Pharmacy Times
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Gel May Fill In for Joint Replacement

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

Presenting at the March 2008 meeting of the AmericanPhysical Society, NIST scientists and colleagues at HokkaidoUniversity in Japan reported on ?double-network hydrogels,?which can be made so tough that they rival cartilage. This tissuecan withstand the abuse of hundreds of pounds of pressure.NIST reports that establishing the details of the molecularstructure will allow for more precise design of the next generationof hydrogels that are tough and rigid at the same time.The researchers hope that a good synthetic cartilage couldendure year after year under the rigors of the body beforeneeding to be replaced.

MRIs Not Needed to Detect OA

Patients seeking relief from osteoarthritis (OA) are often sentfor magnetic resonance imaging (MRI) for diagnosis, but a studyreleased last month at the American Academy of OrthopaedicSurgeons annual meeting found that patients seeking treatmentfor arthritic knees should be given a weight-bearing x-ray first.?MRIs are being used in excess. Many doctors no longer talk toor examine their patients. Instead, they are going right for thetechnology,? said Wayne Goldstein,MD, lead author of the studyand a clinical professor of orthopedics at the University of Illinoisat Chicago College of Medicine.

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

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

More Evidence ThatExercise Helps

A recent study by researchers at the University of NorthCarolina (UNC) at Chapel Hill suggests that moderate exercisecan help older arthritis patients ease their pain andfatigue. The study, reported in the January 2008 issue ofArthritis Care & Research, looked at an exercise programdeveloped by the Arthritis Foundation called PACE (Peoplewith Arthritis Can Exercise), an 8-week series of twice-weeklyclasses available at senior and fitness centers.

Following 346 adults who participated in the program inNorth Carolina, the researchers found that, at the end of the8 weeks, participants generally reported improvements intheir pain and said they had more confidence in their abilityto manage their arthritis; those who attended the mostclasses also developed greater strength and mobility in theirarms and legs.

Swedish Study FindsVegan Diet a Plus

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

A team of researchers at the Karolinska Institutet rheumatologyunit in Stockholm followed 30 RA patients who keptup the vegan/gluten-free diet and 28 others on a normal dietfor a 1-year period, monitoring the progress of their diseaseand various levels of chemicals in their blood. By the end ofthe study, those on the new diet showed a modest improvementin the number of swollen joints (4.3, down from anaverage of 5.3) and a large drop in the level of a chemical inthe blood doctors use to measure inflammatory activity. Nosignificant improvement was seen in the group that ate anormal diet. Findings were reported in the March 2008 issueof Arthritis Research & Therapy.

Gender Bias in Orthopedic Surgery

A University of Toronto study, reportedin the Canadian Medical AssociationJournal (March 11, 2008), has found agender bias favoring men in the treatmentof patients who may need orthopedicsurgery. Looking at patientassessments from 67 physicians inOntario, researchers found that doctorswere twice as likely to recommendtotal knee replacement surgery to men,compared with women. The researchersnoted that acknowledging a genderbias is the first step toward ensuringthat women receive complete andequal 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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