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July 2008 Briefing - Orthopedics

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

Device May Decrease Musculoskeletal Procedure Pain

THURSDAY, July 31 (HealthDay News) -- A reciprocating procedure device decreases patient's pain during musculoskeletal procedures, improves outcomes and may decrease needlestick injuries to health care workers, according to an article published in the July issue of Arthritis & Rheumatism.

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Total Knee Arthroplasty Has Long-Term Benefits

TUESDAY, July 29 (HealthDay News) -- The physical function benefits of total knee arthroplasty to treat osteoarthritis are sustained beyond five years and are seen in both obese and non-obese patients, according to the results of a study published online July 29 in the Annals of the Rheumatic Diseases.

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Subtotal Discectomy Decreases Reoperation Rates

FRIDAY, July 25 (HealthDay News) -- Subtotal discectomy decreases reherniation after lumbar discectomy and is more effective than fragment excision alone, according to an article published in the July issue of the Journal of Spinal Disorders & Techniques.

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White, Middle-Aged Males Most Likely Group to Exercise

FRIDAY, July 25 (HealthDay News) -- The demographic pattern of participation in exercise and sports changed between 1997 and 2006 in England, with fewer young men exercising and more participation by middle-aged and older adults, according to an article published online July 25 in the British Journal of Sports Medicine.

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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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New Technique Identifies Correct Operative Spinal Level

FRIDAY, July 18 (HealthDay News) -- Computer-assisted image guidance may improve identification of the correct vertebral level prior to spinal surgery, according to an article published in the July issue of The Spine Journal.

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Older Patients May Not Voice Surgery Concerns

FRIDAY, July 18 (HealthDay News) -- Older adults who are considering orthopaedic surgery may be reluctant to fully disclose their concerns to their surgeons, researchers report in the July issue of the Journal of Bone & Joint Surgery.

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Pseudoaneurysm After Spinal Device Migration Treatable

THURSDAY, July 17 (HealthDay News) -- Pseudoaneurysm of the aorta due to device migration is a rare but treatable complication following placement of an anterior spinal device, according to an article published in the July issue of The Spine Journal.

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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

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Heparin Improves Outcomes After Knee Arthroscopy

WEDNESDAY, July 16 (HealthDay News) -- One week of low-molecular-weight heparin (LMWH) prevents deep venous thrombosis better than graduated compression stockings in adults having knee arthroscopy, according to an article published in the July 15 issue of the Annals of Internal Medicine.

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AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Many Elderly Patients Not Offered Joint Replacement

TUESDAY, July 15 (HealthDay News) -- While recovery may be lengthy, most elderly patients undergoing joint replacement have excellent outcomes, according to an article published in the July 14 issue of the Archives of Internal Medicine.

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Computer-Assisted Knee Arthroplasty Costs Evaluated

MONDAY, July 14 (HealthDay News) -- The cost-effectiveness of computer-assisted surgery for total knee replacement depends on the annual hospital volume, with the technology providing less return on investment in lower-volume hospitals, according to a study published in the July issue of the Journal of Bone & Joint Surgery.

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Costs May Be Higher at Doctor-Owned Hospitals

MONDAY, July 14 (HealthDay News) -- At physician-owned specialty hospitals, financial incentives linked to ownership may significantly alter practice patterns in ways that increase patient health care expenditures, according to an article published in the July issue of Medical Care.

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Mortality Risk High After Vertebral Fracture in Elderly

FRIDAY, July 11 (HealthDay News) -- Elderly patients of both genders and all ages and ethnicities have a high risk of mortality after a vertebral fracture, researchers report in the July issue of the Journal of Bone & Joint Surgery.

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Early Hip-Fracture Surgery Improves Patient Outcomes

FRIDAY, July 11 (HealthDay News) -- Hip-fracture patients who undergo surgery within 24 hours after hospital admission are significantly less likely to develop pressure ulcers and endure long hospital stays, and more likely to return to independent living than those who undergo later surgery, according to the results of a study published in the July issue of the Journal of Bone & Joint Surgery.

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Technology Improves Assessment of Bone Fusion

THURSDAY, July 10 (HealthDay News) -- While assessment of osseous fusion post arthrodesis is difficult, computer-assisted techniques may decrease subjectivity in assessing post-operative fusion, according to an article published in the June issue of the Journal of Neurosurgery: Spine.

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NSAIDs Improve Postoperative Neurosurgical Pain Control

WEDNESDAY, July 9 (HealthDay News) -- Supplementing opioid analgesics in lumbar spine surgery with non-steroidal anti-inflammatory drugs (NSAIDs) provides better pain control than opioid analgesics alone, according to an article published in the June issue of the Journal of Neurosurgery: Spine.

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Spinal Fusion Outcomes Good in Community Practices

WEDNESDAY, July 9 (HealthDay News) -- In non-academic settings where patients undergo lumbar spinal fusions, consistent functional improvements can be achieved and a simple and inexpensive cohort analysis can accurately measure reductions in disability, according to the results of a study published in the June issue of the Journal of Spinal Disorders & Techniques.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

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MRI Signal Intensity Needs More Study As Outcome Predictor

WEDNESDAY, July 9 (HealthDay News) -- Postoperative MRI signal intensity does not significantly reflect postoperative symptoms or outcomes, according to an article published in the June issue of the Journal of Neurosurgery: Spine.

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FDA Requests New Warning on Fluoroquinolone Labels

TUESDAY, July 8 (HealthDay News) -- Manufacturers of fluoroquinolone antimicrobial drugs must add a boxed warning to the product labeling that explains the increased risk of tendinitis and tendon rupture in those taking the drugs, according to an alert issued by the U.S. Food and Drug Administration Tuesday. The alert also notifies manufacturers that they should provide a medication guide to warn patients about the risk.

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Neurological Status Affects Morbidity in Cervical Fusion

MONDAY, July 7 (HealthDay News) -- Myelopathy increases complications during cervical fusion, regardless of the surgical approach, researchers report in the July issue of the Journal of Neurosurgery: Spine.

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Mutations Found in Autosomal Dominant Brachyolmia

MONDAY, July 7 (HealthDay News) -- Mutations in the TRPV4 gene have been linked to an autosomal dominant form of brachyolmia marked by severe kyphoscoliosis and irregular, flattened cervical vertebrae, according to research published online June 29 in Nature Genetics.

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Drug Reduces Fracture Risk in Men with Heart Failure

TUESDAY, July 1 (HealthDay News) -- Spironolactone, which has been shown to preserve skeletal strength in animals, is associated with a reduced risk of fracture in men with congestive heart failure, according to a report in the July 8 issue of the Journal of the American College of Cardiology.

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Physician's Briefing