Meta-analysis finds initial walking speed positively impacted by knee arthroplasty
Knee arthroplasty helped increase patients’ walking speed at 6 months to 60 months postoperatively, according to a study conducted by researchers in The Netherlands.
For the analysis, the authors looked through 16 independent comparisons of pre-operative and postoperative walking speed for patients who underwent knee arthroplasty. In all, they identified 12 studies in their survey of MEDLINE, Web of Science, and PEDro, for a total of 419 patients.
Primary TKA found effective in patients with BMI greater than 50
Researchers from London, Ontario, found total knee arthroplasty efficacious in patients with body mass indices equal to or greater than 50, but remained cautious about the safety of the procedure in the group due to higher risks of complications and revisions.
Ceramic-on-ceramic an increasingly effective bearing option in THA, surgeon reports
“Ceramic-on-ceramic is a nice option to avoid [wear],” Hari P. Bezwada, MD, said at the International Congress for Joint Reconstruction San Diego 2012 meeting, which was held in collaboration with Orthopedics Today. “It is a hard-on-hard bearing and a low-wear construct. One of the nice things about ceramic is it is the hardest scratch-resistant surface we know. If it is scratch-resistant it is going to be less prone to other issues.”
“Ceramic-on-ceramic has the very lowest wear couple,” Bezwada said. “It is technique dependent, so make sure your components are properly positioned. The fracture risk going forward with the fourth generation is probably exceedingly low. You do not have to worry about metal hypersensitivity.”
“Overall, I think it is the better option for younger patients,” he said.
Follow-up, revision parameters for metal-on-metal hip implants outlined
In a recent presentation, one surgeon outlined his indications for follow-up and revision of metal-on-metal total hip replacements.
Thomas P. Schmalzried, MD, presented his experience at the International Congress for Joint Reconstruction San Diego 2012 meeting, which was held in collaboration with Orthopedics Today.
According to Schmalzried, revision should be considered in patients who display poor clinical results, such as pain or mechanical symptoms. Pseudotumor or other soft tissue involvement, such as edema and necrosis, are also a sign that revision should be performed within 3 months. Osteolysis and high metal ion levels should also bring revision into consideration.
Schmalzried stressed he still observes asymptomatic patients with “clean” MRIs, regardless of their metal ion levels.
Understanding a patient's mental health status before hip replacement surgery may improve education and care
Patients taking antidepressants up to three years prior to undergoing a total hip replacement (THR) were more likely to report greater pain before and after surgery and less satisfaction with their procedure, according to new research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
According to the investigators, a patient's mental health status should be assessed prior to surgery and taken into consideration during post-operative care.
Return to running possible after hip resurfacing
Recreational runners who undergo hip resurfacing, an alternative to a total hip replacement, may be able to return to the sport after surgery, according to a recent study from France. Still, hip resurfacing represents an attractive choice for active individuals. A hip resurfacing implant is easier to revise or repair than a total hip replacement, researchers said.
It also feels more natural than a traditional total hip replacement, according to Anderson, in part because less bone is removed from the head of the femur in hip resurfacing.
"The body has a more normal awareness of that hip, which makes the joint feel more secure in sports with a lot of running, cutting and twisting," Anderson told Reuters Health.
Arthritic knees, but not hips, have robust repair response
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 failure
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.
New protein that plays part in arthritis discovered
A Boise State University study has shed new light on how proteins interact, or bind, with one another in tissues. The new information could help scientists with tissue engineering and strengthening efforts to treat cartilage damage and degeneration by diseases such as osteoarthritis, which affects more than 20 million Americans and is the most common type of arthritis.
The Boise State biologists found that a protein called collagen XI interacts with specific proteins in the part of the tissue that provides structural support to the cell. Collagen XI is one of the few proteins that is known to prevent arthritis, and when it is mutated or absent, the individual will develop arthritis early in life.
Bone drugs may increase longevity of replaced joints
New research may help hip and knee replacements last longer in patients who take commonly prescribed bone-loss drugs. Joint replacement surgeries help millions live with less pain, but many people who have them eventually need repeat procedures when the implants loosen over time.
Now a new study suggests that commonly prescribed osteoporosis drugs may extend the life of replacement joints, but researchers say it is not yet clear which patients will benefit most from the treatment.
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