If you’re in for a hip replacement, this is the type of operation you might want to ask about…
Anterior approach to hip replacement surgeries offers less pain, faster recovery
Lucetter Lagnado writing in the Wall Street Journal reported on the anterior approach to hip replacement surgeries, which NYU Langone Medical Center calls same-day hip replacement surgery. This approach uses the natural openings between muscles to avoid cutting through muscle and tendons as the traditional or posterior method would. Physicians say the anterior approach offers less postoperative pain and faster recovery times for patients.
Comment: This is not really new news… but I think it’s important to know this technique is considered the approach of choice now.
How common is psoriatic arthritis in patients with psoriasis… a lot more common than you might think.
Psoriasis cohort reveals high arthritis risk
Jennie Smith writing in Rheumatology News reported on a study from the University of Toronto. The investigators recruited 464 patients with psoriasis from a dermatology clinic population. The incidence of psoriatic arthritis was almost 3 times what was predicted. Risk factors included disease severity, nail pitting, low education, and uveitis.
Comment: Wow. Much higher than I would have thought.
Here’s a treatment right out of science fiction for knee osteoarthritis sufferers…
Pulsed electromagnetic field therapy may ease pain for patients with knee OA
Reported in Healio… patients with knee osteoarthritis who received pulsed electromagnetic field therapy experienced pain relief and 26% of patients discontinued NSAIDs following treatment, according to results of a recently published report.
Researchers studied 66 patients with knee osteoarthritis (OA) and persistent pain. Patients were age 40 years or older, had OA for longer than 6 months, did not respond to conventional treatment with NSAIDs or acetaminophen, and did not change medications in the prior month.
Patients were randomly assigned 1:1 to treatment either with a pulsed electromagnetic field-generating device or a placebo device with no electromagnetic properties. Sixty patients completed the study, with three patients from each group lost to follow-up. Rates of compliance were similar between groups, with an average use time of about 11 hours per day reported.
At 1 month, a 25.5% reduction in pain was observed in patients who were assigned to the treatment group compared to a 3.6% reduction for patients in the placebo group.
Comment: Interesting. I wonder if the investigators were blinded as well. Investigator bias often skews results. If they were blinded these are impressive results.
More disturbing news about the heart and rheumatoid arthritis
RA increases A fib risk
A 2015 Mayo Clinic study published in BioMed Research International indicated that patients with RA have an increased risk for developing A fib. A fib increases stroke risk by more than 5 times. Patients with RA also have an abnormal diastolic filling of the heart and that is also associated with A fib.
Comment: wish I could offer more good news but it is what it is.
Does intense exercise help or hurt rheumatoid arthritis? The answer next…
Rigorous Exercise Could Aid Rheumatoid Arthritis Pain
Rachel Lutz writing in MD reported arthritis pain severity can be reduced with high-intensity training, such as cycling, according to a study published in the European Journal of Applied Physiology.
Researchers from the Norwegian University of Science and Technology studied seven women with rheumatoid arthritis (RA) aged between 20 and 50 years in order to examine the effects of high-intensity training on their arthritis pain, and to determine if these patients would tolerate exercise intensities above today’s general recommendations.
The patients performed high-intensity interval training twice per week for 10 weeks on spinning bikes, consisting of four sessions of four minute intervals at about 85-95 percent of the maximum heart rate.
The researchers found that the high-intensity interval training produced a 12.2 percent increase in the patients’ maximum oxygen uptake and a 2.9 percent improvement in heart recovery rate. Additionally, body mass index, body fat, and waist circumference in patients decreased by rates of 1.2, 1.0, and 1.6 percent, respectively. Muscle mass increased by 0.6 percent in the patients.
Comment: It’s interesting that all the patients elected to continue the exercise program. This is consistent with what I’ve observed with my patients. You’ve got to make regular exercise as much of a habit as brushing your teeth.
Cows provide this…. And this… but they are important for another reason…next
Cells from cow knee joints used to grow new cartilage tissue in laboratory
Reported in Eurka Alert, this item from Umea Universituy…In an effort to develop a method for cartilage tissue engineering,
researchers at Umeå University in Sweden successfully used cartilage cells from cow knee joints. By creating a successful method with conditions conducive to growing healthy cartilage tissue, the findings could help lead to a new treatment cure for osteoarthritis using stem cell-based tissue engineering. This is according to a doctoral dissertation at Umeå University.
Traveling? Tips Volume 3 From Dr. Jack Cush’s excellent blog, RheumNow
Plane travel: Pack Smart and Pack Light
Read up on how and what to pack to reduce your baggage. Tip someone to carry your bags and check your luggage. Don’t be a martyr: Ask for wheelchair or electric cart to the gate or around in the airport. Exercise on plane by stretching, doing shoulder and ankle circular movements; move legs as if bicycling.
Stop every 2 hours to walk, stretch and move. Prepare the car for comfort. Bring pillows, ice chest, and water. Do shoulder & ankle circles; move legs as if bicycling.
Hip pain? Told your x-rays are normal and don’t show arthritis… don’t believe it… next
Hip osteoarthritis may not appear on X-ray
Reported in Medical Xpress, in the majority of cases, hip x-rays are not reliable for diagnosing hip osteoarthritis (OA), and can delay the treatment of this debilitating disease.
These findings are the first to evaluate the diagnostic performance of an x-ray in patients with clinical signs and symptoms of classic OA. The study appears in the British Medical Journal.
Researchers looked at the Framingham Osteoarthritis and Osteoarthritis Initiative studies, with nearly 4,500 participants. In the Framingham study, only 16 percent of patients with hip pain had radiographic hip OA, and only 21 percent of hips with radiographic OA had hip pain. Results of the Osteoarthritis Initiative were similar with nine percent and 24 percent, respectively. In both study populations, hip pain was not present in many patients with radiographic OA, and many with hip pain did not have imaging evidence of hip OA.
“The majority of older subjects with high suspicion for clinical hip osteoarthritis did not have radiographic hip osteoarthritis, suggesting that many older persons with hip osteoarthritis might be missed if diagnosticians relied on hip radiographs to determine if hip pain was due to osteoarthritis,” explained corresponding author Chan Kim, MD, instructor of medicine at Boston University School of Medicine.
Comment: I see a lot of patients who have seen orthopedic surgeons and told they don’t have osteoarthritis when they did… or even worse, told they have severe osteoarthritis when they didn’t.