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Happy Diwali (11.1.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

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Should They Put Off Hip Replacement Surgery?

The NEJM reports what should be obvious to rheumatologists: that older adults with severe hip osteoarthritis should opt for total hip replacement (THR) over conservative exercise measures as THR yields a clinically important improvement in pain and function.

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Treatment Options for Dupuytren’s Contracture The NEJM reports that in a randomized, controlled, head to head trial, collagenase injections were non-inferior to limited fasciectomy in the treatment of Dupuytren’s contracture. https://t.co/HTW9za8a10 https://t.co/gStCic7x2D
Dr. John Cush @RheumNow( View Tweet )

Treatment Options for Dupuytren’s Contracture

The NEJM reports that in a randomized, controlled, head to head trial, collagenase injections were non-inferior to limited fasciectomy in the treatment of Dupuytren’s contracture.

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Claims study presented at SASM mtg by HSS orthopedists found among >100k Hip/Knee replacement surgeries, the 19% who used CPAP (OSA) had significantly fewer ER visits and postop complications. https://t.co/kg7oCRndqH https://t.co/WRcxUD3c6V
Dr. John Cush @RheumNow( View Tweet )
Postop periprosthetic femoral Fx (POPFF) post hip replacement (THR) is uncommon. POPFF needing surgery 0.92 per 1,000 prostheses years; higher in elderly (1.31) & w/ THR for hip Fx (2.19). 1% risk of POPFF w/in 10yrs of THR (15% these die w/in 1 yr) https://t.co/8u3WUWhHnU https://t.co/LfOSPpYbzw
Dr. John Cush @RheumNow( View Tweet )
Wales registry of primary Unilateral knee replacements (UKRs) for #OA (n 106,206) found no outcome differences based on level of training (15 yr UKR failure rates equal for Trainees/16.4% vs Consultants/17.13% https://t.co/uIo4Sv8Lfu https://t.co/LEMrf3vHaR
Dr. John Cush @RheumNow( View Tweet )
Anterior Cruciate Ligament Injuries are more commone in Female Athletes compared to males playing same contact sports. From 1990-2020, ACL injuries decreased in males by nearly 30%, but did not change in women, who are also less likely to return to sport https://t.co/EiyU440vRT https://t.co/QvYiSOVQZr
Dr. John Cush @RheumNow( View Tweet )

RECIPE Study: Non-opioid Analgesics following Total Hip Arthroplasty

Patients undergoing total hip arthroplasty using a combination of paracetamol, ibuprofen, and dexamethasone, had optimal responses with the lowest morphine consumption, and fewer adverse events.

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1/600 Falls May Die (4.5.2024)

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

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Activity & Pain Tolerance (3.29.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including where you should sit in clinic and why you should worry about secondary Sjogren's in RA.

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Preoperative Delay & Education Benefits Arthroplasty Patients

Medpage Today

Having patients waiting for knee arthroplasty undergo a preoperative program of weight loss, exercise, and other interventions gave them modestly improved pain, function, and quality of life, a small randomized trial showed.



The main point of this pilot study, however, was simply to

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Could Weight-Loss Drug Improve Hip Replacement Outcomes?

MedPage Today

The antidiabetic and weight-loss drug semaglutide (Ozempic, Wegovy, Rybelsus) either does or does not help patients undergoing total hip arthroplasty (THA) avoid complications and other poor outcomes, according to two retrospective studies presented here.

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Methotrexate Nodulosis (1.19.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. How good (or not) are rheumatologists and what to do about MTX nodulosis?





  1. Network meta-analyses of 153 trials & 8713 patients w/ chronic pain from TMJ disorders; Most effective (

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Venous Thromboembolic Risk with Joint Replacement

The role of thromboprophylaxis following total hip (THA) or total knee arthroplasty (TKA) is uncertain and consensus is lacking. A recent study suggests that thromboprophylaxis strategies should be tailored to individual risk of thrombosis and bleeding.

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Incidence, Microbiological Studies, and Factors Associated With Prosthetic Joint Infection After Total Knee Arthroplasty

A study of nearly 80,000 US veterans who underwent primary knee joint arthroplasty (TKA) showed  the incidence of prosthetic joint infection (PJI) was highest in the first 3 months and remained elevated through 12 months compared with 12 months or more after surgery. Gram-negative

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Hard Decisions in RA (9.1.2023)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow, and introduces our September campaign - "Hard Decisions in RA".

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ICYMI: Carpal Tunnel - Steroid injection vs. Night Splinting

A prospective, pragmatic, open-label, randomized trial conducted by the UK National Health Service, studied interventions in patients with carpal tunnel syndrome (CTS) and found no advantage to either CTS corticosteroid injection (CSI) or night splinting (NS) as the initial treatment of CTS.

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EULAR 2023 – Day 1 Report

EULAR 2023 launched today to crowds of attendees.  The opening Plenary session and presidential address by Dr. Ian McInnes was followed by a number of overview and review sessions with but a half-day of abstracts presentations, on several therapeutic areas including osteoarthritis, JIA,

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Microbiome of Hip and Knee Osteoarthritis is not "Sterile"

EurekAlert!

Next-generation DNA sequencing (NGS) techniques show the presence of bacterial DNA in surgical specimens of hip and knee arthritis, from patients undergoing first-time total joint arthroplasty, reports a study in The Journal of Bone & Joint Surgery

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Want to Go Far, Go Together (4.21.2023)

This week on the podcast Dr. Jack Cush reviews the news, regulatory announcements and novel journal reports including a profile on pseudogout, the safety of immune checkpoint inhibitors in RA patients and the diagnostic importance of neutrophils.





  1. CIRCS study: Comparison of

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Optimal Timing of Elective Hip or Knee Arthroplasty

ACR

The American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) released a summary of its new guideline titled “The Optimal Timing of Elective Hip or Knee Arthroplasty for Patients with Symptomatic Moderate to Severe Osteoarthritis or Osteonecrosis Who

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Carpal Tunnel - Steroid injection vs. Night Splinting

A prospective, pragmatic, open-label, randomized trial conducted by the UK National Health Service, studied interventions in patients with carpal tunnel syndrome (CTS) and found no advantage to either CTS corticosteroid injection (CSI) or night splinting (NS) as the initial treatment of CTS

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An Alternative Pain Protocol Following Knee Replacement Surgery

EurekAlert!

A study led by Vinod Dasa, MD, Professor of Orthopaedics at LSU Health New Orleans School of Medicine, reports that a novel surgical pain management strategy following total knee arthroplasty (TKA), or total knee replacement, provided pain relief without opioids. The researchers also found

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Without DMARDS, Shoulder Arthroplasty Increasing in Rheumatoid Arthritis

The need for total shoulder arthroplasty (TSA) in rheumatoid arthritis (RA) patients appears to depend on the use of disease modifying antirheumatic drugs (DMARDs), according to Seminars in Arthroplasty.

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