Surgery

Shanghai hospital retrospective cohort study of 249 pts w/ post-Unilat TKA & lat knee pain. 144 Rx w/ IA steroids vs 105 Rx w/ PO meds. Infection rate w/in 6 mos post-TKA found no signif difference (2.1% vs 2.9%); Injx pts had signif better pain relief, QOL & knee function (KSS) https://t.co/ULVO6KU7pn
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JAMA Staphylococcus aureus Review - s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%) - bacteremia (≥48 hs) has 39% 90-day mortality risk https://t.co/1UQoz7JDPU https://t.co/xTAkakv2he

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Consensus Against Interventional Injections for Chronic Spinal Pain BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or https://t.co/mCsz88JACh
Dr. John Cush @RheumNow( View Tweet )
Joint Implant Metals May Be Leaking Patients with metal-containing joint replacements had significantly higher concentrations of cobalt in their cerebrospinal fluid (CSF) relative to patients without arthroplasties, researchers reported. https://t.co/ubDhWqtTSL https://t.co/GjMnog8mcJ

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Dr. John Cush @RheumNow( View Tweet )
Consensus Against Interventional Injections for Chronic Spinal Pain BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or https://t.co/PfXM210PsZ
Dr. John Cush @RheumNow( View Tweet )
Peripheral Nerve Blocks for Hip Fractures JAMA reviews the use of peripheral nerve block with hip fractures as an effective pain management strategy that can be performed by credentialed clinicians outside of the operating room. https://t.co/baeLWVxeUo https://t.co/ZBTVDT0jGR

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Japanese study of hip replacements (THA) - #RA pts undergoing THA at higher risk for dislocation and reoperation. Retrosp database study of THA - matching 3,951 RA vs 11,853 OA. w/ RA incr risk of dislocation (OR 2.8) & reoperation (OR: 2.25). No diff infx, Fx, VTE, death… https://t.co/Mz8niRlFaa https://t.co/mgcXTnw5Al
Dr. John Cush @RheumNow( View Tweet )
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Earlier ACL reconstruction and a lower risk of knee osteoarthritis

EurekAlert!

A preclinical study by HSS investigators found that earlier anterior cruciate ligament (ACL) reconstruction led to lower immune cell activity, less inflammation and fewer joint changes associated with knee osteoarthritis compared to delayed surgery. The research team shared their study

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2024.year.review

2024 Rheumatology Year in Review

Jack Cush, MD

2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians.  While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list

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A Review of Relapsing Polychondritis

Jack Cush, MD

A current review in the Journal of Thoracic Disease on relapsing polychondritis (RP), suggests that while this rare disorder may have an uncertain pathogenesis, its diagnosis and therapeutical management has improved.

This review focuses on key features, with damage to

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Ankle Fusion or Total Replacement? In a large study of British patients needing surgical treatment for advanced arthritis in the ankle, fusion appeared to be a better option than total ankle replacement. https://t.co/ZFbd2VinpP https://t.co/QCqMkxNLoQ

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Dr. John Cush @RheumNow( View Tweet )
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Opioid Deaths are Down (2.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!

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Postoperative Weight Loss Improves Joint Replacement Survival A cohort study of shows that postoperative weight loss with antiobesity medications significantly reduced the risk of 5-year and 10-year revision among patients with obesity undergoing hip or knee replacement.… https://t.co/u04Lc6DTT0 https://t.co/iZhEICFHUd
Dr. John Cush @RheumNow( View Tweet )
ankle.fusion.medpage

Ankle Fusion or Total Replacement?

Jack Cush, MD

In a large study of British patients needing surgical treatment for advanced arthritis in the ankle, fusion appeared to be a better option than total ankle replacement.

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Scale,weight

Postoperative Weight Loss Improves Joint Replacement Survival

Jack Cush, MD

A cohort study of shows that postoperative weight loss with antiobesity medications significantly reduced the risk of 5-year and 10-year revision among patients with obesity undergoing hip or knee replacement.

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Blood Flow Restriction to Reduce Pain in Knee OA

MedPage Today

A technique now widely used in sports medicine to speed recovery from leg injuries helped reduce symptoms and improve function in people with osteoarthritis (OA) of the knee, a randomized trial showed.

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Happy Diwali (11.1.2024)

Jack Cush, MD

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?

Jack Cush, MD

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

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dupuytrens

Treatment Options for Dupuytren’s Contracture

Jack Cush, MD

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

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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

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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

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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

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Dr. John Cush @RheumNow( View Tweet )
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RECIPE Study: Non-opioid Analgesics following Total Hip Arthroplasty

Jack Cush, MD

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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