How much weight does wearing a fitness tracker help you lose? Next
Wearable Activity Trackers Don’t Improve Weight Loss
Dr. Jack Cush writing in Rheum now reported that an article in JAMA has reported the results of a 24-month trial showing that obese individuals on a long-term healthy diet and exercise program do not have significantly more weight loss from using a wearable device that tracks their activity.
In a randomized clinical trial conducted at the University of Pittsburgh, 471 adult participants (with a BMI between 25-40) enrolled between 2010 and 2012. All subjects were placed on a low-calorie diet, prescribed increases in physical activity, and had group counseling sessions.
Patients randomized to the intervention group were given wearable device and accompanying web interface to monitor diet and physical activity – BodyMedia Fit Core, a wearable activity tracker worn on the upper arm. The Fit Core tracks steps, hours slept and calories burned and costs about $100.
After 24 months, people who used wearable activity trackers lost 2.4 kilograms (5.29 pounds) less than a group on a similar program but using a website to track their progress.
Both groups had improved their body composition, fitness, physical activity and diet, according to the report in JAMA.
The value and impact of wearable technology remains to be proven, especially with regard to weight loss.
Reported by the Academy of Integrative Pain Management this item…
Mud-Bath Therapy in Addition to Usual Care in Bilateral Knee Osteoarthritis: Economic Evaluation
An economic evaluation of mud-bath therapy was conducted alongside a randomized controlled trial. Patients (103) were randomly assigned to receive either a 2 weeks cycle of MBT in addition to their usual treatment or to continue routine care alone. The European Quality-of-Life Questionnaire-5 Dimensions (EQ-5D) questionnaire was administered at baseline, 2 weeks, 3, 6, 9, and 12 months. Direct healthcare resource consumption data up until 12 months were derived from a daily diary given to patients and returned at prescheduled follow-up visits. The results of this cost-effectiveness analysis support the use of the mud bath therapy as mid-term complementary therapy in the management of knee OA.
So… you need knee replacement. Should you get them done one at a time or both at once… next
Simultaneous Versus Staged Bilateral Total Knee Arthroplasty
Dr. Jack Cush writing in Rheumnow reported on a metanalysis from 2013 that identified 18 articles which included over 65,000 patients and compared those undergoing single as opposed to simultaneous total knee replacements.
The incidence of mortality was significantly higher in the simultaneous group at 30 days (RR 3.67, 95% CI 1.68–8.02), 3 months (RR 2.45, 95% CI 2.15–2.79) and 1 year (RR 1.85, 95% CI 1.66–2.06) after surgery.
On the other hand there were no significant differences between the two groups with regard to in-hospital mortality R 1.18, 95% CI 0.74–1.88), post-operative deep vein thrombosis, cardiac complications, and pulmonary embolism or infection rates
Thus the higher mortality rate associated with bilateral total knee arthroplasty should impact patient selection for this surgical option. The good news is that there is no differences in other common complications associated with arthroplasty – infection, thrombotic events, etc.
Your orthopedic surgeon wants to do arthroscopic surgery for your meniscus… better watch out!
Arthroscopic surgery for degenerative meniscus tears increases risk for eventual knee replacement
A recent study published in the journal Osteoarthritis Cartilage showed that patients with osteoarthritis of the knee who undergo arthroscopic surgery for degenerative meniscus tears are at markedly increased risk for potentially having total joint replacement. In the study, 335 patients with osteoarthritis of the knee underwent arthroscopic surgery for degenerative meniscus tears. They were followed for two years.
The authors demonstrated that in patients with knee osteoarthritis, arthroscopic knee surgery with meniscectomy is associated with a 3 fold increase in the risk for future knee replacement surgery.
Comment: Don’t do it if you can avoid it. The meniscus serves of function. It helps to cushion the knee. Any meniscus tissue should be preserved.