Peter Jared writing in the New York Times reported that some hip surgery replacement patients are opting for anterior hip replacement instead of conventional hip replacement surgery that would require a long, painful recuperation. The alternative surgery consists of an incision at the front of the hip instead of through the buttocks or the side of the hip. This approach permits the doctor to reach the hip socket without cutting through major muscle groups. It’s unknown how many surgeries currently use the new approach, but at a recent meeting of hip and knee surgeons, an informal survey suggests that as many as 20% of hip surgeons are now performing anterior hip replacement, according to Dr. Joseph Moskal, Chief of Orthopedic Surgery at Virginia Tech Carilion School of Medicine and Research Institute. Nevertheless, the operation is tricky to perform and there is a steep learning curve for young surgeons.
My comment is that many of my patients who have had the anterior approach surgery absolutely love it. So, it’s good news.
Mary Elizabeth Dallas writing in Health Day reported that the complication rate for hip arthroscopy, a minimally invasive procedure, to repair damage to the inside of the hip joint is higher than previously thought. And this was according to a study at the American Orthopedic Society for Sports Medicine meeting. The new study analyzed information on nearly 600 hip arthroscopies that took place at three hospitals between January 2011 and April 2012. In a news release the study’s lead author stated that the overall complication rate after hip arthroscopy was 7.2% which is much higher than what had previously been reported in the literature which was 1.5%.
So, my comment is this, hip arthroscopy
is a technically difficult and demanding procedure and requires a very gentle
touch.
Janice Lloyd writing in USA Today reported the rise of hip and knee replacements among baby boomers is improving their sex lives. According to a study conducted by the Center for Joint Preservation and Reconstruction, 90% of patients surveyed, total hip or total knee replacement improved overall sexual function including frequency and duration. Lead author Jose Rodriquez says he decided to do the study because he knows doctors aren’t comfortable discussing sex with patients.
So, an added benefit one could say. Thanks for watching.
Elizabeth Rosenthal writing in the New York Times reported on a study published in JAMA. OF more than 100 hospitals, including top-ranked orthopedic centers and community hospitals, only half could provide any sort of price estimate, despite repeated calls. Those that could gave quotes that varied by a factor of more than 10, from $11,100 to $125,798.
Comment: Hmmm… So what’s all this hub-bub about reining in healthcare costs?
Barry Meier writing for the New York Times reported that A year before recalling an artificial hip, an executive at Johnson & Johnson reported in an internal e-mail that the FDA had refused to approve the device, after reviewing company studies that showed it had failed prematurely in “significant” numbers, requiring repeat surgeries for patients. Meier said, “The statements in that e-mail contrast with those made by the company in recent years about the all-metal hip. Before recalling the device amid rising failure rates in 2010, Johnson & Johnson insisted it was safe and maintained that its’ internal studies refuted complaints by surgeons and regulators abroad that the device was flawed.
Stomach protecting drugs Increase Hip Fracture Risk In Postmenopausal Women.
Linda Searing writing in The Washington Post reported that according to a study published in the BMJ, postmenopausal women “who took proton pump inhibitors (PPIs)” such as esomeprazole [Nexium], omeprazole [Prilosec], or lansoprazole [Prevacid], “were 35 percent more likely to have broken their hip than were women who did not use the drugs, increasing to a 51 percent greater risk if the women had ever smoked.” In addition, “the longer women had used PPIs, the greater their risk for a broken hip, with six to eight years of use correlating to a 55 percent greater likelihood.”
An Increase of Heavy Labor, Increases Risk Of Hip Knee Osteoarthritis.
Helen Albert writing in MedWire reported, “Having a job that involves a heavy physical workload increases a person’s risk for developing hip or knee osteoarthritis (OA) and risks are higher with cumulative exposure,” according to a study published in Occupational and Environmental Medicine. The researchers “carried out a follow-up study of the Danish working population from 1981 to 2006″ and “found that male floor- or bricklayers and male and female healthcare assistants had the highest risk for developing knee OA,” while “farmers of both genders the highest risk for hip OA.”
Steven Reinberg writing in Healthday described the findings of a new study published in the British Medical Journal, the upshot of which is that no matter the material, all types of hip replacement devices appear to work the same. Specifically, the newer, metal-on-metal implants seem to be no more effective than older implants and may sometimes even be more problematic, the researchers said. “Metal-on-metal and ceramic-on-ceramic hip implants might not be associated with any advantage, compared with traditional bearings such as metal-on-polyethylene or ceramic-on-polyethylene,” said lead researcher Dr. Art Sedrakyan, director of the Patient-Centered Comparative Effectiveness Program at Weill Cornell Medical College in New York City.
M. Alexander Otto writing in Rheumatology News described a study from Harvard Medical School that examined risk factors for need for revision surgery in the future. These included a BMI greater than 30, a cemented femur implant stem, a prior hip replacement on the other side, a previous orthopedic surgery, or an age younger than 75. Stuff to think about if you’re contemplating a hip replacement.
Barry Meier writing in the New York Times reported the California Technology Assessment Forum, has found insufficient evidence to support hip resurfacing is as safe and effective as a traditional replacement.” The group cites “recent findings by orthopedic registries overseas that some resurfacing devices are failing prematurely and health concerns about metallic debris released as the devices wear.” In resurfacing “more of a patient’s thigh bone is preserved than in a standard operation.” In the operation, “the components…are made of metals like cobalt and chromium,” and “metallic debris-related problems associated with all-metal standard hips have also turned up in some resurfacing patients.”
