October 2010 Briefing - Orthopedics

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

Mortality Higher for Primary Spine Surgery Than Revision

FRIDAY, Oct. 29 (HealthDay News) -- Patients undergoing primary posterior spine fusion (PPSF) of the thoracic and lumbar spine have a higher risk of in-hospital death than those undergoing revision posterior spinal fusion (RPSF), according to a study in the October issue of The Spine Journal.

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NFL Management of Concussion More Conservative Since 2002

FRIDAY, Oct. 29 (HealthDay News) -- The most recent six years of National Football League (NFL) concussion data, published online Oct. 1 in Sports Health: A Multidisciplinary Approach, shows only a slight decline in the incidence of concussions but documents more conservative management by team doctors in their return-to-play recommendations.

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Left Arm Splints Significantly Degrade Driving

FRIDAY, Oct. 29 (HealthDay News) -- Immobilization of a limb does not prevent many people from driving, but wearing an arm splint appears to have a detrimental effect on this skill, according to research published in the Oct. 6 issue of the Journal of Bone & Joint Surgery.

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Probe-to-Bone Best Test for Diabetic Foot Osteomyelitis

WEDNESDAY, Oct. 27 (HealthDay News) -- The best and most efficient test for diagnosing chronic osteomyelitis of the foot in patients with diabetes may be the probe-to-bone (PTB) test, according to research published in the October issue of Diabetes Care.

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Primary Care Trails Other Specialties in Hourly Wages

TUESDAY, Oct. 26 (HealthDay News) -- Primary care physicians have substantially lower hourly wages than other specialists, and although most physicians find Medicare reimbursement inequitable, they show little consensus on how to reform it, according to two studies published in the Oct. 25 issue of the Archives of Internal Medicine.

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Cortisone May Help Tennis Elbow in Short Term

FRIDAY, Oct. 22 (HealthDay News) -- Cortisone injections may provide better short-term relief from tennis elbow than other treatments, but the results don't last beyond three to six weeks, according to research published online Oct. 22 in The Lancet.

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Field of Orthopedic Surgery Found Lacking in Diversity

FRIDAY, Oct. 22 (HealthDay News) -- The field of orthopedic surgery is less diverse than other specialties, employing fewer minorities and the lowest percentage of women, according to research published in the Oct. 6 issue of the Journal of Bone & Joint Surgery.

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Spinal Fractures Spotlighted During World Osteoporosis Day

WEDNESDAY, Oct. 20 (HealthDay News) -- Spinal fractures worldwide occur at an estimated rate of one every 22 seconds, and health care professionals need to be able to recognize the signs of these fractures in their patients, according to the International Osteoporosis Foundation (IOF) report, The Breaking Spine.

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Study Seeks Factors in 'Never-Event' Medical Errors

TUESDAY, Oct. 19 (HealthDay News) -- Wrong-patient and wrong-site procedures -- which are surgical "never events" -- may be continuing at a high frequency, according to research published in the October issue of the Archives of Surgery.

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Cervical Spine Procedure Safe on Outpatient Basis

FRIDAY, Oct. 15 (HealthDay News) -- One-level anterior cervical discectomy and fusion (ACDF) may be safely performed on an outpatient basis with a four-hour postoperative observation period, according to a study published in the October issue of the Journal of Spinal Disorders & Techniques.

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FDA Rescinds Approval of Menaflex Collagen Scaffold

FRIDAY, Oct. 15 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals that ReGen Biologics Inc.'s Menaflex Collagen Scaffold should not have been approved for marketing, as a re-evaluation of scientific data that was completed after a September 2009 agency report revealed issues in the agency's review of the orthopedic device. The FDA will start to withdraw the device's marketing approval status.

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Expectations Don't Predict Recovery Time for All Injuries

FRIDAY, Oct. 15 (HealthDay News) -- Recovery expectations appear to predict future recovery among workers filing injury claims for back pain but not for those filing claims for other musculoskeletal conditions, according to a study published in the October issue of the Journal of Spinal Disorders & Techniques.

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Bisphosphonate Users at Possible Risk of Thigh Fracture

WEDNESDAY, Oct. 13 (HealthDay News) -- Bisphosphonates may put users at risk for atypical thigh bone fractures, according to a warning to health care providers and patients issued Oct. 13 by the U.S. Food and Drug Administration; the risk will be reflected in a labeling change and Medication Guide.

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Evidence Supports Early Spinal Stabilization Surgery

WEDNESDAY, Oct. 13 (HealthDay News) -- In patients with multiple trauma, early surgical stabilization of the spine is associated with a variety of improved outcomes, according to research published in the Oct. 1 issue of Spine.

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Improvements Stable After Adult Spinal Deformity Surgery

WEDNESDAY, Oct. 13 (HealthDay News) -- Most adult patients who undergo surgery for spinal deformity, such as scoliosis, will retain their improvement through three to five years of follow-up, according to a study reported in the Sept. 15 issue of Spine.

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Older Women at Fracture Risk in Spinal Instrumentation Surgery

TUESDAY, Oct. 12 (HealthDay News) -- Postmenopausal women who have spinal fusion with instrumentation are at risk of developing fractures at other nearby vertebrae, usually within two years of the surgery, according to a study in the Oct. 1 issue of Spine.

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Remembered Back Injury Not Predictor for Disc Deterioration

TUESDAY, Oct. 12 (HealthDay News) -- Recollection of a previous back injury does not predict accelerated deterioration of spinal discs, according to a study among identical twins with and without reported prior back injuries, which was published in the Oct. 1 issue of Spine.

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43% of Orthopedic Patients Have Low Vitamin D Level

MONDAY, Oct. 11 (HealthDay News) -- There is a high prevalence of hypovitaminosis D within the adult orthopedic surgery population, according to research published in the Oct. 6 issue of The Journal of Bone and Joint Surgery.

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Word Choice Influences Patient Perception of Prognosis

MONDAY, Oct. 11 (HealthDay News) -- The way clinicians explain a patient's back pain may influence the patient's perceived prognosis and uptake of therapy; sticking with language used in radiology reports may be more helpful than using degenerative terms, such as "wear and tear," according to research published in the Oct. 1 issue of Spine.

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Anti-PE Benefit Seen From Inferior Vena Cava Filters

FRIDAY, Oct. 8 (HealthDay News) -- The prophylactic use of inferior vena cava filters (IVCFs) appears safe and effective in preventing pulmonary embolism (PE) in patients undergoing major spinal surgery who are at high risk, according to research published in the Sept. 15 issue of Spine.

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Scoliosis Surgery Can Offer Benefits in Middle-Aged

WEDNESDAY, Oct. 6 (HealthDay News) -- Patients with symptomatic scoliosis who are 40 or over are likely to have improvements from surgical treatment, though complications are common, according to research published in the Sept. 15 issue of Spine.

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Doctors' Exercise Linked to Confidence Counseling Patients

FRIDAY, Oct. 1 (HealthDay News) -- Physicians' exercise habits and weight are associated with their confidence in their abilities to counsel patients on exercise and diet, as is the level of training they have received in counseling techniques, according to research published in the fall issue of Preventive Cardiology.

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