AAOS Now, September 2012
Supplements for OA: An Unconvincing Story
The glory days for glucosamine began in 1996 with the publication of The Arthritis Cure, by Jason Theodosakis, MD. Millions of people with painful osteoarthritis (OA) flocked to the supplement, along with its common sidekick chondroitin, hopeful that finally something could provide relief for their condition.
FDA Panel Examines MoM Hip Devices
In nearly 23 hours of testimony and deliberations over 2 days in June, the U.S. Food and Drug Administration’s (FDA) Orthopaedic and Rehabilitative Devices Panel (ORDP) considered expert scientific and clinical opinion on the risks and benefits of metal-on-metal (MoM) hip replacement and resurfacing devices.
Tissue Allografts: Source and Distribution Concerns
Recently, a fair amount of media attention, particularly through radio and Internet sources, has focused on allograft tissue. These reports concentrated on the source of human allograft tissue and its eventual use with respect to the informed consent of the donor’s families. Although most of the material presented was factual, the overall messages were that allograft tissue may be unsafe due to its source and that many tissues are used inappropriately.
Preventing Bone Healing from Going up in Smoke
Dioxins are highly toxic chemical by-products of combustion. Perhaps best known as a contaminant in the defoliant Agent Orange used during the Vietnam War, dioxin caused health problems in millions of people who were exposed to it during that conflict. A dioxin was used to poison Ukrainian president Viktor Yushenko in 2004. Many people, however, may not be aware that dioxins are also present in cigarette smoke.
Skin Patch Testing and Associated Total Knee Outcomes
Cutaneous reactions to metals used in orthopaedic implants have been well documented since the 1970s. Recently, a rise in the incidence of cutaneous reactions has been ascribed to certain metals and types of implants. Whether cutaneous reactions are the dominant symptom associated with hypersensitivity responses to implanted orthopaedic devices is controversial. Some reports have shown a poor correlation between skin testing and implanted materials.
New Treatments to Prevent, Delay Osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability worldwide. The disease has traditionally been associated with aging and described using clinical and radiographic criteria reflective of advanced biologic and structural changes of joint destruction. Consequently, disease-modifying treatments are lacking and clinical treatment of OA is palliative until joint replacement.
Get Involved in the AUC Process
Every day, orthopaedic surgeons and their patients are faced with making decisions about treatment options that, unfortunately, often don’t have strong evidential support. In addition, what might be considered appropriate care for a 35-year-old generally healthy patient might not be appropriate for a 70-year-old patient with multiple comorbidities. Clinical practice guidelines (CPGs) may provide some direction.