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Orthopedics

News, opinions and meeting coverage in surgery.

FDA Advisers Tackle Epidural Steroid Shots

Focus on adverse neurologic effects.

Case Study: Fecal Transplant Clears K. Pneumoniae

Treatment of teenage girl suggests another use for fecal microbiota transplant.

PRP Shows Promise for Hamstring Tears

Hamstring injuries are notoriously slow to heal. Can platelet-rich plasma help?

Richard III: Shakespeare Blew It

Shakespeare got almost everything wrong about Richard III’s physical appearance.

Medtronic's Infuse Moves From Operating Room to Courtroom

An investigative series by MedPage Today/Milwaukee Journal Sentinel has been tracking the spinal fusion device called Infuse in a 4-year-long series and now reports how a flawed FDA system for device approval may have led to a long string of adverse events culminating in thousands of liability suits.

Bupivacaine Formula Cuts Narcotic Use

NEW ORLEANS -- A long-lasting formulation of the analgesic bupivacaine (Exparel) can do as good a job reducing post-surgical pain among knee replacement patients as continuous femoral nerve blocks, researchers said here.

Medtronic Sued by 1,000 Infuse Patients

Medtronic said about 1,000 people have sued the company over its bone morphogenetic protein-2 product, Infuse, and that many more lawsuits may be coming.

Vitamin D Blog: Cutting Edema in Athletes' Bones

Vitamin D supplementation might help professional athletes who are being treated for bone marrow edema with bisphosphonates, according to a new study.

Scoliosis Tied to HTN Risk in Adolescents

ORLANDO -- Children with severe spinal curving from scoliosis were more likely to have worsening risk indicators for pulmonary hypertension, researchers reported here.

Opioid Use Common After Spine Surgery

NEW ORLEANS -- One year after surgery to relieve back pain, about of third of patients still were using narcotic painkillers, according to a study that raised new concerns about the long-term use of opioids.

Acute Pain Yields to Lower-Dose Diclofenac

FORT LAUDERDALE, Fla. - Lower-dose submicron particle diclofenac offered good pain control compared with placebo, researchers reported here.

Spinal Implant Prices Vary, Process Drives Up Costs

CHICAGO -- Wide variations exist in the cost of the screws, plates, and cages for spinal implants, which contributes to the escalating costs of surgery and healthcare overall, a researcher said here.

Fracture Care for Kids on Medicaid Called 'Dismal'

CHICAGO -- Children receiving Medicaid are finding it increasingly difficult to obtain prompt orthopedic care following a fracture, a researcher said here.

Mixed Results for Metal Ions Test in MoM Hips

CHICAGO -- Measurement of metal ion levels in whole blood in patients with metal-on-metal hip implants is useful, but imperfect, for identifying those whose new hips are functioning poorly and may be likely to fail, a researcher said here.

Early Stroke Risk After Hip Replacement

Patients undergoing a total hip replacement appear to have an elevated risk of stroke in the weeks following the operation, researchers found.

Doctors Say 45 Common Tests 'Overused'

Nine specialty groups have listed tests and treatments that are frequently overused, such as antibiotics for sinus attacks and CT scans for low back pain, in the first phase of a long-term project.

50-Year-Olds Get New Knees in Record Numbers

During the past three decades there has been a dramatic increase in knee replacement surgeries, particularly among individuals in their 50s, a Finnish study found.

Training Technique Stresses Athletes' Spines

CHICAGO --The squat lift, an exercise that has long been a standard training technique for athletes, puts inordinate stress on the spine and likely is the cause of chronic stress fractures in young athletes.

Spine Fusion Device Ignites Academic Feud

Responding to a series of studies linking Medtronic's bone morphogenetic protein-2 product to a number of serious adverse events, a leading BMP-2 researcher is taking the offensive by taking aim at his critics in a manner that some observers say goes too far. This latest report in an ongoing Milwaukee Journal Sentinel/MedPage Today series details the claims and counterclaims.

Researcher Sounded Alarm on Medtronic's Infuse Years Ago

As part of a continuing investigation into a bone morphogenetic protein-2 product marketed as Infuse, the Milwaukee Journal Sentinel/MedPage Today describe a first-hand account of early signs of problems with the device as well as efforts to minimize the clinical significance of those problems.

Greater Infection Risk with Staples in Hip Surgery

Closure of wounds following orthopedic surgery with staples rather than sutures is associated with a significantly higher risk of superficial infection, a meta-analysis found.

The Top 10 Medical Advances of the Decade

From genome to hormones, doctors pick the top medical advances of the decade.

Herniated Disc Surgery Found Cost-Effective

HANOVER, N.H. -- For patients with a herniated disc, surgery proved a cost-effective alternative to nonsurgical treatment over the course of two years, an observational study found.

Newly Revealed ACL Injury Ends 2008 Season for Tiger Woods

ORLANDO -- Tiger Woods, the world's best golfer, announced today that reconstructive surgery for an anterior cruciate ligament rupture in his left knee will force him off the course for at least the rest of the year.

Ulnar Fovea Test Unlocks Tricky Wrist Pain Diagnosis

ROCHESTER, Minn. -- A simple test of ulnar fovea tenderness that led to discovery of a common type of ligament injury may ease the diagnosis of unexplained wrist pain, researchers found.

Promising Outcomes in Spinal Disc Cadaver Allografts

HONG KONG -- Replacement of degenerative discs in the cervical spine with cadaver allografts shows early promise as an alternative to fusion or artificial discs, found researchers here.

After Meniscectomy, Thigh Muscle Weakness Impairs Knee Function

MALMÃ–, Sweden -- Four years after surgery to repair a non-traumatic meniscus tear, loss of muscle strength in the quadriceps left patients with a painful, unstable knee prone to future osteoarthritis, researchers here reported.

So You've Got Tennis Elbow?

NEW YORK-Few conditions have more ostensible cures than tennis elbow. When MedPage Today published a Special Report during the U.S. Open here on evidence-based cures for tennis elbow, many of our readers shared their own approaches. Here is a sampling (edited for space). Caveat emptor.

Certain Exercise Proposed to Reduce Hip Fracture Risk in Elderly

CAMBRIDGE, England-If hip fractures in the elderly are caused by thinning of the femur that leads to bone buckling in a fall, as a team here contends, cycling, rowing or gymnastics might strengthen the femoral neck and reduce the fracture risk.

Small Trampolines Are Injury Risk to Small Children

COLUMBUS, Ohio-Children are as likely to get injured using recreational mini-trampolines are they are with full-sized trampolines, a study has found. This was particularly so for kids under six.