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Thursday, December 22nd, 2011

Knee pain common complaint in middle-aged and mature women

New research shows 63% of women age 50 and older reported persistent, incident, or intermittent knee pain during a 12-year study period. Predictors for persistent pain included higher body mass index (BMI), previous knee injury, and radiographic osteoarthritis (OA). Details of this longitudinal study are available in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR) Read More…

Tuesday, December 6th, 2011

Quality of life and clinical outcome comparison of semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction: an 11-year follow-up of a randomized controlled trial.

BACKGROUND: There are still controversies about graft selection for primary anterior cruciate ligament reconstruction. Prospective, randomized long-term studies are needed to determine the differences between the graft materials.

HYPOTHESIS: Eleven years after anterior cruciate ligament reconstruction there is no difference in functional outcome and quality of life between patients with patellar tendon or hamstring tendon autografts; however, the patients with patellar tendon autograft would have a higher prevalence of osteoarthritis. Read More…

Monday, November 21st, 2011

A Systematic Review of the Use of Platelet-Rich Plasma in Sports Medicine as a New Treatment for Tendon and Ligament Injuries

Monday, November 21st, 2011

Inflammation plays key role in development of OA

Inflammation plays key role in development of OA.Although osteoarthritis (OA) has traditionally been thought of as the result of “wear-and-tear” on joints, a study published online in the journal Nature Medicine points to the importance of the inflammatory process in the development of OA. The article outlines a series of studies undertaken to examine the role of the inflammatory complement system, one of the body’s key defense systems against bacterial and viral infections. When researchers found an imbalance between protein accelerators and inhibitors of the complement system in the tissues of patients with OA compared to the tissues of healthy individuals, they conducted a series of experiments in bioengineered and normal mice to see how enhancing or inhibiting the expression of certain proteins could contribute to cartilage degeneration. Their results indicate that the membrane attack complex (MAC)-mediated arm of complement is crucial to the development of OA. Read More…

Monday, November 21st, 2011

Shoulder pain improves with either low or high doses of corticosteroid

A Korean study published online in the journal Archives of Physical Medicine and Rehabilitation finds no significant difference in outcomes for patients who received either high doses or low doses of corticosteroids for periarticular shoulder disorder. The multicenter, randomized, triple-blind, placebo-controlled trial involved 79 volunteers with periarticular shoulder disorders who had pain for at least 1 month. Patients were assigned to receive a single injection of 40 mg triamcinolone acetonide, 20 mg triamcinolone acetonide, or placebo. At 2-, 4-, and 8-week follow-up, patients in both experimental groups saw similar improvements in visual analog scale score, Shoulder Disability Questionnaire score, and abduction, external rotation, and internal rotation of active range-of- motion. No such improvements were noted in the placebo group.
Read more…

Monday, November 21st, 2011

Spinal fusion patients often have low levels of vitamin D

Data presented at the annual meeting of the North American Spine Society suggested that many patients undergoing spinal fusion surgery may have low levels of vitamin D. The researchers examined the records of 313 patients scheduled for spinal fusion surgery at a single center during 2010 and 2011. They found that 57 percent had inadequate vitamin D levels (defined as a blood level of less than 30 ng/mL) and of those, 27 percent had vitamin D concentrations considered deficient (less than 20 ng/mL) and 4 percent were considered severely deficient (less than 10 ng/mL). The researchers say that the findings suggest the need presurgical assessment of vitamin D levels in patients being evaluated for spinal fusion. Read more…

Monday, November 21st, 2011

TKA rates have risen significantly since 1997

According to the U.S. Agency for Healthcare Research and Quality, patients aged 45 to 64 years were 2.5 times more likely to be hospitalized for total knee arthroplasty (TKA) in 2009 than in 1997. The agency drew data from the Healthcare Cost and Utilization Project Facts and Figures 2009 report and found that TKA rates for women ages 45 to 64 increased from 16 to 42 stays per 10,000 people between 1997 and 2009, while for men of the same age and over the same period, the rate climbed from 11 to 28 stays per 10,000 people. In addition, the rates for women and men age 65 to 84 years old rose by 69 percent and 55 percent, respectively. Among those age 85 years and older, rates increased by 23 percent for women and 36 percent for men. Read more…

Monday, November 21st, 2011

Chronic opioid use linked to worse TKA outcomes

According to a study published in the November 2 issue of the Journal of Bone & Joint Surgery—American, chronic users of opioid medications may be at a substantially greater risk for complications and painful, prolonged recoveries after total knee arthroplasty (TKA). The researchers reviewed data on 49 TKAs performed on patients who had regularly used opioid medications for pain control prior to surgery, and compared them to a matched cohort of TKA patients who had not used opioids. At mean 3-year follow-up, patients in the opioid group had mean Knee Society scores of 79 points (range=45 to 100 points), compared with a mean of 92 points (range=59 to 100 points) for patients in the non-opioid group. The opioid group had a significantly higher prevalence of complications than the matched group, and 10 patients in the opioid group were referred for outpatient pain management, compared with one patient in the non-opioid group. Read More…

Monday, October 31st, 2011

Platelet-Rich Plasma Versus Autologous Whole Blood for the Treatment of Chronic Lateral Elbow Epicondylitis

According to a study published in the October AJSM, platelet rich plasma (PRP) may be an effective treatment for chronic lateral elbow epicondylitis and superior to autologous blood in the short term. The authors conducted a randomized, controlled trial of 28 patients who received either 3 mL of autologous blood or 3 mL of PRP under ultrasound guidance. At 6-week, 3-month, and 6-month follow up, patients in the PRP group had improved pain visual analog scale scores compared to patients in the autologous group. However, the difference was only statistically significant at 6 weeks. There was no statistically significant difference between groups regarding Liverpool elbow score. Read More…

Sunday, October 23rd, 2011

Omega-3 diet may reduce likelihood of OA