American Academy of Orthopaedic Surgeons, Feb. 25-28, 2009
American Academy of Orthopaedic Surgeons' Annual Meeting
The American Academy of Orthopaedic Surgeons' Annual Meeting took place Feb. 25 to 28 in Las Vegas and attracted more than 25,000 attendees from around the world. The meeting featured 31 symposia, 675 podium and 567 posters, and more than 190 instructional courses addressing recent advances in orthopaedic research, technology and clinical practice.
"The primary focus was on educational events," said Colin Moseley, M.D., of the Shriners Hospitals for Children in Los Angeles, and chair of the Annual Meeting Committee. "This is the meeting that offers orthopaedic surgeons -- who represent only about 3 percent of the nation's doctors -- the most up-to-date information and the most opportunities for interactivity," he noted.
"The big theme is always arthritis, and total joint replacement has been the miracle operation for arthritis, at least with respect to the hip and knee," Moseley said. "We're always looking for advances in that area."
A study presented by Edsel Arandia, M.D., of the Singapore General Hospital, showed that total knee arthroplasty may not be as risky as previously thought in very elderly patients. In a study of 128 patients aged 80 and older, Arandia and colleagues found significant improvements in pain, physical function and quality of life as soon as six months after surgery and at the two-year follow-up.
"In our institution, many surgeons are still skeptical to perform total knee arthroplasty in the very elderly since few data or studies pertaining to the gains of total knee arthroplasty versus the complications and risks that can occur with surgery in elderly patients exist," Arandia said in a statement. "This study shows that with the advent of new technology and techniques in both orthopaedics and geriatric medicine, total knee arthroplasty in the very elderly population is very safe and offers significant gains in their quality of life."
"Unfortunately, other sorts of treatment for arthritis -- such as taking medication or injecting materials into joints -- doesn't seem to be working out as well as we had hoped," Moseley said.
To clarify the usefulness of non-invasive treatments, John Richmond, M.D., and colleagues from the American Academy of Orthopaedic Surgeons released a new clinical practice guideline for the treatment of knee osteoarthritis.
The authors recommended against performing arthroscopic lavage in symptomatic patients without such problems as loose bodies or meniscus tears because current evidence shows that the procedure does not reduce symptoms and poses potential risks. They also recommended against needle lavage, custom-made foot orthotics, and glucosamine/chondroitin supplements.
On the positive side, the authors recommended at least a 5 percent loss in body weight in overweight and obese patients, and low-impact aerobic exercise for all patients with knee osteoarthritis. They also recommended treatment with either acetaminophen in doses less than 4 grams per day, non-steroidal anti-inflammatory drugs, or intra-articular corticosteroids. They did not recommend for or against bracing, acupuncture, and intra-articular hyaluronic acid.
"The Academy created this clinical practice guideline to improve patient care for those suffering from osteoarthritis of the knee," Richmond said in a statement. "This serves as a point of reference and educational tool for both primary care physicians and orthopaedic surgeons, streamlining possible treatment processes for this ever-so common ailment."
Several studies presented by researchers from the Mayo Clinic, SUNY Stony Brook School of Medicine, and Wake Forest University addressed promising new non-surgical treatments for conditions that affect the wrists and hands. These included arthroscopic treatment for thumb and finger arthritis, injection therapy such as Clostridial collagenase for Dupuytren's disease, and botulinum toxin injections for reflex sympathetic dystrophy.
Another study, presented by Daniel Master, M.D., of the University Hospitals Case Medical Center in Cleveland, highlighted the risk of hand injuries associated with snowblowers. In a review of 22 patients who were treated between 2002 and 2005, the researchers found that hand injuries were most often associated with a high level of operator experience (because it created a false sense of security), older machines with fewer safety features, and warmer temperatures that create dense, machine-clogging snow.
"Most injuries occur when the operator tries to unclog the exit chute by reaching into the chutes opening when the machine is still running," Master said in a statement. "What the operator doesn't realize is that there are two blades on a snowblower -- the one in front of the machine that can be seen and a second blade, the impeller blade, which throws the snow out of the exit chute. This impeller blade cannot be seen and causes injuries in most cases."
Among the authors' recommendations: additional safety features on machines and public service announcements from local agencies before and during snowy seasons.
One of the meeting's symposia -- "Hyaline Cartilage Biological Joint Repair, Restoration and Resurfacing" -- featured seven leading researchers who discussed the nature of joint injury involving hyaline cartilage and emerging therapies to regenerate damaged cartilage.
"This is exciting because people have figured out how to use stem cells and other means to restore and grow cartilage, and they're now trying to figure out how to make it grow in the right place in the right shape," Moseley said. "So far, it's only at the research level. But important work has been done, and things are looking up."
AAOS: Soaring Demand for Joint Surgery May Not Be Met
WEDNESDAY, Feb. 25 (HealthDay News) -- The demand for hip or knee replacement surgery is quickly outpacing the ability of the orthopaedic community to supply it, and younger patients are accounting for a greater share of the demand, according to two studies presented at the annual meeting of the American Academy of Orthopaedic Surgeons held Feb. 25 to 28 in Las Vegas.
AAOS: Family History, Gender Linked to Rotator Cuff Tears
WEDNESDAY, Feb. 25 (HealthDay News) -- Family history and female gender may be significant risk factors for rotator cuff tears, according to two studies presented at the annual meeting of the American Academy of Orthopaedic Surgeons held Feb. 25 to 28 in Las Vegas.
This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions or back problem. SpineUniverse does not provide medical advice, diagnosis or treatment. Use of the SpineUniverse.com site is conditional upon your acceptance of our User Agreement
