Category: Orthopedy

Orthopedy, Surgery

Surgery versus Conservative Care for Persistent #Sciatica Lasting 4 to 12 Months

..Among the patients assigned to undergo surgery, the median time from randomization to surgery was 3.1 weeks; of the 64 patients in the nonsurgical group, 22 (34%) crossed over to undergo surgery at a median of 11 months after enrollment. At baseline, the mean score for leg-pain intensity was 7.7 in the surgical group and 8.0 in the nonsurgical group. The primary outcome of the … Continue reading Surgery versus Conservative Care for Persistent #Sciatica Lasting 4 to 12 Months

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Orthopedy

Reasons why #osteoarthritis predicts mortality: path analysis within a Cox proportional hazards model

To identify potentially modifiable factors that mediate the association between symptomatic osteoarthritis (OA) and premature mortality.. ..OA was significantly associated with mortality (TE-adjusted HR 1.14; 95% CI 1.00 to 1.29). The indirect effects for walking frequency were 1.05 (95% CI 1.04 to 1.06), depression 1.02 (95% CI 1.02 to 1.03), anxiety 1.01 (95% CI 1.00 to 1.02) and unrefreshed sleep 1.01 (95% CI 1.00 to 1.01). … Continue reading Reasons why #osteoarthritis predicts mortality: path analysis within a Cox proportional hazards model

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Nephrology, Orthopedy

Acute #kidney injury after primary total hip #arthroplasty: a risk multiplier for complication, mortality, and healthcare utilization

To assess whether acute kidney injury (AKI) is associated with more complications and higher healthcare utilization in people undergoing primary total hip arthroplasty (THA).. ..Adjusted for age, gender, race, income, underlying diagnosis, medical comorbidity, and the insurance payer, AKI in people who underwent primary THA was associated with significantly higher OR (95% CI) of (1) implant infection, 2.34 (95% CI, 1.87, 2.93); (2) transfusion, 2.46 … Continue reading Acute #kidney injury after primary total hip #arthroplasty: a risk multiplier for complication, mortality, and healthcare utilization

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Cardiology, Orthopedy

Clinical Effectiveness and Safety of #Aspirin for Venous #Thromboembolism Prophylaxis After Total Hip and Knee Replacement

Patients undergoing total hip replacement (THR) and total knee replacement (TKR) receive venous thromboembolism (VTE) pharmacoprophylaxis. It is unclear which anticoagulant is preferable. Observational data suggest aspirin provides effective VTE prophylaxis.. ..The RR of VTE after THR and TKR was 1.12 (95% CI, 0.78-1.62) for aspirin compared with other anticoagulants. Comparable findings were observed for deep vein thrombosis (DVT) (RR, 1.04; 95% CI, 0.72-1.51) and … Continue reading Clinical Effectiveness and Safety of #Aspirin for Venous #Thromboembolism Prophylaxis After Total Hip and Knee Replacement

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Diet, Orthopedy, Sports

Association Between #Weight Loss and Spontaneous Changes in #Physical Inactivity in Overweight/Obese Individuals With Knee Osteoarthritis: An Eight‐Week Prospective Cohort Study

To describe spontaneous changes in time spent being physically inactive that is measured continuously by accelerometry during an 8‐week weight‐loss intervention in overweight/obese individuals with knee osteoarthritis (OA).. A total of 124 participants completed the dietary intervention and had valid accelerometer recordings. The mean weight loss was 12.7 kg (95% confidence interval [95% CI] –13.2, –12.1; P < 0.0001) after 8 weeks, which corresponded to … Continue reading Association Between #Weight Loss and Spontaneous Changes in #Physical Inactivity in Overweight/Obese Individuals With Knee Osteoarthritis: An Eight‐Week Prospective Cohort Study

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Orthopedy

Serum CA72-4 is specifically elevated in #gout patients and predicts flares

..CA72-4 was highly expressed in patients with gouty arthritis [median (interquartile range) 4.55 (1.56, 32.64) U/ml] compared with hyperuricaemia patients [1.47 (0.87, 3.29) U/ml], healthy subjects [1.59 (0.99, 3.39) U/ml] and other arthritis patients [septic arthritis, 1.38 (0.99, 2.66) U/ml; RA, 1.58 (0.95, 3.37) U/ml; SpA, 1.56 (0.98, 2.85) U/ml; OA, 1.54 (0.94, 3.34) U/ml; P < 0.001, respectively]. Gout patients with frequent flares (twice or more … Continue reading Serum CA72-4 is specifically elevated in #gout patients and predicts flares

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Gerontology, Orthopedy

#Aspirin and #fracture risk: a systematic review and exploratory meta-analysis of observational studies

This review provides insights into the potential for aspirin to preserve bone mineral density (BMD) and reduce fracture risk, building knowledge of the risk-benefit profile of aspirin. ..Aspirin use was associated with a 17% lower odds for any fracture (OR 0.83, 95% CI 0.70 to 0.99; I2=71%; six studies; n=511 390). Aspirin was associated with a higher total hip BMD for women (SMD 0.03, 95% CI −0.02 to … Continue reading #Aspirin and #fracture risk: a systematic review and exploratory meta-analysis of observational studies

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Diet, Orthopedy

Association of #bisphosphonate therapy with incident lower extremity #fractures in persons with spinal cord injuries/disorders

To investigate the association between prescriptions for bisphosphonates, calcium/Vitamin D supplements, and receipt of DXA screening, and incident fracture risk in men and women with a spinal cord injury/disorder (SCI/D).. There was no significant association between prescriptions for bisphosphonates and incident lower extremity fractures in men (OR 1.04, 95% CI: 0.62-1.77) or women (OR 1.02, 95% CI 0.28-3.75). In men, similar null associations were seen … Continue reading Association of #bisphosphonate therapy with incident lower extremity #fractures in persons with spinal cord injuries/disorders

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Environment, Orthopedy

Association of Ambient and Household Air #Pollution With #Bone Mineral Content Among Adults in Peri-urban South India

..The annual mean (SD) PM2.5 exposure was 32.8 (2.5) μg/m3, and the annual mean (SD) BC exposure was 2.5 (0.2) μg/m3; 57.8% of participants used biomass cooking fuels. In fully adjusted models, PM2.5 was associated with lower BMC in the spine (mean difference, −0.57 g per 3 μg/m3 increase in PM2.5; 95% CI, −1.06 to −0.07 g per 3 μg/m3 increase in PM2.5) and hip … Continue reading Association of Ambient and Household Air #Pollution With #Bone Mineral Content Among Adults in Peri-urban South India

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Orthopedy, Psychiatry

State-Specific Prevalence and Characteristics of Frequent Mental Distress and History of #Depression Diagnosis Among Adults with #Arthritis— United States, 2017

..Persons with arthritis have unique challenges because the interplay between anxiety, depression, and chronic pain is cyclical, with each having the potential to exacerbate the others. What is added by this report? In 2017, frequent mental distress and history of depression were commonly reported by adults with arthritis in all states, with clustering of high prevalence of frequent mental distress in Appalachian and southern states. … Continue reading State-Specific Prevalence and Characteristics of Frequent Mental Distress and History of #Depression Diagnosis Among Adults with #Arthritis— United States, 2017

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Orthopedy

Efficacy and tolerability of #duloxetine in patients with knee #osteoarthritis: a meta‐analysis of randomised controlled trials

..Duloxetine achieved significant reductions in primary outcomes including Brief Pain Inventory 24‐h average pain score (weighted mean difference (WMD) = −0.74, 95% confidence interval (CI) = −0.92 to −0.57), weekly mean of the 24‐h average pain score (WMD = −0.76, 95% CI = −0.96 to −0.56), WOMAC stiffness score (WMD = −0.47, 95% CI = −0.60 to −0.34) and WOMAC physical function score (WMD = … Continue reading Efficacy and tolerability of #duloxetine in patients with knee #osteoarthritis: a meta‐analysis of randomised controlled trials

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Orthopedy

Influence of #sleep problems and co-occurring musculoskeletal pain on long-term prognosis of chronic low #backpain: the HUNT Study

Compared with persons without sleeplessness, persons who often/always experienced sleeplessness had a lower probability of recovery from chronic LBP (RR 0.65, 95% CI 0.57 to 0.74 in women and RR 0.81, 95% CI 0.69 to 0.95 in men). Although there was no clear evidence of statistical interaction between sleeplessness and co-occurring musculoskeletal pain, women and men who often/always experienced sleeplessness and had ≥5 additional chronic pain sites … Continue reading Influence of #sleep problems and co-occurring musculoskeletal pain on long-term prognosis of chronic low #backpain: the HUNT Study

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