September 2012 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for September 2012. 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.

Medicare Knee Replacement Numbers Up Over Last 20 Years

TUESDAY, Sept. 25 (HealthDay News) -- From 1991 to 2010 there was a 161.5 percent annual volume increase in primary total knee arthroplasty (TKA) among Medicare enrollees as well as an increase in per capita utilization, according to research published in the Sept. 26 issue of the Journal of the American Medical Association.

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Spinal Injury Incidence About 5 Percent in Iraq/Afghanistan

MONDAY, Sept. 24 (HealthDay News) -- The incidence of spinal trauma sustained by military personnel in Iraq and Afghanistan is about 5 percent, according to a study published in the Sept. 19 issue of The Journal of Bone & Joint Surgery.

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AAP Strongly Discourages Home Trampolines

MONDAY, Sept. 24 (HealthDay News) -- Home trampoline use is strongly discouraged by the American Academy of Pediatrics (AAP), according to a policy statement published online Sept. 24 in Pediatrics.

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IV Acetaminophen Eases Post-Spinal Op Pain for Children

FRIDAY, Sept. 21 (HealthDay News) -- Children and adolescents given intravenously (IV)-administered acetaminophen after major spine surgery have significantly less postoperative pain, compared with those given placebo, but administration of acetaminophen does not reduce the need for opioids, according to a study published in the Sept. 15 issue of Spine.

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Decrease Seen in Global Peri-Op, Anesthesia-Related Mortality

FRIDAY, Sept. 21 (HealthDay News) -- Over the last five decades, there has been a decrease in perioperative and anesthesia-related mortality, according to a study published in the Sept. 22 issue of The Lancet, a theme issue on surgery.

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Study Looks at Pain Processing Abnormalities in Knee OA

MONDAY, Sept. 17 (HealthDay News) -- For patients with knee osteoarthritis (K-OA), the lack of correlation between clinical pain and radiographic evidence of disease severity may be due to central sensitization, according to a study published online Sept. 7 in Arthritis & Rheumatism.

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Radiography Unnecessary After Spinal Fusion Surgery

FRIDAY, Sept. 14 (HealthDay News) -- In patients who have undergone spinal fusion surgery with intraoperative fluoroscopic guidance and have no postoperative problems, postoperative radiographs do not provide additional clinical information and are not cost-effective, according to a study published in the July issue of The Spine Journal.

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Higher Mortality Risk With Preoperative Hyponatremia

FRIDAY, Sept. 14 (HealthDay News) -- Patients with preoperative hyponatremia have a higher risk of 30-day mortality and morbidity, including coronary events, surgical site wound infections, and pneumonia, according to research published online Sept. 10 in the Archives of Internal Medicine.

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Evidence Lacking for Weight Trends After Joint Arthroplasty

FRIDAY, Sept. 14 (HealthDay News) -- There is no conclusive evidence on whether patients undergoing total joint arthroplasty (TJA) lose or gain weight after surgery, according to a study published online Sept. 7 in Clinical Orthopaedics and Related Research.

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Meta-Analysis: Acupuncture Reasonable Chronic Pain Option

THURSDAY, Sept. 13 (HealthDay News) -- Acupuncture is an effective treatment for chronic pain conditions, including back and neck pain, osteoarthritis, and chronic headache, with pain relief superior to both no-acupuncture controls and sham-acupuncture groups, according to the results of a systematic review and meta-analysis published online Sept. 10 in the Archives of Internal Medicine.

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For Obese, Body Habitus, Not BMI Impacts Op Site Infection

WEDNESDAY, Sept. 12 (HealthDay News) -- For obese patients undergoing lumbar spine fusion surgery, the skin to lamina distance and the thickness of subcutaneous fat are significant risk factors for surgical site infection (SSI), according to a study published in the Sept. 1 issue of Spine.

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Epidural Steroid Injection Impairs Hip Bone Density

WEDNESDAY, Sept. 12 (HealthDay News) -- Epidural steroid injections (ESIs) for radiculopathy negatively impact bone mineral density (BMD) in postmenopausal women, according to a study published online Sept. 3 in Spine.

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Costs of Neck and Back Conditions Increasing in U.S.

TUESDAY, Sept. 11 (HealthDay News) -- For individuals with back and neck conditions, costs have increased in the last decade, with the main increase due to rising medical specialist costs, according to a study published in the Sept. 1 issue of Spine.

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Not All Docs/Nurses Want to Be Asked About Hand Hygiene

FRIDAY, Sept. 7 (HealthDay News) -- Although most health care workers (HCWs) appreciate the role of patients in preventing health care-associated infection, a considerable proportion are uncomfortable with patients asking about their hand hygiene, according to a letter published online Sept. 3 in the Archives of Internal Medicine.

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Bolus Epidural Fentanyl Cuts Post-Spinal Decompression Pain

THURSDAY, Sept. 6 (HealthDay News) -- Intraoperative bolus epidural fentanyl is effective at alleviating early postoperative pain after lumbar canal decompression, according to a study published online Aug. 27 in The Spine Journal.

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Alzheimer's, ALS Death Rates Up for Football Players

WEDNESDAY, Sept. 5 (HealthDay News) -- Neurodegenerative mortality is about three times higher among retired National Football League players, with Alzheimer's disease and amyotrophic lateral sclerosis mortality even higher, compared to the general U.S. population, according to a study published online Sept. 5 in Neurology.

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In RA, Hand Surgery Improves Function, Appearance

MONDAY, Sept. 3 (HealthDay News) -- Treating rheumatoid arthritis (RA) patients with severe hand deformities with a silicone metacarpophalangeal joint arthroplasty (SMPA) procedure produces significant, long-term improvement in hand function and appearance, according to research published in the September issue of Arthritis Care & Research.

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