Today’s Top Story
Study: TKA offers greater pain relief and functional improvement, but higher risk compared to nonsurgical treatment for patients with moderate knee OA.
Data from a study published in the Oct. 22 issue of The New England Journal of Medicine suggest that treatment with total knee arthroplasty (TKA) followed by nonsurgical treatment may offer greater pain relief and functional improvement for patients with moderate-to-severe knee osteoarthritis (OA) than nonsurgical treatment alone. The researchers conducted a randomized, controlled trial of 95 patients who underwent either unilateral TKA followed by 12 weeks of nonsurgical treatment (exercise, education, dietary advice, use of insoles, and pain medication), or 12 weeks of nonsurgical treatment alone. At 12-month follow-up, they found that 26 percent of patients (n = 13) in the nonsurgical group had undergone TKA, while 2 percent of patients (n = 1) in the TKA group received only nonsurgical treatment. Overall, patients in the TKA group saw greater improvement in KOOS4 score compared to those in the nonsurgical-treatment group. However, the TKA cohort had 24 serious adverse event, compared to six in the nonsurgical cohort. Read the complete study…
Other News
Study: Physician ownership of in-office MRI equipment does not increase usage rate among Medicare patients.
Study data published in Health Economic Review indicate that physician ownership of on-site magnetic resonance imaging (MRI) does not increase MRI use in Medicare patients by orthopaedic practice providers, compared to use by physicians in practices without on-site MRI capability. The researchers analyzed Medicare outpatient claims data for the 2007, 2008, and 2009 cohorts of physicians in orthopaedic practices that acquired onsite MRI capacity and compared them to data for physicians in matched non-MRI practices. In all of the Medicare MRI volume change models estimated, the association between onsite MRI acquisition and the change in provider Medicare MRI volume (1-year post acquisition less 1-year pre-acquisition) was consistently small and not statistically significant. The study was funded by the AAOS. Read the study…
President Obama unveils plan for combatting heroin and prescription drug abuse.
During an Oct. 21 forum in Charleston, W.Va., President Obama outlined plans for combatting the nationwide epidemic of heroin and prescription drug abuse. According to the president, these plans include increasing access to drug treatment and expanding training for physicians who prescribe opiate painkillers. The Obama administration aims to double the number of physicians who can prescribe buprenorphine—a drug used to treat opiate addiction—from 30,000 physicians to 60,000 physicians in the next 3 years, The Washington Post reports. More than 40 medical provider groups will train more than half a million physicians, dentists, and others to safely prescribe opiate medications. Read more…
At its October meeting, the AAOS Board of Directors adopted an information statement on Opioid Use, Misuse, and Abuse in Orthopaedic Practice. Read the statement…
Study: Lumbar spine surgery may be appropriate for some patients with Parkinson disease and back pain.
According to a study published in the Oct. 21 issue of The Journal of Bone & Joint Surgery, patients with Parkinson disease may see a reduction in spine-related pain after lumbar spine surgery. The authors conducted a retrospective study of 96 patients with Parkinson disease who underwent lumbar spine surgery between 2002 and 2012. Parkinson disease severity stage was < 2 in 13 patients, 2 in 30 patients, 2.5 in 23 patients, and ≥ 3 in 30 patients. Primary indication for surgery was spinal stenosis in 72 patients, spondylolisthesis in 17 patients, and coronal and/or sagittal deformity in 7 patients. At mean 30.1-month follow-up, the authors found that visual analog scale (VAS) for back pain improved from 7.4 preoperative to 1.8 postoperative, VAS for lower-limb pain improved from 7.7 preoperative to 2.3 postoperative, Oswestry Disability Index score dropped from 54.1 points preoperative to 17.7 points postoperative, and Short Form-12 Physical Component Summary score improved from 26.6 points preoperative to 30.5 points postoperative. Overall, 19 patients had early complications, and 20 required revision surgery. Read more…
Medical school enrollment at an “all-time high.”
According to the Association of American Medical Colleges (AAMC), medical school enrollment grew by 6.2 percent for 2015, following a 3.1 percent increase the previous year. As reported by MedPage Today and HealthLeaders Media, a total of 52,550 individuals—38,460 of whom were first-time applicants—applied to medical school in 2014 for enrollment in 2015, amounting to a 4.8 percent increase from the previous year. Furthermore, medical school enrollment for 2015 was 20,630, an all-time high that equates to an increase of 25 percent compared to 2002. Just more than half (52 percent) of these medical school students are male, a ratio that mirrors the year before. Overall, the starting class for 2015 was 57percent white, 22 percent Asian, 10 percent Hispanic or Latino, and 8 percent African-American. Read more…
Read the release from AAMC…
Study: Antibiotics for children may lead to increased body mass later in life.
A study suggests that children who received both recent and cumulative doses of antibiotics may develop an elevated body mass index (BMI). The study, appearing in the International Journal of Obesity, scanned electronic health records of physician orders for antibiotics in approximately 150,000 children aged 3 to 18 who were under care for at least 1 year before their first BMI was recorded. Antibiotic orders in the prior year were associated with increased BMI, particularly in midteen years, and cumulative orders were associated with persistent increases in BMI. The researchers’ models indicate that antibiotics could be tied to excess weight gains of 0.73 to 1.5 kilograms at age 15. The authors hypothesized that antibiotics might influence metabolism and energy balance by affecting intestinal microbiota. They concluded: “The results suggest that antibiotic use may influence weight gain throughout childhood and not just during the earliest years as has been the primary focus of most prior studies.” Read more…
Read the abstract…
Study: Motion stops joint cartilage from deflating.
Medical News Today reports that researchers at the University of Delaware have discovered how motion can cause cartilage to reabsorb synovial fluid in joints that leaks out over time. The researchers hypothesized that hydrodynamic pressurization—which occurs when the relative motion of two surfaces causes fluid between them to accelerate in the shape of a triangular wedge—forces fluid back into the cartilage. After placing larger-than-average cartilage samples against a glass flat to ensure the presence of a wedge, they found that cartilage thinning and an increase in friction occurred over time at slow-sliding speeds. However, as the sliding speed increased toward typical walking speeds, the effect was reversed. “We observed a dynamic competition between input and output of [synovial fluid],” said David Burris, assistant professor in the university’s mechanical engineering department. “We know that cartilage thickness is maintained over decades in the joint and this is the first direct insight into why. It is activity itself that combats the natural deflation process associated with interstitial lubrication.” Read more…
Call for volunteers: Annual Meeting Committee.
Dec. 1 is the last day to submit your application for a position on the Annual Meeting Committee. The Annual Meeting Committee plans and implements the AAOS Annual Meeting. The following openings are available:
- One member—allied health representative
- One member-at-large
Applicants for the member position must be active fellows with a knowledge of allied health educational needs. Applicants for the member-at-large position must be active fellows with experience and interest in the AAOS Annual Meeting. Learn more and submit your application…(member login required)
