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  • The difficulties of treating shoulder pain in baseball pitchers

    Results of treating shoulder pain in baseball pitchers and other throwing athletes are not as predictable as doctors, patients and coaches would like to think, according to a report in the journal Physical Medicine and Rehabilitation Clinics of North America. Source: Medical News Today

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  • Link possible between oral contraceptive use, ACL injury in females

    Researchers from Denmark have uncovered a potential link between oral contraceptive use and instances of ACL injuries that required surgical intervention in women. The researchers evaluated 4,497 women who were treated operatively for an ACL injury between July 2005 and December 2011 and 8,858 age-matched, uninjured contro Source: Healio

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  • Osteoporosis: Steroid Danger

    10-million Americans have osteoporosis and 18-million more are at risk. The bone disease leads to an increase in fractures in the hip, spine and wrist accounting for one-point-five million painful fractures each year and one woman’s harrowing story of recovery is inspiring. Source: Ivanhoe

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  • Why treating shoulder pain in baseball pitchers and other throwing athletes is so difficult

    Despite increasing medical knowledge, treating shoulder pain in baseball pitchers and other throwing athletes remains one of the most challenging tasks in sports medicine. Results of treatment as not as predictable as patients, doctors or coaches would like to think. Source: Science Daily

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  • Acoustic technique developed to detect knee osteoarthritis

    A revolutionary medical technique using sound waves to identify osteoarthritis in the knee has been developed by researchers.
    The UK is leading this new field of health research based on listening to the sounds emitted by the body.
    Microphones are attached to the knees of patients, and the high frequency sound waves emanating from their knees are measured as they stand up. These acoustic emissions are interpreted by computer software to give information about the health of the patient’s knee.

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  • Researchers found better cup, stem survival after early THA

    Patients who underwent early total hip arthroplasty experienced better 10-year cup and stem survival compared with patients who underwent late total hip arthroplasty, according to study results.
    Researchers searched the Medline databases from January 1990 to January 2014 and retrieved 19 articles reporting on the management of posttraumatic arthritis of the hip following acetabular fractures with the use of late total hip arthroplasty (THA), as well as articles where acetabular fractures were treated with early THA. In all, the researchers assessed THA outcomes following acetabular fracture in 654 patients.

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  • Higher readmission rates experienced after reverse total shoulder arthroplasty

    Compared with patients who underwent hemiarthroplasty or total shoulder arthroplasty, patients who underwent reverse total shoulder arthroplasty had higher readmission rates, according to study results.
    Using the State Inpatient Database from seven different states, researchers identified 26,218 patients who underwent hemiarthroplasty, total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA) from 2005 to 2010. The researchers determined the 90-day readmission rate, causes of readmission and risk factors for readmission. Additionally, factors and risk for readmission were measured using multivariate modeling and a Cox proportional hazards model.

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  • Overuse injuries becoming more common in young athletes

    From Little League players injuring their elbow ligaments to soccer and basketball players tearing their ACLs, sports injuries related to overuse are becoming more common in younger athletes.

    Dr. Matthew Silvis, medical director for primary care sports medicine at Penn State Hershey, says specialization is a big reason why.

    "It has been a kind of societal thing that kids are specializing in one sport at the exclusion of others at a younger age," he says. "The specialization is often driven by parents who believe that their child has to start early and stay serious in order to get a scholarship or be the best."

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  • Young baseball players frequently suffer from preventable arm pain

    The most in-depth survey of its kind found that arm pain is common among supposedly healthy young baseball players and nearly half have been encouraged to keep playing despite arm pain. The findings suggest that more detailed and individualized screening is needed to prevent overuse injury in young ballplayers. The study, led by Columbia University Medical Center (CUMC) researchers, was published in the online edition of the American Journal of Sports Medicine.

    "Both nationally and internationally, we’re witnessing a troubling increase of elbow and shoulder injuries in young baseball players," said study leader Christopher S. Ahmad, MD, chief of sports medicine and professor of orthopedic surgery at NewYork-Presbyterian/Columbia and head team physician for the New York Yankees. "The likely explanation is that they’re throwing too much, too early, putting increasing demands on their bodies that their bodies are not ready for. Despite current guidelines and precautions – for example, limiting pitch counts and emphasizing off-season rest – many players are still sustaining overuse injury to their throwing arm. Thus, it’s vital that we develop better ways for coaches, parents, and clinicians to identify players at risk so we can prevent irreversible injury and season-ending surgery."

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  • Ankle Replacements of the Future

    It’s a surgery that is becoming increasingly more common. Ankle replacements usually are needed because of a bad accident or arthritis. But artificial ankles have come a long way and not all of them are the same.
    David Sander believes he is a walking medical marvel and told Ivanhoe, “It’s really a miracle.”
    The miracle is that he’s walking at all after he slipped on an icy city sidewalk in the middle of winter. Sander said, “I lifted up my leg and my foot was backwards, and I said to myself oh my god.”
    After his initial surgery David knew it would eventually come to a replacement, his cartilage was gone leaving him with painful, debilitating arthritis. But he worried failure rates were high for artificial ankles. 

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  • TKA provides excellent outcomes after lower-extremity amputation

    Although total knee arthroplasty is rare after lower-extremity amputation, it can provide excellent functional and clinical outcomes, according to study results.

    Researchers reviewed 13 primary total knee arthroplasties (TKAs) in 12 patients with prior lower-extremity amputation, among which 12 TKAs were performed on the contralateral side of the amputated limb and one was performed on the ipsilateral side. Using clinical examinations and patient surveys, the researchers calculated preoperative and postoperative Knee Society scores. The study’s primary endpoint was failure, which was defined as revision for any reason. Average clinical follow-up occurred at 6.8 years.

    The researchers observed improvement in Knee Society scores from 30.4 preoperatively to 88.5 following TKA with a prior contralateral amputation.

    At final follow-up, radiographic evidence of aseptic loosening of the tibial components was observed in 23.1% of patients, and the researchers recommended augmentation of tibial fixation with a stem during TKA after contralateral amputation.

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  • Older patients still fastest-growing demographic for TKA

    Despite total knee arthroplasty becoming more prevalent in patients younger than 65 years of age, the main demographic of growth is still among patients older than 65, according to recent study data.
    Researchers compared 1999 to 2008 U.S. census data for individuals 18 to 44 years old, 45 to 64 years old, and 65 years and older and the number of total knee arthroplasties (TKAs) performed annually in each age group. Per-capita incidence rates were calculated, and the growth rate in all demographics was determined.

    Approximately 305,000 TKAs were performed beyond the number predicted by population growth alone in 2008. Patients older than 65 years of age represented the largest growing cohort, as 151,000 recorded TKA procedures and a per-capita growth rate from 5.2 to 9.1 procedures per 1,000 individuals was observed. Per-capita growth rate also increased from 1.4 to 3.3 procedures per 1,000 individuals among patients 45 to 64 years old.

    TKAs were found to have increased 234% during the span of this study, from 264,000 in 1999 and approximately 616,000 in 2008, with fewer than 48,000 of the additional procedures able to be explained by population increase, according to the researchers.

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  • Antibiotic cement during primary TKA may not decrease infection rates

    Judicious risk-stratified usage of antibiotic cement during primary total knee arthroplasty may not decrease infection at 1 year, according to study results.

    Researchers retrospectively reviewed data for 3,292 patients who underwent primary total knee arthroplasty (TKA). Patients were grouped into cohorts based on whether their surgery involved plain or antibiotic cement, or if they were high-risk patients who received antibiotic cement, and infection rates were compared between the cohorts.

    Study results showed a 30-day infection rate of 0.29% in cohort 1, 0.2% in cohort 2 and 0.13% in cohort 3.

    Infection rates in all cohorts increased at all time points, with 6-month rates at 0.39% in cohort 1, 0.54% in cohort 2 and 0.38% in cohort 3, and 1-year rates at 0.78% in cohort 1, 0.61% in cohort 2 and 0.64% in cohort 3. However, no statistically significant between-group differences in infection rates were seen at any of the time intervals studied, according to the researchers.

    Disclosure:Chimento received research support from DePuy and is an associate board member for Louisiana Orthopedic.

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  • No functional differences found between short-, straight-stem THA implants

    Recently published study data indicated short-stem and straight-stem implants for total hip arthroplasty exhibited no significant differences in functional outcome measures.

    Researchers conducted a randomized, double-blinded study of 80 patients who underwent total hip arthroplasty (THA). Patients were grouped by whether their THA utilized a short-stem or conventional straight-stem implant. Radiological and functional outcomes were evaluated at 6 weeks postoperatively, and quality of life was quantified via Harris Hip Score, SF-36 and WOMAC scores.

    No significant changes in offset differences were observed in either group from before surgery to after surgery. At final follow-up, no significant differences between groups were found in Harris Hip Score, SF-36 or WOMAC values, according to the researchers.

    Comparison of long-term survival rates among both cohorts will help determine whether short stems are a viable alternative THA solution, the researchers concluded.

    Disclosure: The authors have no relevant financial disclosures.

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  • Orthopedic surgery generally safe for patients age 80 and older

    Over the past decade, a greater number of patients, age 80 and older, are having elective orthopaedic surgery. A new study appearing in the Journal of Bone and Joint Surgery (JBJS) found that these surgeries are generally safe with mortality rates decreasing for total hip (THR) and total knee (TKR) replacement and spinal fusion surgeries, and complication rates decreasing for total knee replacement and spinal fusion in patients with few or no comorbidities (other conditions or diseases).

    “Based on the results of this study, I think very elderly patients, particularly those with few or no comorbidities, should strongly consider the benefits of these procedures,” said lead study author Hiroyuki Yoshihara, MD, PhD, an orthopaedic surgeon at State University of New York (SUNY) Downstate Medical Center and Nassau University Medical Center.

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