December 2009 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for December 2009. 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.

Precautions and Training Can Reduce Scalpel Injuries

THURSDAY, Dec. 31 (HealthDay News) -- Although less common than needle-stick injuries, cuts from scalpels also put operating room personnel at risk and can be reduced by closely following safety precautions and taking advantage of new technology, according to a study in the December issue of the AORN Journal.

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Therapy Found Ineffective for Chronic Low Back Pain

THURSDAY, Dec. 31 (HealthDay News) -- Transcutaneous electric nerve stimulation (TENS) is not recommended for treating chronic low back pain, though it appears effective in treating the pain of diabetic peripheral neuropathy, according to an American Academy of Neurology guideline published online Dec. 30 in Neurology.

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Ultrasound Detects Shoulder Dislocation After Birth Injury

WEDNESDAY, Dec. 30 (HealthDay News) -- Ultrasound can be used to detect a posterior shoulder dislocation in infants 3 to 6 months old with a permanent brachial plexus birth injury (BPBI), according to a study in the January issue of Radiology.

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Ultrasound-Guided Injection Can Benefit Lateral Hip Pain

TUESDAY, Dec. 29 (HealthDay News) -- In patients with gluteus medius tendinopathy, peritendinous ultrasound-guided corticosteroid injection may be an effective treatment, according to a study published in the January issue of the American Journal of Roentgenology.

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Technique Found Effective, Safe in Spinal Stabilizations

MONDAY, Dec. 28 (HealthDay News) -- In patients undergoing spinal stabilization, intraoperative computed tomography in combination with neuronavigation improves the accuracy of screw placement, according to a study in the Dec. 15 issue of Spine.

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Effects of Screw Length on Spine Reconstruction Studied

TUESDAY, Dec. 22 (HealthDay News) -- In treating spinal disorders that require spino-pelvic reconstruction, short screws have similar biomechanical strength as long screws if augmented by bone cement, according to a study in the December issue of the Journal of Spinal Disorders & Techniques.

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Surveillance Can Reduce Treatment in Mild Hip Dysplasia

TUESDAY, Dec. 22 (HealthDay News) -- In infants with mildly dysplastic hips, active surveillance for six weeks, as opposed to immediate abduction splinting can reduce the need for treatment yet lead to similar results at 1 year of age, according to research published online Dec. 21 in Pediatrics.

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Risk of Neurologic Deficit Right After Spinal Surgery Low

MONDAY, Dec. 21 (HealthDay News) -- The likelihood of developing a major neurologic deficit immediately after spinal surgery is low, according to a study in the December issue of the Journal of Spinal Disorders & Techniques.

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Surgical Approach May Affect Lung Function in Scoliosis

MONDAY, Dec. 21 (HealthDay News) -- In adolescents with scoliosis who undergo surgery, thoracotomy and thoracoscopy are associated with declines in lung function, while thoracoabdominal surgery has no significant effect, according to a study in the December issue of the Journal of Spinal Disorders & Techniques.

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Integrated Approach Assesses Residents' Surgical Ability

MONDAY, Dec. 21 (HealthDay News) -- An integrated approach can effectively assess orthopedic residents' competence in the performance of carpal tunnel release surgery, according to a study in the Dec. 1 issue of the Journal of Bone & Joint Surgery.

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Pelvic Fracture May Increase Trauma Patients' Risk of Death

MONDAY, Dec. 21 (HealthDay News) -- In trauma patients, pelvic fracture is significantly associated with death, but its effect should be considered in relation to other variables, according to a study in the Dec. 1 issue of the Journal of Bone & Joint Surgery.

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Study Examines Low Back Pain Therapy Techniques

FRIDAY, Dec. 18 (HealthDay News) -- In patients with low back pain, a clinical prediction rule may be generalizable to additional thrust manipulation techniques but not to non-thrust manipulation techniques, according to a study in the Dec. 1 issue of Spine.

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Goal Achievement Impacts Spine Patients' Satisfaction

FRIDAY, Dec. 18 (HealthDay News) -- In patients with chronic disabling spinal disorders who complete a functional restoration program, goal achievement may be a valuable patient-centered measure of treatment outcome, according to a study in the Dec. 1 issue of Spine.

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Reduction Technique Effective for Shoulder Dislocation

FRIDAY, Dec. 18 (HealthDay News) -- For the reduction of an anterior shoulder dislocation, the new FARES (Fast, Reliable, and Safe) method is significantly more effective, faster, and less painful than conventional methods, according to a study in the Dec. 1 issue of The Journal of Bone & Joint Surgery.

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Improvement Threshold Defines Low Back Pain Success

THURSDAY, Dec. 17 (HealthDay News) -- In patients with low back pain, a successful outcome may be defined as at least a 50 percent improvement on the Modified Oswestry disability index, according to a study in the Dec. 1 issue of Spine.

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Digital Radiography Rapidly Localizes Spine Level

TUESDAY, Dec. 15 (HealthDay News) -- Digital radiography is considerably faster than conventional radiography in localizing the cervical spine level during surgery, which may reduce hospital costs, according to a study in the December issue of The Spine Journal.

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Delayed Surgery May Be Better for Some Knee Injuries

MONDAY, Dec. 14 (HealthDay News) -- Delaying surgery to treat multiple-ligament knee injuries may yield similar stability outcomes as acute surgery, while staged surgery yields better subjective results, according to a study in the Dec. 1 issue of the Journal of Bone & Joint Surgery.

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Lower Speed Limit Reduces Casualties in London

FRIDAY, Dec. 11 (HealthDay News) -- In London, the introduction of 20 mph speed zones has significantly reduced road injuries and deaths, according to a study published online Dec. 10 in BMJ.

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Factors Affecting Back-Pain Sick Leave in Chile Identified

FRIDAY, Dec. 11 (HealthDay News) -- Chileans are more likely to take longer sick leave for low back pain if they have a history of sick leave for low back pain, do manual labor, or were seen by an orthopedic surgeon, similar to other Western populations, according to a study in the December issue of The Spine Journal.

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Spinal Surgeries May Improve Back Pain and Sexual Function

FRIDAY, Dec. 11 (HealthDay News) -- Total disc replacement and posterior fusion both lead to improvements in not only lower back pain but also sexual function, according to a study in the December issue of The Spine Journal.

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Patients Often Lack Knowledge of Their Own Medications

THURSDAY, Dec. 10 (HealthDay News) -- Patients routinely under-report, or even over-report, their outpatient and inpatient medications, and should be included in hospital medication management to improve safety, according to a study published online Dec. 10 in the Journal of Hospital Medicine.

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Algorithm Developed for Metal-on-Metal Hip Resurfacing

THURSDAY, Dec. 10 (HealthDay News) -- Ideal candidates for metal-on-metal hip resurfacing may be identified with a new algorithm, according to a study in the November supplement of the Journal of Bone & Joint Surgery.

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Aggressive Identification of Patients Cuts Hip Fractures

THURSDAY, Dec. 10 (HealthDay News) -- Aggressive identification and management of patients at risk for osteoporosis-related hip fractures can substantially reduce the incidence rate, according to a study published in the Nov. 1 supplement of the Journal of Bone & Joint Surgery.

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Transplantation Technique Feasible for Spinal Cord Injury

THURSDAY, Dec. 10 (HealthDay News) -- In the treatment of spinal cord injury, transplantation of readily available mono-nuclear bone marrow cells may be an alternative to the use of bone marrow stromal cells, according to an animal study published in the Nov. 15 issue of Spine.

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New Technique Effective in L5 Radicular Syndrome

THURSDAY, Dec. 10 (HealthDay News) -- In patients with L5 radicular syndrome, an ultrasound-guided L5 nerve root block using electrical nerve stimulation is safe and effective, according to a study in the Nov. 15 issue of Spine.

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Symptom Responses in Spinal Pain Found of Limited Use

THURSDAY, Dec. 10 (HealthDay News) -- In the conservative management of spinal pain, clinically induced changes in spinal symptoms (i.e., symptom responses) have limited prognostic value, according to a study in the Nov. 15 issue of Spine.

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Low Back Pain Management Guidelines Have Improved

MONDAY, Dec. 7 (HealthDay News) -- Guidelines on the management of acute and chronic low back pain have improved in recent years but still require greater transparency, applicability and editorial independence, according to a study in the Nov. 1 issue of Spine.

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Depression Linked to Poorer Spinal Surgery Outcomes

MONDAY, Dec. 7 (HealthDay News) Lumbar spinal stenosis (LSS) patients who undergo decompressive surgery are more likely to report poorer outcomes from surgery if they were suffering from depression prior to surgery or in the early stages of recovery, according to a study in the Nov. 1 issue of Spine.

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New Cervical Spine Surgery Protocol May Reduce Delirium

FRIDAY, Dec. 4 (HealthDay News) -- A modified perioperative protocol for elderly patients undergoing cervical spine surgery that involves early commencement of mobilization, resumption of normal circadian rhythm, and reduction or avoidance of methylprednisolone may reduce postoperative delirium risk, according to a Japanese study published in the Nov. 1 issue of Spine.

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Post-Op Thromboembolism Risk Persists in Women

FRIDAY, Dec. 4 (HealthDay News) -- Middle-aged women who undergo inpatient surgery have a greatly elevated risk of venous thromboembolism in the weeks and months after surgery compared to women who have not had surgery, according to a study published Dec. 3 in BMJ.

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Osteoarthritis Proves Costly for Individuals and Insurers

THURSDAY, Dec. 3 (HealthDay News) -- Osteoarthritis (OA) is responsible for a substantial burden in health care expenditures, particularly in women, according to research published in the December issue of Arthritis & Rheumatism.

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Rural Residents More Likely to Have Total Joint Replacement

WEDNESDAY, Dec. 2 (HealthDay News) -- Medicare beneficiaries living in rural areas may be more likely to have total knee or hip replacement surgery than urban beneficiaries, contrary to factors that would suggest the opposite relationship, according to research published in the December issue of Arthritis & Rheumatism.

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Women Researchers Lag Behind Men in Grant Awards

TUESDAY, Dec. 1 (HealthDay News) -- Female physicians with a proven interest in research are less likely to receive prestigious research grants from the National Institutes of Health (NIH) than are male physicians, according to a study in the Dec. 1 issue of the Annals of Internal Medicine.

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