Image courtesy of yodiyim at FreeDigitalPhotos.net
A study published in the European League Against Rheumatism Annual Congress last month shows that the incidence of knee and hip replacement declined after the introduction of biologics to national rheumatoid arthritis (RA) treatment guidelines.
The study looked at 30,868 patients diagnosed with RA at the rheumatology department between 1996 and 2011 and compared them with 301,527 controls from the general population. The baseline total knee replacement (TKR) incidence rate per 1,000 person-years was 5.87 for RA versus 0.42 for the controlled group. Prior to 2002, the incidence of total knee replacement increased among RA patients, but started to decrease after the introduction of bDMARDs and their associated guidelines in 2003. In February of 2007, the rate of TKR changed to 1.8 TKRs/1,000 person. Over the study period, the incidence of total knee replacement and total hip replacement increased among the general population controlled group. In contrast, there was a downward trend among RA patients.
Lene Dreyer, MD, from the Center for Rheumatology and Spine Diseases in Denmark, is one of the author the study. Dreyer explained: “Our findings show a clear downward trend in these two operations in RA patients in Denmark since the additions of [biologic disease-modifying anti rheumatic drugs] bDMARDs to treatment protocols. Also, the overall pattern of our findings is in line with those recently reported from England and Wales.”
Below is a video examining the quality of rehabilitation care, specifically in hip and knee replacements: Continue reading →
A research presented at the annual meeting of the American College of Rheumatology shows that knee replacements in young adults are growing. The culprit is an increased rate of obesity. David Ayers, M.D., the Chair and Professor of orthopedics and physical rehabilitation and Director of the Musculoskeletal Center of Excellence at UMass Medical School said in an interview with The Huffington Post: “What was once thought of as a procedure for older people or those with sporting injuries is changing. Our study shows that younger patients are more obese and experience the same amount of pain and functional disability as older patients and in some cases even more.” Continue reading →
Arthritis affects 1 in 5 British Columbia residents, so healthcare to treat the more than 100 different types of the disease is extremely important to the more than 600,000 British Columbians living with the disease. Any party that wishes to become government needs to consider these constituents. To help the parties understand this, Arthritis Consumer Experts (ACE) sent a questionnaire to the candidates of the BC Liberal Party and the New Democratic Party.
Leading in with background information about the high number of people who undergo joint replacement surgeries due to arthritis, the questionnaire asked the following: Continue reading →
I recently was reminded about the frailty of joints weakened by arthritis and age. My 90-year old father slid off his chair and the 18-inch drop to the floor was enough to snap the ball off his hip joint. His bones were so brittle that the break was not the result of a nosedive down a set of stairs or a spectacular fall. Unfortunately, his experience is a common one for seniors who struggle with balance or mobility issues and often, also have undiagnosed osteoporosis. Continue reading →
Women appear to have a higher risk of implant failure than men following total hip replacement after considering patient-, surgery-, surgeon-, volume- and implant-specific risk factors.
Total hip replacement, also known as total hip arthroplasty (THA), is more often performed in women than men. Sex-specific risk factors and outcomes have been investigated in other major surgical procedures and, in theory, might be more important to study in THA because of anatomical differences between men and women, the authors write in the study background.
Researchers noted this was true even after taking other individual risk factors into account. They said their findings could help doctors better manage the differences between men and women.
Spinal anesthesia could reduce the risk for postoperative complications in certain patients undergoing total knee repair surgery (arthroplasty), showed a recent study. The study looked at the differences in surgery times and risk of complications between anesthesia choices among patients undergoing knee repair.
The spinal form was associated with shorter surgery times and shorter hospital stays compared to general anesthesia. As well, patients were less likely to experience wound infections or need a blood transfusion.
However, “It is important to recognize that the differences in complication rates between spinal and general anesthesia are small and that general anesthesia remains a reasonable choice for many patients undergoing total knee arthroplasty,” says one of the researchers.
A hip replacement technique, invented by the late Sir John Charnley 50 years ago, revolutionized the procedure and became the ‘gold standard’. The surgeon, who had a love of engineering, developed his artificial hip joint and surgical technique at Wrightington Hospital in Lancashire, England.
Women and smaller men are being warned against “resurfacing”, which is an alternative to traditional hip replacement procedures. The procedure, originally promoted as a method that would allow younger patients to stay more active, turns out to have an “unacceptably high” early failure rate compared to plastic-and-metal implants.