Alternate type of surgery may prevent total knee replacement
2021-02-01
(Press-News.org) An underused type of knee surgery in younger patients, called high tibial osteotomy, shows considerable success in reducing the need for total knee replacement, according to new research in CMAJ (Canadian Medical Association Journal).
"High tibial osteotomy is a knee surgery aimed at younger patients in the earlier stages of knee osteoarthritis. One of its goals is to prevent or delay the need for knee replacement," says coauthor Dr. Trevor Birmingham, Canada Research Chair in the Faculty of Health Sciences and the Bone and Joint Institute at Western University, London, Ontario. "In some ways, it's like performing a front-end alignment on your car to stop asymmetric wear on your tires and increase their longevity."
Knee osteoarthritis is a common cause of pain and disability and puts tremendous burden on health care systems. Total knee replacement is frequently performed on older patients with end-stage disease and limited mobility.
In Canada, rates of total knee replacement are high and increasing, while rates of high tibial osteotomy are low and decreasing. One reason for this is the perception that high tibial osteotomy is not warranted if the joint is going to be replaced soon afterwards. The findings of this new study contradict this perception.
Of the patients in this study getting high tibial osteotomy in London, Ontario (643 knees in 556 patients), 95% did not need a total knee replacement within 5 years, and 79% did not get a total knee replacement within 10 years. Even in patients traditionally not considered ideal candidates for high tibial osteotomy (e.g., women and patients with later-stage disease), about 70% did not get a knee replacement within 10 years.
The procedure is particularly suitable for people who are younger, have less severe joint damage and who may be more physically active. "Those patients especially contribute to the burden of knee osteoarthritis," says Mr. Codie Primeau, lead author. "There is a treatment gap between exhausting nonoperative treatments and appropriateness for joint replacement, resulting in many years of pain, lost productivity and associated costs."
"Given these findings, high tibial osteotomy may be underused in Canada and could be performed more often to delay or prevent the need for total knee replacement," says coauthor Dr. Robert Giffin, professor of surgery at Western University's Schulich School of Medicine & Dentistry and the Bone and Joint Institute.
"Total knee replacement after high tibial osteotomy: time-to-event analysis and predictors" is published February 1, 2021.
INFORMATION:
ELSE PRESS RELEASES FROM THIS DATE:
2021-02-01
A calculation so complex that it takes twenty years to complete on a powerful desktop computer can now be done in one hour on a regular laptop. Physicist Andreas Ekström at Chalmers University of Technology, together with international research colleagues, has designed a new method to calculate the properties of atomic nuclei incredibly quickly.
The new approach is based on a concept called emulation, where an approximate calculation replaces a complete and more complex calculation. Although the researchers are taking a shortcut, the solution ends up almost exactly the same. It is reminiscent of algorithms ...
2021-02-01
February 1, 2021 - Researchers have identified another good reason to eat more mushrooms. New research , published in Food Science & Nutrition (January 2021) found that adding a mushroom serving to the diet increased the intake of several micronutrients, including shortfall nutrients such as vitamin D, without any increase in calories, sodium or fat.
Dr. Victor L. Fulgoni III and Dr. Sanjiv Agarwal modeled the addition of mushrooms to National Health and Nutrition Examination Survey (NHANES) 2011-2016 dietary data looking at a composite of white, crimini and portabella mushrooms at a 1:1:1 ratio; one scenario including UV-light exposed mushrooms; and one scenario including oyster mushrooms ...
2021-02-01
AUGUSTA, Ga. (Feb. 1, 2020) - A gene panel that looks for about 10 times the number of cancer-causing genes as panels currently used to diagnose and fine tune treatment for a variety of cancers is effective at identifying problematic genes in the most common leukemia, investigators report.
The 523-gene panel, developed by San Diego-based biotech company Illumina, which includes all genes known to potentially cause cancer, can be readily adopted for use in clinical laboratories to diagnose acute myeloid leukemia, or AML, the investigators report in the journal PLOS ONE.
Identifying ...
2021-01-31
(Singapore--January 31, 2021 2:40 p.m. SPT 1:40 a.m. EST)--Patient-reported outcomes from the phase III CROWN study showed that time to treatment deterioration (TTD) in pain in chest, dyspnea, and cough was comparable between those who received lorlatinib and patients who took crizotinib. The research was presented today at the International Association for the Study of Lung Cancer's 2020 World Conference on Lung Cancer Singapore.
Lorlatinib, a third-generation ALK inhibitor, significantly improved progression-free survival compared to crizotinib in ...
2021-01-31
COVID-19 mortality racial disparities in the U.S. are associated with social factors like income, education and internet access, according to a Rutgers study.
The study, published in the Journal of Racial and Ethnic Health Disparities, highlights the need for public health policies that address structural racism.
The researchers investigated the association between COVID-19 cases and deaths in 2,026 U.S. counties from January to October 2020 and social determinants of health, which can raise the risk for infection and death.
They also looked at factors known or thought to impact COVID-19 outcomes, including the counties' population density, days since the first COVID-19 death and percent of residents who are over age 65, are smokers or who have chronic diseases such as obesity, ...
2021-01-30
CHICAGO (January 30, 2021) -- Select patients born with heart defects and who undergo congenital heart surgery recover with few complications and reduced opioid use when a comprehensive, evidence-based enhanced recovery after surgery (ERAS) program is used, according to research presented at the 57th Annual Meeting of The Society of Thoracic Surgeons.
"We have embarked on a new paradigm for patient care with the goal of improving recovery, patient experience, and the value of care that we provide," said Nathalie Roy, MD, from Boston Children's Hospital in Massachusetts. ...
2021-01-30
CHICAGO (January 30, 2021) -- Women are significantly less likely than men to undergo coronary artery bypass grafting (CABG) using guideline-recommended approaches, which may result in worse outcomes after surgery, according to a scientific presentation at the 57th Annual Meeting of The Society of Thoracic Surgeons.
"This study highlights key differences between women and men in surgical techniques used for CABG and reveals opportunities to improve outcomes in women," said Oliver K. Jawitz, MD, from Duke University in Durham, North Carolina.
Using the STS Adult Cardiac Surgery Database--which contains records of nearly all CABG procedures performed in the US--Dr. Jawitz and colleagues from Duke and The Johns Hopkins University ...
2021-01-30
CHICAGO (January 30, 2021) -- The most deadly global health crisis in a century has resulted in a substantial decline in overall heart surgery volume and an unexplained increase in deaths after coronary artery bypass grafting, according to late-breaking research presented at the 57th Annual Meeting of The Society of Thoracic Surgeons.
"This study was a true herculean analysis and tour de force that showed the COVID effect on adult cardiac surgery volume, trends, and outcomes," said Tom C. Nguyen, MD, from the University of California San Francisco. "The pandemic has changed the world as we know it, causing a dramatic drop in adult cardiac surgery volume and worsening patient outcomes."
Dr. Nguyen and colleagues queried the STS Adult ...
2021-01-30
(Singapore--January 30, 2021 11:00 p.m. SPT/January 30, 2021 10:00 a.m. EST)-- Nivolumab monotherapy is an effective treatment option for relapsed malignant mesothelioma (MM), according to research presented today at the International Association for the Study of Lung Cancer World Conference on Lung Cancer.
Malignant mesothelioma is an intractable cancer, and no phase III trial has yet shown an improvement in overall survival following the standard first line chemotherapy doublet comprising pemetrexed and cisplatin or carboplatin since it was licensed in 2004.
Professor Dean Fennell, chair of Thoracic Medical Oncology at the University of Leicester in collaboration with Professor Gareth Griffiths and his team at the Southampton Clinical Trials Unit, University of Southampton, ...
2021-01-30
(Singapore--January 30, 2021 11:00 p.m. SPT/January 30, 2021 10:00 a.m. EST)-- A phase III study examining whether messenger (m)RNA expression correlated with sensitivity or resistance to chemotherapy did not confer a statistically significant advantage in overall survival for patients with resected stage II-III non-small cell lung cancer (NSCLC), according to research presented at the International Association for the Study of Lung Cancer World Conference on Lung Cancer.
Lung cancer researchers and clinicians have sought methods to improve chemotherapy's modest 5% overall survival rate for patients with NSCLC. Dr. Silvia Novello, professor of medical oncology at the University of Torino at ...
LAST 30 PRESS RELEASES:
[Press-News.org] Alternate type of surgery may prevent total knee replacement
