News Updates
Hip resurfacing: The metal-on-metal bearing material is not the problem
Source — Healio
MoM hip resurfacing is not a new technology any more, and the devices that have been approved by the FDA after sufficient clinical trials have been available for more than a decade. It is important to avoid making statements about a procedure based on the poor results of subsequent designs which were still in their experimental (non-FDA approved) phase.
Many have written off MoM HRA, and this is unfortunate because superb results have been achieved with several devices in several centers for the young and active patient. The MoM bearing, unlike polyethylene of first generation devices, is not the problem. It is a treatment option for arthritis that is worth pursuing and improving. It just makes sense to save the head and neck, and adhere to a fundamental tenet of orthopedics espoused by our forebears — save bone.
It is my fervent desire to improve surgeon and patient education and emphasize that there are techniques to solve the problems associated with MoM hip resurfacing. Charles Kettering said, “The world hates change, yet it is the only thing that has brought progress.”
ACR approves standardized measures to determine RA disease activity
Source — Healio
A working group organized by the American College of Rheumatology has analyzed more than 60 disease activity measures for rheumatoid arthritis and recommended six measures that can be applied in clinical practice, according to a press release. The analysis by the Rheumatoid Arthritis (RA) Clinical Disease Activity Measures Working Group apppear in Arthritis Care & Research.
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.
Synovial fluid tests with leukocyte esterase strips improved periprosthetic joint infection detection
Source — Orthosupersite
A prospective cohort study showed that leukocyte esterase reagent strips can play an important role in the rapid diagnosis of periprosthetic joint infection when following patients after total joint arthroplasty.
“LE [leukocyte esterase] is a very accurate test for diagnosing PJI [periprosthetic joint infection],” Parvizi said at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting, here.
LE at 2-plus had 100% positive predictive value and 100% specificity. I am not aware of a single test in our armamentarium today that carries the same specificity and positive predictive value,” he said, noting the strips, which are commercially available, cost about 25 cents each and can detect PJI in about 1 minute.
Knee replacement may lower a patient’s risk for mortality and heart failure
Source — 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.