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Optimal Timing of Elective Hip or Knee Arthroplasty

Mar 14, 2023

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

Mar 13, 2023

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

Feb 27, 2023

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

Feb 09, 2023

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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Burnout #10 (2.3.2023)

Feb 03, 2023

Dr. Jack Cush reviews the past week of news on

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Periprosthetic Joint Infections

Jan 23, 2023

Recent NEJM has reviewed arthroplasty-associated infection and periprosthetic joint infections (PJI), noting this is a rare event; notably these infections are caused by skin microorganisms introduced during arthroplasty surgery or may be seeded post-surgically, via hematogenously spread or

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Substandard Therapy in Rheumatoid Arthritis

Medpage Today
Dec 13, 2022

Clinicians could improve outcomes in their patients with rheumatoid arthritis (RA) by paying attention to certain markers of care quality, such as early referral to certified rheumatologists and prescribing standard drugs for RA, new research suggested.

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Orthopedic surgery patients do fine without opioid painkillers

Oct 05, 2022

Hamilton, ON (Oct. 4, 2022) – Patients can recover from orthopedic surgery just as well without using opioid-based painkillers, says a McMaster University and Hamilton Health Sciences (HHS) study published by the Journal of the American Medical Association (JAMA).

Study results showed

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Simultaneous Versus Staged Knee Arthoplasty?

Jun 23, 2022

Aside from cost, there are significant concerns regarding efficacy and safety outcomes and recovery time. These issues are compounded with the need for bilateral TKR, wherein the patient and surgeon need to decide whether to have both TKRs done simultaneously or staged (single TKR one after

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Updated ACR/AAHKS Guidelines on Drug Use in Knee & Hip Arthroplasty Patients

Feb 28, 2022

The American College of Rheumatology and the American Association of Hip and Knee Surgeons released a summary of their updated guideline for the Perioperative Management of Antirheumatic Medication in Patients with Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty.

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Hand OA and Heroes in Rheumatology (2.11.2022)

Feb 11, 2022

Interesting reports this week about dementia, who gets hand OA and a great list of women Heroes and Pillars of Rheumatology. Tune in as Dr. Jack Cush reviews the news and journal articles from this past week in

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Best of 2021: Jack of All Subspecialties

Dec 31, 2021

It's great to be a rheumatologist, but boy, it's getting harder and harder. You have to be a jack of all trades. You have to be good at cardiovascular disease, osteoporosis, vaccination, inflammatory bowel disease - it just never ends. This and more, as Dr. Cush summarizes more than a dozen

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Indications Awaiting (12.17.21)

Dec 17, 2021

There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory

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RheumNow Podcast – #ACA: Ask Cush Anything (10.8.2021)

Oct 08, 2021

Arthritis numbers are rising, and people are finally talking about osteoarthritis. Also, ACR 2021 is just a few weeks away - are you ready? Finally, I'll review cases and questions submitted by viewers in Ask Cush Anything (#ACA). This, and nearly a dozen news items and reports, are discussed in

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RheumNow Podcast – Jack of All Subspecialties (10.1.2021)

Oct 01, 2021

Dr. Jack Cush reviews the news and journal articles from the past week on

  1. A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of JIA, although infections during fetal

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Post-Arthroscopic Increase in Septic Arthritis

Sep 27, 2021

A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern.

Between 2003-2017 they identified 299 NJI (40 children and 259 adults) with more infections in men (33% women vs 67

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RheumNow Podcast – Driving in Pain (8.20.2021)

Aug 20, 2021

You know, I'm a very good driver. We all think we're great drivers - but consider what it's like to drive in pain: would you be a good driver? Also, I want you to consider the diagnosis of calcium pyrophosphate dihydrate disease (CPPD). But first, let's look at a study out of Scotland, looking

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RheumNow Podcast – Booster Shots for COVID (8.13.2021)

Aug 13, 2021

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

  1. In a head to head trial Upadacitinib was superior to Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis. 24wk DBRCT, 924 pts given either UPA 30/d vsDUP 300 EOW. ESI75 response@

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Biologics Reduce Surgical Needs in RA

Aug 10, 2021

In Canada, biologic DMARDs (bDMARDs) were introduced after 2001, and since that time there have been significant reductions in hip and knee arthroplasty (THA/TKA) among patients with rheumatoid arthritis (RA), but not in patients with osteoarthritis (OA).

A cohort of RA and OA

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Lumbar Spine Decompression Alone is Superior to Decompression with Fusion

Aug 05, 2021

The NEJM has published a multicenter study wherein patients with surgical lumbar spinal stenosis and degenerative spondylolisthesis were found to fair equally well (noninferior if treated with decompression surgery alone compared to decompression with instrumented fusion.

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Delays in Joint Replacement as JIA Patients Reach Adulthood

Aug 05, 2021

A retrospective cohort study examined the need for joint replacement surgery in juvenile idiopathic arthritis (JIA) and showed there has been a trend to delay arthroplasty over time. The JIA category, year of implant, and presence of complications significantly affected implant survivorship

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RheumNow Podcast – Psoriatic Arthritis Without Psoriasis (7.30.2021)

Jul 30, 2021

How much psoriasis do you need to have in order to have psoriatic arthritis? This plus a review of rheumatology and COVID news from the past week on

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RheumNow Podcast – As Good As I Ever Was (7.2.2021)

Jul 02, 2021

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

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Knee Replacement in Obese OA is Cost Effective

Jun 24, 2021

Debates over ideal candidates for total knee replacement (TKR) in osteoarthritis patients often excludes those who are obese, but a recent article in the Annals of Internal Medicine suggests that TKR is both effective and cost-effective in obese patients (BMI >40 kg/m2)

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No requirement to stop cDMARDs before surgery. For biologics stop 1 dose before and restart 14 days post op, JAKi stop 7 days before, restart 14 days post op, glucocorticoids >10mg/day increases risk of infection in #rheumatoidarthritis Michael D George #EULAR2021