News and Publications
Knee Injections vs. Knee Replacement: What are My Options?
Source: Medical News Today
According to the Arthritis Foundation, over 50 million Americans have arthritis. The most common form of arthritis is osteoarthritis, which is a degenerative joint disease. Though it can occur in younger people, it often affects people 50 years of age and older.
Hip Replacement Surgery & In One Day
New approach to common hip surgery allows patients to come in at 9 a.m. and leave the hospital at 5 p.m.
Newer UKR prosthesis for patients with osteoarthritis achieved satisfactory results
Patients who received a newer prosthesis similar to the Miller-Galante knee design showed significantly better Knee Society function scores than patients who had a long-used prosthesis to which it was compared. However, the two implants performed about the same at short-term follow-up, according to a presenter.
After hip-replacement surgery, medication use decreases
Source: Medical Xpress
A new study, published November 15, in the journal Pain provides information on the trajectories of prescription drug use before and after hip-replacement surgery—total hip arthroplasty (THA), one of the most common types of joint replacement surgery. Hip-replacement surgery is commonly followed by long-term reductions in the use of prescription drugs for pain and insomnia.
Recommendations for patient activity after knee replacement vary among surgeons
During recovery after knee replacement surgery, exercise is critical. After initial recovery, patients will want to resume more strenuous activities. In addition to exercise prescribed by a physical therapist, several studies have shown patients who participated in athletic activities prior to surgery will want to continue this practice after surgery. However, how much activity and how strenuous this activity should be remains unclear.
Which Patients Are at Greatest Risk for Readmission after THA?
A recently published multi-center study provides guidance on modifiable risk factors orthopaedic surgeons can address prior to surgery to reduce the chances of patients being readmitted following total hip arthroplasty.
Patient-specific predictive model offers more accurate preoperative templating in hip arthroplasty
A prediction model presented better estimates of the actual size of implants used in total hip arthroplasty and, in the long term, may help reduce the cost of health care by minimizing implant inventory costs, according to study results.
Early knee arthritis symptoms first felt when using stairs
Source: Medical News Today
People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts.
The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.
Obese patients may experience diminished knee pain after gastric bypass surgery
Source: Medical News Today
There is a known link between elevated body mass index (BMI) and symptomatic knee osteoarthritis (OA). While patients who have undergone gastric bypass surgery (GBS) – a procedure that closes off much of the stomach and causes food to bypass a portion of the small intestine – typically lose weight, the comparative impact of this weight loss on knee pain and function has not been measured.
Longer hospital stays, higher costs for obese total knee replacement patients
Source: Medical News Today
Obesity is associated with longer hospital stays and higher costs in total knee replacement (TKR) patients, independent of whether or not the patient has an obesity-related disease or condition (comorbidity), according to a new study published in the Journal of Bone and Joint Surgery (JBJS).
Complication rates for nonagenarian patients similar to those of younger patients undergoing total hip replacement surgery
Source: Medical News Today
As more Americans are living well into their 90s, the number of nonagenarian total hip replacement (THR) candidates continues to increase.
The authors of the study concluded that nonagenarian patients can safely undergo a THR, despite advanced age and a higher prevalence of comorbidities. Overall, the nonagenarian patients experienced a complication rate comparable to those of younger THR patients, and the higher mortality rate is well within expectations for individuals age 90 and older.
Total Hip Replacement: Innovative Procedure Reduces Pain, Speeds Recovery
The demographics – and the numbers – for hip replacement surgery are changing. According to the American Academy of Orthopaedic Surgeons, between 200,000 and 300,000 total hip replacements are performed in the United States each year, the majority of them on people over the age of 60. But the number of
total hip replacements performed on younger people is increasing and it is estimated that the total number will grow dramatically over the next few years.
Study: Day-of-surgery discharge found effective for UKA patients using refined perioperative pathway
Day-of-surgery discharges can be safe, efficient and increase patient satisfaction when using a refined perioperative pathway for appropriately selected patients who undergo unicompartmental knee arthroplasty, according to results of a recently published study.
“(Unicompartmental knee arthroplasty) UKA patients can be discharged on the day of surgery with a high satisfaction rate,” Steven Barnett, MD, from the Hoag Orthopedic Institute in Irvine, Calif., told Orthopedics Today. “This provides orthopedic surgeons with the ability to effectively treat these patients while minimizing cost associated with this procedure.
Barnett said surgeons at his institution recognized that UKA patients had less difficulty with pain management, decreased length of stay and achieved better results in physical therapy during hospitalization.
“This led us to begin managing these patients with a 23-hour overnight stay and eventually discharging them on the day of surgery,” Barnett said.
Barnett said within a 2-year to 3-year period, surgeons moved UKA patients from an inpatient setting to a day of surgery discharge after adopting techniques related to general and regional anesthesia, local soft-tissue infiltration and oral perioperative pain management.
Under this perioperative pathway, he and colleagues successfully discharged 160 consecutive UKA patients who were a mean of 65 years old with a mean American Society of Anesthesiology class of 1.8. The mean recovery room time was 121 minutes and no patients had uncontrolled pain or nausea that required an overnight stay. Patients had high satisfaction scores and researchers noted significant improvements in Knee Society Clinical Rating System scores.
“Our current algorithm is dependent upon patient education prior to surgery. Patients are instructed on crutch use, postoperative wound management, precautions, and [deep vein thrombosis] DVT prophylaxis at an extensive preoperative visit,” Barnett said. “Pain management on the day of surgery entails use of multimodal oral analgesics started prior to the procedure combined with both regional nerve blocks and peri-articular infiltration of a local anesthetic mixture. Activity limitations and weight bearing precautions are reinforced prior to discharge from the surgery center.”
Barnett said other surgeons performing UKA have adopted the pathway described in this study with success.
“The authors are confident that results will continue to be optimal and look forward to adapting these protocols to other arthroplasty procedures moving forward,” he said.
Knee replacement often beneficial for ra: study
The common belief that rheumatoid arthritis patients don’t benefit from knee replacement surgery as much as those with the more common osteoarthritis has been challenged by the findings from a pair of studies by New York City scientists.
New hip replacement approach offers multiple benefits
Source: Daily Republic
It’s no fun walking around with an ailing hip; anyone with severe arthritis knows that kind of pain all too well. For years, orthopedic surgeons have been performing total hip replacements when less invasive options don’t provide the desired results.
The bottom line for those who have hip pain that significantly interferes with their quality of life is that there’s no need to suffer. If non-operative treatments don’t provide the long term relief, hip replacement or resurfacing may be the answer.
Baby boomers feed need for joint replacements; Docs seeing more patients under age of 65
Source: Daily News
US baby boomers are fueling a wave of joint replacement surgeries, hoping to use new artificial knees and hips to stay active as they get older.
The 45-64 age group accounted for more than 40 percent of the more than 906,000 total knee or total hip replacement surgeries in 2009, the last year for which figures were available from the American Academy of Orthopedic Surgeons.
Boomers will account for a majority of these joint replacements in 2011, according to projections by Drexel University specialist Steven Kurtz.
What is knee replacement surgery? What is knee arthroplasty?
Source: Medical News today
Replacement surgery in a damaged knee joint by placing an artificial prosthesis will alleviate pain and help better movement of the knee.
For most patients, a replacement knee surgical procedure will last for at least 15 to 20 years, especially if cared for properly and not put under too much strain. More than 90% of people who have total knee replacement surgery experience a dramatic decrease in knee pain and a significant improvement in their ability to perform common activities of daily living.
Hip replacement device helps to halve recovery timeSource: BBC
The Direct Anterior Approach (DAA) technique means the replacement hip is fitted without cutting through muscle or tendons.
During surgery the patient lies on his or her back and the foot is secured in a lightweight boot attachment. This allows the technician to move the leg easily and repeatedly, flexing the hip to the correct position so the surgeon can properly and accurately fix the new hip using X-ray.
New company enters market to use vitamin E to extend life of hip, knee implants
Source – Marco News.com
Vitamin E isn’t an antioxidant just for your skin and nails anymore — it’s expanding to joint implants.
Zimmer, a company also based in Warsaw, is seeking FDA approval to offer its own version.
Can surgery help you stay in the game?
Source – Boston.com
Demand for knee and hip replacement rises–
Arthritic knee crimping your tennis game? Toss it out and get a new one.
Demand for joint replacement surgery, once confined largely to patients well past retirement age, has been growing rapidly among a class of people doctors have dubbed the “young actives’’ – those in the 45 to 64 age group who are determined to stay fit.
Marco lecture proves robotic knee replacement surgery has leg up on traditional methods
Source – Marco News.com
Buechel, an orthopedic surgeon at Physicians Regional Healthcare System, is on the cutting edge of robotic joint replacement, having performed 439 robotic knee surgeries or about 5 percent of all such surgeries worldwide. He also teaches other doctors the technique.
Errors occur with traditional partial knee replacements, Buechel said, because doctors are not as likely to place implants into the knee joint with complete accuracy. The robotic system pinpoints alignments to within one millimeter and one degree, he asserted.
New method will increase likelihood of success in cartilage grafting procedures
Source – Medical News Today
For years, doctors have been able to treat defects in joint cartilage by grafting cartilage donated from cadavers into patients’ bad joints. Using current methods, donated cartilage can be stored for 28 days for a transplant before the tissue becomes too degraded to transplant into a patient. Now, researchers from the University of Missouri have found a way to store donated cartilage more than twice as long.
Some seniors at greater risk of falls and hip fractures due to undiagnosed neurological disorders
Source — Medical News Today
Hip fractures are a common cause of morbidity and mortality in elderly patients. Cervical myelopathy is a common neurological condition that can diminish balance and coordination. Undiagnosed neurological disorders may predispose patients to falls and fractures. Screening for cervical myelopathy should be standard care for all hip fracture patients, to reduce the risk for additional falls and fractures.
Hip dysplasia can be reliably diagnosed by ultrasound at 6 months
Source — Medical News Today
Developmental dislocation (dysplasia) of the hip (DDH) is a common congenital condition in which a child’s upper thighbone is dislocated from the hip socket. The condition can be present at birth or develop during a child’s first year of life. Plain radiography (X-rays) has long been the gold standard screening modality for this condition in 6-month-old children, despite concerns over exposing very young children to ionizing radiation.
Ultrasound provided good quality images with 100 percent diagnostic correlation to the X-rays in all patients. Ultrasound is a reliable alternative imaging method to X-rays for DDH screening in 5-to-7 month old children.
Follow-up online support after joint replacement surgery benefits patients
Source —Medical News Today
Patients who have had total joint replacement (TJR) are expected to return to their physician’s office or clinic regularly for routine follow-up care.
Web-based follow-up can provide significant time and cost savings to TKR patients without complications, and make the physician’s office more accessible to new patients, patients awaiting surgery, and/or patients with post-surgical complications.
Arthritic knees, but not hips, have robust repair response
Source — e! Science News
Researchers at Duke University Medical Center used new tools they developed to analyze knees and hips and discovered that osteoarthritic knee joints are in a constant state of repair, while hip joints are not. “This suggests the knee has capacity for repair we didn’t know about and the main treatment strategy probably would need to focus on turning off the breakdown of knee tissue,” said Virginia Kraus, MD, PhD, professor of Rheumatology and Immunology at Duke. “I was hugely surprised to find this.”
Perhaps the natural repair response would be sufficient to lead to a reversal or halting of the disease process in the knee if the joint breakdown could be halted, Kraus said.
Knee replacement may lower a patient’s risk for mortality and heart failureSource — e! Science News
New research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) highlights the benefits of total knee replacement (TKR) in elderly patients with osteoarthritis, including a lower probability of heart failure and mortality.
There were significant positives in the osteoarthritis TKR group: the risk of mortality was half that of the non-TKR group and the congestive heart failure rate also was lower, at three, five and seven years after surgery. There was no difference in diabetes rates among both groups. Depression rates were slightly higher in the TKR group during the first three years after surgery, though there was no difference at five and seven years.
Getting a New Knee or Hip? Do it Right the First Time
THERE is nothing like a new hip or knee to put the spring back in your step. Patients receiving joint implants often are able to resume many of the physical activities they love, even those as vigorous as tennis and hiking. No wonder, then, that joint replacement is growing in popularity.