagnoses and is penalizing hospitals financially for readmissions in this timeframe. “In 2015, [CMS is] probably going to include total hip and total knee arthroplasty in the penalties for readmission, and the penalties may be a maximum of 3%,” Beaver said.

Study inclusion criteria

Beaver and his colleagues sought to determine whether outpatient or inpatient TJA influenced hospital readmission rates during the 30-day postoperative period. They completed telephone surveys with 235 patients, including 137 outpatients and 98 inpatients who underwent TJA at the same institution between September 2010 and May 2011. One surgeon performed all of the outpatient TJAs, and two surgeons who performed the inpatient TJAs, which included hospital stays with a minimum of 2 days.

Criteria for outpatient TJA included a body mass index of less than 40 kg/m2 and no active cardiopulmonary issues, sleep apnea, or history of deep venous thrombosis or pulmonary embolus. Patients also had to live less than 1 hour from the hospital and have good family support.

Readmission rates were 5.7% for inpatient TJA vs. 10.1% for outpatient TJA. “At our cohort size, there was no statistical significance seen,” Beaver said.

When researchers included emergency room visits with readmissions, 6.7% of inpatients and 12.4% of outpatients required unplanned medical care after hospital discharge; again, according to Beaver, this difference was not statistically significant.

Readmission rates

Researchers observed no statistically significant differences between the two groups for readmission during the first 4 postoperative days or when stratified by joint: In the inpatient group, seven total knee arthroplasty (TKA) patients and no total hip arthroplasty (THA) patients were readmitted during the 30-day postoperative period, and in the outpatient group, 16 TKA patients and one THA patient were readmitted.

Both patient groups reported high patient satisfaction, with no statistically significant difference between the two groups.

“There was no statistical difference when looking at 30-day hospital readmission rate and patient satisfaction,” Beaver said. “However, there was a higher readmission rate for the outpatient surgery group, which was clinically meaningful. This may have financial implications due to higher readmission rates for the outpatient group. Implications could affect bundled payments in the future, and this is especially true for total knee arthroplasty.”

Read More


Hepatitis C infection did not affect outcomes after total hip arthroplasty
Source:
Healio

Clinical and patient-reported outcomes following total hip arthroplasty in patients with chronic hepatitis C were comparable to outcomes of patients without the infection at a mean 6-year follow-up, according to a presenter at the American Academy of Orthopaedic Surgeons Annual Meeting.

“Hepatitis C can affect approximately 3% of orthopedic patients, many of whom undergo total joint arthroplasty,” said Samik Banerjee, MBBS, MS, MRCS (Glasg), of the Department of Orthopaedic Surgery and Center for Joint Preservation and Replacement at the Rubin Institute for Advanced Orthopedics and Sinai Hospital of Baltimore. “However, there has been a paucity of reports on the outcomes of primary total hip arthroplasty in patients with hepatitis C.”

Similar implant survivorship

Banerjee and his colleagues compared the clinical and patient-reported outcomes of 49 patients (54 hips) who underwent primary total hip arthroplasty (THA) to a matched cohort of 148 THAs in patients without hepatitis C. All patients underwent THA during 2002 to 2011. Patients with hepatitis C included 10 women and 39 men who had a mean age of 57 years. Mean follow-up was 6 years, and the underlying cause of hip disease was end-stage osteoarthritis in 49 hips and avascular necrosis in five. Patients were matched according to age, gender, body mass index, cause of hip disease and mean follow-up duration.

Overall implant survivorship was statistically similar between the groups: 98% in the patients with hepatitis C and 98.5% in the matched control group. “The hepatitis C group had one aseptic revision, while the matched cohort had two revisions during this period,” Banerjee said during his presentation.

Researchers also found no difference between the groups in the postoperative Harris hip score, with an improvement to a mean of 89 points in the patients with hepatitis C and an improvement to a mean of 90 points in the comparison group.

Superficial infection, hematoma

Banerjee and colleagues also reported no significant differences in the complication rate between the groups, but in the hepatitis C group, he and his colleagues found a superficial infection and two wound hematoma cases. Furthermore, they found no differences in the SF-36 physical and mental component scores or UCLA activity scores. Postoperative radiographic evaluation revealed no component malalignment, symptomatic progressive radiolucencies, change in component position or implant subsidence.

“From our study, we can agree [with previously published data] that there is no difference in aseptic implant survivorship, activity levels or functional outcomes after THA,” Banerjee said. “We believe that a prior history of chronic hepatitis C alone may not predict inferior clinical outcomes, and we also believe more prospective studies are necessary to better evaluate these outcomes.”

Read More


Blood Metal Ions Tied to Failed Hip Replacement, Resurfacing
Source:
HCP live

Raised levels of blood metal ions are associated with failed metal-on-metal hip resurfacings and total hip arthroplasties, according to a study published in the July 2 issue of The Journal of Bone & Joint Surgery.

The researchers found that patients with failed arthroplasty had significantly higher blood cobalt and chromium ion levels than patients with non-failed arthroplasty (P < 0.01).

Read More


Partial knee replacement safer than total knee replacement
Source:
Medical News Today

Partial knee replacement surgery is safer than total knee replacement according to a new study published in The Lancet.

Patients who had a partial knee replacement are 40 per cent more likely to have a re-operation, known as revision surgery, during the first eight years after the replacement, than those that had a total knee replacement.

Read More


Obesity may be driving increasing need for knee and hip replacements in steadily younger patients
Source:
dailyRx

The impact of being overweight has far reaching health implications — implications that may be taking a toll at an earlier age.

In a new study, researchers found that packing on the pounds may be setting the stage for total knee or hip replacement at increasingly younger ages.

Further, the scientists found that being overweight or obese had a greater impact on the knee than the hip.

Read More


New approach to total knee replacement spares muscle, decreases pain
Source:
The Daily Progress

Total knee arthroplasty, also known as total knee replacement, is one of the most commonly performed orthopedic procedures. According to the American Academy of Orthopedic Surgeons, as of 2010, more than600,000 total knee replacements were being performed annually in the United States. The number of total knee replacements performed annually in the U.S. is expected to grow by 673 percent to 3.48 million procedures by 2030.

To start, a rigorous preoperative optimization process is now in place to help minimize the risk of complications after surgery. Patients also attend a joint education class to be advised of what to expect before, during and after the surgery. Studies have shown that these educational classes improve patient outcomes.

Read More


Semi-constrained implant improves revision knee arthroplasty outcomes
Source:
OrthoSpineNews

Use of a semi-constrained implant in revision knee arthroplasty produced acceptable implant survival and functional outcomes during the long-term follow-up period, according to study results.

Read More


Are doctors performing too many unnecessary knee-replacement surgeries?
Source:
CBS News

More than one-third of total knee replacements performed in the U.S. were deemed "inappropriate" in a new study that used a patient classification system to weigh the risks and benefits.

The study, published June 30 in the journal Arthritis & Rheumatology, looked at 175 people who underwent total knee replacement surgery.

Read More


Ask a Sports Medicine Doc: Hip injuries among youth
Source:
VailDaily

Q: My 14 year old daughter is a competitive ski racer and has been having hip pain. Could she have a labral tear?

A: Hip injuries are on the rise in adolescent athletes. This is due to the increasing number of young athletes participating in organized sports as well as advances in technology that have improved clinician’s diagnostic ability.

Read More


Smith & Nephew DYONICS(TM) PLAN brings first-of-its-kind, individualized surgical planning to hip arthroscopy
Source:
The Wall Street Journal

Smith & Nephew (NYSE:SNN;LSE:SN), the global medical technology business, will launch its DYONICS PLAN Hip Impingement Planning System at this week's American Academy of Orthopaedic Surgeons (AAOS) annual meeting in New Orleans. Unlike standard imaging tools, DYONICS PLAN is a revolutionary 3D software system that allows surgeons to visualize, assess and generate a comprehensive surgical report for each patient's unique Femoroacetabular impingement (FAI) surgery before that patient ever enters the operating room.

Read More


MRI to 'see through' metal screws developed to follow patients after hip fracture surgery
Source:
ScienceDaily

People who sustain the most common type of hip fracture are at increased risk of complications. A special type of MRI has been developed that can show a detailed image following fracture repair, without the distortion caused by metal surgical screws that are problematic in standard MRIs. Each year, more than 340,000 people suffer a broken hip in the United States.

Read More


Genetics may explain high-functioning senior athletes with hip abnormalities
Source:
ScienceDaily

Genetics may explain why some senior athletes are high functioning despite having one or both hip abnormalities typically associated with early onset osteoarthritis: developmental dislocation of the hip (dysplasia), a loose hip joint; or femoroacetabular impingement (FAI), a condition in which the hip bones are abnormally shaped.

Read More


Magnesium may protect against hip fractures
Source:
ScienceDaily

Drinking water with a relatively high concentration of magnesium protects against hip fractures, according to results of a new study. The researchers studied variations in magnesium and calcium levels in drinking water between different areas, as these are assumed to have a role in the development of bone strength. They wanted to examine whether there was a correlation between magnesium and calcium concentrations in drinking water and the incidence of hip fracture. The study results show that magnesium protects against hip fracture for both men and women. The researchers found no independent protective effect of calcium.

Read More


Silk-based surgical implants could offer a better way to repair broken bones
Source:
ScienceDaily

Using pure silk protein derived from silkworm cocoons, investigators have developed surgical plates and screws that offer improved remodeling following injury and can be absorbed by the body over time. When a person suffers a broken bone, current treatment calls for the surgeon to insert screws and plates to help bond the broken sections and enable the fracture to heal. These "fixation devices" are usually made of metal alloys. But metal devices may have disadvantages: Because they are stiff and unyielding, they can cause stress to underlying bone, among other problems.

Read More


Complication rates for nonagenarian patients similar to those of younger patients undergoing total hip replacement surgery
Source:
Medical News Today

As more Americans are living well into their 90s, the number of nonagenarian total hip replacement (THR) candidates continues to increase.

The authors of the study concluded that nonagenarian patients can safely undergo a THR, despite advanced age and a higher prevalence of comorbidities. Overall, the nonagenarian patients experienced a complication rate comparable to those of younger THR patients, and the higher mortality rate is well within expectations for individuals age 90 and older.

Read More


Glucosamine fails to prevent deterioration of knee cartilage, decrease pain
Source:
ScienceDaily

Oral glucosamine supplementation is not associated with a lessening of knee cartilage deterioration among individuals with chronic knee pain, a short-term study found. Findings indicate that glucosamine does not decrease pain or improve knee bone marrow lesions -- more commonly known as bone bruises and thought to be a source of pain in those with osteoarthritis.

Read More


More osteoarthritis noted later in life in kids who have ACL reconstruction
Source:
ScienceDaily

Adolescents who have an Anterior Cruciate Ligament (ACL) reconstruction are more likely to demonstrate osteoarthritic changes later in life, researchers have discovered. “Early reconstruction of ACLs is often the trend for young more skeletally mature athletes to restore knee stability and prevent progressive meniscal and/or articular cartilage damage. Often these procedures do allow individuals to return to the playing field and continue an active lifestyle. However, it is still important to evaluate long-term effects such as osteoarthritis when considering surgeries for these pediatric patients,” said the lead researcher.

Read More


Women report more pain than men after knee replacement surgery, study shows
Source:
ScienceDaily

One of the biggest concerns of patients considering knee replacement is the amount of pain they will have after surgery. Although it is a very successful operation overall to relieve arthritis pain and restore function, persistent postoperative pain can be a problem for some individuals. Researchers determined which patients were at highest risk for increased postoperative pain based on demographic and surgical variables.

Read More


Chance of falling after knee replacement not increased by regional anesthesia
Source:
ScienceDaily

Two types of regional anesthesia do not make patients more prone to falls in the first days after having knee replacement surgery as some have previously suggested, according to a study based on nearly 200,000 patient records. Regional forms of anesthesia – spinal or epidural (neuraxial) anesthesia and peripheral nerve blocks (PNB) – which only numb the area of the body that requires surgery, provide better pain control and faster rehabilitation and fewer complications than general anesthesia, research shows. But some surgeons avoid using them due to concerns regional anesthesia may cause motor weakness, making patients more likely to fall when they are walking in the first days after knee replacement surgery.

Read More


Select rheumatoid arthritis patients can safely undergo same-day double knee replacement
Source:
Medical News Today

Same-day bilateral knee replacement surgery is safe for select patients with rheumatoid arthritis, researchers from Hospital for Special Surgery in New York have found.

Generally, patients with an inflammatory systemic disease such as rheumatoid arthritis (RA) are sicker than patients with the degenerative condition osteoarthritis (OA), says senior study author Mark Figgie, M.D., chief of the Surgical Arthritis Service at Hospital for Special Surgery, and the hospital's first Allan E. Inglis, MD, Chair in Surgical Arthritis.

Read More


The leading cause of failed prosthetic knee joints is infection
Source:
Medical News Today

The number of total knee replacement (TKR) procedures continues to climb, as does the number of revision total knee replacement (RTKR) surgeries.

Elderly and female patients with a moderate number of comorbidities represented the largest proportion of the revision population. The authors suggest that optimizing patient health before surgery and paying meticulous attention to efforts by the surgical team to minimize the risk of periprosthetic joint infection may decrease the number of knee replacement revisions.

Read More


Improving knee replacements with iASSIST system
Source:
ScienceDaily

Each year, approximately 600,000 total knee replacement procedures are performed in the United States, a number that is expected to rise in the next decade as the population ages. For the first time in the United States, an iASSIST system is now in use. iASSIST is a computer navigation system with Bluetooth-like technology that improves surgical precision and accuracy in total knee replacements, decreasing the need for revision surgery.

Read More


Colles' fracture patients found to be at risk for later hip fracture
Source:
dailyRx

Certain types of bone fractures have the potential to put you at risk for further bone fractures — even on a different part of your body. Wrist and hip fractures are one of these combinations. A recent study found that patients who have suffered a Colles' wrist fracture are at a significantly higher risk of experiencing a hip fracture, compared to people who have not had a Colles' fracture. The researchers found that osteoporosis (bone disease) is a risk factor associated with hip fracture, especially if a patient has had a Colles' fracture and has osteoporosis.

Read More


Drugs Related to Cannabis Have Pain-Relieving Potential for Osteoarthritis
Source:
ScienceDaily

Chemical compounds synthesized in the laboratory, similar to those found in cannabis, could be developed as potential drugs to reduce the pain of osteoarthritis.

These compounds could also reduce joint inflammation, according to new research carried out at the Arthritis Research UK Pain Centre at The University of Nottingham.

Read More


Multidisciplinary treatment can help with pain after TKA or THA
Source:
Healio

Multidisciplinary pain treatment has been shown in a recent study to one way to aid patients following total knee arthroplasty and total hip arthroplasty procedures.

In the study, investigators found that multidisciplinary pain treatment (MPT) “has beneficial short-term and mid-term effects on subjective pain intensity, physical capability and depression levels in patients with persistent pain after joint arthroplasty,” lead author Christian Merle, MD, MSc, and colleagues, wrote.

Merle and colleagues conducted a retrospective study that followed 40 patients (mean age 62 years) with persistent unexplained pain following total knee arthroplasty (TKA) or total hip arthroplasty (THA) that previous treatments were unable to rectify. The procedures were performed between April 2007 and April 2010.

The evaluations, which were done before MPT, after 3 weeks of MPT and at 32 months mean follow-up, focused on the patients’ pain intensity, physical capability and psychological status, according to the study.

All the scores used showed a significant improvement at the completion of MPT over the baseline pain scores. At 32 months’ follow-up, pain intensity, physical capability and depression levels deteriorated slightly, but were significantly better than at baseline.

The results showed 79% of the 34 patients available for final follow-up reported a reduction in pain on the Numeric Rating Scale of 0.5 to 5.0 points. All patients reported pre-MPT NSAID use, 41% of patients continued to use NSAIDs and15% of them reported using opioids after 32 months.

Because MPT helps to alleviate unexplained pain following TKA and THA, Merle and colleagues noted in the study it may help patients avoid exploratory revision surgery.

Read More


Study: Good results seen with algorithmic approach in treatment of hip instability
Source:
Healio

Hip instability can be successfully managed using a six-part algorithm that helps surgeons identify and treat variations in instability, according to a presenter at the Current Concepts in Joint Replacement Winter Meeting, here.

“Our conclusion, then, is this demonstrates a six-part algorithm for treating an unstable hip,” Wayne G. Paprosky, MD, said. “We think it is probably one of the most successful series of its size. We are now advocating the use of tripolar constrained liners where possible, especially in these type III abductor deficiencies.”

Paprosky and colleagues performed a retrospective analysis of 77 consecutive hip arthroplasties that were revised due to instability, according to the abstract. They identified six variations of instability and placed patients in numbered from one to six based on the etiology of the instability, which included acetabular component malposition, femoral component malposition, abductor deficiency, impingement, late wear, or “unclear etiology.”

Once the instability was identified, type I and II instabilities were treated with component revision, type III and VI instabilities were treated with a constrained liner, type IV instabilities were treated by removing the impingement and type V was treated with a liner change.

The success rate was 84.4% for all treatments of instability. When treatment for type III abductor insufficiencies were removed, which accounted for 8 of 12 revisions in the study, the success rate was 92%, according to the abstract.

Read More


Obese patients have high risk of complications after TJR, but high BMI does not contraindicate surgery
Source:
Healio

Obese patients who undergo total joint replacement have a higher risk of complications, but there is no body mass index level where the surgery would be contraindicated, according to a recent presentation, here.

“We understand that notable obesity increases most complications,” Daniel J. Berry, MD, said at the Current Concepts in Joint Replacement Winter Meeting. “There is no [body mass index] BMI threshold, but we should use good judgment in whether we operate on patients at a high BMI, and remember the rate of complications seems to rise fast above a BMI of 40.”

For patients who undergo total hip arthroplasty, complications such as nerve injury, infection and wound healing are increased, according to the abstract. Berry noted that although obese patients have lower functional and activity scores compared to nonobese patients, obese patients start with lower functional and activity scores so pain relief and postoperative change is comparable.

Berry said strategies for patients to lose weight before joint replacement surgery include diet and bariatric surgery. However, he noted weight loss through surgery may result in a patient who is malnourished. If a surgeon decides to perform total joint replacement surgery on an obese patient, Berry recommended optimizing metabolic, wound and anticoagulant management to reduce postoperative complications. Overall, he said it is important to include the patient in the decision-making process.

“Use good surgical judgment, consider carefully in each patient [whether] the risks are greater than the benefits and engage the patient in the shared decision-making process,” he said. “They understand they have a high body mass index. It is helpful for them to be engaged in the discussion so whatever the outcome of surgery they feel like they participated in the decision.”

Read More


Risk Factors for Complications After Knee Replacement
Source:
dailyRx

While knee replacement surgery can help to improve mobility, there can be complications connected to this procedure. And some patients may be at a higher risk for experiencing these complications than others. A recent study found that being older, having diabetes and being obese were significant risk factors for death or experiencing complications like wound infections in the 30 days after knee replacement surgery. The authors of this study noted that patients and physicians should be mindful of any new symptoms or pain that occurs after having knee replacement surgery.

Read More


Research to Revolutionize Indications for Knee Surgery
Source:
ScienceDaily

The Finnish Degenerative Meniscal Lesion Study (FIDELITY) compared surgical treatment of degenerative meniscal tears to placebo surgery. A year after the procedure the study participants, both those in the group who underwent surgery and the ones in the placebo group, had an equally low incidence of symptoms and were satisfied with the overall situation of their knee.

Read More


Stem Cell Therapy Following Meniscus Knee Surgery May Reduce Pain, Restore Meniscus
Source:
ScienceDaily

A single stem cell injection following meniscus knee surgery may provide pain relief and aid in meniscus regrowth, according to a novel study appearing in the January issue of the Journal of Bone and Joint Surgery (JBJS).

In the first-of-its-kind study, "Adult Human Mesenchymal Stem Cells (MSC) Delivered via Intra-Articular Injection to the Knee, Following Partial Medial Meniscectomy," most patients who received a single injection of adult stem cells following the surgical removal of all or part of a torn meniscus, reported a significant reduction in pain.

Read More


What Patients Need to Know About Revision Surgery After Hip or Knee Replacement
Source:
ScienceDaily

Hundreds of thousands of hip and knee replacement surgeries are performed in the United States each year, and they are highly successful in eliminating pain, restoring mobility and improving quality of life.

Over the past two years, Dr. Westrich has seen a sharp increase in the number of people coming in for a second hip or knee replacement, called a revision surgery. When the implant wears out or another problem develops, people often need a second surgery in which the existing implant or components are taken out and replaced.

Dr. Westrich says patients should be aware of warning signs that there may be a problem, such as pain that comes on suddenly or trouble getting around. They also may have decreased range of motion. Anyone with a joint replacement experiencing these symptoms should see their doctor immediately, Dr. Westrich adds.

Read More


Patient age, diabetes increase mortality risk after TKA
Source:
Healio

Older patients and patients with diabetes have an increased risk of mortality and postoperative complications following primary total unilateral knee arthroplasty, according to recently published data.

Philip J. Belmont, Jr., MD and colleagues studied 15,321 patients who underwent primary unilateral total knee arthroplasty (TKA). They found that the results “underscore that diabetes mellitus and increased age are notable risk factors for mortality.”

The patients in the study had a mean age of 67.3 years. Overall, 61.2% of the patients were classified as having obesity, 18.2% of the patients had diabetes, and 50% of the patients were graded as class 3 or higher on the basis of the American Society of Anesthesiologists (ASA) classification system.

The researchers found a 30-day mortality rate of 0.18%. Overall, 1.83% of the patients had major complications and 5.6% of the patients experienced overall complications. Cardiac arrest (44%), systemic shock (18.5%) and renal failure (18.5%) were the most common specific complications among the patients who died. Risk factors for complications after TKA were an age of 80 years or older, operative times greater than 135 minutes, body mass indices of 40 kg/m2 or greater, and ASA classification of 3 or greater.

“The 2.2% mortality or major complication rate that we found for patients who underwent a unilateral TKA confirms the need for diligent medical management during the perioperative period,” Belmont stated in the study.

Read More


Preoperative erythropoietin may reduce allogenic blood transfusion in hip, knee arthroplasty
Source:
Healio

Researchers performed a systematic review of randomized clinical trials and found using preoperative erythropoietin-stimulating agents increased hemoglobin levels in patients undergoing elective hip and knee arthroplasty.

“Erythropoietin improves postoperative hemoglobin levels and decreases the need for allogeneic blood transfusion in patients undergoing hip or knee surgery,” Khalid Alsaleh, MD, and colleagues wrote in the study.

Alsaleh and colleagues evaluated 26 trials with 3,560 participants who underwent unilateral, bilateral, primary or revision hip or knee arthroplasty, according to the abstract. Patients were given erythropoietin-stimulating agents (ESAs) preoperatively and compared with patients undergoing similar surgeries who received preoperative autologous blood donation, intravenous iron or placebo.

Receiving preoperative ESAs increased hemoglobin levels in that patient group. Between the ESA group and the control groups, the mean hemoglobin level was 7.16 g/L. There was no significant difference between groups for the risk of thromboembolism, according to the abstract.

Read More


Researchers recommend wellness programs for increased number of young TJR patients with obesity
Source:
Healio

Results from a new total joint replacement database show that the increase in young patients with obesity contributes to increased rates of total joint replacement in the United States, and researchers recommend hospitals and private practices implement wellness programs to improve patient outcomes.

“Postoperative rehabilitation and support programs should target improved physical activity and diet to promote weight loss and a healthier lifestyle. We should focus on standard best practices for physical therapy and health management after joint replacement surgery,” David C. Ayers, MD, chair of the Department of Orthopaedics and Physical Rehabilitation and director of the Musculoskeletal Center of Excellence at the University of Massachusetts Medical School, told Orthopedics Today. “Such standards currently do not exist. Figuring those out, and how to lose weight, should be a priority. It has to be about more than just fixing joint pain. It has to be about long-term health, function and quality of life.”

The joint replacement database, called the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) database, is the result of a four-year, $12 million grant in 2010 to develop a system that tracks process and outcomes in total joint replacement (TJR).

“FORCE-TJR is already the largest joint replacement database in the nation and growing. It is also the only TJR database to include patient-reported outcomes,” Ayers said. “The information being collected by FORCE-TJR has the potential to directly influence clinical best practices, health care policy and the overall health and quality of life for more than 60 million people living with arthritis in the United States.”

The results from the first 9,000 patients enrolled in the database has shown 55% of patients younger than 65 years are obese, compared to 43% of patients who are older than 65 years. Further, 11% of patients younger than 65 years had a body mass index greater than 40 compared to 5% of patients older than 65 years.

Ayers said health wellness programs, such as those used in specialties with patients who have diabetes and heart disease, should be implemented in joint replacement programs.

“Wellness incentives are a big part of health care reform here in Massachusetts. Their effectiveness hasn’t been fully understood, but we have them for a reason,” he said. “Incentives to live a healthier lifestyle benefit the patient and ultimately reduce health care costs for everyone. When you eliminate complications, readmissions and revision surgeries, you also eliminate some very potent cost drivers in the health care system.”

Read More


Hip arthrodesis converted to THA associated with high complication rates
Source:
Healio

Researchers at the University of Leeds, in Leeds, United Kingdom, found complication rates were high after arthrodesis in eight studies and after conversion from hip arthrodesis to total hip arthroplasty in eleven studies, according to results of a systematic review.

“Arthrodesis of the hip provides excellent rates of union allowing most patients to live a pain-free life for many years,” Sameer Jain, MB, ChB, MRCS, and colleagues wrote in the study. “However, altered hip biomechanics ultimately lead to adjacent joint pain with many suffering from lower back and knee pain. Many of these patients will therefore require conversion [total hip arthroplasty] THA to restore hip function and relieve pain.”

Jain and colleagues analyzed results of 249 hips in eight published studies and found union rates of 37.5% to 100%, patient satisfaction rates of 69% to 100% and an overall 8.4% complication rate. In those studies, adjacent joint pain was reported in the low back in up to 75% of cases and in the ipsilateral knee in up to 57% of cases, according to the abstract.

In 11 studies that investigated conversion to THA, Jain and colleagues noted a 54% complication rate, which was due to factors such as mechanical failure, nerve palsy and deep infection.

“Patients must be aware that although complete pain relief is unlikely, functional improvement can be expected. However, this is a technically challenging procedure with less satisfying results than primary THA,” Jain and colleagues wrote. “Complication and revision rates are high and for this reason, arthrodesis of the hip should be considered with caution in younger, more active patients with greater physical demands. However, with newer implant designs, bearing couples, fixation methods and advances such as computer-assisted surgery, success rates of conversion THA may improve.”

Read More


Good results seen with highly porous acetabular implants in revision THA
Source:
Healio

Highly porous, commercially pure, titanium matrix acetabular components are safe and efficacious in patients who underwent revision total hip arthroplasties, according to a study recently presented.

“We prefer these highly porous jumbo cups for treatment of chronic discontinuity with major bone loss,” Morteza Meftah, MD, of Ranawat Orthopaedics, Hospital for Special Surgery (HSS) in New York City said. “Non-cemented custom cages, cemented cup/cage combination, or allograft are alternative choice if you want to treat Paprosky III or chronic pelvic discontinuity due to osteolysis. In our hands, Tritanium jumbo cups have reduced or eliminated the need for cup/cage combinations in such cases.”

He added, “The new porous Tritanium theoretically needs less bone (bleeding surface) to osteointegrate. This is important in major revision surgery when the bleeding surface is less than primary. We found that much less (around 30%) of bleeding bony surface is required for fixation with these implants.”

Jumbo cups

Researchers evaluated 24 patients who underwent revision total hip arthroplasty for major acetabular defects with Tritanium acetabular components (Stryker; Mahwah, NJ) between 2007 and 2010, and had a mean follow-up of 4 years. Most patients had a preoperative Paprosky classification of IIIA or IIIB with pelvic discontinuity. There were 10 men and 14 women, and patients had a mean age of 69 years.

Meftah noted the Tritanium cups consist of trabecular metal implants, designed to resemble the trabecular bone structure. The trabecular implants are a highly porous 3-D surface utilizing commercially pure titanium (CPTi) powder technology.

“The jumbo cups are about 10 mm larger than the native socket, 58 mm or larger in women and 62 mm or larger in men,” Meftah said. “The use of these highly porous cups has theoretically improved osseointegration, due to a small percentage of the bleeding bone that is required.”

During the revision procedures, surgeons performed progressive reaming to obtain a bleeding bone interface. The interference fit between the anterior inferior iliac spine, pubis and ischium was achieved with the use of Tritanium jumbo cups. Bone graft was utilized before placement of the cup in the non-bleeding portions of the defect.

“It is a good idea to use a trial component to test the stability prior to the actual implant. Use the distraction technique in chronic discontinuity to obtain a wedge interface with 2-mm to 5-mm oversize jumbo cups and at least two to five screws to enhance fixation,” Meftah said. There were no cup/cages or wedges used in this series. Most patients required a cup diameter of 62 mm or bigger, according to Meftah.

Results

The investigators analyzed patients’ radiographic and clinical results, and extent of osseointegration. The WOMAC score was 30.5 points, the patient-administered questionnaire (PAQ) score was 25.2 and HSS score was 25.3, with Meftah noting that lower numbers for the WOMAC and PAQ are better and higher numbers for the HSS are better. All three clinical outcomes were good at final follow-up.

The abduction angle was 43° with an anteversion of 20°. Osseointegration occurred in all cups, with a minimum osseointegration incidence of 30% and maximum of 75%. “The most osseointegration was in zone I, which was superior, and zone VI, which was posterior,” Meftah said.

He added, “We had good patient satisfaction with significant improvement of pain. None of the patients had any complications, dislocations, infections or failure of osseointegration at final follow-up.” – by Renee Blisard Buddle.


Socially isolated patients with arthritis have more pain after THR
Source:
Healio

SAN DIEGO – Socially isolated patients with osteoarthritis are nearly three times more likely to experience serious ongoing pain after total hip replacement than patients with good social ties, according to researchers from Hospital for Special Surgery.

“Previous studies have shown that social isolation is a risk factor for poor health outcomes,” Lisa A. Mandl, MD, MPH, from Hospital for Special Surgery, stated. “Studies show that people who don’t have good social ties are at increased risk of suffering a heart attack or stroke, and even dying, compared to those who enjoy the social support of family, friends and the community.”

In the study, social isolation was defined based on whether the patients were married, were members of any community or religious groups or had fewer than six friends or relatives. Mandl and colleagues noted that, although the 132 rheumatoid arthritis (RA) patients and 392 osteoarthritis (OA) patients had similar demographics and proportions of socially isolated patients, the OA patients had a statistically significant association with postoperative decreased WOMAC scores and social isolation, according to the abstract.

Severe social isolation in OA patients was also significantly associated with WOMAC scores less than 60 points and 2.9 times postoperative pain than control patients, but it was not associated with poor postoperative function.

Patients with OA who underwent a total hip replacement had worse pain outcomes than patients with RA. In RA patients, severe social isolation was significantly associated with poor postoperative function, but not postoperative pain.

“We believe further prospective studies should be done to determine whether interventions to evaluate and improve patients’ social ties before surgery could lead to a better pain outcome after hip replacement,” Mandl said. “It could be a way to improve outcomes without medication or other costly interventions. I see no downside to helping patients get the social support they may need to improve their quality of life.”

Read More


Healing and Surviving After Knee and Hip Replacements
Source:
dailyRx

For some people with aching bones and joints, knee or hip replacement surgery may be a treatment option. But pre-existing conditions may affect how a patient responds to surgery.

A recent study found that joint replacement patients with certain pre-existing conditions had a greater risk of having a second surgery or not surviving the next one to 10 years than patients without such disorders.

Read More


Surgeons describe new knee ligament
Source:
Medical News Today

At the Belgian University Hospitals Leuven, two knee surgeons have for the first time given a full anatomical description of a new ligament that they term the anterolateral ligament (ALL).

The new ligament is thought to play an important role in anterior cruciate ligament (ACL) tears.

Read More


Study: Day-of-surgery discharge found effective for UKA patients using refined perioperative pathway
Source:
Healio

Day-of-surgery discharges can be safe, efficient and increase patient satisfaction when using a refined perioperative pathway for appropriately selected patients who undergo unicompartmental knee arthroplasty, according to results of a recently published study.

“[Unicompartmental knee arthroplasty] UKA patients can be discharged on the day of surgery with a high satisfaction rate,” Steven Barnett, MD, from the Hoag Orthopedic Institute in Irvine, Calif., told Orthopedics Today. “This provides orthopedic surgeons with the ability to effectively treat these patients while minimizing cost associated with this procedure.

Barnett said surgeons at his institution recognized that UKA patients had less difficulty with pain management, decreased length of stay and achieved better results in physical therapy during hospitalization.

“This led us to begin managing these patients with a 23-hour overnight stay and eventually discharging them on the day of surgery,” Barnett said.

Barnett said within a 2-year to 3-year period, surgeons moved UKA patients from an inpatient setting to a day of surgery discharge after adopting techniques related to general and regional anesthesia, local soft-tissue infiltration and oral perioperative pain management.

Under this perioperative pathway, he and colleagues successfully discharged 160 consecutive UKA patients who were a mean of 65 years old with a mean American Society of Anesthesiology class of 1.8. The mean recovery room time was 121 minutes and no patients had uncontrolled pain or nausea that required an overnight stay. Patients had high satisfaction scores and researchers noted significant improvements in Knee Society Clinical Rating System scores.

“Our current algorithm is dependent upon patient education prior to surgery. Patients are instructed on crutch use, postoperative wound management, precautions, and [deep vein thrombosis] DVT prophylaxis at an extensive preoperative visit,” Barnett said. “Pain management on the day of surgery entails use of multimodal oral analgesics started prior to the procedure combined with both regional nerve blocks and peri-articular infiltration of a local anesthetic mixture. Activity limitations and weight bearing precautions are reinforced prior to discharge from the surgery center.”

Barnett said other surgeons performing UKA have adopted the pathway described in this study with success.

“The authors are confident that results will continue to be optimal and look forward to adapting these protocols to other arthroplasty procedures moving forward,” he said.

Read More


Knee Braces for Osteoarthritis Treatment
Source:
dailyRx

Osteoarthritis is the most common joint issue for middle-aged and older adults. The good news is that there may be a simple solution to help patients deal with the pain.

A recent study examined the effectiveness of wearing a patellofemoral (the joint connecting the back of the knee cap and the thigh bone) knee brace for reducing knee pain and damaged bone marrow (tissue inside the bones).

Read More


Sports Injuries Strike Again
Source:
dailyRx

Sports are a great way for kids to get exercise and have fun. But sometimes young athletes get hurt.

Many sports injuries are mild and heal on their own. Others — such as knee ligament tears — may be more serious and require surgery.

Athletes who have had surgery to repair knee ligament tears are more likely to experience another knee ligament tear than uninjured athletes, according to a recent study.

Read More


Knees Buckling Under Pressure
Source:
dailyRx

Your body weight and your job may be putting considerable pressure on your knees. This pressure could lead to a medical condition called knee osteoarthritis.

A recent study found that having a higher body mass index (a measure of height and weight) and living a more active lifestyle were both associated with a higher risk of knee osteoarthritis.

Read More


Knee Replacement Often Beneficial for RA: Study
Source:
WebMD

The common belief that rheumatoid arthritis patients don't benefit from knee replacement surgery as much as those with the more common osteoarthritis has been challenged by the findings from a pair of studies by New York City scientists.

Read More


Omega-3 fatty acids may help reduce risk of hip fracture in postmenopausal women
Source:
Healio

The risk of hip fractures in postmenopausal women may be reduced through consuming more omega-3 polyunsaturated fatty acids, according to a study published in the Journal of Bone and Mineral Research.

“We don’t yet know whether omega-3 supplementation would affect results for bone health or other outcomes,” Tonya Orchard, PhD, RD, LD, from Ohio State University, stated in a press release. “Though it is premature to make a nutrition recommendation based on this work, I do think this study adds a little more strength to current recommendations to include more omega-3s in the diet in the form of fish, and suggests that plant sources of omega-3 may be just as important for preventing hip fractures in women.”

Read More


Women With Lupus Seem at Higher Risk for Hip Fractures
Source:
MedlinePlus

Women with lupus the autoimmune disease that can damage skin, joints and organs also are at higher risk of a hip fracture known as a cervical fracture, new research from Taiwan suggests.

Dr. Shu-Hung Wang, of the Taipei Veterans General Hospital, and his colleagues evaluated nearly 15,000 adults 90 percent of them women who had lupus. They followed them for an average of six years.During that time, 75 suffered a hip fracture. Of those, 57 were cervical fractures of the hip; the other 18 were trochanteric fractures of the hip.

Read More


Arthritis & Your Knees Presented by Dr. Tom Smith, Orthopedic Surgeon and Steve Hanley, Physical Therapist

Thursday, May 16 1:00-2:00 p.m.

ATI Physical Therapy
1 N. La Grange Rd, Unit 2 C
La Grange, IL
(The former Border's Bldg)

RSVP to Amanda 630.699.4094
Refreshments will be served


Knee osteoarthritis patients have improved knee loads when using specialized mobility shoe
Source:
Daily Rx

When patients with knee osteoarthritis are walking, their knees may jut out to the side. Shoes that imitate barefoot walking can help with that.

A recently published study found that wearing a "mobility" shoe keeps the knee joint more aligned in knee osteoarthritis patients.

Using flat, flexible footwear can significantly reduce knee loading in patients with the joint condition, according to researchers.

Read more


ACL surgery techniques using double versus single bundle ligaments provide equal stability
Source:
Daily Rx

Surgery for a blown anterior cruciate ligament (ACL) inside the knee is becoming more and more common. New techniques to perform the surgery are on the rise across the country.

Damaged ACLs that were replaced using a double-bundle technique during surgery were as stable as patients who received the single-bundle technique, according to a study presented at a conference.

In double-bundle, the new ligament has two parts whereas the single bundle just has one.

Read more


Total knee replacements for juvenile idiopathic arthritis last for decades in most patients
Source:
Daily Rx

People typically think knee replacement surgery is only for older adults with arthritis. But the surgery is also used for young patients when joint damage has become severe.

Recently, researchers found knee replacements did not last as long in young patients with juvenile idiopathic arthritis (JIA) as they do in older osteoarthritis patients.

Still, the procedure can be a life-changer for many patients with JIA – a painful disease that affects children. In patients with JIA, about 92 percent of knee replacements lasted 10 years and a little over 75 percent lasted 20 years.

Read more


Patients with diabetes at no greater risk for infection or other complications after total knee replacement
Source:
newsroom.aaos.org

Patients with diabetes were no more likely to suffer infection, deep vein thrombosis(a deep vein blood clot) or other complications following total knee replacement(TKR) than patients without diabetes, according to new research published online today, in advance of its publication in the March 2013 Journal of Bone and Joint Surgery (JBJS).

Read more


Which knees need the knife?
Source:
Daily Rx

Jeffery Katz, MD, of Orthopedic and Arthritis Center for Outcomes Research Brigham and Women's Hospital, Boston, and colleagues led the study to determine if patients with a meniscal tear and knee osteoarthritis had better outcomes with surgery plus physical therapy or just physical therapy.

Read more


Return-to-work rate high after knee replacement
Source:
webmd.com

Getting back to work after knee-replacement surgery is a big concern for people contemplating the procedure. Now, a new study shows that most people return to work after a total knee replacement -- even those with physically demanding jobs.

"We are now reaching a population that is younger and actively working. Most have very arthritic knees and expect to go back to work," Orozco said. Better implant materials that support more weight, improved surgical techniques that spare muscle, and better post-surgery patient care plans -- including pain management and physical therapy -- have increased the popularity of knee replacement in recent years, he said.

Read more


Cartilage damage helps detect osteoarthritis?
Source:
ivanhoe.com

Osteoarthritis is the most common joint disorder and affects about one-third of older adults. New research suggests that cartilage damage from exercise may aid in early detection of osteoarthritis.

"We discovered that GAG-depleted tissue is most vulnerable to high rates of loading and not just the magnitude of the load. This finding suggests that people with early degradation of cartilage, even before such changes would be felt as pain, should be careful of dynamic activities such as running or jumping," Grodzinsky was quoted as saying.

Read more


A new approach to hip surgery
Source:
The New York Times Health

Larry Kufel had always been an active man, tall and rangy, who worked out regularly and picked up basketball games at the gym. But age was taking a toll on his joints, and it had become clear that he needed a hip replacement.

The procedure that Mr. Kufel received is called anterior hip replacement. The surgeon makes the incision at the front of the hip instead of through the buttocks or the side of the hip. This approach permits the doctor to reach the hip socket without cutting through major muscle groups. Proponents claim that the procedure results in less pain and fewer complications for patients than standard hip replacement.

Read more


Hip surgery flip! Direct Anterior Hip Replacement
Source:
ivanhoe.com

The numbers are sky-rocketing. There were more than 300 thousand total hip replacements in 2010, that's up 135 thousand compared to just ten years earlier. As more and more people need help to relieve the pain, there's an option that's becoming popular with patients and surgeons.

"It's a less invasive approach," Stefan Kreuzer, MD, associate professor at Memorial Hermann Hospital, told Ivanhoe. He went through the front of her leg to get to her hip, instead of the more traditional technique of going through the back.

The doctor says the normal post-operative restrictions on hip movements do not apply to patients who undergo direct anterior hip replacement. He tells us it great for most people in need of a hip replacement, including highly active patients. The doctor is currently training surgeons from around the world on the technique.

Read more


New technique revolutionizing hip-replacement surgery
Source:
palmbeachpost.com

"It's a 'micro-invasive' technique," says Grandic.

And it offers myriad advantages over other techniques.

"All muscles, tendons, ligaments and soft tissue are spared, and the hip socket is never twisted into unnatural positions during surgery," Grandic explains.

Thus, he says, patients experience little or no post-operative discomfort; are able to walk immediately, with no restrictions; and are usually discharged from the hospital within 24 to 48 hours.

Read more


Quit smoking and enjoy that new hip
Source:
Daily Rx

Total hip replacement and smoking cigarettes just don't mix. That's because smoking can cramp the healing process. Even quitting just before surgery is better than not quitting at all.

Researchers recently studied a group of patients who had undergone total hip replacement surgery. Patients who were current smokers had higher rates of infection, pain and loosened hip joints, which had to be corrected with a second surgery, compared to non-smokers.

Read more


New surgery makes hip replacement easier
Source:
charlotteobserver.com

The surgery is extensive. It involves removing the joint – the damaged bone and cartilage – and replacing it with prosthetic parts made of metal, plastic or ceramics. Typically, surgeons enter the joint from the rear, which requires cutting through muscle and cartilage. But a relatively new procedure enables surgeons to enter from the front and only stretch the muscles aside, avoiding the cutting and minimizing pain and recovery time. Those who use this anterior technique say the benefits are substantial.

Read more


The fate of new hips in women
Source:
DailyRx.com

Hip joint replacements can help patients regain normal mobility. But just like any surgery, risks are involved in hip replacement. And women may have a higher risk than men when it comes to failure of the new hip.

Women were slightly more likely than men to have a failed hip replacement within three years of surgery, according to a new study.

The findings highlighted the risks and precautions patients should consider before deciding to get a new hip.

Read More


Toss the vitamin D and calcium?
Source:
DailyRx.com

Preventing the risk of fractures as you grow older is important. Previously, vitamin D and calcium supplements were thought to help reduce that risk – but recommendations have changed.

The Task Force actually recommends against vitamin D in daily doses of 400 IU or less and calcium in daily doses of 1000 mg or less because it can increase the risk of kidney stones. At those doses, supplements do not prevent fractures in younger men and women.

However, the Task Force continues to recommend vitamin D supplements to prevent falls in adults 65 and older who are at higher risk for falls.

Read More


More intense activity results in greater polyethylene wear for THA patients
Source:
Healio

More intense activity, rather than amount of activity, has been linked with greater in-vivo polyethylene wear in highly crosslinked polyethylene implants, according to a results of a study from the Orthopaedic Research Society Annual Meeting.

“Based on this information, patients can be better instructed on what protects their joint form wear and what activities can be performed without affecting longevity,” Senden said. “Given our results, patients can protect the longevity of their implants without being less active.”

Read More


What's it like: To get hip replacement surgery
Source:
Newsok.com

Joint degeneration from age, wear or disease can drive a doctor's decision to replace your hip joint. Learn what the surgery and recovery is like.

Read More


ACL insurance insight
Source:
Ivanhoe.com

ACL injuries have increased 400% in teens and adolescents in the last ten years. They’re also on the rise among baby boomers. To make sure you don’t have to pay out-of-pocket to fix the injury, doctors are using a new tool to show surgery works.

That’s where the gait-rite system comes in. This 26 foot carpet contains sensors to assess gait after injury and again after surgery to show how patients are doing.

Dr. Maloney says that, “We will have seen that their gait has been restored to what we consider normal and safe and allow them to progress.”

Read More


OA pain loss through weight loss
Source:
DailyRx.com

Osteoarthritis is known as the "wear and tear" form of arthritis. If you're overweight, you could be putting more strain on your joints and adding to this wear and tear. But losing weight could change that.
A recent study showed that patients with knee osteoarthritis may be able to relieve pain and improve function by losing weight.

Read More


Why so idle with knee OA?
Source:
DailyRx.com

Being obese or overweight can make osteoarthritis worse. Staying physically active is one of the best ways to avoid putting on extra pounds. However, many osteoarthritis patients remain inactive.

These findings suggest that there may be a serious need to improve physical activity among patients with knee osteoarthritis. According to the authors, increasing physical activity among these patients will likely involve weight management, healthy diet and improving pain and disability.

Read More


Disabled by weight: obese with arthritis
Source:
DailyRx.com

Being obese is just plain unhealthy. All that excess fat can make outcomes worse for patients with any of a number of diseases, including rheumatoid arthritis.

A recent study showed that morbidly obese patients with inflammatory polyarthritis - which includes diseases like rheumatoid arthritis - had higher levels of disability than arthritis patients who were not obese. Morbidly obese patients had about twice the odds of disability compared to those who were not obese

Read More


New rheumatoid arthritis drug performs
Source:
DailyRx.com

Painful swollen joints are familiar to those with rheumatoid arthritis. But patients may have another option if they don't respond well to typically used medications.

A recent industry-funded study found that combining a new drug called tofacitinib with an existing prescription drug improved symptoms in those with rheumatoid arthritis. Rheumatoid arthritis is a condition that involves inflammation, pain and swelling in the joints.

Read More


Strong muscles better for function in OA
Source:
DailyRx.com

Osteoarthritis of the knee can get in the way of physical activity. For people with this condition, strong muscles may be the key to maintaining strong physical function.

In a recent study, people with severe knee osteoarthritis had more trouble on a test of physical ability when they had poor muscle strength in their legs. Their performance on the test was not influenced by pain, age or body weight.

The authors said that muscle strengthening treatments may help people with severe osteoarthritis of the knee.

Read More


Treatment with platelet-rich plasma shows potential for knee osteoarthritis
Source:
Medical News Today

Several treatments for osteoarthritis exist, including exercise, weight control, bracing, nonsteroidal anti-inflammatories, Tylenol, cortisone shots and viscosupplementation, a procedure that involves injecting a gel-like substance into the knee to supplement the natural lubricant in the joint. A new treatment that is being studied by a small number of doctors is PRP injections. PRP, which is produced from a patient's own blood, delivers a high concentration of growth factors to arthritic cartilage that can potentially enhance healing.

Read More


Vitamin K for healthy knees
Source:
DailyRx.com

Vitamin K supports bones and cartilage. So researchers wanted to know if low vitamin K was linked to joint damage and osteoarthritis.

The study found that people who had low levels of vitamin K in their blood were about 33 percent more likely to develop knee osteoarthritis.

Also, people with low vitamin K levels were about two times more likely to show signs of damaged cartilage in their knees.

The authors suggested that vitamin K may be important for keeping knees healthy.

Read More


New hip replacement approach offers multiple benefits
Source:
Daily Republic

It's no fun walking around with an ailing hip; anyone with severe arthritis knows that kind of pain all too well. For years, orthopedic surgeons have been performing total hip replacements when less invasive options don't provide the desired results.

The bottom line for those who have hip pain that significantly interferes with their quality of life is that there's no need to suffer. If non-operative treatments don't provide the long term relief, hip replacement or resurfacing may be the answer.

Read More


Osteoarthritis: new light shed on how painful joint wear and tear develops
Source:
Science Daily

The cause of osteoarthritis -- other than known risk factors such as age or earlier injury -- is not yet known. The researchers at the MedUni Vienna have discovered, however, that certain proteins known as lectins, and in particular galectins, have a role to play in the painful wear and tear of the joints.

These new findings, according to the vision of the MedUni Vienna researchers, could lead to galectins in future being used both in the treatment and, as bio-markers, in the disease prediction of osteoarthritis.

Read More


Baby boomers feed need for joint replacements; Docs seeing more patients under age of 65
Source:
Daily News

US baby boomers are fueling a wave of joint replacement surgeries, hoping to use new artificial knees and hips to stay active as they get older.

The 45-64 age group accounted for more than 40 percent of the more than 906,000 total knee or total hip replacement surgeries in 2009, the last year for which figures were available from the American Academy of Orthopedic Surgeons.

Boomers will account for a majority of these joint replacements in 2011, according to projections by Drexel University specialist Steven Kurtz.

Read More


Sports training and ACL reconstruction should focus on unique characteristics of the female knee
Source:
Medical News Today

Female athletes are three times more likely to suffer from anterior cruciate ligament (ACL)ruptures, one of the most common knee injuries, compared to male athletes. The ACL is one of the four main ligaments within the knee that connect the femur (upper leg bone) to the tibia (lower leg bone). Recent research highlights the unique anatomical differences in the female knee that may contribute to higher injury rates, and should be taken into consideration during reconstructive surgery and sports training, according to a review article in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

Read More


Vitamin D no help for arthritis in the knee
Source:
Medical News Today

Adults with osteoarthritis in the knees who take vitamin D supplements did not show an improvement in pain relief or cartilage loss, according to a new study published in JAMA.

Read More


17 Ways to fight osteoporosis
Source:
Health.com

Most people know calcium strengthens bones. But there are more than a dozen other ways to fight osteoporosis, the silent, bone-thinning condition that can lead to fractures, back and neck pain, and a loss of up to 6 inches of height over time.

Taking preventive measures is key, as many people with osteoporosis will get bone fractures before they even know they have the disease.

Read More


Congrats to MacNeal hospital on receiving an "A" safety score

The nonprofit Leapfrog Group has released updated hospital safety scores for U.S. hospitals. Under the system, hospitals are given A, B, C, D or F scores based on preventable medical errors, injuries, accidents, and infections. Among the findings:

  • Of the 2,618 general hospitals issued a Hospital Safety Score, 790 earned an "A," 678 earned a "B," 1004 earned a "C," 121 earned a "D," and 25 earned an "F."
  • 58 percent of hospitals maintained the same grade level as they had in previous scores issued in June, while 34 percent changed by one grade level (higher or lower), and 8 percent moved two grade levels or more.
  • No one class of hospitals (such as teaching or public hospitals) dominated among those showing the highest safety scores.
  • Hospitals with "A" scores included those with multiple national accolades, as well as institutions that serve highly vulnerable, impoverished, or health-challenged populations.

Read More


ORIF prevented need for later THA in acetabular fracture patients
Source:
Healio.com

Long-term follow-up showed that open reduction and internal fixation successfully treated displaced acetabular fractures in patients without the need for subsequent total hip arthroplasty, according to this study.

Read More


Study confirms socioeconomic value of hip protectors, joint arthroplasty
Source:
Healio.com

Researchers in a recent issue of Orthopedic Research and Review have concluded that medical devices, such as hip protectors and total joint arthroplasty implants, are cost-effective and significantly improve patients’ lives, confirming their socioeconomic value.

“Orthopedic devices such as knee and hip implants or hip protectors have the potential to improve people’s lives. They allow for greater flexibility, faster return to an active, independent lifestyle and reduced risk of future fractures to name but a few benefits,” Yves Verboven, executive director at the European Health Technology Institute for Socio-Economic Research (EHTI), stated in a press release.

Read More


Quit the bottle to build happy bones
Source:
Daily Rx

Avoiding alcohol combined with regular exercise can help men build the bones lost from alcoholism, a new study has found.

The amount of osteocalcin, which is a protein in the bones and teeth, increased over the eight-week period as men continued to avoid alcohol.

This means that there was a "higher rate of bone formation during continuous abstinence," the authors said in their study.

Read More


Global efforts necessary to prevent fragility fractures due to osteoporosis
Source:
Medical News Today

The International Osteoporosis Foundation (IOF) has released a new report, revealing approximately 80 percent of patients treated in clinics or hospitals following a fracture are not screened for osteoporosis or risk of future falls. Left untreated, these patients are at high risk of suffering secondary fractures and facing a future of pain, disfigurement, long-term disability and even early death.

The report 'Capture the Fracture - A global campaign to break the fragility fracture cycle' calls for concerted worldwide efforts to stop secondary fractures due to osteoporosis by implementing proven models of care.

Read More


Embracing the brace
Source:
Daily Rx

Knees are only meant to bend forward and backward. If a knee pops and locks up with major pain, something serious is going on there, and it's most likely an ACL injury.

The injuries often need surgery to reconstruct the ligament, followed by therapy to help rehabilitate the knee.

It does not lower pain, protect from reinjuring the knee or improve the stability of the knee. Rather, braces add an unnecessary expense to the recovery.

Vitamins and other supplements also don't help in the healing process.

Beginning physical therapy shortly after surgery, ideally within a few days after, can bring great outcomes for patients.

Read More


Does rehab help before joint replacement?
Source:
Daily Rx

Before going through knee replacement surgery, patients often do some rehab for their aching joint. That is, they try to improve pain and function before surgery. But does this pre-surgery rehab improve outcomes?

According to recent research, pre-surgery rehabilitation seemed to do little to improve pain, function and motion after knee replacement surgery.

Read More


More magnesium, less arthritis
Source:
Daily Rx

What you put in your body can affect your risk of disease, even your risk of osteoarthritis. If you're trying to prevent this "wear-and-tear" type of arthritis, you may want to eat more almonds and spinach.

Eating more magnesium - a mineral found in many green vegetables, beans and nuts - it may lower the risk of knee osteoarthritis.

Read More


Most damage, most gain in knee replacement
Source:
Daily Rx

If you have knee osteoarthritis, you can take steps to prevent permanent damage. For those with the damage done, joint replacement surgery may relieve pain and boost knee function.

Osteoarthritis patients with the most joint damage before surgery may be the most likely to benefit from total knee replacement.

Read More


MRI may spot arthritis unseen by X-ray
Source:
Daily Rx

Osteoarthritis happens when joints and joint tissues wear down over time. Usually, doctors use X-ray imaging to see this joint damage. But another imaging technique may give doctors a better picture.

Magnetic resonance imaging (MRI) spotted many signs of knee osteoarthritis in patients that had no signs of knee osteoarthritis in X-ray images.

Read More


Cartilage made from stem cells
Source:
Medical Breakthroughs

Using pluripotent stem cells, a team of Duke Medicine researchers has engineered cartilage. The findings suggest that induced pluripotent stem cells (iPSCs) may be a viable source of patient-specific articular cartilage tissue.

Read More


Vanguard in La Grange Debuts Medical Offices in Former Attic
Source:
Western Springs Patch

The medical group held its grand opening last Wednesday for its new orthopedics and plastic/reconstructive surgery offices on the building's second floor.

Virtually no hint remains that the second floor of Vanguard Medical Group in La Grange was once mostly a disused attic.

Read More


Learn how Chicago's top Orthopedic Experts at Macneal Hospital can get your life back on track

Thursday, October 18 at 5 PM
Presented by Thomas Smith, D.O.
MacNeal Hospital-Staff Room
3249 S. Oak Park Avenue
Berwyn, IL 60402

  Click here for more information


Dr Tom Smith, will have an open house at his new practice location 47 South 6th Avenue in La Grange, on Wednesday, October 17, 2012, 4 to 7 PM.


MacNeal hospital honored as one of Chicagoland's Best Hospitals.

MacNeal Hospital is ranked as one of U.S. News & World Report's Best Regional Hospitals, with distinctions in Orthopedics and Urology.


Vanguard MacNeal Hospital Acheives Gold Standard in Nursing Excellence.
Source:
Macneal.com

Vanguard MacNeal Hospital has achieved Magnet® recognition by the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program®, which ensures that rigorous standards for nursing excellence are met.

Magnet is the highest recognition an organization can receive for nursing care as established by the ANCC, a division of the American Nurses Association (ANA). This award recognizes health care organizations that provide the very best in nursing care and uphold the tradition of professional nursing practice. Of the more than 140 hospitals in the state of IL, MacNeal is proud to be one of only 33 in the state and 7 within the Chicago land area to hold this prominent designation.

Read More


Study shows direct correlation between linear wear of hip implants and patient activity
Source:
Healio.com

German and American researchers have conducted one of the first studies indicating a direct link between patient activity and the rate of linear wear in total hip replacements using alumina heads and conventional polyethylene.

Using univariate regression analysis, Finn and colleagues were able to assess weight, age at surgery, peak activity, medium intensity steps, high intensity steps, inclination angle and acetabular anteversion, according to the abstract. Age, weight, gender and cup position were not associated with the linear wear rate.

Read More


Tough gel stretches to 21 times its length, recoils, and heals itself - may pave the way to replacing damaged cartilage in human joints
Source:
Medical News Today

A team of experts in mechanics, materials science, and tissue engineering at Harvard have created an extremely stretchy and tough gel that may pave the way to replacing damaged cartilage in human joints.
"Conventional hydrogels are very weak and brittle - imagine a spoon breaking through jelly," explains lead author Jeong-Yun Sun, a postdoctoral fellow at the Harvard School of Engineering and Applied Sciences (SEAS). "But because they are water-based and biocompatible, people would like to use them for some very challenging applications like artificial cartilage or spinal disks. For a gel to work in those settings, it has to be able to stretch and expand under compression and tension without breaking."

Read More


Pioneering plan for stem cell hip replacements
Source:
Herald Scotland

SCOTS researchers have revealed plans to create a revolutionary new hip implant that will use the latest stem cell technology to allow patients to grow their own bone, removing the need for regular replacement surgery.

Read More


Minor exercise can protect premenopausal women's bones
Source:
Medical News Today

According to new research, premenopausal women who engage in physical activity can significantly reduce a known inhibitor of bone formation called sclerostin.

The study, which will be published in the October issue of Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM), also found that physical activity improved IGF-1 levels, which have a positive impact on bone formation.

"Physical activity training is conceptually simple, inexpensive, and can serve practical purposes including reducing the risk of low bone mass, osteoporosis, and consequently fractures. Our study found that even minor changes in physical activity were associated with clear effects on serum levels of sclerostin, IGF-1 and bone turnover markers."

Read More


Osteoarthritis after ACL surgery
Source:
Daily Rx

Your anterior cruciate ligament, or ACL, is one of four ligaments in the knee. If your ACL tears, you may need surgery. Unfortunately, many patients develop osteoarthritis after surgery, regardless of the type of surgery.

Patients who have undergone single bundle ACL reconstruction surgery may not have a greater osteoarthritis risk than those who have undergone double bundle ACL reconstruction.

Read More


Low Rates of Knee Arthritis in Women
Source:
Daily Rx

Knee osteoarthritis is one of the main health burdens in the United States. Because of this condition, there is a need to better understand the course of disease to prevent and slow knee arthritis.

Middle-age women develop osteoarthritis at fairly low rates. However, in women who already have the condition, symptoms are likely to get worse within 15 years.

Read More


Robot assistance simplifies placing patient-specific UKA prostheses in pilot study
Source:
Healio.com

A new robotic device led to placement of unicompartmental knee arthroplasty implants matched to the patient's anatomy that exceeded the accuracy of placements involving traditional procedures and components, according to results of a pilot study presented at the British Orthopaedic Association Congress 2012, here.

Preoperatively surgeons made operative plans for all these cases using input from CT scans that guided component position, orientation and selection of component size. Intraoperatively the surgeon holds the burr used to remove bone, but the robot provides haptic and visual feedback, Andrews said.

Read More


PCL repair surgery did not lead to growth problems in pediatric, adolescent patients
Source:
Healio.com

Following failed conservative treatment, PCL repair or reconstruction is a safe and viable treatment option for pediatric and adolescent patients with multiligament or isolated PCL injuries, according to recent study results.

Read More


Patients with high BMI show similar improvements in patient-reported outcomes after TKA
Source:
Healio.com

Researchers from the United Kingdom have reported similar improvements in patient-reported outcomes after elective total knee arthroplasty regardless of patient body mass index, according to a recent study published in the Journal of Bone & Joint Surgery.

“Patients achieve equivalent improvements in knee function and general health irrespective of their preoperative BMI,” Baker told ORTHOPEDICS TODAY. “Obese patients gain as much benefit from knee replacement as patients with a ‘normal’ BMI, even if they do not end up at a similar postoperative level. Accordingly, we feel that the obese should not be excluded from the benefit experienced by their fellow patients with lower BMI from undergoing total knee replacement.”

Read More


Meta-analysis finds initial walking speed positively impacted by knee arthroplasty
Source:
Healio.com

Knee arthroplasty helped increase patients’ walking speed at 6 months to 60 months postoperatively, according to a study conducted by researchers in The Netherlands.
For the analysis, the authors looked through 16 independent comparisons of pre-operative and postoperative walking speed for patients who underwent knee arthroplasty. In all, they identified 12 studies in their survey of MEDLINE, Web of Science, and PEDro, for a total of 419 patients.

Read more


Primary TKA found effective in patients with BMI greater than 50
Source:
Healio.com

Researchers from London, Ontario, found total knee arthroplasty efficacious in patients with body mass indices equal to or greater than 50, but remained cautious about the safety of the procedure in the group due to higher risks of complications and revisions.

Read more


What is knee replacement surgery? What is knee arthroplasty?
Source:
Medical News today

Replacement surgery in a damaged knee joint by placing an artificial prosthesis will alleviate pain and help better movement of the knee.

For most patients, a replacement knee surgical procedure will last for at least 15 to 20 years, especially if cared for properly and not put under too much strain. More than 90% of people who have total knee replacement surgery experience a dramatic decrease in knee pain and a significant improvement in their ability to perform common activities of daily living.

Read More


Direct anterior approach to THA yields good results, depends upon surgeon experience
Source:
Healio.com

The use of the direct anterior approach in total hip arthroplasty can yield good results backed by numerous studies but depends upon proper education, according to one surgeon’s experience.

J. Bohannon Mason, MD, shared his findings at the International Congress for Joint Reconstruction San Diego 2012 meeting, which was held in collaboration with Orthopedics Today.

“The best approach? They all have advantages and disadvantages,” he said. “When you look at [DA], it does require special instrumentation and I would say it does require special training – however, you have quick recovery, stability and proper cup positioning.”

Read More


Tart cherries may help millions reduce inflammation to manage pain, according to new research
Source:
Medical News Today

Tart cherries may help reduce chronic inflammation, especially for the millions of Americans suffering from debilitating joint pain and arthritis, according to new research from Oregon Health & Science University presented at the American College of Sports Medicine Conference (ACSM) in San Francisco, Calif.1 In fact, the researchers suggest tart cherries have the "highest anti-inflammatory content of any food" and can help people with osteoarthritis manage their disease.

Along with providing the fruit's bright red color, the antioxidant compounds in tart cherries - called anthocyanins - have been specifically linked to high antioxidant capacity and reduced inflammation, at levels comparable to some well-known pain medications.

Read More


Long-term study reveals lower steady state wear with highly crosslinked polyethylene liners
Source:
Healio.com

After an initial period of rapid penetration in the first year, investigators of a level 1 study using radiostereometric analysis found a significantly lower steady state wear rate during 10-year follow-up among total hip arthroplasties performed with highly crosslinked polyethylene liners compared to conventional polyethylene.

Read More


Follow-up, revision parameters for metal-on-metal hip implants outlined
Source:
Healio.com

In a recent presentation, one surgeon outlined his indications for follow-up and revision of metal-on-metal total hip replacements.

Thomas P. Schmalzried, MD, presented his experience at the International Congress for Joint Reconstruction San Diego 2012 meeting, which was held in collaboration with Orthopedics Today.

According to Schmalzried, revision should be considered in patients who display poor clinical results, such as pain or mechanical symptoms. Pseudotumor or other soft tissue involvement, such as edema and necrosis, are also a sign that revision should be performed within 3 months. Osteolysis and high metal ion levels should also bring revision into consideration.

Schmalzried stressed he still observes asymptomatic patients with “clean” MRIs, regardless of their metal ion levels.

Read More


Autograft hip reconstruction provides good outcomes for athletes
Source:
Medical News Today

A common, painful hip condition in elite athletes may be able to be repaired with an improved surgical technique, according to researchers presenting their work at the American Orthopaedic Society for Sports Medicine's Annual Meeting in Baltimore, Maryland.

"In our review of 21 male, elite athletes who had hip pain and instability issues (hypoplastic or labrum tear), 81 percent returned to play at a similar level as before they were hurt, after receiving an arthroscopic reconstruction technique using an ipsilateral iliotibial band autograft," said research author, Marc J. Philippon, MD, of the Steadman Philippon Research Institute in Vail, Colorado.

Read More


"Coming soon to La Grange"

Starting in June our Westchester office will be relocated to
47 South 6th Avenue
La Grange, Il 60525

Please check our Website, Facebook and twitter for information regarding our "Open House"


On May 17th, come out and join us at 2pm to hear

Dr. Tom Smith, Hip and Knee Specialist who is a board-certified Orthopedic Surgeon with Vanguard Medical Group, speak about the anatomy of the hip, joint pain, joint replacement, and some simple steps you can take.

Dr. Smith will also be sharing how he has been successfully performing Direct Anterior Approach Hip Replacement Surgery, a technique that few physicians are currently using due to the extensive training and specialized equipment. This surgery results in less pain, greater mobility and a quicker recovery time.

JOIN US!

When: Thursday, May 17th at 2pm
Located at: 51 E. Cossitt Avenue, La Grange, Illinois
Call (708)354-7600 to reserve your seat today!

Click here for more information

 


The new knee replacements
Source
Lifescript

Knee osteoarthritis. It can start out as an occasional twinge that eventually becomes a constant pain, making it difficult to walk, stay active or just get through the day.
And when joint degeneration starts affecting your life, you may start thinking about surgery.

You're not alone. Knee replacements have become increasingly common among younger women, according to a January 2012 Finnish study published in Arthritis & Rheumatism.

Read on to learn what you need to know about knee replacements.

Read More


Knee injuries in women linked to motion, nervous system differences
SourceHealio.com

The reason women are more prone to knee injuries than men may go beyond differences in muscular and skeletal structure, according to researchers from Oregon State University.

“There are some muscular and skeletal differences between men and women, but that doesn’t explain differences in injury rates as much as you might think,” study author Samuel T. Johnson stated in an Oregon State University news release. “No one has really studied the role of the nervous system the way we have in explaining these differences, specifically the way sensory information is processed and integrated with motor function in the spinal cord.”

“We’re finding differences in nervous system processing,” Johnson stated. “The causes for those differences are unclear, but it may be due to either a biological difference, such as hormones, or a cultural difference such as different exercise and training patterns.”

Read More


What is arthroscopy?
SourceHealio.com

Arthroscopy is an orthopedic procedure that is used to diagnose and treat joint or soft tissue problems by placing a small instrument, called an arthroscope, through a small incision into the joint. Once used exclusively as a preparation method for surgery, it is now an alternative to more invasive surgical procedures and is preferable in some cases due to a shorter recovery time.

Read More


Polyurethane scaffold promotes meniscal regeneration, shows good 2-year results
SourceHealio.com

Arthroscopic implantation of a polyurethane scaffold to treat partial meniscal lesions showed good results over other meniscal treatment methods at the 2-year follow-up, according to research presented at the European Society of Sports Traumatology Knee Surgery and Arthroscopy Congress 2012, here.

“This new scaffold is very interesting with preliminary results comparable to the CMI (Menaflex Collagen Meniscus Implant; Regen Biologics), but with an easier surgical management,” Muccioli said in his presentation.

Read More


Smoking linked to worse outcomes in joint replacement
SourceArthritis Today

Two studies presented at the 2012 annual meeting of the American Academy of Orthopaedic Surgeon highlight the dangers that smoking poses to patients receiving total knee or hip implants.

The researchers found that the overall revision rate – meaning the number of surgeries that had to be redone – was 10 times higher for smokers compared with nonsmokers: 10 percent vs. 1 percent. Smokers also had a significantly higher rate of complications compared with non-smokers (21 percent vs. 12 percent), including blood clots, abnormal heartbeat, irregular heartbeat, urinary tract infection and kidney failure.

Quitting’s not easy, but it’s worth it, says Dr. Lombardi. “The effect of nicotine may persist, but obviously it will [lessen] if you stop.”

Read More


Can oral bacteria cause a joint replacement to fail?
SourceHealth Point Capital

Researchers at Case Western Reserve University may have found a potential link between gum disease and joint health, with particular implications for failing joint replacements. Working collaboratively, dental, orthopedic and arthritis specialists tested the DNA in synovial fluid in 36 patients with both native and replacement joints. Some samples showed the presence of oral bacteria in the fluid, which the scientists suggest could be contributing to aseptic loosening or excessive wear in joint replacement patients when no infection is present.

Though the results were modest, the study's authors say that this confirms a pathway for oral bacteria between the mouth and joints. This adds to the body of literature showing the relationship between dental disease and other conditions, including heart disease and stroke.

Further, they recommend that patients with arthritis or failed prosthetic joints be examined for the presence of periodontal diseases and be treated accordingly and suggest that appropriate treatment of periodontal disease may help prevent joint replacements. The study was published in the Journal of Clinical Rheumatology.

Read More


Indications and techniques for hip arthroscopy continue to evolve
SourceHealio.com

"Hip arthroscopy is an evolving science," Charles A. Bush-Joseph, MD, of Midwest Orthopaedics at Rush in Chicago, told Orthopedics Today. "We are clearly better able to more accurately diagnose hip and groin conditions. Industry is catching up. There has been dramatic innovation in the equipment surgeons use to perform these types of procedures, making them more reliable and reproducible."

Read More


High impact sports reduce durability of hip implants
Source Healio.com

French researchers have confirmed that high-impact sport, such as jogging or soccer, increases the risk of total hip arthroplasty mechanical failure, according to a study published in Clinical Orthopaedics and Related Research.

“Since participation in sport is now a reality for a significant number of total hip arthroplasty (THA) patients, surgeons may need to adapt their choices of bearing surfaces in implants to accommodate this growing trend,” the authors wrote.

Read More


Four Area Hospitals Ban Sugary Drinks
Source - CBS Chicago

Do you know just one sugary drink a day can make you fat? Medical experts say they're the biggest culprit when it comes to obesity.

CBS 2′s Roseanne Tellez has details on a first-of-its-kind medical conference, right here in Chicago.

Read More


Sugary drinks out at 4 Chicago-area hospitals
Source - abc7chicago

Obesity rates are staggering in this country, and some experts say that is reason enough to cut back on sugary drinks.

Vanguard Health announced Wednesday it will phase out sugary drinks at the four hospitals it operates in the Chicago area. That news came during a "Rethink Your Drink" symposium held at Rush University Medical Center.

Read More


Can surgery help you stay in the game?
SourceBoston.com

Demand for joint replacement surgery, once confined largely to patients well past retirement age, has been growing rapidly among a class of people doctors have dubbed the “young actives’’ - those in the 45 to 64 age group who are determined to stay fit.

Still, even with the rise of obesity and longer lives, public health researchers say the rate of joint replacement failures requiring revisions is about 1 percent a year, mostly in the relatively younger patients who “outlive’’ the 10-to-20-year working life spans of their replacement joints. And as technique and technology have improved, the rates of infection, dislocations, and other complications have declined.

Read More


Untreated varicose veins put patients at greater DVT risk following THA
SourceOrthosupersite

As the search continues for methods to reduce deep vein thrombosis and pulmonary embolism risk in patients undergoing total joint arthroplasty, researchers have found increased rates of deep vein thrombosis within 90 days of undergoing total hip arthroplasty among patients with untreated varicose veins.

“Overall patients should consider having their varicose veins treated prior to undergoing total hip arthroplasty (THA) in an attempt to reduce DVT [deep vein thrombosis],” Anahita Dua, MD, of Brookfield, Wisc., said at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting, here.

Read More


ACR approves standardized measures to determine RA disease activity
SourceOrthosupersite

A working group organized by the American College of Rheumatology has analyzed more than 60 disease activity measures for rheumatoid arthritis and recommended six measures that can be applied in clinical practice, according to a press release. The analysis by the Rheumatoid Arthritis (RA) Clinical Disease Activity Measures Working Group apppear in Arthritis Care & Research.

“Our goal was to determine which RA disease activity measures could accurately distinguish the various levels of RA activity and would also be reasonable to implement in clinical practice,” Salahuddin Kazi, MD, from the Dallas Veterans Affairs Medical Center in Texas and a lead study investigator, stated in a press release.

Read More


Some seniors at greater risk of falls and hip fractures due to undiagnosed neurological disorders
SourceMedical News Today

Hip fractures are a common cause of morbidity and mortality in elderly patients. Cervical myelopathy is a common neurological condition that can diminish balance and coordination. Undiagnosed neurological disorders may predispose patients to falls and fractures. Screening for cervical myelopathy should be standard care for all hip fracture patients, to reduce the risk for additional falls and fractures.

Read More


Understanding a patient's mental health status before hip replacement surgery may improve education and care
SourceMedical News Today

Patients taking antidepressants up to three years prior to undergoing a total hip replacement (THR) were more likely to report greater pain before and after surgery and less satisfaction with their procedure, according to new research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

According to the investigators, a patient's mental health status should be assessed prior to surgery and taken into consideration during post-operative care.

Read More


Knee replacement may lower a patient's risk for mortality and heart failure
Sourcee! Science News

New research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) highlights the benefits of total knee replacement (TKR) in elderly patients with osteoarthritis, including a lower probability of heart failure and mortality.

There were significant positives in the osteoarthritis TKR group: the risk of mortality was half that of the non-TKR group and the congestive heart failure rate also was lower, at three, five and seven years after surgery. There was no difference in diabetes rates among both groups. Depression rates were slightly higher in the TKR group during the first three years after surgery, though there was no difference at five and seven years.

Read More


2 knee replacements may be better than 1
Sourcee! Science News

"Our study found that the risk of developing a serious joint infection that required an additional knee revision surgery was two times higher in patients who had staged knee replacements compared to the patients who had both knees replaced at the same time (2.2 percent after staged knee replacements and 1.2 percent after bilateral knee replacements)," said John P. Meehan, MD, study author and orthopaedic surgeon from the University of California, Davis.

Similar to previous studies, this study found that the risk of adverse cardiovascular events such as having a heart attack or developing a blood clot that travels to the lungs was higher after undergoing simultaneous knee replacements, but there was no significant difference in overall mortality.

Dr. Meehan added that further research is now needed to better define which patients should not be considered for bilateral simultaneous knee replacement.

Read More

You will need the Adobe Reader to view and print these documents. Get Adobe Reader

Location Map - Tom Smith, D.O. - Hip and Knee Surgeon
Patient Forms - Tom Smith, D.O. - Hip and Knee Surgeon
Patient Testimonials - Tom Smith, D.O. - Hip and Knee Surgeon
Location Map - Tom Smith, D.O. - Hip and Knee Surgeon
Patient Forms - Tom Smith, D.O. - Hip and Knee Surgeon
Patient Testimonials - Tom Smith, D.O. - Hip and Knee Surgeon
Location Map - Tom Smith, D.O. - Hip and Knee Surgeon
Patient Testimonials - Tom Smith, D.O. - Hip and Knee Surgeon
follow Us
Your Practice Online

© Tom Smith, D.O. Hip & Knee Surgeon Joint Replacement Surgery IL Chicago