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May 2011 Briefing - Orthopedics

May 2011 Briefing - Orthopedics

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

BMD and FRAX Score Tied to Fracture Risk in Diabetes

TUESDAY, May 31 (HealthDay News) -- In older adults with type 2 diabetes mellitus (DM), bone mineral density (BMD) T score and age or World Health Organization Fracture Risk Algorithm (FRAX) score are associated with increased fracture risk, according to a study published in the June 1 issue of the Journal of the American Medical Association.

Abstract (http://jama.ama-assn.org/content/305/21/2184.short )Full text (subscription or payment may be required) (http://jama.ama-assn.org/content/305/21/2184.full )

Effect Estimates May Be Inflated in Biomarker Studies

TUESDAY, May 31 (HealthDay News) -- Biomarker effects are often overestimated in highly cited studies compared to the effects reported in subsequent meta-analyses of the same associations, according to a review published in the June 1 issue of the Journal of the American Medical Association.

Abstract (http://jama.ama-assn.org/content/305/21/2200.short )Full Text (subscription or payment may be required) (http://jama.ama-assn.org/content/305/21/2200.full )Editorial (subscription or payment may be required) (http://jama.ama-assn.org/content/305/21/2229.extract )

Lateral Radiography Can Measure Prevertebral Soft Tissue Width

TUESDAY, May 31 (HealthDay News) -- Use of upright magnetic resonance imaging (MRI) has validated the use of lateral radiography for measuring prevertebral soft tissue (PVST) width, which is dependent on spinal level and gender, according to a study published in the May issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430%2811%2900253-1/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430%2811%2900253-1/fulltext )

Modic Changes Common in Patients With Lower Back Pain

FRIDAY, May 27 (HealthDay News) -- A high prevalence of Modic changes is seen among Spanish patients with chronic lower back pain (LBP) for whom magnetic resonance imaging (MRI) has been prescribed, according to a study published in the May issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430(11)00222-1/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430(11)00222-1/fulltext )

Chronic Pain Treatment May Reverse Brain Abnormalities

FRIDAY, May 27 (HealthDay News) -- Treatment of chronic low back pain (CLBP) may reverse functional and structural brain abnormalities, according to a study published in the May 18 issue of The Journal of Neuroscience.

Abstract (http://www.jneurosci.org/content/31/20/7540.abstract )Full Text (subscription or payment may be required) (http://www.jneurosci.org/content/31/20/7540.full )

Peripheral Nerve Injury May Cause Substantial Disability

FRIDAY, May 27 (HealthDay News) -- Patients with peripheral upper-extremity nerve injury may have substantial disability and pain at more than six months following the injury, according to a study published in the May 18 issue of The Journal of Bone & Joint Surgery.

Abstract (http://www.ejbjs.org/cgi/content/abstract/93/10/929 )Full Text (subscription or payment may be required) (http://www.ejbjs.org/cgi/content/full/93/10/929 )

Chiropractic Spine Manipulation Unlikely to Cause Injury

THURSDAY, May 26 (HealthDay News) -- Maximum chest compression induced during chiropractic thoracic spine manipulations is associated with minimal risk of Abbreviated Injury Scale (AIS) 1 level injuries, according to a study published online May 16 in the Journal of Manipulative and Physiological Therapeutics.

Abstract (http://www.jmptonline.org/article/S0161-4754(11)00061-3/abstract )Full Text (subscription or payment may be required) (http://www.jmptonline.org/article/PIIS0161475411000613/fulltext )

Contact With Drug Industry Linked to Positive Attitudes

WEDNESDAY, May 25 (HealthDay News) -- The extent of contact that medical students have with the pharmaceutical industry is associated with positive attitudes about marketing, according to a review published online May 24 in PLoS Medicine.

Abstract (http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001037#abstract1 )Full Text (http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001037 )

More Scans for Back Pain by Doctors Who Bill for MRI

WEDNESDAY, May 25 (HealthDay News) -- Patients with low back pain in the care of primary care physicians or orthopedists who own or lease magnetic resonance imaging (MRI) equipment are more likely to receive an MRI, according to a study published online April 21 in Health Services Research.

Abstract (http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2011.01265.x/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2011.01265.x/full )

Excessive Calcium Intake Does Not Lower Fracture Risk

WEDNESDAY, May 25 (HealthDay News) -- Increasing calcium intake above a satisfactory level is not associated with a further reduction of osteoporotic fracture rates in women, according to a study published online May 24 in BMJ.

Abstract (http://www.bmj.com/content/342/bmj.d1473 )Full Text (http://www.bmj.com/content/342/bmj.d1473.full )

Herniated Lumbar Disc Tied to Poor Vocational Prognosis

TUESDAY, May 24 (HealthDay News) -- The risk of an unfavorable vocational prognosis after hospital contact for herniated lumbar disc (HLD) is substantial and is associated with various risk factors, according to a study published in the May 20 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/05200/Predictors_of_Vocational_Prognosis_After_Herniated.17.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/pages/login.aspx?ReturnUrl=%2fspinejournal%2fsecure%2fpages%2fpurchase.aspx%3fan%3d00007632-201105200-00017 )

CT Fluoroscopy Superior to C-Arm in Disc Herniation

MONDAY, May 23 (HealthDay News) -- Computed tomography (CT) fluoroscopy is clinically more effective and safer than C-arm fluoroscopy for cervical transforaminal steroid injections for treatment of patients with cervical disc herniation, according to a study published in the May issue of The Spine Journal.

Abstract (http://www.thespinejournalonline.com/article/S1529-9430%2811%2900256-7/abstract )Full Text (subscription or payment may be required) (http://www.thespinejournalonline.com/article/S1529-9430%2811%2900256-7/fulltext )

Type II Odontoid Fractures May Up Elderly Mortality Risk

MONDAY, May 23 (HealthDay News) -- Type II odontoid fractures in the elderly are associated with a high mortality rate irrespective of the intervention, according to a study published in the May 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/05150/Type_II_Odontoid_Fractures_of_the_Cervical_Spine_.8.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/pages/login.aspx?ReturnUrl=%2fspinejournal%2fsecure%2fpages%2fpurchase.aspx%3fan%3d00007632-201105150-00008 )

Tai Chi May Prevent Falls and Improve Mental Health

FRIDAY, May 20 (HealthDay News) -- Tai chi may help fall prevention and improve psychological health but has been shown not to be effective in the symptomatic treatment of cancer and rheumatoid arthritis (RA), according to a study published online May 16 in the British Journal of Sports Medicine.

Abstract (http://bjsm.bmj.com/content/early/2011/05/02/bjsm.2010.080622.abstract )Full Text (subscription or payment may be required) (http://bjsm.bmj.com/content/early/2011/05/02/bjsm.2010.080622.full )

Many Medical Students Lack Confidence in Medical Law

FRIDAY, May 20 (HealthDay News) -- The majority of medical students lack confidence in their knowledge and skills across many areas of medical law, according to a study published online May 16 in the Journal of Medical Ethics.

Abstract (http://jme.bmj.com/content/early/2011/04/13/jme.2010.041566.abstract )Full Text (subscription or payment may be required) (http://jme.bmj.com/content/early/2011/04/13/jme.2010.041566.full )

In Vivo 3-D Cervical Spine Kinematics Demonstrated

THURSDAY, May 19 (HealthDay News) -- In vivo three-dimensional (3-D) magnetic resonance imaging (MRI) kinematics of the cervical spine during head rotation identifies differences in cervical motion between patients with cervical spondylosis and healthy controls, according to a study published in the May 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/05010/In_Vivo_Three_Dimensional_Kinematics_of_the.4.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/secure/pages/purchase.aspx?an=00007632-201105010-00004 )

Nerve Blockade May Reduce Acute Pain After Hip Surgery

THURSDAY, May 19 (HealthDay News) -- Nerve blockade may be effective for reducing acute pain after hip fracture, but evidence is lacking for most other pain management interventions, according to a review published online May 16 in the Annals of Internal Medicine.

Abstract (http://www.annals.org/content/early/2011/05/12/0003-4819-155-1-201107050-00346.abstract )Full Text (subscription or payment may be required) (http://www.annals.org/content/early/2011/05/12/0003-4819-155-1-201107050-00346.full )

Therapeutic Climbing Beneficial for Chronic Low Back Pain

FRIDAY, May 13 (HealthDay News) -- Compared with a standard exercise regime, therapeutic climbing offers patients with chronic low back pain superior benefits in terms of perceived health and physical functioning, according to a study published in the May 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/05150/The_Effects_of_Therapeutic_Climbing_in_Patients.3.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/pages/login.aspx?ReturnUrl=%2fspinejournal%2fsecure%2fpages%2fpurchase.aspx%3fan%3d00007632-201105150-00003 )

Poor Cardiovascular Outcomes for U.S. Women

THURSDAY, May 12 (HealthDay News) -- In the United States, women have worse cardiovascular treatment and outcomes than men, according to the Women's Health in American Hospitals report released on May 3 by HealthGrades.

More Information (http://www.healthgrades.com/health-news/ArticleDetail.aspx?id=652521 )

Proton Pump Inhibitors May Increase Fracture Risk

WEDNESDAY, May 11 (HealthDay News) -- Use of proton pump inhibitors (PPIs), but not histamine 2 receptor antagonists (H2RAs), is associated with an increased risk of fracture, according to a meta-analysis published in the May/June issue of the Annals of Family Medicine.

Abstract (http://www.annfammed.org/cgi/content/abstract/9/3/257 )Full Text (http://www.annfammed.org/cgi/content/full/9/3/257 )Editorial (http://www.annfammed.org/cgi/content/full/9/3/200 )

Medical Education Participants Recognize Funding Bias

WEDNESDAY, May 11 (HealthDay News) -- Although most medical professionals believe that commercial funding of continuing medical education (CME) introduces bias, most are not willing to pay higher fees to offset or eliminate such funding sources, according to a study published in the May 9 issue of the Archives of Internal Medicine.

Abstract (http://archinte.ama-assn.org/cgi/content/abstract/171/9/840 )Full Text (subscription or payment may be required) (http://archinte.ama-assn.org/cgi/content/full/171/9/840 )Editorial (subscription or payment may be required) (http://archinte.ama-assn.org/cgi/content/extract/171/9/847 )

Heart Failure Linked to Higher Osteoporotic Fracture Risk

WEDNESDAY, May 11 (HealthDay News) -- Heart failure is associated with an increased risk for vertebral compression fracture (VCF), and more than half of those with VCF have multiple fractures, according to a study published online May 10 in Circulation: Heart Failure.

Abstract (http://circheartfailure.ahajournals.org/content/early/2011/05/10/CIRCHEARTFAILURE.111.961185.abstract )Full Text (subscription or payment may be required) (http://circheartfailure.ahajournals.org/content/early/2011/05/10/CIRCHEARTFAILURE.111.961185.full.pdf+html )

NSAIDs May Increase Cardio Risk in MI Patients

TUESDAY, May 10 (HealthDay News) -- In patients with prior myocardial infarction (MI), even short-term treatment with most nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with an increased risk of recurrent MI and death, according to a study published online May 9 in Circulation.

Abstract (http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.110.004671v1 )Full Text (http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.110.004671v1 )

Self-Image Impacts Pain Perception in Scoliosis Patients

MONDAY, May 9 (HealthDay News) -- The majority of patients with adolescent idiopathic scoliosis (AIS) report experiencing back pain, and those who perceive themselves as less deformed or have less of a desire to change their spinal deformity have a greater reduction in pain after posterior spinal fusion surgery, according to a study published in the May 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/05010/Prevalence_and_Predictors_of_Pain_in_Surgical.11.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/secure/pages/purchase.aspx?an=00007632-201105010-00011 )

Calcium Supplementation Inadequate in Elderly

FRIDAY, May 6 (HealthDay News) -- Dietary calcium intake is lower in the elderly and, despite increased frequency of supplemental calcium use, this cohort does not meet the recommended adequate intake (AI) of calcium, according to a study published in the May issue of the Journal of the American Dietetic Association.

Abstract (http://www.adajournal.org/article/S0002-8223%2811%2900138-6/abstract )Full Text (subscription or payment may be required) (http://www.adajournal.org/article/S0002-8223%2811%2900138-6/fulltext )Editorial (subscription or payment may be required) (http://www.adajournal.org/article/S0002-8223(11)00136-2/fulltext )

New Implant Likely to Stabilize Spine After Facetectomy

THURSDAY, May 5 (HealthDay News) -- Following medial facetectomy, use of Auxiliary Facet System (AFS) instrumentation has a minor influence on flexion/extension and lateral bending, stabilizes axial rotation, and reduces intradiscal pressure (IDP), according to a study published in the April 20 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/04200/Influence_of_an_Auxiliary_Facet_System_on_Lumbar.3.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/secure/pages/purchase.aspx?an=00007632-201104200-00003 )

Condition-Specific Comorbidity Index May Improve Accuracy

THURSDAY, May 5 (HealthDay News) -- A condition-specific comorbidity index may be significantly better than the commonly used Deyo Comorbidity Index for adjusting mortality, morbidities, and hospital disposition measures, according to a study published in the April 20 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/04200/The_Risk_of_Risk_Adjustment_Measures_for.12.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/pages/login.aspx?ReturnUrl=%2fspinejournal%2fsecure%2fpages%2fpurchase.aspx%3fan%3d00007632-201104200-00012 )

Bisphosphonates Tied to Small Risk of Atypical Fractures

WEDNESDAY, May 4 (HealthDay News) -- Among patients with atypical fractures, there is a high prevalence of current bisphosphonate use, but the absolute risk of these fractures is small, according to a study published in the May 5 issue of the New England Journal of Medicine.

Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1010650 )

Scoliosis Surgery Has More Risks, Benefits for Elderly

TUESDAY, May 3 (HealthDay News) -- Elderly patients who undergo surgery for scoliosis have an increased risk of complications but may experience greater improvement in disability and pain than younger patients, according to a study published in the May 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2011/05010/Risk_Benefit_Assessment_of_Surgery_for_Adult.10.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/secure/pages/purchase.aspx?an=00007632-201105010-00010 )

Anterior Instability Linked to Rotator Muscle Strength

TUESDAY, May 3 (HealthDay News) -- Patients with recurrent anterior instability may have internal rotator and external rotator weakness, which can be analyzed most appropriately by comparison with a control group, according to a study published in the April 20 issue of The Journal of Bone & Joint Surgery.

Abstract (http://www.ejbjs.org/cgi/content/abstract/93/8/759 )Full Text (subscription or payment may be required) (http://www.ejbjs.org/cgi/content/full/93/8/759 )

Total Disc Replacement Viable Alternative to Arthrodesis

MONDAY, May 2 (HealthDay News) -- Lumbar total disc arthroplasty is a viable alternative to arthrodesis for the treatment of two-level degenerative disc disease, according to a study published in the April 20 issue of The Journal of Bone & Joint Surgery.

Abstract (http://www.ejbjs.org/cgi/content/abstract/93/8/705 )Full Text (subscription or payment may be required) (http://www.ejbjs.org/cgi/content/full/93/8/705 )Editorial (subscription or payment may be required) (http://commentary.jbjs.org/index.php/2011/03/354/ )