September 2011 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for September 2011. 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.

Better Outcomes for Cervical Spine Arthroplasty Than Fusion

FRIDAY, Sept. 30 (HealthDay News) -- For treatment of single-level degenerative cervical disc disease, the use of cervical disc arthroplasty is associated with significantly superior outcomes at 48 months versus anterior cervical discectomy with fusion, according to a study published in the Sept. 21 issue of The Journal of Bone & Joint Surgery.

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Doctors, Patients Identify Tacit Clues in Their Interactions

FRIDAY, Sept. 30 (HealthDay News) -- Both doctors and patients identify tacit clues as well as judgments based on these clues during video elicitation interviews of health maintenance examinations, according to a study published in the October issue of the Journal of Evaluation in Clinical Practice.

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Spinal MRI Reviewer Accuracy Equal Across Training Levels

FRIDAY, Sept. 30 (HealthDay News) -- Doctors at multiple levels of training can accurately and efficiently interpret the integrity of the posterior ligamentous complex (PLC) on spinal magnetic resonance imaging (MRI), according to a study published in the August issue of The Spine Journal.

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Three Weekly Hyaluronate Shots Improve Ankle Arthritis

THURSDAY, Sept. 29 (HealthDay News) -- Three weekly intra-articular injections of hyaluronate are safe and effective for patients with unilateral ankle arthritis, according to a study published in the Sept. 21 issue of The Journal of Bone & Joint Surgery.

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Stratified Care May Be Best Option for Back Pain Patients

THURSDAY, Sept. 29 (HealthDay News) -- Stratifying back pain patients by prognosis may be more effective and less costly than a one-size-fits-all approach, according to research published online Sept. 29 in The Lancet.

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Elderly Recover Adequately After Cervical Laminoplasty

WEDNESDAY, Sept. 28 (HealthDay News) -- Elderly patients with cervical spondylotic myelopathy (CSM) can benefit from laminoplasty and have adequate recoveries in terms of achieved Japanese Orthopedic Association (JOA) scores for cervical myelopathy, according to a study published online Sept. 8 in Spine.

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U.S. Docs Feel They Give More Patient Care Than Required

TUESDAY, Sept. 27 (HealthDay News) -- Many primary care physicians in the United States believe that their patients are receiving too much medical care, and that the pressure to do more than is necessary could be reduced by malpractice reform, adjusting financial incentives, and spending more time with patients, according to a study published in the Sept. 26 issue of the Archives of Internal Medicine.

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Bigger Osteophyte Size Ups Severe Cartilage Damage Risk

TUESDAY, Sept. 27 (HealthDay News) -- For patients with magnetic resonance imaging (MRI)-diagnosed tibiofemoral osteoarthritis, the likelihood of severe cartilage damage increases with increasing osteophyte size, and only a small proportion of knees exhibit atrophic and hypertrophic phenotypes, according to a study published online Sept. 14 in Arthritis & Rheumatism.

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Reasons for Referral to Specific Docs Differ Among Physicians

TUESDAY, Sept. 27 (HealthDay News) -- Primary care physicians (PCPs) and medical and surgical specialists differ in their reasons for selecting specific colleagues for referrals, with PCPs more concerned about physician communication and medical record sharing than specialists, according to a study published online Sept. 16 in the Journal of General Internal Medicine.

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Lower Walking Speed, Altered Gait in Overweight Women

MONDAY, Sept. 26 (HealthDay News) -- Overweight, older women have altered gait and reduced walking performance due to poor relative strength and rate of torque development (RTD) of lower-extremity muscles compared to older women of normal weight, according to a study published in the October issue of the Journal of Electromyography and Kinesiology.

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Multilevel Hemilaminectomy Economical for Lumbar Stenosis

FRIDAY, Sept. 23 (HealthDay News) -- Multilevel hemilaminectomy is a cost-effective treatment for lumbar stenosis-associated radiculopathy, and it improves pain, disability, and quality of life among patients, according to a study published in the August issue of The Spine Journal.

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Back Pain Outcomes Similar for Surgery, Cognitive Intervention

FRIDAY, Sept. 23 (HealthDay News) -- Patients with chronic low back pain (CLBP) and disc degeneration who undergo either surgery or cognitive intervention and exercise have similar results for trunk muscle strength, cross-sectional area, and density at a seven- to 11-year follow-up, according to a study published in the August issue of The Spine Journal.

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BMI, Tibiofemoral Alignment Affect Knee Implant Survival

THURSDAY, Sept. 22 (HealthDay News) -- Proper tibial, femoral, and overall anatomic alignment is important for implant survival after total knee replacement, and a higher body mass index (BMI) increases implant failure rates, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

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Videos Prior to Spine Surgery Aid, Strengthen Patient Choices

WEDNESDAY, Sept. 21 (HealthDay News) -- Watching an evidence-based videotape decision aid helps patients with lumbar spine disorders form and/or strengthen a treatment preference in a balanced, unbiased way, according to a study published online Aug. 15 in Spine.

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Mortality Up in Hospitals With More Minority Trauma Patients

WEDNESDAY, Sept. 21 (HealthDay News) -- The odds of in-hospital mortality for trauma patients are associated with the proportion of minority patients in the hospital, according to a study published online Sept. 19 in the Archives of Surgery.

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Work Intensity Similar Across Physician Specialties

MONDAY, Sept. 19 (HealthDay News) -- The level of physician work intensity appears to be similar among specialties, with variations in the specific dimensions of stress, physical demands, performance, and temporal demand, according to a study published online Sept. 3 in Medical Care.

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Prolia Approval Expanded to Fracture Prevention in Cancer

MONDAY, Sept. 19 (HealthDay News) -- The U.S. Food and Drug Administration has expanded approval for the Amgen bone-building drug Prolia (denosumab) to include prostate cancer or breast cancer patients who are taking certain hormonal therapies.

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Posterior Shoulder Dislocation Has Low Prevalence

MONDAY, Sept. 19 (HealthDay News) -- Prevalence of posterior dislocation is low, with recurrent instability the most common complication after injury, and functional deficit persisting at two years after injury, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

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Lineage-Restricted Stem Cells Regenerate Digit Tip in Mice

MONDAY, Sept. 19 (HealthDay News) -- Lineage-restricted, tissue-resident stem cells are involved in the regeneration of the distal digits in mice, according to an experimental study published online Aug. 25 in Nature.

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Lower Frontal/Saggital Proprioceptive Acuity in OA

FRIDAY, Sept. 16 (HealthDay News) -- Patients with knee osteoarthritis (OA) have reduced proprioceptive acuity in both the sagittal and frontal planes compared with healthy control subjects, according to a study published in the September issue of Arthritis & Rheumatism.

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Surgery Effective for Subaxial Cervical Synovial Cysts

THURSDAY, Sept. 15 (HealthDay News) -- Surgical resection can be an effective treatment for patients presenting with cervical radiculopathy or myelopathy who have a subaxial cervical synovial cyst with minimal postoperative complications, according to a study published in the Sept. 15 issue of Spine.

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Many Mistakenly Believe FDA OKs Only Safe, Effective Drugs

WEDNESDAY, Sept. 14 (HealthDay News) -- A considerable proportion of the U.S. public mistakenly believes that the U.S. Food and Drug Administration approves only effective and safe drugs, but providing consumer explanations can lead to better drug choices, according to a study published in the Sept. 12 issue of the Archives of Internal Medicine.

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Cam-Type Deformities Linked to MRI-Detected Hip Damage

MONDAY, Sept. 12 (HealthDay News) -- In young asymptomatic males, magnetic resonance imaging (MRI) detects cam-type deformities associated with labral lesions, impingement pits, and labral deformities, according to a study published online Sept. 8 in Arthritis & Rheumatism.

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Medical Students Show Racial, Cultural Patient Preference

WEDNESDAY, Sept. 7 (HealthDay News) -- Medical students may have a preferential bias toward whites and wealthier patients, but this does not appear to influence their clinical decision making or physician-patient interactions, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Odds of Board Certification Vary in New Doctors

WEDNESDAY, Sept. 7 (HealthDay News) -- Certification of recent U.S. medical school graduates by the American Board of Medical Specialties (ABMS) varies across specialties by educational and demographic factors, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Many Hospital Staff Uniforms Contaminated With Bacteria

WEDNESDAY, Sept. 7 (HealthDay News) -- More than 60 percent of hospital staff uniforms are contaminated with potentially pathogenic bacteria, including drug-resistant species, according to a study published in the September issue of the American Journal of Infection Control.

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FDA: New Contraindication, Updated Warning for Reclast

FRIDAY, Sept. 2 (HealthDay News) -- The drug label for Reclast (zoledronic acid) has been updated to reflect the risk of kidney failure, according to a safety alert issued Sept. 1 by the U.S. Food and Drug Administration.

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