MAY 01, 2008

Gel May Fill In for Joint Replacement

Researchers at the National Institute of Standards and Technology (NIST) are looking at a new substance that could prove to be an alternative to total joint replacement.

Presenting at the March 2008 meeting of the American Physical Society, NIST scientists and colleagues at Hokkaido University in Japan reported on ?double-network hydrogels,? which can be made so tough that they rival cartilage. This tissue can withstand the abuse of hundreds of pounds of pressure. NIST reports that establishing the details of the molecular structure will allow for more precise design of the next generation of hydrogels that are tough and rigid at the same time. The researchers hope that a good synthetic cartilage could endure year after year under the rigors of the body before needing to be replaced.

MRIs Not Needed to Detect OA

Patients seeking relief from osteoarthritis (OA) are often sent for magnetic resonance imaging (MRI) for diagnosis, but a study released last month at the American Academy of Orthopaedic Surgeons annual meeting found that patients seeking treatment for arthritic knees should be given a weight-bearing x-ray first. ?MRIs are being used in excess. Many doctors no longer talk to or examine their patients. Instead, they are going right for the technology,? said Wayne Goldstein,MD, lead author of the study and a clinical professor of orthopedics at the University of Illinois at Chicago College of Medicine.

Researchers reviewing a random sample of 50 OA patients who had total knee arthroplasty found that 32 had an MRI, yet the MRI did not offer any additional diagnostic information that could not be provided by an x-ray.

Use of medical imaging is rising rapidly, and the procedure?s costs consume 10% to 15% of Medicare payments to physicians. The researchers see education of both physicians and patients as a way to address the problem, noting that ?virtually every adult experiencing a knee problem should first have an appropriate set of x-rays before considering an MRI.?

More Evidence That Exercise Helps

A recent study by researchers at the University of North Carolina (UNC) at Chapel Hill suggests that moderate exercise can help older arthritis patients ease their pain and fatigue. The study, reported in the January 2008 issue of Arthritis Care & Research, looked at an exercise program developed by the Arthritis Foundation called PACE (People with Arthritis Can Exercise), an 8-week series of twice-weekly classes available at senior and fitness centers.

Following 346 adults who participated in the program in North Carolina, the researchers found that, at the end of the 8 weeks, participants generally reported improvements in their pain and said they had more confidence in their ability to manage their arthritis; those who attended the most classes also developed greater strength and mobility in their arms and legs.

Swedish Study Finds Vegan Diet a Plus

Patients with rheumatoid arthritis (RA) may find symptom relief after switching to a vegan and gluten-free diet, a Swedish study has found.

A team of researchers at the Karolinska Institutet rheumatology unit in Stockholm followed 30 RA patients who kept up the vegan/gluten-free diet and 28 others on a normal diet for a 1-year period, monitoring the progress of their disease and various levels of chemicals in their blood. By the end of the study, those on the new diet showed a modest improvement in the number of swollen joints (4.3, down from an average of 5.3) and a large drop in the level of a chemical in the blood doctors use to measure inflammatory activity. No significant improvement was seen in the group that ate a normal diet. Findings were reported in the March 2008 issue of Arthritis Research & Therapy.

Gender Bias in Orthopedic Surgery

A University of Toronto study, reported in the Canadian Medical Association Journal (March 11, 2008), has found a gender bias favoring men in the treatment of patients who may need orthopedic surgery. Looking at patient assessments from 67 physicians in Ontario, researchers found that doctors were twice as likely to recommend total knee replacement surgery to men, compared with women. The researchers noted that acknowledging a gender bias is the first step toward ensuring that women receive complete and equal access to care.

F A S T   F A C T : Patients with arthritis account for 36 million outpatient visits annually.

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