Monday May 14, 2012
Participation in high-impact sports or activities significantly increases wear and decreases the survivorship of hip replacements, according to researchers. Football, skiing, tennis, jogging, soccer, and martial arts are examples of high-impact activities. It is not uncommon for orthopedic surgeons to warn patients about high-impact activity but there have not been many studies that actually evaluated the effect on artificial joints.
According to the study results published in the journal Clinical Orthopaedics and Related Research, a team of French researchers compared the function, wear rates, and survivorship of hip implants in 70 patients who participated in high-impact sports and 140 patients who participated in low-impact activities. They assessed the need for revision related to mechanical failure and loosening of the hip prostheses. The assessments were made at least 11 years after the hips were surgically implanted. Patients also completed questionnaires about their sports participation and quality of life. Those participating in high-impact sports reportedly had better function and quality of life than patients participating in low-impact activities. However, at 15-years followup, survivorship of hip implants was 80% for high-impact participants compared to about 94% for the low-impact participants. Patients and doctors need to be aware of the risk of high-impact activity on implant survivorship.
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Wednesday May 9, 2012
According to study results presented at the World Congress on Osteoarthritis, overweight women who followed a 2.5 year diet and exercise program had a significant reduction in the incidence of knee osteoarthritis. The PROOF (Prevention of Knee Osteoarthritis in Overweight Females) study, which was conducted in the Netherlands, set out to assess whether a weight loss program plus oral glucosamine sulfate could prevent knee osteoarthritis. The trial involved 200 women who participated in the weight loss program and 200 women who served as controls and did not participate in the weight loss program. In both groups, half received glucosamine (1,500 mg/day) as well. The women who were selected for the study were 50 to 60 years old, had a body mass index of at least 27, but had no x-ray evidence or clinical signs of osteoarthritis at the study onset.
According to MD Consult, the weight loss program included a weekly group session involving various low-impact sports. The women also had sessions with a dietician. The program was designed to be a regimen that women would stick with. After 2.5 years, researchers determined that among those who complied with the program, there was 25% incidence of knee osteoarthritis among the control group and 10% in the weight loss program group. Researchers did admit that compliance was an issue. Only 25% of women remained compliant with the program. Diet and exercise are lifestyle modifications that require strict commitment. Difficult to do, even with the goal of osteoarthritis prevention.
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Saturday May 5, 2012
Knee osteoarthritis patients who will eventually need knee replacement have greater cartilage loss early in the course of their disease compared to patients who don't go on to require knee replacement. Those findings were presented at the World Congress on Osteoarthritis, based on data from the Osteoarthritis Initiative. The study involved 109 knees from study participants who had knee replacement between the first and fourth year of the Osteoarthritis Initiative, according to Rheumatology News.
MRI was used to measure cartilage thickness. Researchers found that patients who had received a knee replacement had three times as much cartilage loss as controls (patients who did not go on to have surgery). Cartilage loss may be a useful biomarker going forward in clinical trials. Aside from predicting knee replacement, cartilage loss may predict the effectiveness of DMOADs in clinical trials. Also, the findings support the theory that if treatments could slow cartilage loss, the need for knee replacement might be delayed. For now, a link between cartilage loss and knee replacement has been drawn.
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Friday May 4, 2012
According to a report in Rheumatology News, a review of the medical charts of 264 patients revealed that many who had bariatric surgery experienced "near-complete resolution" of their knee osteoarthritis. The findings showed that 3 types of bariatric surgery produced statistically significant results for obesity-related comorbidities (e.g., hypertension, diabetes, osteoarthritis).
Of patients undergoing RYGB (roux-en-Y gastric bypass), 71% reported that knee osteoarthritis resolved. Knee osteoarthritis also resolved for 63% of those who had LSG (laparoscopic sleeve gastrectomy) and 51% of patients who had LAGB (laparoscopic adjustable gastric banding). If the preliminary results can be matched in clinical trials, the body mass index requirement for bariatric surgery may be lowered for those with comorbidities.
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