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News Updates

Lifelong physical activity increases bone density in men

Source:
Science Daily

Men have many reasons to add high-impact and resistance training to their exercise regimens; these reasons include building muscle and shedding fat. Now a researcher has determined another significant benefit to these activities: building bone mass. The study found that individuals who continuously participated in high-impact activities, such as jogging and tennis, during adolescence and young adulthood, had greater hip and lumbar spine bone mineral density than those who did not.

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Hip dysplasia: When is surgery required?

Source:
Medical Xpress

What causes hip dysplasia in adults, and can it be treated without a total hip replacement?.

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Newer UKR prosthesis for patients with osteoarthritis achieved satisfactory results

Source:
Healio

Patients who received a newer prosthesis similar to the Miller-Galante knee design showed significantly better Knee Society function scores than patients who had a long-used prosthesis to which it was compared. However, the two implants performed about the same at short-term follow-up, according to a presenter.

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Treatment of Locked Posterior Shoulder Dislocation With Bone Defect

Source:
Healio

Posterior shoulder dislocation is rare, and in most cases, it occurs secondary to violent trauma, seizures, or electric shock.1 Approximately 50% of these dislocations are associated with reverse Hill-Sachs lesions.2 Hill and Sachs3 described the lesion in an anterior shoulder dislocation caused by engagement of the humeral head into the glenoid edge and located posterosuperiorly in the head.

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Rates of Complications and Secondary Surgeries After In Situ Cubital Tunnel Release Compared With Ulnar Nerve Transposition: A Retrospective Review

Source:
JHS

The short-term complication rates of cubital tunnel surgery are low (3.2%), but higher for patients with chronic kidney disease. The secondary surgery rate after cubital tunnel surgery was 5.7% overall, but higher for patients with prior elbow trauma and for patients undergoing ulnar nerve transposition.

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Care of Shoulder Pain in the Overhead Athlete

Source:
Healio

Shoulder complaints are common in the overhead athlete. Understanding the biomechanics of throwing and swimming requires understanding the importance of maintaining the glenohumeral relationship of the shoulder.

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Patient-reported results, knee stability improved after all-inside double-bundle ACL reconstruction

Source:
Healio

Investigators found significant improvements from preoperative measures at 24.8-month follow-up for both mean side-to-side differences and Lysholm scores in patients who underwent double-bundle ACL reconstruction using a special drill pin guide and reamer, along with a laser-guided device to facilitate a transtibial approach.

Read More

Imaging Identifies Cartilage Regeneration in Long-Distance Runners

Source:
RSNA News

Using a mobile MRI truck, researchers followed runners for 4,500 kilometers through Europe to study the physical limits and adaptation of athletes over a 64-day period, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

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Martial arts can be hazardous to kids

Source:
Medical Xpress

Perhaps there’s a black belt in your child’s future. But for safety’s sake, kids should only engage in noncontact forms of martial arts, a new American Academy of Pediatrics report says.

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BLOG: Hardware complications in revision ACL reconstruction take careful consideration

Source:
Healio

Revision ACLR can pose a variety of surgical challenges. Evaluation of patient risk factors, prior surgical technique, prior tunnel placement, tunnel osteolysis, prior grafts utilized and implanted hardware must be considered prior to performing a revision ACLR case.

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Rate of injuries among youth soccer players doubled, new study finds

Source:
Science Daily

From 1990 through 2014, the number of soccer-related injuries treated in hospital emergency departments in the US each year increased by 78 percent and the yearly rate of

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Study finds predictors for ACL injury are dissimilar between male and female athletes

Source:
Healio

Except for increased anterior-posterior knee laxity, results from this study indicated female athletes and male athletes were not similar with regard to predictors for first-time noncontact ACL injury.

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Technique pearls for revision shoulder arthroplasty aid in preventing fracture, preserving bone stock

Source:
Healio

We present simple techniques for revision shoulder arthroplasty using a telescoping osteotome technique for glenoid removal, an open-book (vertical) osteotomy technique for extraction of the humeral stem and the use of an ultrasonic device and carbide burr for clearing bone and cement mantles.

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Primary hip arthroscopy yields improved patient-reported outcome scores

Source:
Healio

Patients who underwent primary hip arthroscopy experienced greater improvement in patient-reported outcome scores at 2-year follow-up compared with patients who

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Study indicates stem cell therapy for spinal cord injury helps patients regain some function

Source:
Stem Cells Portal

A clinical trial testing the effect of a stem cell therapy on patients with complete cervical cord injury is showing encouraging results, according to the company producing the new treatment.

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Stem Cell Therapy – Specialized Cells with the Ability to Self-Replicate Could Reform Healthcare!

Source:
Bio-ITWorld

Stem cell therapy also known as regenerative medicine is the use of stem cell to restore injured, degenerated or diseased body tissues. The cells are manipulated into a specific type of cells and are transplanted into affected organs to replace the damaged cells and contribute in repairing the defective tissue.

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Stem cell therapy restores arm, hand movement for paralyzed man

Source:
Medical News Today

Researchers have restored arm and hand function to a paralyzed man with injections of an agent called AST-OPC1.

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Altering stem cell perception of tissue stiffness may help treat musculoskeletal disorders

Source:
Stem Cells Portal

A new biomaterial can be used to study how and when stem cells sense the mechanics of their surrounding environment.

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Stem Cells for Arthritis – Innovation in Technology and Medicine

Source:
Bio-ITWorld

The biggest advantage of stem cell therapy is that unlike with surgery; this procedure can be conducted within a day and there is minimal downtime. Patients can return to work within just a day or two and they are saved from taking time from work. Surgery comes with an increased risk of infection, but in case of stem cells, patients don’t have to worry about infection. Earlier one could get stem cells only from human umbilical cord, but now stem cells can also be obtained from the bone marrow of a healthy person and used to treat arthritis.

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Stem cells grown into 3-D lung-in-a-dish

Source:
Science Daily

By coating tiny gel beads with lung-derived stem cells and then allowing them to self-assemble into the shapes of the air sacs found in human lungs, researchers have succeeded in creating three-dimensional lung “organoids.”

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Stem-Cell Treatments Become More Available, and Face More Scrutiny

Source:
The Wall Street Journal

In two days of hearings next month, the U.S. Food and Drug Administration will consider if clinics offering stem-cell treatments should be more closely regulated.

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REGENEXX: NEW STEM CELL SAFETY PAPER

Source:
ryortho

Colorado-based Regenexx has, according to the June 15, 2016 news release, published “the world’s largest stem cell safety paper. The study was published in International Orthopaedics (March 30, 2016). The purpose of the study was to determine if mesenchymal-stem-cell-based therapies [MSC] are safe procedures when used for orthopedic degenerative conditions or injuries, and it included 2,372 subjects who received a total of 3,012 stem cell injection procedures.

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Guided procedures ensure accuracy of therapeutic injections

Source:
medicalxpress

When it comes to pain in the hip, knee or shoulder that requires therapeutic injections, be sure to seek a physician who is trained in image-guided procedures to deliver the medication accurately, says a physical medicine and rehabilitation expert at Baylor College of Medicine.

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Prospective study showed TKA not detrimental to patient participation in sports

Source:
Healio

Results of a study presented at European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress, here, showed patients who participated in sports before total knee arthroplasty were able to participate in sports postoperatively and in some cases, patients were more active in sports after surgery.

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Improvements seen after reverse PAO for patients with FAI secondary to acetabular retroversion

Source:
Healio

At mid- and long-term follow-up, clinical and radiographic results improved among young patients with either isolated retroversion or retroversion and hip dysplasia who underwent reverse periacetabular osteotomy for treatment of femoroacetabular impingement.

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Better fix for torn ACLs

Source:
Science Daily

At mid- and long-term follow-up, clinical and radiographic results improved among young patients with either isolated retroversion or retroversion and hip dysplasia who underwent reverse periacetabular osteotomy for treatment of femoroacetabular impingement.

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Comparable results seen with high- vs low-intensity plyometric exercise after ACL reconstruction

Source:
Healio

Results from this randomized controlled trial showed both low- and high-intensity plyometric exercise for rehabilitation following ACL reconstruction positively affected knee function, knee impairments and psychological status among patients after 8 weeks of intervention.

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Newer UKR prosthesis for patients with osteoarthritis achieved satisfactory results
Source:
Healio

Patients who received a newer prosthesis similar to the Miller-Galante knee design showed significantly better Knee Society function scores than patients who had a long-used prosthesis to which it was compared. However, the two implants performed about the same at short-term follow-up, according to a presenter.

Read More

No significant differences found between simple, vertical mattress shoulder repair
Source:
Healio

Although no significant differences were found in contact pressure between suture labral repair and vertical mattress labral repair of the shoulder, researchers found an increase in mean contact pressure and peak pressure between intact shoulders and the two repair groups, according to study results.

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Obesity and total joint arthroplasty: Time to examine needs in a different light
Source:
Healio

The prevalence of obesity in the general population is increasing. Obesity is estimated to affect approximately one-third of adults in the United States. It is estimated that 6.1 million patients who undergo total joint arthroplasty will be obese by 2040.

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High, inside starting point and intramedullary reaming are keys for Jones fracture fixation in athletes
Source:
Healio

Jones fractures are fractures of the proximal fifth metatarsal metaphyseal-diaphyseal junction that are common in young athletic populations, particularly elite athletes. The poor blood supply to the fifth metatarsal has been well documented, and Jones fractures develop along a watershed area between the intramedullary nutrient and metaphyseal arteries. Surgical fixation is indicated in cases of failed nonoperative treatment, re-fracture, nonunion or when more rapid recovery is required typically in active individuals.

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A look at factors correlated with scapular notching after reverse shoulder arthroplasty
Source:
Healio

At the American Academy of Orthopaedic Surgeons Annual Meeting, Eric Ricchetti, MD, discussed implant and patient-specific factors correlated with scapular notching following reverse shoulder arthroplasty. He noted increased range of motion caused more impingement events which lead to scapular notching.

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Platelet-rich plasma injections may lead to improvements in tissue healing
Source:
Medical Xpress

Tiger Woods, Kobe Bryant and A-Rod have all used it, but does platelet-rich plasma therapy (PRP) really work for the every-day active person? According to a University of Alberta Glen Sather Sports Medicine Clinic pilot study on patients with chronically sore shoulders published in PLOS ONE, preliminary findings say yes.

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Total knee arthroplasty: analysis shows EXPAREL reduces length of hospital stay and improves discharge status compared to standard analgesic modality
Source:
Medical News Today

Pacira Pharmaceuticals, Inc. has announced results of new data showing that EXPAREL® (bupivacaine liposome injectable suspension) infiltration compared to a standard analgesic regimen in patients undergoing total knee arthroplasty (TKA) significantly decreased the length of hospital stay and increased the likelihood that a patient would be discharged to their home rather than a care facility when released from the hospital.

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Hemiarthroplasty, TSA yielded pain relief for patients with atraumatic osteonecrosis
Source:
Healio

Patients with atraumatic osteonecrosis of the humeral head experienced lasting pain relief and improved range of motion after undergoing either hemiarthroplasty or total shoulder arthroplasty, according to results.

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New pain relief technique for ACL knee surgery preserves muscle strength
Source:
Medical News Today

Anesthesiologists can significantly reduce loss of muscle strength in ACL knee surgery patients using a new pain management technique, a new study has found.

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Why treating shoulder pain in baseball pitchers and other throwing athletes is so difficult
Source:
Science Daily

Despite increasing medical knowledge, treating shoulder pain in baseball pitchers and other throwing athletes remains one of the most challenging tasks in sports medicine.

“The results of treatment are not as predictable as the patient, family, trainer, coach and doctor would like to think,” according to an article in the journal Physical Medicine and Rehabilitation Clinics of North America.

Read More

Study supports efficacy of closed reduction, percutaneous fixation of crescent-fracture dislocations
Source:
Healio

Recently published data highlight the safety and efficacy of closed reduction and percutaneous screw fixation for the treatment of crescent fracture-dislocation of the sacroiliac joint and indicate satisfactory function and radiographic outcomes with the procedure.

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Imaging identifies cartilage regeneration in long-distance runners
Source:
Medical News Today

Using a mobile MRI truck, researchers followed runners for 4,500 kilometers through Europe to study the physical limits and adaptation of athletes over a 64-day period, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

Read More

What Happens When You Crack Your Knuckles
Source:
Daily Rx News

Despite the wives’ tales that tie cracking your knuckles to problems like arthritis, many habitual knuckle-crackers just can’t help themselves. But do they really have anything to fear?

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Patient-reported results, knee stability improved after all-inside double-bundle ACL reconstruction
Source:
Healio

Investigators found significant improvements from preoperative measures at 24.8-month follow-up for both mean side-to-side differences and Lysholm scores in patients who underwent double-bundle ACL reconstruction using a special drill pin guide and reamer, along with a laser- guided device to facilitate a transtibial approach.

Read More

High rate of bone graft resorption found after Latarjet procedure for shoulder instability
Source:
Healio

Researchers of this study note that although the open Latarjet procedure provided significant improvement in clinical scores for patients with anterior shoulder instability and glenoid bone loss, 90.5% of patients showed graft resorption on CT at 1-year postoperatively.

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Recommendations for patient activity after knee replacement vary among surgeons
Source:
Healio

During recovery after knee replacement surgery, exercise is critical. After initial recovery, patients will want to resume more strenuous activities. In addition to exercise prescribed by a physical therapist, several studies have shown patients who participated in athletic activities prior to surgery will want to continue this practice after surgery. However, how much activity and how strenuous this activity should be remains unclear.

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KATOR suture anchor system receives FDA 510(k) clearance
Source:
Healio

KATOR announced it has received FDA 510(k) clearance for the KATOR Suture Anchor System.

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Stresses on elbow during pitching may alter multiple structures
Source:
Healio

In a pre- and post-season ultrasound evaluation of high school pitchers’ elbows, adaptive changes occurred to multiple structures about the elbow from stresses placed on the elbow during one season of pitching, based on results of a recently published study.

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Higher rates of obesity seen over time in patients undergoing revision TKA
Source:
Healio

DALLAS — Research presented here at the American Association of Hip and Knee Surgeons Annual Meeting found patients undergoing revision total knee arthroplasty have become significantly more at risk for obesity in recent years.

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Recurrent shoulder dislocation prevented with combination Bankart repair and Bristow procedure
Source:
Healio

Although investigators of this study found a combination of Bankart repair and Bristow procedure prevented recurrent shoulder dislocation in rugby players, some patients complained of insufficiency in quality of their play when performing specific movements.

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Bats and balls, not base runners, cause worst injuries to major league catchers
Source:
Medical Xpress

Contrary to popular belief, the worst injuries baseball catchers face on the field come from errant bats and foul balls, not home-plate collisions with base runners, according to findings of a study led by researchers at the Johns Hopkins University School of Medicine.

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A 48-year-old woman with right knee pain
Source:
Healio

A 48-year-old woman with a history of hypertension, rheumatoid arthritis treated with chronic prednisone, and a two-pack- per-week cigarette use, presented to clinic with 8 years of right knee pain. She had an intra-articular steroid injection with some relief 6 years ago. She denied any hip pain and uses a cane for ambulation. On physical examination she appears to be a healthy 5’2’’, 160-pound woman who walks with an antalgic gait. She has a 20° flexion contracture, with flexion limited to 90°, and a mild valgus deformity of her knee. The extremity was neurovascularly intact and she had full, painless hip range of motion.

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Stiff shoulders less likely to re-tear after rotator cuff repair vs non-stiff shoulders
Source:
Healio

Patients who had preoperative shoulder stiffness and those who developed stiffness at 6 weeks and 12 weeks postoperatively after rotator cuff repair were less likely to experience a re-tear compared with patients who had no stiffness, according to results presented here.

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What constitutes good treatment of tennis elbow?
Source:
Medical Xpress

The two most common treatments for tennis elbow are physiotherapy and cortisone injections. It is unclear which of these gives the best result, and diagnosis can be problematic for general practitioners. Now researchers at teh University of Oslo have taken a closer look at the treatment methods.

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Greater strength, endurance found in quadriceps after PCL tear vs ACL tear
Source:
Healio

Compared with ACL tears, the quadriceps muscle of the injured limb had greater strength and endurance after PCL tears, according to study results.

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UNMC study: knee replacement viable option for rheumatoid arthritis
Source:
Medical News Today

Kaleb Michaud, Ph.D., has for a long time listened to patients with rheumatoid arthritis (RA) talking about improved quality of life after their total joint replacements. But until now, there’s been little information that actually measures how the surgery impacts quality of life for RA patients.

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Treatment of shoulder instability helps return collegiate athletes to playing field
Source:
Medical News Today

Athletes who suffer a shoulder instability injury may return to play more successfully after being treated arthroscopically compared to nonoperative treatment, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting.

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Swiss researchers evaluate fetal progenitor tenocytes for repairing tendon injuries
Source:
Medical Xpress

Tendon injuries, especially those acquired while engaging in sports, are not easily healed due to the fibrous nature of tendon tissues which transmit forces from muscle to bone and protect surrounding tissues against tension and compression. Tendon injuries to wrists, knees, elbows and rotator cuffs, often from over use when playing golf or tennis, are increasingly common for both professional and amateur athletes (“weekend warriors”) alike.

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Shoulder dominance has no effect on function, quality of life after proximal humerus fracture
Source:
Healio

Recently published data indicated there was no significant difference with regard to shoulder dominance in the functional outcome and quality of life perception observed in proximal humeral fractures.

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Make no bones about it: The female athlete triad can lead to problems with bone health
Source:
Medical Xpress

Participation in sports by women and girls has increased from 310,000 individuals in 1971 to 3.37 million in 2010. At the same time, sports-related injuries among female athletes have skyrocketed. According to a new study in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), women with symptoms known as the “female athlete triad” are at greater risk of bone stress injuries and fractures.

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Routine gait analysis may be a helpful guide for post-TKA rehabilitation
Source:
Healio

Many patients who underwent total knee arthroplasty did not experience improvement in their gait relative to preoperative patients by 12 months postoperatively; however, use of routine gait analysis was helpful for guiding patients’ postoperative rehabilitation and may be useful for developing strategies for mobility improvement, according to researchers’ findings.

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Reverse Shoulder Arthroplasty for the Massive Rotator Cuff Tear
Source:
ICJR

Orthopaedic surgeons have become increasingly interested in the use of reverse total shoulder arthroplasty to manage massive rotator cuff tears. This has been due to the success we have had with the procedure as the rate of complications decreased, thanks to the significant knowledge we have gained over the course of the past 10 years of using the reverse prosthesis.

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Panel discusses epidemic of youth sports injuries, role of prevention programs
Source:
Healio

At Orthopedics Today Hawaii 2015, we convened a special Banyan Tree session to talk about injuries in youth athletes. This is a real problem that all orthopedic surgeons see on a regular basis — one that, I think, is still under-recognized. In this Orthopedics Today Round Table, we highlight the discussion, particularly as it relates to overhead sports, as well as how orthopedic surgeons can play a role in stemming the tide of injuries. We also talk about innovations to help with prevention and treatment, as well as the role of the STOP Sports Injuries and Pitch Smart programs.

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Nearly half of patients safe for discharge by postoperative day 2 after total joint arthroplasty
Source:
Healio

Among patients who underwent total joint arthroplasty required to follow the Medicare 72-hour-stay rule, 47.88% were safe for discharge to a skilled nursing facility by postoperative day 2, according to results presented at the American Orthopaedic Association Annual Meeting.

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3D Imaging and Templating May Improve Glenoid Positoning in Anatomic TSA
Source:
ICJR

All patients had postoperative, artifact-reduction 3D CT scans to evaluate glenoid position relative to the preoperative plan. No patients in this study were lost to follow up.

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Osteochondral autograft transplantation may offer higher rate of return to pre-injury athletics
Source:
Healio

Among patients who underwent cartilage repair of the knee, osteochondral autograft transplantation enabled a much higher rate of return to pre-injury athletics, according to results presented at the International Cartilage Repair Society Annual Meeting.

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University of Iowa team developing bioactive gel to treat knee injuries
Source:
Medical News Today

Injectable gel encourages self-healing of cartilage

Knee injuries are the bane of athletes everywhere, from professionals and college stars to weekend warriors. Current surgical options for repairing damaged cartilage caused by knee injuries are costly, can have complications, and often are not very effective in the long run. Even after surgery, cartilage degeneration can progress leading to painful arthritis.

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High risk of capsular restretching found among women and elite athletes
Source:
Healio

Even after successful arthroscopic Bankart repair and capsular shift, women, elite athletes and patients with frequent dislocations were at high risk of capsular restretching, according to study results.

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Women fare better than men following total knee, hip replacement
Source:
Medical Xpress

While women may have their first total joint replacement (TJR) at an older age, they are less likely to have complications related to their surgery or require revision surgery, according to a new study presented today at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). The findings contradict the theory that TJR is underutilized in female patients because they have worse outcomes then men.

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Caregivers frequently unaware of safety guidelines for young baseball pitchers
Source:
Healio

Results of a survey presented at the American Academy of Orthopaedic Surgeons Annual Meeting indicated caregivers were frequently unaware of safety guidelines recommended for young baseball pitchers.

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A hip and trunk training program for athletes reduces ACL injuries
Source:
Medical Xpress

With the help of the Hockeyroos UWA researchers have developed a hip and trunk training program that could reduce the high rates of anterior cruciate ligament (ACL) injuries in all levels of sport.

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An Injury Curveball for Young Pitchers
Source:
Daily Rx

The love of America’s pastime might lead many young players to play as often and as hard as they can, sometimes for multiple teams. However, that might increase these players’ risk of getting hurt.

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Year-round baseball in the South could lead to more injuries, according to UF Health research
Source:
Medical News Today

Baseball pitchers are prone to elbow injuries, but pitchers who live or play in the South are at even more risk, a new University of Florida Health study finds.

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Year-round baseball leads to more youth injuries, study says
Source:
Medical Xpress

Being able to play baseball year-round puts young pitchers in the southern United States at increased risk for an overuse injury in their throwing arm, a new study finds.

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Elbow muscle strength plays key role in injury risk, prevention
Source:
Healio

The elbow muscle strength of baseball pitchers could play a bigger role in injury risk and prevention than previously thought, according to biomedical researchers at Northwestern University.

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Floseal Hemostatic Matrix may improve blood-loss control in TKA
Source:
Healio

Use of Floseal Hemostatic Matrix in total knee arthroplasty safely provided improved control of blood loss and reduced the predicted probability of postoperative blood transfusion, according to study results.

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Exercise science study shows no increased risk of injury from uphill/downhill running
Source:
Medical Xpress

Like many runners, former BYU track star Katy Andrews Neves has had her share of injuries. Unlike most runners, one of those injuries has been witnessed by millions of people around the world.

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Common hip issue in teens misdiagnosed as pulled muscle
Source:
Science Daily

An athlete felt pain in his groin after a collision at the plate with an opposing player. He thought he had pulled a muscle, but
it turns out he was suffering from a common condition seen in teens and young adults known as hip impingement.

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Osteoarthritis patients will benefit from jumping exercise
Source:
Medical Xpress

Progressive high-impact training improved the patellar cartilage quality of the postmenopausal women who may be at risk of osteoporosis (bone loss) as well as at risk of osteoarthritis. This was found out in the study carry out in the Department of Health Sciences at University of Jyväskylä, Finland. The effects of high-impact exercise were examined on knee cartilages, osteoarthritis symptoms and physical function in postmenopausal women with mild knee osteoarthritis. The study was conducted in cooperation with the Central Finland Central Hospital and the Department of Medical Technology, Institute of Biomedicine in University of Oulu in Finland.

Read More

No significant differences found between simple, vertical mattress shoulder repair
Source:
Healio

Although no significant differences were found in contact pressure between suture labral repair and vertical mattress labral repair of the shoulder, researchers found an increase in mean contact pressure and peak pressure between intact shoulders and the two repair groups, according to study results.

Read More

Study shows substantial benefits in obese patients after hip arthroscopy
Source:
Healio

Although obese patients undergoing hip arthroscopy started with lower absolute scores preoperatively and ended with lower overall absolute postoperative scores, they showed substantial benefit from surgery, demonstrating a degree of improvement similar to non-obese patients, according to study results.

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Alternative for pain control after knee replacement surgery
Source:
Science Daily

Injecting a newer long-acting numbing medicine called liposomal bupivacaine into the tissue surrounding the knee during surgery may providea faster recovery and higher patient satisfaction, a new study has found.

Read More

Why treating shoulder pain in baseball pitchers and other throwing athletes is so difficult
Source:
Science Daily

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.

Read More

Osteoporosis: Steroid Danger
Source:
Ivanhoe

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.

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Link possible between oral contraceptive use, ACL injury in females
Source:
Healio

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 controls.

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The difficulties of treating shoulder pain in baseball pitchers
Source:
Medical News Today

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.

Read More

Thumbs-up for mind-controlled robotic arm
Source:
Science Daily

A paralyzed woman who controlled a robotic arm using just her thoughts has taken another step towards restoring her natural movements by controlling the arm with a range of complex hand movements.

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Staying at Home for Knee Rehab
Source:
DailyRx

After a knee replacement, there’s no place like home for your physical therapy — or at least home may be just as good a place as a clinic to do your exercises.

In a new study, knee replacement patients who followed a six-week, monitored exercise program at home showed similar progress to those who were in regular outpatient rehabilitation programs.

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Frequent BMD tests unnecessary for postmenopausal women with good scores
Source:
Healio

Postmenopausal women not diagnosed for osteoporosis on an initial bone mineral density test are unlikely to sustain a major osteoporotic fracture or to reap any benefit from repeat screening before age 65 years, according to research published in Menopause.

“This longitudinal study found that, among postmenopausal women aged 50 to 64 years without osteoporosis on their first BMD test, less than 1% experienced a hip or clinical vertebral fracture and less than 3% experienced a major osteoporotic fracture by 7 years,” the researchers wrote.

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Overuse injuries becoming more common in young athletes
Source :
Science Daily

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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Picture emerges of how kids get head injuries
Source :
Science Daily

A study in which more than 43,000 children were evaluated for head trauma offers an unprecedented picture of how children most frequently suffer head injuries, report physicians. The findings also indicate how often such incidents result in significant brain injuries, computerized tomography (CT) scans to assess head injuries, and neurosurgery to treat them.

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Intra-articular tranexamic acid benefitted TKA patients without increased risk of DVT, PE
Source :
Healio

Among patients who underwent total knee arthroplasty, intra-articular tranexamic acid significantly reduced total blood loss, drainage, reduction of hemoglobin and the need for transfusion without increasing the incidence of deep venous thrombosis and pulmonary embolism, making it safe and efficacious, according to study results.

Through a search of various databases for relevant randomized, controlled trials, researchers included seven studies comprising 622 patients. The researchers calculated mean difference in total blood loss, risk ratio for transfusion and complication rate in the tranexamic acid-treated group vs. the placebo group.

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Bilateral TKA staged at 1-week intervals deemed safe alternative in select patients
Source :
Healio

For patients with advanced degenerative disease and deformities of both knees who desire a single rehabilitation period, staging total knee arthroplasty in each knee a week apart is a safe alternative, particularly for patients with medical comorbidities precluding a simultaneous operation, according to study results.

Researchers compared a consecutive series of 234 patients who underwent either a simultaneous or staged bilateral total knee arthroplasty (TKA) to a matched-control group of unilateral TKA.

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Divergent trends seen in meniscal and cartilage injuries between primary and revision ACL repair
Source :
Healio

In a community-based sample, the prevalence of articular cartilage injury increased between primary and revision ACL repair, whereas the prevalence of meniscal injury decreased, according to recent study findings.

Researchers studied 261 patients who underwent both primary and revision ACL reconstruction (ACLR) between February 2005 and September 2011 via community-based registry. Patient data (sex, age, race and BMI), procedure characteristics and descriptive statistics (medians, interquartile ranges, frequencies and proportions) were the metrics used for evaluation.
Overall, 256 patients required revision ACLR due to instability, and the remaining five were due to infection.

Cartilage injuries nearly doubled (14.9% to 31.8%) from primary to revision ACLR, whereas meniscal tears decreased overall from 54.8% at primary ACLR to 43.7% at revision. This trend was also reflected in lateral meniscus tears (32.2% at primary, 18.4% at revision), though medial meniscus tears were observed to be the same (32.6%) at both primary and revision ACLR, according to the researchers.

A 70.8% prevalence of meniscus tear in revision was observed in patients who had meniscus fixation during primary ACLR.


Disclosure: The authors have no relevant financial disclosures.

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Study reveals shifting trends in the surgical treatment of SLAP lesions
Source :
Healio

A review of information from the American Board of Orthopaedic Surgery part II database indicates that the rate of SLAP repairs performed for both cases of isolated SLAP lesions and those undergoing concomitant rotator cuff repair has decreased, while the rates of biceps tenodesis and tenotomy for these cases have increased.

“Practice trends for orthopedic board candidates indicate that the proportion of SLAP repairs has decreased over time, with an increase in biceps tenodesis and tenotomy,” Brendan M. Patterson, MD, MPH, and his colleagues wrote in their study. “Increased patient age correlates with the likelihood of treatment with biceps tenodesis or tenotomy versus SLAP repair.”

Using the database, the investigators identified 8,963 cases treated for isolated SLAP lesions and 1,540 cases that underwent concomitant rotator cuff repair and treatment for SLAP lesions between 2002 and 2011. Mean patient age was 40.7 years.

Researchers reviewed surgical logs for the following procedures: SLAP repair, open or arthroscopic biceps tenodesis, biceps tenotomy, and arthroscopic rotator cuff repair with concomitant SLAP repair.

Patterson and colleagues found the proportion of SLAP repairs decreased from 69.3% to 44.8% for patients with isolated SLAP lesions. The proportion of biceps tenodesis for these cases increased from 1.9% to 18.8% and biceps tenotomy went from 0.4% to 1.7%. Similarly, the investigators found the proportion of SLAP repair decreased in cases undergoing concomitant rotator cuff repair (from 60.2% to 15.3%).

The proportion of biceps tenodesis or tenotomy for these cases increased from 6.0% to 28.0%. A subanalysis of biceps tenodesis showed that open procedures increased from 1.9% to 9.5% during the total study period, and arthroscopic biceps tenodesis increased in from 0.2% to 9.3% from 2007 to 2011.

Overall, investigators discovered a significant difference in the mean age of patients who had SLAP repair (37.1 years) compared with those who had biceps tenodesis (47.2 years) and biceps tenotomy (55.7 years).

Disclosure: This study was paid for by the University of North Carolina at Chapel Hill, Department of Orthopaedic Surgery, Sports Medicine Research Fund.

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Higher baseline expectations for TJR improved health-related quality of life, satisfaction
Source :
Healio

Health-related quality of life and satisfaction improved among patients who had higher expectations for total joint replacement at baseline compared with patients who had lower expectations, according to study results.

Researchers recruited 892 patients preparing for total joint replacement (TJR) of the knee or hip due to primary osteoarthritis. Before surgery and for 12 months afterward, patients completed questionnaires with five questions about expectations before surgery; an item to measure satisfaction; WOMAC and SF-12; and questions about sociodemographic information. The researchers performed general linear models and logistic regression analysis to determine the association of patients’ expectations at baseline with satisfaction and changes in health-related quality of life (HRQoL) 12 months after surgery.

Study results showed larger improvements in HRQoL at 12 months among patients who had higher pain relief or ability to walk expectations. WOMAC and SF-12 physical component summary domains also improved more among patients with high expectations regarding the ability to walk, interact with other and psychological wellbeing expectations, according to the researchers.

Patients with very high expectations on the SF-12 physical component summary regarding their ability to walk and with high or very high pain relief expectations on SF-12 mental component summary experienced better improvement compared with patients with low expectations, the researchers found.

The researchers also found patients who had high or very high daily activities expectations were more likely to be satisfied.

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Antibiotic cement during primary TKA may not decrease infection rates
Source :
Healio

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.

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No functional differences found between short-, straight-stem THA implants
Source :
Healio

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.

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Orthopedic surgery generally safe for patients age 80 and older
Source :
MedicalXpress

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).

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Shoulder activity not associated with severity of atraumatic rotator cuff tear
Source:
Healio

Among patients with atraumatic rotator cuff tears, shoulder activity was not associated with severity of the tear, but was affected by patients’ age, sex and occupation, according to study results.

Researchers prospectively enrolled patients with an atraumatic rotator cuff tear on MRI in the Multicenter Orthopaedic Outcomes Network shoulder study of nonoperative treatment. Patients were asked to complete a previously validated shoulder activity scale; 434 patients completed the scale and were included in the analysis. Mean patient age was 62.7 years.

The researchers performed a regression analysis to assess the association of shoulder activity level to rotator cuff tear characteristics, including tendon involvement and traction, as well as patient factors such as age, sex, smoking and occupation.

Shoulder activity was not associated with severity of the rotator cuff tear, according to the researchers. However, shoulder activity was negatively associated with age and female sex. According to the regression model, 69-year-old patients with rotator cuff tears were 1.5 points less active on the 20-point scale vs. identical 56-year-old patients; female patients were 1.6 points less active vs. similar male patients. Occupation was also a significant predictor of shoulder activity level, with unemployed patients predicted to be 4.8 points less active compared with employed patients.

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Extended capsular release unnecessary for shoulder stiffness in arthroscopic surgery
Source:
Healio

Although arthroscopic capsular release is a known treatment for shoulder stiffness, posterior extended capsular release might not be necessary in arthroscopic surgery, according to study results.

Researchers enrolled 75 patients who underwent arthroscopic capsular release for shoulder stiffness. The patients were randomly assigned to one of two groups: those in whom capsular release, including release of the rotator interval and anterior and inferior capsule, was performed (n = 37), and those in whom capsular release was extended to the posterior capsule (n = 38).

The researchers used American Shoulder and Elbow Surgeons scores, Simple Shoulder Test, VAS pain scores and range of motion (ROM) for evaluation before surgery, at 3, 6 and 12 months postoperatively, and at the last follow-up. Mean follow-up was 18.4 months.

ROM increased significantly among both groups at the last follow-up compared with preoperative scores (P < .05). However, there were no statistical differences between the two groups in American Shoulder and Elbow Surgeons scores, Simple Shoulder Test and VAS pain scores at the last follow-up (P > .05), according to the researchers.

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Anatomic features not tied to pain in rotator cuff tears
Source:
MedicalXpress

Anatomic features associated with the severity of atraumatic rotator cuff tears are not associated with pain level, according to a study published in the May 21 issue of The Journal of Bone & Joint Surgery.

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Obesity may be driving increasing need for knee and hip replacements in steadily younger patients
Source:
dailyRx

The impact of being overweight has far reaching health implications — implications that may be taking a toll at an earlier age.

In a new study, researchers found that packing on the pounds may be setting the stage for total knee or hip replacement at increasingly younger ages.

Further, the scientists found that being overweight or obese had a greater impact on the knee than the hip.

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NFL players return to the game after stabilizing shoulder surgery
Source:
MedicalNewsToday

Shoulder instability is a common injury in football players but the rate of return to play has not been regularly determined following surgery. A new study, discussed at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting, details that return rates for NFL players is approximately 90 percent no matter what the stabilization procedure (open vs. arthroscopic).

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Risk factors identified for little league shoulder
Source:
MedicalNewsToday

As cases of Little League Shoulder (LLS) occur more frequently, the need for additional information about the causes and outcomes of the condition has become clear. Researchers presenting at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting shared new data identifying associated risk factors, common treatment options and return to play.

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High success rates seen for combined meniscal, ACL repair
Source:
Healio

Concurrent meniscal and ACL repair has shown high rates of success, according to a presenter here.

Researchers evaluated 235 patients from the Multicenter Orthopaedic Outcomes Network (MOON) who underwent both unilateral primary ACL reconstructions and concurrent meniscal repair between 2002 and 2004. Of the meniscal repairs, 154 were medial, 72 were lateral and nine underwent both.

Validated patient-oriented outcome data (KOOS, WOMAC) scores, Marx activity scores and IKDC scores were recorded at 2 and 6 years follow-up. Failure of meniscal repairs was determined by subsequent ipsilateral repair.

“This represents the largest cohort combining meniscus repair and ACL reconstruction follow-up for a minimum of 6 years,” Robert W. Westermann, MD, said during the American Orthopaedic Society for Sports Medicine Annual Meeting.

Overall, 86% of meniscal repairs were successful at 6-year follow-up; of these, 86.4% were medial meniscal repair, 86.1% were lateral meniscal repairs and 77.8% were in cases where both were repaired, according to Westermann.

Of the 33 repair failures, nine (27.3%) were related to revision ACL surgery. On average, medial meniscal repairs failed sooner than lateral repairs (2.1 years vs. 3.7 years).

KOOS Symptoms, KOOS Pain, KOOS KRQOL, WOMAC Pain, and IKDC values all improved significantly when comparing baseline scores to 6-year follow-up, according to Westermann. Marx Activity levels gradually declined from time of injury to 6-year follow-up. — by Christian Ingram

Reference:
Westermann RW. Paper #44.Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.

Disclosure:Westermann has no relevant financial disclosures.

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Autografts may improve ACL reconstructions
Source:
Medical News Today

Anterior Cruciate Ligament (ACL) reconstructions occur more than 200,000 times a year, but the type of material used to create a new ligament may determine how long you stay in the game, say researchers who presented their work at the Annual Meeting of the American Orthopaedic Society of Sports Medicine (AOSSM).

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Exercise intensity often overestimated
Source:
Medical News Today

Do you work out for health benefits and feel you are exercising more than enough? You might be among the many Canadians who overrate how hard they work out or underestimate what moderate intensity exercise means, according to a recent study out of York University’s Faculty of Health.

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Identifying risk factors for ACL re-injury
Source:
Medical News Today

Re-tearing a repaired knee Anterior Cruciate Ligament (ACL) happens all too frequently, however a recent study being presented today at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting suggests that identification and patient education regarding modifiable risk factors may minimize the chance of a future ACL tear.

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Partial knee replacement safer than total knee replacement
Source:
Medical News Today

Partial knee replacement surgery is safer than total knee replacement according to a new study published in The Lancet.

Patients who had a partial knee replacement are 40 per cent more likely to have a re-operation, known as revision surgery, during the first eight years after the replacement, than those that had a total knee replacement.

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New approach to total knee replacement spares muscle, decreases pain
Source:
The Daily Progress

Total knee arthroplasty, also known as total knee replacement, is one of the most commonly performed orthopedic procedures. According to the American Academy of Orthopedic Surgeons, as of 2010, more than600,000 total knee replacements were being performed annually in the United States. The number of total knee replacements performed annually in the U.S. is expected to grow by 673 percent to 3.48 million procedures by 2030.

To start, a rigorous preoperative optimization process is now in place to help minimize the risk of complications after surgery. Patients also attend a joint education class to be advised of what to expect before, during and after the surgery. Studies have shown that these educational classes improve patient outcomes.

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ACL injury risk reduced in young athletes by universal neuromuscular training
Source:
Medical News Today

The ACL is a critical ligament that stabilizes the knee joint. An ACL injury, one of the most common sports injuries, often requires surgery and a lengthy period of rehabilitation before an athlete can return to sport and other activities. Recent research has found that screening tools, such as "hop" or isokinetic (computer/video) tests to identify neuromuscular deficits, as well as neuromuscular training programs, may reduce ACL injuries.

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Positive results for meniscal allograft transplantation surgery for young athletes with knee pain
Source:
Medical News Today

Patients undergoing meniscal allograft transplantation (MAT) surgery require an additional operation approximately 32% of the time, but overall see a 95% success rate after an average five-year follow-up, according to new research released at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day.

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Sport makes muscles and nerves fit
Source:
Medical News Today

Endurance sport does not only change the condition and fitness of muscles but also simultaneously improves the neuronal connections to the muscle fibers based on a muscle-induced feedback. This link has been discovered by a research group at the Biozentrum of the University of Basel. The group was also able to induce the same effect through raising the protein concentration of PGC1α in the muscle.

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Baseball pitchers, volleyball spikers have something in common: Similar shoulder, elbow injuries
Source:
Science Daily

Baseball and volleyball players share the similar arm injuries due to overuse of their shoulders and elbows. In both circumstances, the shoulder muscles generate and transmit an incredible amount of energy and serve as the transition point where built up energy is transferred from the rest of the body down the arm. After too many pitches or serves, these shoulder muscles get overworked and tend to cause the shoulder to tighten up.

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Short term improvements only for shoulder revision repair surgery
Source:
Medical News Today

Long-term outcomes of revision arthroscopic rotator cuff repair surgery is not as successful as in a first-time surgery, according to researchers from the Orthopaedic Research Institute in Sydney, Australia, who presented their work at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day.

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Rotator Cuff Repair and Immobilization
Source:
Methodist Orthopedics

Shoulder rotator cuff repair aims to suture torn rotator cuff tendons and provide them with the optimal environment to heal and minimize chance of retear. Overall retear rates have decreased over the years, but are still a major concern. Better suture techniques have been thoroughly investigated but there is less attention paid to the rehabilitation protocol. Currently the gold standard for rehabilitation after surgery is to wear an abduction brace and begin physical therapy for passive range of motion within the first few weeks. As surgical techniques have evolved from open surgery to arthroscopic surgery, there are questions as to whether this rehabilitation protocol is ideal. Animal studies have shown that longer periods of immobilization are beneficial to healing after rotator cuff repair.

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Collagen for the knee: Gel-like implant invented
Source:
Science Daily

Millions of people suffer cartilage damage to the knee every year. Cartilage injuries are not only painful; they can lead to osteoarthritis decades later. In the course of the disease, the protective shock absorbing cartilage that covers the bone within the joint slowly is removed until the bone is finally exposed, typically requiring an artificial joint replacement. A biotechnology company has developed a one-step minimally-invasive surgical procedure for the treatment of cartilage defects: a gel-like implant.

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FDA approves Eliquis® (apixaban) to reduce the risk of blood clots following hip or knee replacement surgery
Source:
Medical News Today

Bristol-Myers Squibb Company and Pfizer Inc. has announced that the U.S. Food and Drug Administration (FDA) approved a Supplemental New Drug Application (sNDA) for Eliquis (apixaban) for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery.

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