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Study: 1/3 of knee replacements are questionableWhether to replace aging knees can be a tough decision. More than 650,000 Americans underwent total knee replacement surgery last year, but a new paper from researchers at Virginia Commonwealth University suggests that a third of those were not “appropriate,” based on standard medical criteria. The study authors analyzed 175 cases, looking at imaging tests to find the degree of arthritis, as well as each patient’s age and reported pain level. Only 44% of the operations were rated “appropriate.” Thirty-four percent were “inappropriate,” while 22% were inconclusive. But appropriateness is in the eye of the beholder, says Dr. Jeffery Katz, an orthopedic surgeon at Brigham and Women’s Hospital in Boston. When the current criteria were developed in the late 1990s, knee replacement “was considered a treatment of last resort,” Katz writes in an editorial published alongside the study in the Journal of Arthritis and Rheumatism. Today, many are being done in relatively healthy people in their 50s and 60s. Some shoe insoles don't relieve knee painFor patients with medial knee osteoarthritis, lateral wedge insoles do not reduce knee pain, according to a new study published in the Journal of the American Medical Association. Medial knee osteoarthritis is when the cushioning layer (cartilage) between the knees deteriorates over time resulting in the bone rubbing against each other leaving a person with knee pain, stiffness and swelling. This injury is becoming more prevalent and can make some everyday activities more difficult, including walking, running and using stairs. Obesity, genetics, biological and environmental factors as well as increased usage can make someone more prone to developing knee osteoarthritis. Using shoe inserts is a fairly common treatment for knee pain because it's not invasive and it's fairly inexpensive. Researchers reviewed 12 studies that included a total of 885 participants, 502 who received lateral wedge insoles for the treatment of knee pain. "We don't seem to see a difference in pain when using a lateral wedge compared to a flat wedge," said lead study author Matthew Parkes. Parkes, who is also a statistician at the University of Manchester, noted that although using the lateral wedge seems like an attractive treatment because it's not invasive - and pretty cheap - the data doesn't support an average overall effect. More kids injured playing football, soccerFootball injuries among children have increased 22% in the last decade, according to a new study. Overall, however, sports injuries among children have decreased. The findings surprised Dr. Shital Parikh, associate professor of orthopaedic surgery at Cincinnati Children’s Hospital and the study's lead author. Parikh will present his research at the American Academy of Orthopaedic Surgeons’ annual meeting on Thursday. When he started analyzing the numbers from the National Electronic Injury Surveillance System, Parikh expected to find a big increase in kids’ injuries based on what he and his colleagues have seen in their practice. Instead he found that the overall number of activity injuries for kids aged 5 to 14 decreased 11.3%. The researchers looked at data from bicycle, basketball, football, roller sports, playground equipment, baseball/softball, soccer and trampoline injuries. Study: Vitamin D lowers bone-fracture risk only at high dosesIf you're wondering whether to take a vitamin D supplement to keep your bones healthy, it's understandable if you - and even your doctor - are at a loss. Vitamin D is essential for bone health, but the research on supplements has been inconsistent. Some studies have concluded that vitamin D supplements can lower the risk of bone fractures, while others suggest the pills provide little to no benefit. The latest study on the topic, published today in the New England Journal of Medicine, may help clear up some of the confusion. 'Love for Alyssa': Examining arthrogryposisArthrogryposis has presented many challenges to Alyssa Jadyn Hagstrom. At just 8 years old, the condition has left her with no use of her legs and arms, and limited use of her fingers. Alyssa is the subject of photographer Jennifer Kaczmarek’s exhibition called “Love for Alyssa,” which aims to use photography, video and an online blog to raise funds for Alyssa’s and others’ medical needs. The project has put a spotlight on the little-known condition. Arthrogryposis causes limited range of motion in children’s joints and affects one in 3,000 infants, according to Donald Bae, an orthopedic surgeon at Boston Children’s Hospital. Study questions efficacy and safety of knee injectionsIf you're one of the estimated 27 million Americans with osteoarthritis, you're probably all too familiar with the feeling of aching, swollen, or stiff knees. Nonsteroidal anti-inflammatory drugs such as ibuprofen may relieve those painful symptoms in most patients. But for others, doctors may prescribe a more invasive treatment that involves injecting hyaluronic acid in to the knee, called viscosupplementation. Now, a new report questions the efficacy of this treatment for osteoarthritis in the knee. Hyaluronic acid is a lubricating fluid that is naturally found in the knee, but degenerates over time in people with osteoarthritis. The effect of the injection used in viscosupplementation is to stimulate cells in the knee to increase production of hyaluronic acid. Will my meniscus tear heal without surgery?Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society. Question asked by Gloria from San Antonio, Texas I just learned I have a tear in my meniscus. Can this heal any way other than surgery? Knees bearing the weight of obesityObesity isn’t just about waistlines or clothing sizes. The toll of carrying all that excess weight affects your joints, and your knees can take a pounding. Four studies presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons, examined how the heavier Americans have gotten, the more stress they’ve put on their knees. A Harvard Medical School research team found that the number of total knee replacement surgeries has doubled from 1997 to 2007. FULL POST Torn ACL may not always mean surgeryTearing an ACL doesn't always mean a trip to the operating room, especially if you're young and active, researchers report in the New England Journal of Medicine. The knee's ACL, or anterior cruciate ligament, acts like a rubber band that connects your thigh bone to your leg bone. It provides stability to the knee especially when playing sports such as soccer, basketball or tennis that call for stopping, planting and pivoting. When it pops or tears it requires a trip to your doctor. FULL POST Glucosamine no relief for low back pain sufferers![]() New research leaves more questions than answers for those with chronic low back pain. A study released Tuesday in the Journal of the American Medical Association suggests glucosamine pills do not provide relief for lower back pain. The study, conducted at Oslo University Hospital in Norway, looked at 250 people over the age of 25, with chronic low back pain who also had degenerative discs in their lower backs. Researchers gave half of the patients daily doses of 1,500 miligrams of glucosamine. The other half received a placebo. |
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love. ![]() ![]() |
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