"Allografts have been in vogue in orthopaedic medicine for over 20 years; however, many questions regarding their use still remain. Are allografts safe? The answer is yes, in spite of the recent spate of infections attributed to contaminated grafts. Do allografts work? Well, yes -- and no."
"Cervical arthroplasty preserves motion of the FSU. Both the endplate angle of the treated disc space and the angle of the FSU became kyphotic after insertion of the Bryan prosthesis. The overall sagittal balance of the cervical spine, however, was preserved."
Effects of a Cervical Disc Prosthesis on Segmental and Cervical: "Cervical arthroplasty preserves motion of the FSU. Both the endplate angle of the treated disc space and the angle of the FSU became kyphotic after insertion of the Bryan prosthesis. The overall sagittal balance of the cervical spine, however, was preserved."
Effects of a Cervical Disc Prosthesis on Segmental and Cervical: "Cervical arthroplasty preserves motion of the FSU. Both the endplate angle of the treated disc space and the angle of the FSU became kyphotic after insertion of the Bryan prosthesis. The overall sagittal balance of the cervical spine, however, was preserved."
"The long-term function of an artificial cervical disc device is critical to its clinical success. The Prestige I Cervical Disc System has been used clinically since June 1998, and long-term results can now begin to be assessed. The authors conducted clinical and radiographic examinations at 3 and 4 years postoperatively to evaluate the long-term performance of the Prestige I device."
"The rate of vertebral fractures after kyphoplasty is higher than would be expected if the index fractures had gone untreated, new research suggests. The increased fracture risk seems to be limited to a 2-month period following the procedure."
"Traditional Chinese acupuncture reduces knee pain and improves function for osteoarthritis patients, according to a 26-week, randomized controlled trial funded by the National Institutes of Health and reported yesterday at the annual scientific meeting of the American College of Rheumatology."
"Evaluation of the Subchondral Fracture in Predicting the Extent of Femoral Head Necrosis in Perthes Disease: A Prospective Study of 92 Patients"
The authors previously published a rule for the differential diagnosis of septic arthritis of the hip and transient synovitis of the hip using the assessment of 4 independent predictors: history of fever, unwillingness to bear weight, erythrocyte sedimentation rate (ESR) > 40 mm/hr, and a serum white blood cell count > 12,000 cells/mm3. They rightly state the importance of validating a test on a population different from that from which it was derived, and also rightly state that the performance of the test should be expected to be poorer in the validation study.
"In this study, the authors mined KID, the Kids' Inpatient Database, for the years 1997 and 2000. This database is sponsored by the federal Department of Health and Human Services through the Agency for Research and Quality, and contains information on pediatric inpatient care in community hospitals in about half of the states in the US. There are 1.9 million discharge records for 1997 and 2.5 million for 2000."
"Spinal arthroplasty may become the next gold standard for the treatment of degenerative cervical spine disease. This new modality must be studied rigorously to ensure in vivo efficacy and safety. The authors review the preliminary clinical experience and radiographic outcomes following insertion of the Bryan Cervical Disc Prosthesis (Medtronic Sofamor Danek, Memphis, TN)."
"Cervical spinal cord compression managed via an anterior approach with an arthrodesis may be associated with a decreased range of motion and accelerated adjacent-segment degeneration. Artificial cervical disc replacement may address these problems."
"Value of Magnetic Resonance Imaging and Discography in Determining the Level of Cervical Discectomy and Fusion"
Oral nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve the symptoms of OA but can produce harmful systemic effects and end-organ damage," write Sanford H. Roth, MD, and J. Zev Shainhouse, MD, from Dimethaid Health Care Ltd in Markham, Ontario, Canada. "A topical NSAID formulation may provide symptom relief with fewer adverse effects. A new topical diclofenac sodium solution — containing the absorption enhancer dimethyl sulfoxide — was evaluated for the relief of the symptoms of primary OA of the knee.
"Water-based and land-based exercise programs both provide functional improvements over control for patients with osteoarthritis (OA), according to the results of a randomized trial published in the December issue of the Annals of the Rheumatic Diseases. Although strength gain was greater on land, the investigators suggest that water therapy should be used to improve aerobic capacity in those unable to do so on land, and that further studies are needed to demonstrate long-term benefits."
"Water-based and land-based exercise programs both provide functional improvements over control for patients with osteoarthritis (OA), according to the results of a randomized trial published in the December issue of the Annals of the Rheumatic Diseases. Although strength gain was greater on land, the investigators suggest that water therapy should be used to improve aerobic capacity in those unable to do so on land, and that further studies are needed to demonstrate long-term benefits."
"Pfizer Inc. said on Friday it is sending additional information to healthcare professionals about its arthritis drug Bextra (valdecoxib), a COX-2 inhibitor"
The company also said it reviewed heart risk in rheumatoid arthritis and osteoarthritis patients and saw no increased heart risk in patients taking the Bextra from 6 to 52 weeks. However, in two trials in high-risk coronary artery bypass graft surgery, an increase in heart events was seen in patients taking Bextra alone or in combination with another drug.
Americans of all ages must do more to protect their bones now to protect themselves from fractures and other related problems later in life, U.S. health officials warned on Thursday.
About 10 million Americans 50 years of age and older already have osteoporosis, and another 34 million risk developing it. By 2020, 14 million older adults could develop osteoporosis, with another 47 million at risk.
The report also called for bone density testing in women over 65 and anyone who breaks a bone after age 50.
The report also called for bone density testing in women over 65 and anyone who b""Discectomy, decompression, and fusion are traditionally used to manage cervical disc disease accompanied by neural element compression that is refractory to conservative management. Concerns regarding stress at levels adjacent to fusion and possible adjacent-level degeneration as well as a desire to maintain a more normal biomechanical environment have led to investigation of cervical disc replacement as an alternative to fusion procedures. Cervical disc prostheses currently under investigation are constructed of predominantly metal-on-polyethylene or metal-on-metal bearing surfaces, and use roughened titanium surfaces and osteoconductive coatings to facilitate fixation. The unique anatomy and biomechanics of the cervical spine must be considered when extrapolating from the experience of appendicular arthroplasty and lumbar disc replacement."
"New research suggests that vitamin D intake is an often overlooked factor in bone health, even in women who are being treated for osteoporosis, according to two studies reported here at the 26th annual meeting of the American Society for Bone and Mineral Research (ASBMR)."
"In a comparison study between once-weekly doses of alendronate (Fosamax) and risedronate (Actonel), alendronate increased bone mineral density (BMD) at all measured sites more than risedronate, according to results reported here at the 26th annual meeting of the American Society for Bone and Mineral Research (ASBMR)."
"In the wake of Merck's voluntary, worldwide withdrawal of rofecoxib (Vioxx) on Sept. 30, concerns are surfacing over whether the adverse cardiovascular risk documented with rofecoxib may be a class effect extending to the other cyclooxygenase-2 (COX-2) inhibitors. The U.S. Food and Drug Administration (FDA) issued a public health advisory to inform patients about the withdrawal of rofecoxib, and Acting Commissioner Lester M. Crawford announced the FDA's intention to closely monitor other COX-2 inhibitors for similar adverse events."
Pfizer's drug valdecoxib (Bextra) is also "under a cloud because another FDA physician reviewing the data on that drug concluded there may be an increased cardiovascular risk," said Dr. Wolfe, who is also an adjunct professor of internal medicine at Case Western Reserve University in Cleveland, Ohio. "I think it is very likely that the effect of increasing cardiovascular risk is a class effect." According to agency files obtained in a lawsuit by Public Citizen, an unredacted review by the FDA Medical Officer recommended nonapproval for valdecoxib for acute pain, citing the Coronary Artery Bypass Graft (CABG) Surgery study 035. Even though the entire study population received prophylactic low-dose aspirin, this trial showed an excess of serious cardiovascular thromboembolic adverse events including death in association with the use of valdecoxib, 40 mg twice daily, when added to ad lib parenteral narcotic analgesia. In other databases, including formal safety Trials 47 and 62, valdecoxib at doses higher than 20 mg per day was associated with a greater incidence of edema and hypertension than were ibuprofen, naproxen, and diclofenac.
"For example, a chest computed tomogram (CT) corresponds to about 400 chest x-rays, implying a risk similar to smoking 700 cigarettes. Here, we have a paradox: in Europe, when you buy a cigarette pack you are faced with a large, bold, and funereal black notice stating that 'Smoking severely damages your health' or 'You can die from smoking'; then you have a thallium scan, and no one minds telling you that the long-term risk corresponds to smoking 1,400 cigarettes."
"For example, a chest computed tomogram (CT) corresponds to about 400 chest x-rays, implying a risk similar to smoking 700 cigarettes. Here, we have a paradox: in Europe, when you buy a cigarette pack you are faced with a large, bold, and funereal black notice stating that 'Smoking severely damages your health' or 'You can die from smoking'; then you have a thallium scan, and no one minds telling you that the long-term risk corresponds to smoking 1,400 cigarettes."
"An analysis of data from the Framingham Offspring Study suggests that men can improve bone mineral density (BMD) with moderate consumption of beer, while women gain a similar benefit from moderate consumption of wine."
"One of the most controversial aspects of fracture management is the simple question about how to best fix an ankle syndesmosis injury. There is no consensus about the size of screws (3.5 mm or 4.5 mm), number of screws (1 or 2), or number of cortices engaged per screw (3 or 4)."
"The U.S. Food and Drug Administration (FDA) and Novartis warned healthcare professionals via letter of osteonecrosis of the jaw (ONJ) associated with zoledronic acid (Zometa) and pamidronate disodium (Aredia) use, mainly in cancer patients who have received bisphosphonates as a component of their therapy, according to an alert sent today from MedWatch, the FDA's safety information and adverse event reporting program."
"It is not an understatement to state that minimally invasive hip replacement surgery has piqued the interest of surgeons, patients, and the media. All of these interest groups are awaiting validation of what is believed to be a dramatic advance in hip arthroplasty (see above editorial)."
"Ankle syndesmosis injuries are notoriously difficult to manage if initially undiagnosed, and it has been emphasized recently that subtle syndesmosis injuries can accompany Weber B distal fibular fractures in which the syndesmosis has traditionally been considered to be stable. All ankle fractures and other injuries with suspected disruption of the syndesmosis should be examined under anesthesia as well as fluoroscopically in order to determine whether there is syndesmotic widening with load. The so-called Cotton or Hook test refers to the demonstration of coronal plane (lateral) instability manifest as distal tibia-fibular widening on an anteroposterior x-ray of the ankle. Others have recommended an external rotation test, with similar demonstration of coronal plane instability."
"Early attempts at spinal arthroplasty in the 1950s yielded limited success. A revival of this procedure occurred in the 1980s and became a realistic treatment option in the 1990s. Both lumbar and cervical arthroplasties have been introduced in the US since 2000 for randomized, prospective studies in accordance with the Food and Drug Administration (FDA) investigational device exemption provisions. In June 2004 the first lumbar arthroplasty device was approved by the FDA for use in the US. It is likely that cervical arthroplasty will soon follow and may be available for widespread use as early as 2006. In this paper the authors review the historical development of cervical arthroplasty."
"Merck & Co., Inc., announced today a voluntary withdrawal of rofecoxib (Vioxx) from the U.S. and worldwide market due to safety concerns of an increased risk of cardiovascular events, according to an alert from MedWatch, the U.S. Food and Drug Administration (FDA) safety information and adverse event reporting program."
"Both total hip and knee arthroplasty have demonstrated outstanding clinical results. The functional spinal unit composed of the intervertebral disc and facet joints is at least as complex. The intricacies of the coupled motions of the functional spinal unit have made development of an artificial disc a challenge. There have been several failed attempts to create a disc replacement that recapitulates normal motion while providing significant longevity and a low incidence of complications."
"Compared with daily bisphosphonate therapy, weekly treatment is associated with improved compliance, but more than half of patients with osteoporosis prescribed the weekly dose still fail to use the drug as prescribed, according to an analysis of data from prescription databases."
"Improved primary care treatment of depression for the elderly not only reduces depressive symptoms but reduces arthritis pain and improves quality of life, according to the results of a randomized controlled trial published in the Nov. 12 issue of The Journal of the American Medical Association."
"Such genetic factors as body mass index and medial tibial bone area appear to play a role in the development of knee osteoarthritis, according to a report in the October Annals of the Rheumatic Diseases."
"Reduction of venous hypertension and edema in the lower limbs is the mainstay of treatment for venous leg ulcers. The application of graduated compression bandaging, hosiery, or intermittent pneumatic compression aims to achieve this by forcing fluid in the interstitial spaces back into the vascular and lymphatic systems. The choice of a particular compression system depends on individual patient variables, including ankle circumference, patient mobility, nature of ulceration, degree of edema, and patient tolerance and adherence."
"As described by Dr. Eugene Apert in 1906, Apert's syndrome is characterized by the clinical triad of craniosynostosis, midface hypoplasia, and symmetric syndactyly of the hands and feet.[1] These children present with irregular craniosynostosis characterized by a high, full forehead and a fiat occiput and early fusion of the coronal sutures. In infancy, there is a wide and gaping defect in the region of the sagittal and metopic sutures, resulting in an enlarged fontanelle."
"Steroid injection into the carpometacarpal joint (CMCJ) of the thumb is not beneficial for patients with osteoarthritis (OA), according to the results of a randomized trial published in the October issue of the Annals of Rheumatic Diseases."
I'm a resident in Orthopaedics and am interested in computers, movies, music and books. I'm in a rock band and am an aspiring songwriter as well.
