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April 2008 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for April 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Potential Susceptibility Genes for Osteoporosis Identified

WEDNESDAY, April 30 (HealthDay News) -- Genes associated with bone mineral density and low-energy fractures in European populations have been identified, according to a report published online April 29 in the New England Journal of Medicine.

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Physicians Lack Feedback on Accuracy of Diagnoses

TUESDAY, April 29 (HealthDay News) -- Clinical diagnosis is a largely open-loop system in which there is no systematic way for clinicians to obtain feedback on the outcome of their diagnoses, according to an article published in a supplement to the May issue of The American Journal of Medicine.

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Thiazolidinediones May Raise Risk of Hip, Wrist Fractures

MONDAY, April 28 (HealthDay News) -- Patients with diabetes who take the oral insulin-sensitizing drugs rosiglitazone and pioglitazone may be at an increased risk of suffering hip and wrist fractures, according to an article published in the April 28 issue of the Archives of Internal Medicine.

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Palliative Care Can Improve Patient Care Most, Poll Finds

MONDAY, April 28 (HealthDay News) -- In an international poll conducted by BMJ to determine which area of health care would enable doctors to make the greatest difference to patients, palliative care for non-malignant disease received the most votes, the BMJ Group announced at the International Forum on Quality and Safety in Health Care in Paris this week.

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Endoscopic Lumbar Discectomy Safe and Effective

THURSDAY, April 24 (HealthDay News) -- Full-endoscopic interlaminar and transforaminal lumbar discectomy produces results similar to those of conventional microsurgery without the same risk of damage due to trauma, according to a study published in the April 20 issue of Spine.

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Spinal Fracture Outcome Same With or Without Surgery

THURSDAY, April 24 (HealthDay News) -- Over the medium to long term, operative and nonoperative treatment for traumatic thoracic and lumbar spinal fractures result in similar overall outcomes, according to a study published in the April 20 issue of Spine.

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Magnetic Resonance Images of Herniated Disc Reliable

THURSDAY, April 24 (HealthDay News) -- Readers of magnetic resonance images of intervertebral disc herniation are able to accurately and reliably assess disc morphology, according to a study published in the April 20 issue of Spine.

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Upsurge in U.S. Patients with Hip, Knee Replacements

FRIDAY, April 18 (HealthDay News) -- The number of primary knee and hip replacements performed in the United States is increasing at a steep rate, requiring that the health care community take steps to prepare for this demand and manage its economic burden, according to a report in the April 15 issue of Arthritis Care & Research.

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Nail Fixation Rate Soaring for Hip Fractures

THURSDAY, April 17 (HealthDay News) -- Since 1999, there has been a dramatic increase in the rate of young surgeons performing intramedullary nail fixation for intertrochanteric hip fractures despite a lack of evidence demonstrating its superiority over plate fixation and other evidence suggesting it may be associated with more complications, according to a review article published in the April issue of the Journal of Bone & Joint Surgery.

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Electronic Medical Records Improve Elderly Patient Care

WEDNESDAY, April 16 (HealthDay News) -- Elderly and diabetic patients are better served by the use of electronic medical and health records, according to two studies published in the April issue of the Journal of General Internal Medicine.

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Loop Diuretics Linked to Bone Loss in Older Men

MONDAY, April 14 (HealthDay News) -- Loop diuretics may lead to accelerated hip bone loss in older men, researchers report in the April 14 issue of the Archives of Internal Medicine.

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Radiation from Kyphoplasty Hazardous to Surgeon

MONDAY, April 14 (HealthDay News) -- Surgeons who perform kyphoplasty frequently may be exposed to radiation doses in unprotected areas, such as the hands and eyes, that exceed occupational safety limits, according to an article published in the Journal of Spinal Disorders & Techniques in April.

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Risk of Lumbar Degeneration After Spinal Fusion Varies

MONDAY, April 14 (HealthDay News) -- In patients undergoing low lumbar spinal fusions, floating L4/5 fusions are more likely to result in degenerative changes in adjacent segments than L4/S1 or L5/S1 fusions, according to an article published in Journal of Spinal Disorders & Techniques in April.

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New Guidelines Issued for Lumbar Spinal Stenosis

MONDAY, April 14 (HealthDay News) -- New clinical guidelines for the diagnosis and treatment of degenerative lumbar spinal stenosis issued by the North American Spine Society (NASS) provide clinicians with the latest evidence-based recommendations for delivering optimal care to patients with the spinal disorder. The guidelines are published in the March/April issue of the Spine Journal.

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Individualized Health Care Budgets Improve Care

FRIDAY, April 11 (HealthDay News) -- The U.K.'s National Health Service (NHS) should allow patients individual control of their health care budgets, an approach that has been shown in pilot studies to improve outcomes and patient satisfaction in a cost-effective manner, according to an analysis published April 12 in BMJ.

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Survey Examines Spine Surgery Complication in Japan

FRIDAY, April 11 (HealthDay News) -- In Japan, the incidence of vertebral artery injury during cervical spine surgery is similar to or slightly less than that reported in the literature. In many cases, this potentially catastrophic complication can be successfully managed with tamponade, according to a report published in the April issue of Spine.

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Spinal Fusion Works in Elderly Despite Osteoporotic Bone

FRIDAY, April 11 (HealthDay News) -- Using surgical rods and screws that are specially designed for osteoporotic bone allows good outcomes in elderly patients who undergo lumbar arthrodesis for severe lumbar stenosis, according to an article published in the April issue of the Journal of Spinal Disorders & Techniques.

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Subjective Measures Inform Success of Back Surgery

FRIDAY, April 11 (HealthDay News) -- While objective measures are commonly used to gauge the success of surgery for lumbar canal stenosis, several subjective measures can gauge patient satisfaction and should be used in evaluating surgical outcomes, according to an article published in the March/April issue of the Spine Journal.

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Non-Organic Sign Testing Reliable in Low Back Pain

THURSDAY, April 10 (HealthDay News) -- When trained observers perform non-organic sign testing in patients with chronic low back pain, the interobserver reliability of the Waddell score is moderate and the intraobserver reliability is good, according to research published in the April issue of Spine.

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Lumbar Decompression Doesn't Lead to Weight Loss

THURSDAY, April 10 (HealthDay News) -- After successful lumbar decompression surgery, most overweight and obese patients either maintain or gain body weight despite significant improvements in physical function and symptoms such as neurogenic claudication, according to a study published in the April issue of the Journal of Bone & Joint Surgery.

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Surgical Technique Prevents Nerve Pain After Back Surgery

THURSDAY, April 10 (HealthDay News) -- Postoperative nerve pain after posterior lumbar interbody fusion surgery (PLIF) can be prevented with careful surgical technique, according to an article published in the March/April issue of the Spine Journal.

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Consider Health Literacy Level When Writing for Patients

THURSDAY, April 10 (HealthDay News) -- Giving patients clearly written educational materials that convey key messages without resorting to jargon is an important part of engaging patient compliance with treatment and can contribute to health literacy, according to an article published in the April issue of Chest.

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Optimal Range of Motion Found After Knee Replacement

WEDNESDAY, April 9 (HealthDay News) -- After total knee arthroplasty with a posterior cruciate-retaining prosthesis, a range of motion between 128 and 132 degrees is associated with an optimal outcome, according to research published in the April 1 issue of the Journal of Joint & Bone Surgery.

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Corticosteroid Use Questioned in Nerve Root Infiltration

WEDNESDAY, April 9 (HealthDay News) -- In the non-surgical treatment of lumbar disc herniation with nerve root infiltration, corticosteroids show no additional benefit when combined with a local anesthetic, according to the results of an animal study published in the April issue of Spine.

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Doctors Vote on the Ways to Make Biggest Difference

WEDNESDAY, April 9 (HealthDay News) -- The BMJ has begun accepting votes on which areas of health care allow doctors to make the biggest difference to patient care, with a shortlist of six areas each being championed by eminent doctors and researchers. The winning topic will gain special coverage in the BMJ and the BMJ Group's 24 other specialist journals and online education products.

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Drug Reduces Clotting Risk After Hip Replacement

MONDAY, April 7 (HealthDay News) -- A synthetic oligosaccharide with anti-factor Xa and IIa activities reduces the rate of venous thromboembolism after hip replacement surgery, researchers report in the April 15 issue of the Journal of the American College of Cardiology.

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Child Gymnasts at High Risk for Injury

MONDAY, April 7 (HealthDay News) -- Gymnastics has one of the highest injury rates of all girls' sports, accounting for an average 26,600 hospital emergency department treatments a year in children, according to an article published in the April issue of Pediatrics.

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