February 2010 Briefing - Orthopedics

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

Diabetes Status Tied to Infection Risk After Foot, Ankle Surgery

FRIDAY, Feb. 26 (HealthDay News) -- Patients undergoing foot and ankle surgery are more likely to have postoperative infections if they have complicated diabetes mellitus, while patients with uncomplicated diabetes do not appear to have a higher risk than patients without diabetes, according to research published in the Feb. 1 issue of the Journal of Bone & Joint Surgery.

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Spinal Stenosis Cases Can Be Managed Nonoperatively

FRIDAY, Feb. 26 (HealthDay News) -- In patients with spinal stenosis, those without concomitant degenerative spondylolisthesis or scoliosis can be managed nonoperatively regardless of the number of levels; and, if surgery is performed, the number of levels treated does not predict outcome. However, among patients with concomitant degenerative spondylolisthesis, those with only single level stenosis tend to improve more than those with multilevel stenosis, especially after surgery, according to a research published in the Feb. 15 issue of Spine.

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Behavioral Intervention Found to Improve Low Back Pain

FRIDAY, Feb. 26 (HealthDay News) -- A behavioral intervention that encourages physical activity in patients with chronic lower back pain reduces disability and pain and is cost-effective, according to a study published online Feb. 26 in The Lancet.

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Radiographs Help Predict Curve Flexibility in Scoliosis

THURSDAY, Feb. 25 (HealthDay News) -- In the prediction of curve flexibility and postoperative correction in adolescent idiopathic scoliosis, traction under general anesthesia radiographs perform equivalently to supine bending radiographs, according to a study in the Feb. 15 issue of Spine.

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Lasofoxifene Examined in Postmenopausal Women

WEDNESDAY, Feb. 24 (HealthDay News) -- The nonsteroidal selective estrogen-receptor modulator lasofoxifene may reduce the risk of fractures, stroke, estrogen receptor (ER)-positive breast cancer, and coronary heart disease in postmenopausal women with osteoporosis. However, the drug significantly increases the risk of venous thromboembolic events, according to a study in the Feb. 25 issue of the New England Journal of Medicine.

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Questionnaire May Help Predict Chronic Low Back Pain

WEDNESDAY, Feb. 24 (HealthDay News) -- In patients with (sub) acute low back pain, the Acute Low Back Pain Screening Questionnaire Dutch Language Version (ALBPSQ-DLV) may help identify those at risk of developing chronic low back pain because of psychosocial factors, according to a study in the Feb. 15 issue of Spine.

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Iron Treatment for Anemia May Not Help After Hip Surgery

WEDNESDAY, Feb. 24 (HealthDay News) -- Iron supplementation for anemia after hip fracture surgery does not significantly improve hemoglobin levels, bringing into question the current practice of iron supplementation after orthopedic surgery, according to a study in the Feb. 1 issue of the Journal of Bone & Joint Surgery.

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Physicians Working Fewer Hours for Lower Fees

TUESDAY, Feb. 23 (HealthDay News) -- Physicians in the United States have been working fewer hours for lower fees in the past decade, according to research published in the Feb. 24 issue of the Journal of the American Medical Association.

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Venous Thrombosis Not a Major Risk in Spine Surgery

TUESDAY, Feb. 23 (HealthDay News) -- Patients undergoing spine surgery do not have a significant risk of deep venous thrombosis or pulmonary embolism, particularly if they are given pharmacologic prophylaxis, but this measure raises the risk of epidural hematoma, according to research published in the Feb. 1 issue of the Journal of Bone & Joint Surgery.

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No Gait Benefit for Minimally Invasive Hip Replacement

TUESDAY, Feb. 23 (HealthDay News) -- A minimally invasive approach for hip replacement has no advantage over the standard approach with regard to gait kinematics, according to a study in the Feb. 1 Journal of Bone & Joint Surgery. A related review in the same issue suggests that racial and ethnic minorities may have a higher risk of death or complications after knee or hip replacement.

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Medical Checklists Needed to Improve Care and Outcomes

MONDAY, Feb. 22 (HealthDay News) -- The checklists so common in aviation and many professions are underused in medicine and, if more widely adopted, would provide powerful tools to standardize care and improve patient outcomes, according to an article published Dec. 31 in Critical Care.

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Active Straight Leg Raising Reliable to Assess Back Pain

FRIDAY, Feb. 19 (HealthDay News) -- Among women with back pain, the subjective assessment of difficulty when taking the active straight leg raising (ASLR) test generally correlates well with the objectively measured force of the leg raises, according to a study in the Feb. 1 issue of Spine.

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Many Adults in Utah Report Using Opioids Incorrectly

FRIDAY, Feb. 19 (HealthDay News) -- In 2008, one-fifth of adults in Utah had been prescribed an opioid pain medication in the past year, with some respondents reporting use of these medications despite no prescription for them, according to an article in the Feb. 19 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Lumbar Fusion Linked to Improved Driver Reaction Time

TUESDAY, Feb. 16 (HealthDay News) -- The driver reaction time (DRT) in patients a week after lumbar fusion surgery is not significantly slower than their preoperative DRT, and after three months recovery their DRT may be faster than their preoperative DRT, according to a study in the Feb. 1 issue of Spine.

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Photodynamic Therapy Found to Strengthen Rat Vertebrae

TUESDAY, Feb. 16 (HealthDay News) -- Photodynamic therapy (PDT) improves the spinal bone structure, stiffness and strength in rats and may offer a way to ablate metastatic tumor tissue and strengthen the spines of human cancer patients, according to a study in the Feb. 1 issue of Spine.

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Racial Disparities Seen in New York Surgical Patients

TUESDAY, Feb. 16 (HealthDay News) -- In New York City, minority patients are significantly less likely than Caucasians to use high-volume surgeons and hospitals when undergoing procedures with an established volume-mortality association, according to a study in the February issue of the Archives of Surgery.

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Poor Sleep Linked to More Car Accidents in Teenagers

TUESDAY, Feb. 16 (HealthDay News) -- Poor sleep habits are associated with a higher risk of car accidents among teenagers, according to a study in the Feb. 15 issue of the Journal of Clinical Sleep Medicine.

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2009 H1N1-Related Deaths and Hospitalizations Examined

MONDAY, Feb. 15 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has provided updated estimates of the 2009 H1N1 cases, related hospitalizations and deaths, with approximately 57 million cases occurring between April 2009 and January 2010.

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Physical Activity Surveillance Methods Need Improvement

MONDAY, Feb. 15 (HealthDay News) -- Relying on self-reported data to study disparities in physical activity can produce misleading information about population-wide trends, and surveillance should be revised to use more objective methods of data collection, according to research published online Feb. 10 in the American Journal of Public Health.

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Shoulder Injuries Compared in High School Baseball, Softball

FRIDAY, Feb. 12 (HealthDay News) -- Although high school baseball and softball players tend to have similar rates of shoulder injuries, there are factors at play that may help improve preventive efforts, according to research published online Feb. 8 in Pediatrics.

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Systemic Treatment Deemed Effective for Giant-Cell Tumor

THURSDAY, Feb. 11 (HealthDay News) -- Denosumab, an antibody that targets cells involved in bone destruction, is the first systemic treatment shown to be effective in treating giant-cell tumor, a rare osteolytic tumor that can metastasize to the lung, according to a study published online Feb. 10 in The Lancet Oncology.

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Laparoscopic Practice Takes Physical Toll on Surgeons

THURSDAY, Feb. 11 (HealthDay News) -- Many surgeons who perform laparoscopic surgery suffer pain, numbness, stiffness, fatigue and other physical symptoms, often as a result of high case load, according to a study published online Dec. 24 ahead of print in the Journal of the American College of Surgeons.

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AHRQ: U.S. Adults Seeing Big Barriers to Specialty Care

WEDNESDAY, Feb. 10 (HealthDay News) -- In 2007, about one in 13 of U.S. adults reported that access to specialist care was a "big problem," according to a December report issued by the Agency for Healthcare Research and Quality (AHRQ).

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FDA Initiative Aims to Cut Medical Radiation Exposure

WEDNESDAY, Feb. 10 (HealthDay News) -- The U.S. Food and Drug Administration has launched a new initiative that aims to reduce exposure to radiation from computed tomography (CT), nuclear medicine studies and fluoroscopy, the three procedures that are the main sources of medically-related radiation exposure.

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H1N1 Vaccination Still Highly Recommended

MONDAY, Feb. 8 (HealthDay News) -- Despite H1N1 virus levels stabilizing, transmission remains an issue and vaccination continues to be an effective option for prevention of this potentially serious condition, according to a Feb. 5 press briefing by the U.S. Centers for Disease Control.

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Many American Adults Do Not Get Recommended Vaccines

MONDAY, Feb. 8 (HealthDay News) -- Although most parents ensure their children are vaccinated, adults often do not receive recommended vaccinations themselves, according to a new report, Adult Immunization: Shots to Save Lives.

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Physical Inactivity, Not Just Lack of Exercise, Harms Health

FRIDAY, Feb. 5 (HealthDay News) -- Sedentary behavior and a lack of whole-body movement are independent predictors of increased mortality and increased incidence of obesity, diabetes, heart disease and cancer, regardless of level of physical exercise, according to an article published online Feb. 4 in the British Journal of Sports Medicine.

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Coalition Launches Campaign to Limit Residents' Hours

FRIDAY, Feb. 5 (HealthDay News) -- To prevent medical errors caused by doctor fatigue, a coalition of public interest and patient safety groups is urging the Accreditation Council for Graduate Medical Education (ACGME) to limit the amount of time residents must work without sleep to 16 hours and to increase resident supervision.

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Backpack Weight Linked to Back Issues in Children

FRIDAY, Feb. 5 (HealthDay News) -- Increasing backpack loads are associated with more back pain, lumbar asymmetry, and decreases in lumbar disc height in children, according to research published in the Jan. 1 issue of Spine.

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Health Care Spending Makes Record Leap in GDP Share

THURSDAY, Feb. 4 (HealthDay News) -- A growth in health spending in 2009, coupled with a sagging economy, created the largest one-year jump in health care's share of the nation's gross domestic product since 1960, according to an article published online Feb. 4 in Health Affairs.

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Views of Physicians, Patients Differ on Spinal Surgery

THURSDAY, Feb. 4 (HealthDay News) -- Surgeons, family physicians, and their patients have different perceptions of what constitutes good grounds for spinal surgery, according to a study in the Jan. 1 issue of Spine.

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Diversity Growth Incremental in the Medical Professions

THURSDAY, Feb. 4 (HealthDay News) -- One hundred years after the Flexner Report recommended closing five of the seven African-American medical schools then extant, African-Americans and other minorities remain grossly underrepresented in the medical professions, according to an article in the February issue of Academic Medicine.

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Surgery Not Necessarily Better for Lumbar Disc Herniation

THURSDAY, Feb. 4 (HealthDay News) -- Both surgical and non-surgical treatments for lumbar disc herniation are effective, and the relative long-term benefits of surgery may differ depending on whether or not the patient has workers' compensation, according to a study in the Jan. 1 issue of Spine.

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The Lancet Retracts Study Linking MMR Vaccine, Autism

WEDNESDAY, Feb. 3 (HealthDay News) -- On Feb. 2, The Lancet retracted a controversial 1998 study that linked the measles, mumps and rubella (MMR) vaccine to autism and gastrointestinal problems.

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Xiaflex Approved for Rare Hand Condition

WEDNESDAY, Feb. 3 (HealthDay News) -- Collagenase clostridium histolyticum (Xiaflex) has been approved by the U.S. Food and Drug Administration as the first drug to treat a disabling hand condition called Dupuytren's contracture.

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President Proposes $911 Billion Budget for HHS

TUESDAY, Feb. 2 (HealthDay News) -- As part of his 2011 budget proposal, President Barack Obama has proposed $911 billion for the U.S. Health and Human Services (HHS) Department, according to a Feb. 1 announcement by the secretary of HHS, Kathleen Sebelius.

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Antioxidants Found to Alter Muscle Oxygen Use in Rats

MONDAY, Feb. 1 (HealthDay News) -- Antioxidants alter the pattern of oxygen delivery and consumption in resting and contracting muscle in aged rats, according to recent studies at Kansas State University, including research originally published in the December 2008 issue of the Journal of Applied Physiology.

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Algorithm Developed to Segment the Meniscus in MRIs

MONDAY, Feb. 1 (HealthDay News) -- Semi-automated segmentation of magnetic resonance images can accurately assess the lateral meniscus in patients with and without knee osteoarthritis, according to a study published in Osteoarthritis and Cartilage.

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