The addition of self-administered acupressure to knee health education sessions may relieve pain in patients with knee osteoarthritis, according to published results. Researchers performed a randomized clinical trial to evaluate rehabilitation outcomes in 314 patients (mean age, 62.7 years) who presented with probable knee OA from September 2019 to May 2022. They randomly assigned 157 patients to perform self-administered acupressure and 157 patients in a control group to receive knee health education sessions only. Patients in the acupressure group received two acupressure training sessions ..read more

Published results showed use of denosumab may reduce radiographic progression and prevent new erosive joints among patients with erosive hand osteoarthritis. Researchers randomly assigned patients with erosive hand OA to receive either 60 mg of denosumab every 3 months (n = 51) or a placebo (n = 49) for 48 weeks. Researchers considered change in the total Ghent University Scoring System score at week 24, where positive changes correspond to remodeling, as the primary endpoint. Secondary endpoints included change in the Ghent University Scoring System score and the number of new erosive joints ..read more

Women, regardless of whether they use oral contraceptives, may be less likely to develop musculotendinous injuries compared with men, according to published results. Researchers compared incidences of orthopedic musculotendinous injuries (MTI) between 42,267 women using oral contraceptives, 42,267 women not using oral contraceptives and 42,267 men. All cohorts were matched based on age and BMI. Researchers found 231 women (0.55%) using oral contraceptives, 1,078 women (2.55%) not using oral contraceptives and 1,476 men (3.49%) developed an MTI. After controlling for potential covariates ..read more

The incidence of pediatric knee injuries has been increasing in the last several years due to increased sports participation; in particular, the ACL is the most commonly injured knee ligament. Over time, treatment strategies of pediatric ACL injuries have changed from conservative to early surgical treatment. Indeed, it has been shown that not treating an unstable knee leads to a higher prevalence of meniscal and chondral injuries. The main problem with early treatment is possible physeal disruption, which may impair bone growth. To avoid this, several surgical techniques have been described ..read more

The number one financial goal for most physicians, including orthopedists, is getting to a comfortable retirement on their own timeline and with the lifestyle they want. This is borne out by independent physician studies and David’s experience of working with more than 1,500 physicians in his career. In continuation of our March article on three long-term strategies to implement in decades to meet one’s personal retirement goals, this installment explores targeted steps to ensure financial stability when one is within 10 years of retiring or in retirement already. Specifically, we ..read more

Click here to read the Cover Story, "Ideal total elbow replacement remains elusive." A posterior approach is indicated for both open reduction and internal fixation and total elbow arthroplasty, with multiple approaches described for navigating around the extensor mechanism. For total elbow arthroplasty, triceps options include the reflect, para-tricipital, split or tongue approach. The ideal approach provides adequate exposure enabling optimal placement of implants while minimizing soft-tissue disruption, additional injuries and complications. While dividing the triceps is seemingly risky, i ..read more

After the development of total hip arthroplasty in the 1970s, orthopedists continued to push surgical innovations to develop total joint replacement in other extremities. Despite the progress made with knee and shoulder replacements, elbow replacement continued to lag. “The main reason for the poor success rate of the early implants in the early ‘70s was because the design of implants had not matured enough to recognize the need to clearly understand the kinematics and the biomechanics of the [elbow] joint,” Bernard F. Morrey, MD, FAOA, clinical professor in the department of ..read more

A 42-year-old man with no past medical history and prescribed no medications presented to the ED with complaints of pain and swelling in his left lower leg during the last 48 hours. The patient noticed the pain while walking to work the day prior but denied any trauma or injury to the leg. The pain did not resolve with rest. He stated the pain and swelling were progressively worsening, and he was now having difficulty ambulating, prompting him to come to the ED. On initial ED evaluation, the patient’s distal left lower extremity was moderately edematous compared with the contralateral ..read more

The landscape of orthopedic surgery practice has significantly changed during the past decade, with a marked shift toward varied employment models over traditional private practices. The most recent American Academy of Orthopaedic Surgeons Census reported 30,141 orthopedists on record with the AAOS, with 36% of respondents in private practice –orthopedic group setting; 17% in hospital/medical centers and 14% in academic practice with the salary from an institution. The Physicians Advocacy Institute and Avalere Health reported 108,700 physicians left independent practice for employment as ..read more

According to published results, use of perioperative IV dexamethasone was not associated with increased risk of periprosthetic joint infection or wound healing complications after total shoulder arthroplasty. Researchers from the Keck School of Medicine at the University of Southern California analyzed data from 135,333 adults who underwent elective shoulder arthroplasty between 2016 and 2020. According to the study, 61.2% of patients underwent reverse TSA, 33.8% underwent anatomic TSA and 5% underwent hemiarthroplasty. Researchers compared outcomes between 89,266 patients (mean age, 69.1 ..read more