December 2012 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for December 2012. 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.

rhBMP-2 Linked to Increased Rate of Retrograde Ejaculation

FRIDAY, Dec. 28 (HealthDay News) -- For patients with lumbar spondylosis or spondylolisthesis of the lowest lumbar levels who undergo open anterior lumbar interbody fusion (ALIF), use of recombinant human bone morphogenetic protein-2 (rhBMP-2) is associated with an increased rate of retrograde ejaculation (RE), according to research published in the October issue of The Spine Journal.

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Surgical Never Events Costly, Cause Considerable Harm

FRIDAY, Dec. 28 (HealthDay News) -- Surgical never events, including retained foreign bodies and wrong-site, wrong-patient, and wrong-procedure surgeries, are costly and incur considerable harm to patients, according to research published online Dec. 18 in Surgery.

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EP Studies Helpful in Lumbar Spinal Stenosis Prognosis

THURSDAY, Dec. 27 (HealthDay News) -- Electrophysiological abnormalities have been identified that are of some prognostic value in determining deteriorating clinical status over the long term for patients with mild-to-moderate lumbar spinal stenosis (LSS), according to research published in the December issue of the European Spine Journal.

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Spinal Fatigue Model Predicts Risk of Lumbar Spinal Failure

WEDNESDAY, Dec. 26 (HealthDay News) -- The risk of lumbar spinal injury following repetitive compressive loading can be predicted using a model which includes age and sex, according to research published in the Dec. 15 issue of Spine.

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Cementless Hips Survive Well in Younger Patients

WEDNESDAY, Dec. 26 (HealthDay News) -- Cementless hip implants survive well in younger adults undergoing hip replacement surgery on long-term follow-up, though the overall reoperation rates are similar to cemented implants due to greater polyethylene wear, according to a study published in the Dec. 5 issue of The Journal of Bone & Joint Surgery.

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Increased Serum Metal Levels After Lumbar Disc Replacement

FRIDAY, Dec. 21 (HealthDay News) -- Serum metal levels of cobalt and chromium are elevated at all postoperative time points up to 36 months following metal-on-metal lumbar disc replacement, according to research published in the November issue of the European Spine Journal.

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Upper Lumbar Disc Space Related to Hip Pain

FRIDAY, Dec. 21 (HealthDay News) -- Disc space narrowing at disc levels L1/L2 and L2/L3, visible on lumbar radiographs, may help to identify hip pain patients whose pain originates in the lumbar spine, according to research published in the November issue of the European Spine Journal.

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Motor Vehicle Incidents Common in Medical Residents

FRIDAY, Dec. 21 (HealthDay News) -- During training, internal medicine residents commonly experience motor vehicle incidents, including crashes and near misses, but less commonly experience blood and body fluid (BBF) exposures, according to research published in the December issue of the Mayo Clinic Proceedings.

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Spanish Registry IDs Predictors of Low Back Pain Improvement

THURSDAY, Dec. 20 (HealthDay News) -- For patients with acute or chronic low back pain (LBP), predictors have been identified for clinically relevant improvements in LBP, pain down the leg (LP), and disability at three months, according to research published in the November issue of The Spine Journal.

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Substantial Morbidity, Mortality From Fungus-Tainted Steroid

WEDNESDAY, Dec. 19 (HealthDay News) -- Considerable morbidity and mortality resulted from the use of three lots of fungus-contaminated methylprednisolone acetate, recalled by the pharmacy, according to a preliminary report published online Dec. 19 in the New England Journal of Medicine.

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Many Docs Use Social Media to Find, Share Medical Data

WEDNESDAY, Dec. 19 (HealthDay News) -- Most physicians use social media on at least a weekly basis, and report that it improves the quality of patient care they deliver, according to a study published in the September/October issue of the Journal of Medical Internet Research.

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Denosumab Does Not Delay Nonvertebral Fracture Healing

WEDNESDAY, Dec. 19 (HealthDay News) -- Denosumab does not appear to delay fracture healing or contribute to other complications when used to treat postmenopausal women with osteoporosis, according to research published in the Dec. 5 issue of The Journal of Bone & Joint Surgery.

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For Whiplash, Usual Care, Single PT Session Found Adequate

TUESDAY, Dec. 18 (HealthDay News) -- For patients with acute whiplash, usual care in the emergency department and a single session with a physical therapist are recommended, according to a study published online Dec. 18 in The Lancet.

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Surgery, Exercise Long-Term Outcomes Equal for Back Pain

MONDAY, Dec. 17 (HealthDay News) -- Over nine years of follow-up, patients with chronic low back pain randomized to lumbar fusion do not report better outcomes than those receiving cognitive intervention and exercises, according to a study published in the December issue of the European Spine Journal.

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Health Care Satisfaction Rated As High by Unacculturated Hispanics

MONDAY, Dec. 17 (HealthDay News) -- Hispanic patients, particularly unacculturated Hispanics, rate their health care experience more highly than do other patient groups, according to a study published in the October issue of the Journal of Immigrant and Minority Health.

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Risk Factors ID'd for Revision of Total Hip Replacement

MONDAY, Dec. 17 (HealthDay News) -- Younger, taller, and heavier patients who undergo primary total hip replacement (THR) are at a greater risk of needing a revision surgery, according to research published in the December issue of Arthritis Care & Research.

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Omega-3 Supplements Don't Increase Surgical Blood Loss

FRIDAY, Dec. 14 (HealthDay News) -- Omega-3 fatty acid (n-3FA) supplements do not correlate with higher perioperative blood loss during spinal fusion procedures, according to a study published in the December issue of the European Spine Journal.

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Trunk Exercise Reduces Pain, Disability in Low Back Pain

FRIDAY, Dec. 14 (HealthDay News) -- For patients with chronic low back pain, compared with general exercise, specific trunk exercise results in significant reductions in self-rated disability and pain but similar changes in anticipatory postural adjustments, according to a study published in the Dec. 1 issue of Spine.

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Exercise Performance Enhanced With Virtual Partner

THURSDAY, Dec. 13 (HealthDay News) -- Exercise duration is improved by exercising with a virtual partner, especially with a moderately superior partner, according to a study published in the October issue of the Annals of Behavioral Medicine.

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Current Health Costs Pushing Docs to Make Urgent Choices

WEDNESDAY, Dec. 12 (HealthDay News) -- The current growth in health care's share of the gross domestic product (GDP) and need to implement learning health systems is forcing physicians to make important choices, according to a perspective piece published online Dec. 12 in the New England Journal of Medicine.

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Smoking Cessation Cuts Pain in Patients With Spine Disorders

WEDNESDAY, Dec. 12 (HealthDay News) -- For patients with painful spinal disorders, there is a strong, clinically significant association between smoking cessation and improved patient-reported pain scores, according to a study published in the Dec. 5 issue of The Journal of Bone & Joint Surgery.

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Degeneration Similar With, Without Disc Prosthesis Surgery

WEDNESDAY, Dec. 12 (HealthDay News) -- Compared with rehabilitation, disc prosthesis surgery for chronic low back pain is associated with the same level of adjacent level degeneration (ALD) but with increased facet arthropathy (FA) at the implant level, according to a study published in the Dec. 1 issue of Spine.

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NSAIDs Exacerbate Exercise-Induced Small Intestinal Injury

WEDNESDAY, Dec. 12 (HealthDay News) -- Nonsteroidal anti-inflammatory drugs (NSAIDs) aggravate exercise-induced small intestinal injury in athletes, according to a study published in the December issue of Medicine & Science in Sports & Exercise.

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Nonsurgical Repair of Achilles Tendon May Be Preferable

TUESDAY, Dec. 11 (HealthDay News) -- Although surgical repair of a ruptured Achilles tendon is thought to reduce the risk of rerupture, nonsurgical management shows similar rerupture rates when functional rehabilitation with early range of motion is used, according to research published in the Dec. 5 issue of The Journal of Bone & Joint Surgery.

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Number of Independent Physicians Continues to Decline

MONDAY, Dec. 10 (HealthDay News) -- Physician business models are transforming, with a sustained shift away from independent practice, according to report released by the consulting firm Accenture.

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Readmission Seen in ~7 Percent of Elective Spine Surgeries

MONDAY, Dec. 10 (HealthDay News) -- About 7 to 8 percent of Medicare beneficiaries who undergo elective spine surgery for degenerative conditions are readmitted to the hospital within 30 days, according to a study published in the October issue of The Spine Journal.

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Spinal Fusion Surgery Not Associated With Stroke

MONDAY, Dec. 10 (HealthDay News) -- Undergoing spinal fusion surgery does not affect the risk of stroke within the three years after surgery, according to a study published in the December issue of the European Spine Journal.

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No Evidence That Doping Enhances Athletic Performance

FRIDAY, Dec. 7 (HealthDay News) -- Although use of recombinant human erythropoietin (rHuEPO) is prohibited among athletes because it reportedly enhances performance, there is no scientific evidence that it does so, according to a study published online Dec. 6 in the British Journal of Clinical Pharmacology.

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Spine Education Seems Ineffective in Pain Prevention

FRIDAY, Dec. 7 (HealthDay News) -- Educational interventions, mainly focused on a biomechanical/biomedical model, do not seem to be effective in preventing low back pain, according to a review published in the December issue of the European Spine Journal.

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Anticompetitive Market Power Common in Managed Care Plans

FRIDAY, Dec. 7 (HealthDay News) -- For each of the three most popular types of managed care plans in the United States (point-of-service plan [POS], health maintenance organization [HMO], and preferred provider organization [PPO]), anticompetitive market power is widespread, according to a Nov. 28 news release from the American Medical Association (AMA).

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FDA: Public-Private Venture Set to Improve Regulatory Science

THURSDAY, Dec. 6 (HealthDay News) -- The Medical Device Innovation Consortium (MDIC), the first public-private partnership to promote medical device regulatory science, has been established, according to a Dec. 3 news release issued by the U.S. Food and Drug Administration.

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Evidence Supports Premise: OR Distractions Up Surgical Errors

THURSDAY, Dec. 6 (HealthDay News) -- Typical operating room distractions and interruptions (ORDIs) potentially increase the likelihood of surgical errors among surgical trainees, according to a study published in the November issue of the Archives of Surgery.

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Five-Hour Protected Sleep Feasible for Medical Interns

TUESDAY, Dec. 4 (HealthDay News) -- Implementation of a five-hour period of protected sleep is feasible for medical interns on long shifts, resulting in interns getting more uninterrupted sleep and feeling more alert the next day, according to a study published in the Dec. 5 issue of the Journal of the American Medical Association.

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Increasing Number of Workers in Self-Insured Health Plans

MONDAY, Dec. 3 (HealthDay News) -- There has been a recent increase in the percentage of workers in the private sector who are enrolled in self-insured health plans, in which the employer assumes the financial risk related to health insurance (unlike a fully-insured plan, where the insurance company assumes the risk), according to research published in the November issue of the Employee Benefit Research Institute's Notes.

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Epidural Steroid Shot Has Adverse Effect on Bone Density

MONDAY, Dec. 3 (HealthDay News) -- For postmenopausal women, treatment of the pain associated with radiculopathy with epidural steroid injection (ESI) has an adverse effect on bone mineral density (BMD), according to a study published in the Dec. 1 issue of Spine.

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