August 2010 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for August 2010. 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.

Post-Op Delirium Linked to Cerebral Vascular Disease

MONDAY, Aug. 30 (HealthDay News) -- Delirium after spinal fusion in elderly patients is more common in those with a history of cerebral vascular disease, low hemoglobin and hematocrit levels after surgery, and poor nutrition, according to a study in the Aug. 15 issue of Spine.

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Collar Preferable to Imaging in Unevaluable Trauma Patients

FRIDAY, Aug. 27 (HealthDay News) -- Imaging tests used for cervical spine clearance in unevaluable trauma patients lack sensitivity and are not cost-effective compared with empirical immobilization by a semi-rigid collar, according to research published in the Aug. 15 issue of Spine.

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Health Costs Likely High in LBP Patients With High Disability

MONDAY, Aug. 23 (HealthDay News) -- Low back pain (LBP) patients with high levels of disability have an increased likelihood of incurring high health care costs, and depression appears to play an important role in back pain patients' direct health care utilization, according to research published in the Aug. 15 issue of Spine.

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Thousands of Heat Illnesses Occur in Teen Athletes Yearly

FRIDAY, Aug. 20 (HealthDay News) -- On average, high school athletes in the United States have an estimated 9,237 time-loss heat illnesses annually, and the highest rate is among football players, according to a report in the Aug. 20 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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MRI May Not Explain Long-Term Whiplash Pain

FRIDAY, Aug. 20 (HealthDay News) -- Although some patients with whiplash-associated disorders (WAD) continue to experience neck pain in the long term, magnetic resonance imaging (MRI) may not explain their symptoms, according to a study in the Aug. 15 issue of Spine.

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Immediate In-Brace Correction Influences Scoliosis Outcomes

FRIDAY, Aug. 20 (HealthDay News) -- Prior analyses of the effect of bracing on long-term outcomes for correction of adolescent idiopathic scoliosis identified immediate in-brace correction as influential; a new study confirming these analyses and giving insight into the biomechanics of bracing has been published in the Aug. 15 issue of Spine.

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Active RA Predicts Decreases in Hand Bone Density

THURSDAY, Aug. 19 (HealthDay News) -- Rheumatoid arthritis (RA) disease activity is an important predictor of hand bone loss in female patients with long-standing, destructive RA, according to research published in the September issue of Rheumatology.

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Sham, Real Acupuncture Result in Similar Pain Relief in OA

THURSDAY, Aug. 19 (HealthDay News) -- Traditional Chinese acupuncture (TCA) is no better than sham acupuncture for patients with osteoarthritis of the knee, but patients whose acupuncturist communicates positive expectations have better pain reduction and satisfaction than patients whose acupuncturist has a neutral communication style, according to a study in the September issue of Arthritis Care & Research.

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Body Position and Anesthesia Can Alter Scoliosis Deformity

WEDNESDAY, Aug. 18 (HealthDay News) -- Spine curvature in scoliosis is corrected somewhat by different body positions and anesthesia during surgery, which can confound the determination of fusion levels, according to a study in the August issue of the Journal of Spinal Disorders & Techniques.

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Mortality Lower for Hip Surgery Patients With Home Care

MONDAY, Aug. 16 (HealthDay News) -- Most elderly patients who are discharged home after hemiarthroplasty do not receive home care, but those who do are 43 percent less likely to die within three months than those who are sent home without home care, according to research published online Aug. 16 in CMAJ, the journal of the Canadian Medical Association.

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Minimally Invasive Fusion Found Superior to Open Surgery

FRIDAY, Aug. 13 (HealthDay News) -- Minimally invasive transforaminal lumbar interbody fusion (TLIF) is superior to open surgical approaches for the treatment of 1-level degenerative lumbar diseases, according to research published in the Aug. 1 issue of Spine.

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Screening, Eradication Curtail Post-Surgery Staph Infections

FRIDAY, Aug. 13 (HealthDay News) -- Methicillin-sensitive Staphylococcus aureus (S. aureus) colonization is more prevalent among orthopedic surgeons than a high-risk patient group, but an institution-wide prescreening program for detecting and eradicating methicillin-sensitive and methicillin-resistant S. aureus among orthopedic surgery patients is feasible and can reduce surgical site infection rates, according to a pair of studies in the Aug. 4 issue of the Journal of Bone & Joint Surgery.

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Osteobiologic Risks, Benefits Should Be Individualized

THURSDAY, Aug. 12 (HealthDay News) -- All available osteobiologic options for spine fusion carry risk, but some are not fully known, and patients may not be aware of the risks and benefits of specific fusion materials, according to research published in the Aug. 1 issue of Spine.

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Adherence to Discography Guidelines Is Lackluster

THURSDAY, Aug. 12 (HealthDay News) -- National compliance with professional guidelines for discography, a controversial procedure to diagnose disc damage contributing to back pain, ranges from poor to fair, according to research published in the August issue of the Journal of Spinal Disorders & Techniques.

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Most Useful Marfan Syndrome Diagnostic Criteria Identified

THURSDAY, Aug. 12 (HealthDay News) -- While features of Marfan syndrome can be found in the general population, clinicians should be alert for craniofacial, thumb and wrist, and other indicators that are highly specific to the condition, according to a study in the Aug. 4 issue of the Journal of Bone & Joint Surgery.

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Two Wrist Fracture Treatments Have Similar Outcomes

THURSDAY, Aug. 12 (HealthDay News) -- Elderly patients with distal radial fractures treated with either surgery or cast immobilization achieve similar functional status one year later, although the surgical patients have greater grip strength, according to a study in the Aug. 4 issue of the Journal of Bone & Joint Surgery.

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Some Adversity Exposure May Improve Back Pain Outcomes

WEDNESDAY, Aug. 11 (HealthDay News) -- Among individuals with chronic back pain (CBP), those with some lifetime exposure to adverse events report less impairment and health care use than those with a high level of exposure to adverse events or no exposure to adversity, according to a study in the September issue of PAIN.

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Vertebroplasty Found Beneficial for Fracture Pain Control

TUESDAY, Aug. 10 (HealthDay News) -- Pain control with percutaneous vertebroplasty is superior to pain control with conservative management for acute osteoporotic vertebral compression fractures, according to research published online Aug. 10 in The Lancet.

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Spinal Fusion Procedure Safe in Obese Patients

MONDAY, Aug. 9 (HealthDay News) -- Obese patients undergoing extreme lateral interbody fusion (XLIF) for degenerative disease of the lumbar and thoracic spine do not have more complications than non-obese patients who undergo the procedure, according to research published in the August issue of the Journal of Spinal Disorders & Techniques.

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Angiography Urged for Vascular Bleeding After Spine Surgery

MONDAY, Aug. 9 (HealthDay News) -- Evaluation of possible vascular injuries occurring during spinal surgery should be rapid, starting with computed tomography (CT) in most cases and progressing immediately to angiography if arterial bleeding is suspected, according to research published in the August issue of the Journal of Spinal Disorders & Techniques.

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Few Procedures Account for Most Ortho Adverse Events

MONDAY, Aug. 9 (HealthDay News) -- Most adverse events that occur within 30 days after orthopedic surgery arise from a small number of procedures, according to research published in the Aug. 4 issue of the Journal of Bone & Joint Surgery.

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Fractures Comprise Sizable Portion of HS Sports Injuries

FRIDAY, Aug. 6 (HealthDay News) -- Fractures are a common type of injury among high school athletes, with potentially serious repercussions for the students and their families, according to research published in the July issue of the Clinical Journal of Sports Medicine.

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Podiatric Care Reduces Amputation Risk in Diabetes

FRIDAY, Aug. 6 (HealthDay News) -- Foot amputation or hospitalization resulting from foot ulcers in diabetes patients can be prevented or delayed with timely care from a podiatrist, and increased podiatry use by diabetes patients may result in substantial health care cost savings, according to research presented at the annual scientific meeting of the American Podiatric Medical Association, held from July 15 to 18 in Seattle.

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Industry-Funded Clinical Trials Yield More Positive Outcomes

TUESDAY, Aug. 3 (HealthDay News) -- Drug clinical trials supported by industry are more likely to produce favorable results than trials supported by government or nonprofit/nonfederal organizations, and they are less likely to be published within two years of the study being completed, according to research published in the Aug. 3 issue of the Annals of Internal Medicine.

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