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January 2013 Briefing - Orthopedics

January 2013 Briefing - Orthopedics

Here are what the editors at HealthDay consider to be the most important developments in Orthopedics for January 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

PhysioDirect Equal to Usual Care for Musculoskeletal Issues

WEDNESDAY, Jan. 30 (HealthDay News) -- For patients with musculoskeletal problems, PhysioDirect, a service which invites patients to telephone a physical therapist for initial assessment and advice, followed by face-to-face physical therapy if necessary, is similarly effective to usual care, but is associated with slightly lower patient satisfaction, according to a study published online Jan. 29 in BMJ.

Full Text (http://www.bmj.com/content/346/bmj.f43 )

Physicians Commonly Report Unsafe Hospital Workloads

TUESDAY, Jan. 29 (HealthDay News) -- Physicians say they often face unsafe hospital workloads, according to a study published online Jan. 28 in JAMA Internal Medicine.

Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1566604 )

Back Pain Researchers Identify Current Priorities

TUESDAY, Jan. 29 (HealthDay News) -- Low back pain (LBP) primary care researchers indicate that the identification and management of specific subgroups of patients and translation of research into clinical practice should be the most important current priorities, according to a study published in the Jan. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/01150/Primary_Care_Research_Priorities_in_Low_Back_Pain_.8.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/01150/Primary_Care_Research_Priorities_in_Low_Back_Pain_.8.aspx )

Brain Scans Show Doctors Empathize With Patients

TUESDAY, Jan. 29 (HealthDay News) -- Physicians who empathize with a patient in pain and feel relief when the patient receives effective treatment show activity in brain regions associated with pain relief and reward, according to a study published online Jan. 29 in Molecular Psychiatry.

Abstract (http://www.nature.com/mp/journal/vaop/ncurrent/abs/mp2012195a.html )Full Text (subscription or payment may be required) (http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2012195a.html )

Pedicle Subtraction Osteotomy Better With Two Surgeons

TUESDAY, Jan. 29 (HealthDay News) -- Using a two-surgeon strategy for pedicle subtraction osteotomies is associated with better outcomes, according to a study published in the January issue of Spine Deformity.

Abstract (http://www.spine-deformity.org/article/S2212-134X(12)00034-2/abstract )Full Text (http://www.spine-deformity.org/article/S2212-134X(12)00034-2/fulltext )

Substantial Increase in Spinal Interventional Techniques Seen

MONDAY, Jan. 28 (HealthDay News) -- Between 2000 and 2008, there was a nearly 108 percent increase in the number of Medicare recipients receiving spinal interventional techniques, according to a study published in the Jan. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/01150/Growth_of_Spinal_Interventional_Pain_Management.9.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/01150/Growth_of_Spinal_Interventional_Pain_Management.9.aspx )

FDA Panel Votes for Tougher Restrictions on Hydrocodone

FRIDAY, Jan. 25 (HealthDay News) -- A U.S. Food and Drug Administration advisory panel met Thursday and Friday to discuss the fate of certain painkillers that contain the opioid known as hydrocodone, concluding in a vote in favor of moving hydrocodone combination products into the more restrictive Schedule II category of controlled substances.

More Information (http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/UCM334277.pdf )

Psychological Factors Impact Upper-Extremity Disability

THURSDAY, Jan. 24 (HealthDay News) -- Psychological factors, including kinesiophobia and catastrophic thinking, are important predictors of the magnitude of upper-extremity-specific disability, according to a study published in the Jan. 2 issue of The Journal of Bone & Joint Surgery.

Abstract (http://jbjs.org/article.aspx?articleid=1486390 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleid=1486390 )

ACPE Survey Finds Skepticism Relating to Online Doc Ratings

THURSDAY, Jan. 24 (HealthDay News) -- Physicians are skeptical of online ratings, and believe that few patients use them, according to a survey published by the American College of Physician Executives (ACPE).

More Information (http://www.acpe.org/resources/surveys/2013_Doctor_measures_survey.aspx )

Back Pain Intensity Most Influential in Fusion Decision

THURSDAY, Jan. 24 (HealthDay News) -- Patients seeing a spine surgeon are most influenced by low back pain intensity when considering whether to proceed with spinal fusion surgery, according to a study published in the Jan. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/01150/Pain_Intensity_and_Patients__Acceptance_of.7.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/01150/Pain_Intensity_and_Patients__Acceptance_of.7.aspx )

Large Teaching Hospitals Face More Readmission Penalties

WEDNESDAY, Jan. 23 (HealthDay News) -- Large hospitals, teaching hospitals, and safety-net hospitals (SNHs) are more likely than other hospitals to be penalized under the Centers for Medicare & Medicaid Services' Hospital Readmissions Reduction Program (HRRP), according to a research letter published in the Jan. 23/30 issue of the Journal of the American Medical Association.

Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1558273 )

Care Transition Initiative Decreases Rehospitalizations

WEDNESDAY, Jan. 23 (HealthDay News) -- Communities instituting quality improvement initiatives for care transitions see significant declines in the rate of 30-day rehospitalizations and hospitalizations, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1558278#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1558278 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1558260 )

High BMI Increases Risk of Chronic Low Back Pain Later

WEDNESDAY, Jan. 23 (HealthDay News) -- High body mass index (BMI) significantly increases the risk of chronic low back pain later, according to a study published in the Jan. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/01150/Body_Mass_Index_as_a_Risk_Factor_for_Developing.6.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/01150/Body_Mass_Index_as_a_Risk_Factor_for_Developing.6.aspx )

Early Predictors of Occupational Back Reinjury Identified

TUESDAY, Jan. 22 (HealthDay News) -- About 25 percent of workers with back injury report reinjury after returning to work, with risk factors including male sex, previous similar injury, and having health insurance, according to a study published in the Jan. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/01150/Early_Predictors_of_Occupational_Back_Reinjury_.11.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/01150/Early_Predictors_of_Occupational_Back_Reinjury_.11.aspx )

Efforts Failed to Up Primary Care, Rural Resident Training

FRIDAY, Jan. 18 (HealthDay News) -- The 2005 redistribution of graduate medical education (GME) funds did little to train more residents in primary care and in rural areas, according to a study published in the January issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/1/102.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/1/102.full )

Post-Laminectomy Spine Strength Can Be Predicted

THURSDAY, Jan. 17 (HealthDay News) -- Following lumbar laminectomy, loss of strength and shear stiffness (SS) can be predicted in the human lumbar spinal segment using measurable parameters, according to a study published in the December issue of the European Spine Journal.

Abstract (http://link.springer.com/article/10.1007/s00586-012-2250-y )Full Text (http://link.springer.com/article/10.1007/s00586-012-2250-y/fulltext.html )

Even Brief Interruptions Dramatically Increase Errors

WEDNESDAY, Jan. 16 (HealthDay News) -- Even momentary interruptions of two to four seconds can significantly affect a person's ability to accurately complete a task requiring considerable thought, according to research published online Jan. 7 in the Journal of Experimental Psychology: General.

Abstract (http://psycnet.apa.org/psycinfo/2013-00033-001/ )Full Text (subscription or payment may be required) (http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2013-00033-001 )

Family Docs Are Early Adopters of Electronic Health Records

WEDNESDAY, Jan. 16 (HealthDay News) -- Family practice physicians are adopting electronic health record (EHR) systems at a fast pace, with 68 percent using an EHR system by 2011, and 80 percent expected to be users by 2013, according to research published in the January/February issue of the Annals of Family Medicine.

Abstract (http://annfammed.org/content/11/1/14.abstract )Full Text (http://annfammed.org/content/11/1/14.full )

Improved Driving Reaction Times After Lumbar Disc Sx

TUESDAY, Jan. 15 (HealthDay News) -- Driving reaction times (DRTs), which are increased for patients with radiculopathy, improve after lumbar disc surgery, according to a study published in the November issue of the European Spine Journal.

Abstract (http://link.springer.com/article/10.1007/s00586-012-2378-9 )Full Text (subscription or payment may be required) (http://link.springer.com/article/10.1007/s00586-012-2378-9 )

Certain Online Behaviors of Docs Warrant Investigation

MONDAY, Jan. 14 (HealthDay News) -- There is high consensus among state medical boards regarding the likelihood of probable investigations for certain online behaviors, according to a study published in the Jan. 15 issue of the Annals of Internal Medicine.

Full Text (subscription or payment may be required) (http://annals.org/article.aspx?articleid=1556363 )

Top Five Issues for Docs and Patients Identified for 2013

MONDAY, Jan. 14 (HealthDay News) -- The top five issues that will impact physicians and patients in 2013 have been identified, according to a report published Dec. 10 by The Physicians Foundation.

More Information (http://www.physiciansfoundation.org/news/the-physicians-foundation-identifies-top-five-issues-to-impact-physicians-a/ )

Lower Cuff Pressure Reduces Wound Complications in TKA

MONDAY, Jan. 14 (HealthDay News) -- Lower tourniquet cuff pressure, achieved using a limb-occlusion pressure method, is associated with reduced postoperative wound complications after total knee arthroplasty, according to research published in the Dec. 19 issue of The Journal of Bone & Joint Surgery.

Abstract (http://jbjs.org/article.aspx?articleID=1473742 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleID=1473742 )

National U.S. Health Care Spending Relatively Stable

FRIDAY, Jan. 11 (HealthDay News) -- The growth in national U.S. health care spending was relatively stable in 2011, but growth in personal health care spending accelerated, according to a study published in the January issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/1/87.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/1/87.full )

Etanercept Seems Beneficial in Partial Spinal Cord Injury

THURSDAY, Jan. 10 (HealthDay News) -- Treatment of rabbits with a partial spinal cord injury (SCI) with the intramuscularly-administered tumor necrosis factor-α (TNF-α) inhibitor etanercept is associated with improved clinical and electrophysiological recovery processes, according to research published in the December issue of the European Spine Journal.

Abstract (http://rd.springer.com/article/10.1007/s00586-012-2319-7# )Full Text (subscription or payment may be required) (http://rd.springer.com/article/10.1007/s00586-012-2319-7/fulltext.html )

SPIRIT 2013 Clinical Trial Protocol Guidelines Issued

THURSDAY, Jan. 10 (HealthDay News) -- A panel of experts, including trial investigators, trial coordinators, and representatives from ethics and regulatory agencies, has developed the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 guidelines for the minimum content of a clinical trial, according to a statement published online Jan. 8 in the Annals of Internal Medicine.

Abstract (http://annals.org/article.aspx?articleid=1556168#Abstract )Full Text (http://annals.org/article.aspx?articleid=1556168 )

Lumbar Extensor Training Improves Chronic Back Pain

THURSDAY, Jan. 10 (HealthDay News) -- An exercise regimen can improve functional status for men with chronic nonspecific low back pain (CNSLBP) without improving low back muscular morphology, according to a study published in the Dec. 15 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2012/12150/The_Effects_of_Dynamic_Isolated_Lumbar_Extensor.17.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2012/12150/The_Effects_of_Dynamic_Isolated_Lumbar_Extensor.17.aspx )

Multiple Stressors Contribute to Readmission Within 30 Days

WEDNESDAY, Jan. 9 (HealthDay News) -- Nearly one-fifth of Medicare patients discharged from the hospital are readmitted within 30 days, which seems to arise from a combination of factors contributing to patient vulnerability, according to research published in the Jan. 9 issue of the New England Journal of Medicine.

Full Text (http://www.nejm.org/doi/full/10.1056/NEJMp1212324 )

Meniscal Repair Failure About 23 Percent After Five Years

WEDNESDAY, Jan. 9 (HealthDay News) -- The long-term rate of failure after meniscal repair is similar for all techniques, with a pooled rate of 23.1 percent, according to a review published in the Dec. 19 issue of The Journal of Bone & Joint Surgery.

Abstract (http://jbjs.org/article.aspx?articleid=1473743 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleid=1473743 )

Vitamin D Does Not Improve Knee OA Progression, Symptoms

WEDNESDAY, Jan. 9 (HealthDay News) -- For adults with symptomatic knee osteoarthritis (OA), vitamin D supplementation for two years does not reduce knee pain or cartilage volume loss compared to placebo, according to a study published in the Jan. 9 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1556148#Abstract )Full Text (http://jama.jamanetwork.com/article.aspx?articleid=1556148 )

Health Care Use Dropped Among All During Recession

TUESDAY, Jan. 8 (HealthDay News) -- Health care use declined significantly among all races and ethnicities during the recession from 2007 to 2009, with the only ethnic disparity being fewer physician visits by Hispanics compared with whites, according to a study published online Jan. 7 in JAMA Internal Medicine.

Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1555816 )

Impaired Cognition, Depression Common in Aging NFL Players

TUESDAY, Jan. 8 (HealthDay News) -- Retired professional football players may be more likely to have cognitive impairments or depression, which are associated with white matter abnormalities and changes in cerebral blood flow, according to a study published online Jan. 7 in JAMA Neurology.

Abstract (http://archneur.jamanetwork.com/article.aspx?articleid=1555584#Abstract )Full Text (subscription or payment may be required) (http://archneur.jamanetwork.com/article.aspx?articleid=1555584 )Editorial (subscription or payment may be required) (http://archneur.jamanetwork.com/article.aspx?articleid=1555587 )

Second Impact Syndrome Endangers Young Athletes

TUESDAY, Jan. 8 (HealthDay News) -- Neuroimaging scans performed after first and second head injuries in a high school football player may help physicians better understand a rare and devastating traumatic brain injury, known as second impact syndrome (SIS), that results from premature return to play, according to a case report published online Jan. 1 in the Journal of Neurosurgery: Pediatrics.

Abstract (http://thejns.org/doi/abs/10.3171/2012.11.PEDS12343 )Full Text (http://thejns.org/doi/full/10.3171/2012.11.PEDS12343 )

Study Questions Effect of Disc Replacement on Low Back Pain

MONDAY, Jan. 7 (HealthDay News) -- Although total disc replacement for chronic low back pain due to degenerative disc disease yields statistically significant improvements compared to conventional fusion, the clinical relevance is unclear and conclusions regarding effectiveness are hampered by low quality evidence and short follow-up, according to a study published in the Jan. 1 issue of Spine.

Full Text (http://journals.lww.com/spinejournal/Fulltext/2013/01010/Total_Disc_Replacement_for_Chronic_Discogenic_Low.7.aspx )

Shared Savings May Promote Care Coordination Entity Use

MONDAY, Jan. 7 (HealthDay News) -- Use of shared savings could encourage individuals who are dually eligible for Medicare and Medicaid to enroll in state-designed care coordination entities (CCEs), according to a perspective piece published online Jan. 2 in the New England Journal of Medicine.

Full Text (http://www.nejm.org/doi/full/10.1056/NEJMp1214155 )

Cervical Spine Instabilities Frequently Develop in RA

MONDAY, Jan. 7 (HealthDay News) -- Nearly half of all patients with rheumatoid arthritis (RA) initially without any cervical spine instabilities will develop some type of instability within about five years, according to research published in the Dec. 15 issue of Spine.

Full Text (http://journals.lww.com/spinejournal/Fulltext/2012/12150/Incidence_and_Aggravation_of_Cervical_Spine.4.aspx )

Direct Costs for Low Back Pain Care in U.K. Are Substantial

THURSDAY, Jan. 3 (HealthDay News) -- The financial burden of caring for patients with chronic low back pain (CLBP) in the United Kingdom is twice that of caring for patients without CLBP, according to a study published in the Jan. 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/01010/Costs_Associated_With_Treatment_of_Chronic_Low.13.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/01010/Costs_Associated_With_Treatment_of_Chronic_Low.13.aspx )

Fracture Risk Down With Adherence to Bisphosphonates

THURSDAY, Jan. 3 (HealthDay News) -- For patients with an osteoporotic fracture, adherence to bisphosphonate treatment is associated with reduced fracture risk; and for veterans with rheumatoid arthritis, non-adherence to bisphosphonate treatment is over 50 percent, according to two studies published in the December issue of Arthritis Care & Research.

Abstract - Curtis (http://onlinelibrary.wiley.com/doi/10.1002/acr.21759/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/acr.21759/full )Abstract - Richards (http://onlinelibrary.wiley.com/doi/10.1002/acr.21777/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/acr.21777/full )

Association Between Health Care Cost, Quality Inconsistent

THURSDAY, Jan. 3 (HealthDay News) -- The direction of the association between health care cost and quality is unclear, with inconsistent evidence indicating positive, negative, mixed, and indeterminate associations, according to a review published in the Jan. 1 issue of the Annals of Internal Medicine.

Full Text (subscription or payment may be required) (http://annals.org/article.aspx?articleid=1487781 )Editorial (subscription or payment may be required) (http://annals.org/article.aspx?articleid=1540566 )

Surgery Consultation Common After MRI of the Spine

WEDNESDAY, Jan. 2 (HealthDay News) -- Almost half of patients whose primary care physicians recommend a lumbosacral or cervical spine magnetic resonance imaging (MRI) scan go on to receive a surgical consultation, but few end up undergoing spinal surgery, according to research published in the Jan. 1 issue of Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/2013/01010/Patterns_of_Care_After_Magnetic_Resonance_Imaging.10.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/01010/Patterns_of_Care_After_Magnetic_Resonance_Imaging.10.aspx )

House Joins Senate to Avert Medicare Cuts

WEDNESDAY, Jan. 2 (HealthDay News) -- The House of Representatives settled on an 11th-hour agreement late Tuesday night that has averted the widespread tax increases and spending cuts that would have gone into effect January 1. This agreement occurred 21 hours after the U.S. Senate did its part to steer the country clear of the "fiscal cliff."

More Information (http://www.whitehouse.gov/ )