June 2010 Briefing - Orthopedics

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

Doctors Agree Malpractice Fears Drive Overuse of Tests

MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.

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Obesity May Not Complicate Spine Surgery

MONDAY, June 28 (HealthDay News) -- Though some studies have suggested higher body mass index (BMI) increases risk for complications after spine surgery, a new study published in the July issue of The Spine Journal did not find any such correlation.

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Spinal Kinematics Unlikely Marker for Teen Back Pain

FRIDAY, June 25 (HealthDay News) -- Spinal kinematics may not effectively distinguish adolescents with nonspecific chronic low back pain (NSCLBP) from their pain-free counterparts unless those with NSCLBP are subclassified, according to a study in the June 15 issue of Spine.

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Recent Low Back Pain Guidelines Offer Similar Advice

FRIDAY, June 25 (HealthDay News) -- Recent clinical practice guidelines offer similar recommendations for assessing and managing low back pain, and clinicians can improve patient care by adopting these recommendations, according to a review published in the June issue of The Spine Journal.

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Surgery Provides Improved Outcomes in Spinal Stenosis

THURSDAY, June 24 (HealthDay News) -- Symptomatic spinal stenosis patients who undergo surgical treatment maintain substantially greater improvements in pain and function measures through four years compared to those treated nonoperatively, according to a study published in the June 15 issue of Spine.

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Oral Bisphosphonate Use May Reduce Breast Cancer Risk

WEDNESDAY, June 23 (HealthDay News) -- The use of oral bisphosphonates by postmenopausal women appears to significantly reduce the risk of some breast cancers, according to a pair of studies published online June 21 in the Journal of Clinical Oncology.

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Editorial

Spinal Surgical Site Infections Usually S. Aureus

TUESDAY, June 22 (HealthDay News) -- Both deep and superficial surgical site infections (SSIs) after spinal surgery are usually caused by Staphylococcus aureus; successful treatment of deep infections is possible with single stage debridement and intravenous antibiotics, and superficial infections can effectively be treated with local wound care and oral antibiotic therapy, according to research published in the June 1 issue of Spine.

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Bone Health Supplements Don't Increase Coronary Calcium

FRIDAY, June 18 (HealthDay News) -- Postmenopausal women who take calcium plus vitamin D supplements for bone health do not increase their levels of coronary artery calcium (CAC) and increase their cardiovascular disease risk as a result, according to a study published online June 14 in Menopause.

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Lack of Fitness, Inactivity Linked to Walking Falls

FRIDAY, June 18 (HealthDay News) -- Poor physical fitness and physical inactivity may increase the risk of falls while walking, particularly in men, according to research published in the July issue of the American Journal of Preventive Medicine.

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Duloxetine Beneficial in Treating Chronic Low Back Pain

THURSDAY, June 17 (HealthDay News) -- Duloxetine appears to significantly reduce pain and improve functioning in nondepressed individuals with non-neuropathic chronic low back pain (CLBP), according to a study published in the June 1 issue of Spine, though during the study, more subjects on duloxetine discontinued treatment because of adverse events than those on placebo.

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Psychological Variables Predict Disability From Back Pain

THURSDAY, June 17 (HealthDay News) -- Long-term disability from low back pain (LBP) may be prevented by targeting interventions to several psychological variables, according to research published in the June 1 issue of Spine.

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Arthroplasty Growth Rates Similar Across Hospitals

FRIDAY, June 11 (HealthDay News) -- The use of arthroplasty of lower extremity joints is rising at a similar rate in markets that have new arthroplasty programs and in those that don't, according to a study published in the June 1 issue of the Journal of Bone & Joint Surgery.

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Brace Prevents Curve Progression in Scoliosis

FRIDAY, June 11 (HealthDay News) -- The use of a Boston brace for more than 12 hours daily in patients with adolescent idiopathic scoliosis is effective in controlling curve progression, according to a prospective study published in the June 1 issue of the Journal of Bone & Joint Surgery.

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Care Costs Substantial Before Lumbar Discectomy

FRIDAY, June 11 (HealthDay News) -- Patients with lumbar disc herniation incur substantial charges for preoperative care in the months before discectomy -- during a period of conservative management -- which are roughly equally divided between diagnostic charges and therapeutic charges, according to research published in the June issue of The Spine Journal.

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Study Assesses Improvement Scores After Cervical Fusion

THURSDAY, June 10 (HealthDay News) -- Following cervical fusion for degenerative disorders, patients may notice a minimally clinically important change if they have an eight-point decrease in Neck Disability Index (NDI) or a three-point decrease in arm or neck pain, according to research published in the June issue of The Spine Journal.

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S. aureus Infections a Greater Risk After Certain Procedures

THURSDAY, June 10 (HealthDay News) -- The frequency and type of invasive Staphylococcus aureus infections following surgeries vary according to the type of procedure, with cardiothoracic and neurosurgical procedures linked to the highest risks, according to research published in the July issue of Infection Control & Hospital Epidemiology.

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Fatal Medication Errors Rise in July at Teaching Hospitals

TUESDAY, June 8 (HealthDay News) -- In July there is a significant increase in fatal medication errors at medical institutions, and this spike is at least partly due to the arrival of new medical residents, according to a study published online May 29 in the Journal of General Internal Medicine.

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Overlap Exists in TBI, Fractures Attributable to Abuse

MONDAY, June 7 (HealthDay News) -- In children younger than 3, considerable overlap exists in the occurrence of traumatic brain injuries (TBIs) and fractures attributable to abuse, though accidental falls occur more commonly than abuse, even among very young children, according to a study published online June 7 in Pediatrics.

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Smoking Cessation Approach Reduces Surgery Complications

MONDAY, June 7 (HealthDay News) -- Initiating a smoking cessation intervention program after acute fracture surgery and carrying it out for six weeks may reduce the risk of post-surgical complications, according to a study in the June 1 issue of the Journal of Bone & Joint Surgery.

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Case Study Shows Poor Results of Back Pain Overtreatment

THURSDAY, June 3 (HealthDay News) -- For low back pain, overly aggressive surgical treatment and overtreatment with narcotics can result in severely adverse outcomes for the patient, including increased pain, loss of functionality and drug addiction, according to a case report in the May 20 issue of Spine.

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Cost Varies by Region in Spinal Fusion for Scoliosis

THURSDAY, June 3 (HealthDay News) -- There is significant variation in the cost and hospital length of stay (LOS) for spinal fusion for idiopathic scoliosis in different regions of the United States, according to research published in the May 15 issue of Spine.

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Prolia Approved for Postmenopausal Women With Osteoporosis

WEDNESDAY, June 2 (HealthDay News) -- The injected drug Prolia (denosumab) has been approved by the U.S. Food and Drug Administration to treat postmenopausal women at high risk of bone fracture due to osteoporosis.

FDA

Exercise Offers Benefits After Low Back Rehabilitation

WEDNESDAY, June 2 (HealthDay News) -- Patients with chronic low back pain who participate in a post-rehabilitation exercise program enjoy benefits in trunk muscle endurance and level of disability compared to patients who receive usual care, according to a study in the May 20 issue of Spine.

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