American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting

SAN FRANCISCO, Feb. 8, 2012 /PRNewswire-USNewswire/ -- The 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) takes place this week at the Moscone Convention Center in San Francisco.  Each day, the public relations department will send the most newsworthy components of the meeting.  To schedule an interview about any of the topics below, contact AAOS public relations.

Media Highlights:

Video-Based Home Exercise Can Minimize Osteoarthritis Pain, Improve Mobility

• Exercise did not stop osteoarthritis progression

The benefits of exercise in minimizing pain and improving mobility for individuals living with osteoarthritis has been well documented. Over a one-year period, 107 individuals with diagnosed osteoarthritis in the knee were randomized to either a DVD-based exercise group, or a control group. The "DVD" group received a DVD-based exercise program, as well as verbal and hands-on exercise instructions, for the first four to eight weeks. The individuals in both groups were evaluated at three, six and 12 months. Participants in the exercise group reportedly exercised 5.3, 5.0 and 3.8 times per week at three, six and 12 month intervals.  The improvements in pain and physical function were significantly greater in the DVD group than the control group at all intervals. However, there were no significant differences between the two groups in osteoarthritis progression. Video-based home exercise programs can enhance adherence to a prescribed exercise program, can reduce pain, improve physical function, and improve life quality in patients living with knee osteoarthritis.

Anxiety Trait Linked to Postoperative Pain in Men Following Total Knee Replacement

• Women less satisfied with pain control after surgery

Increased pain following surgery has long been linked to anxiety and "catastrophizing," an extreme response to stress. Ninety-seven patients – men and women – who were about to undergo minimally invasive total knee replacement (TKR) surgery, completed a brief survey to quantify their level of anxiety, as well as their typical level of anxiety and potential for catastrophizing. Pain data was then collected for seven days following surgery. Catastrophizing did not correlate with postoperative pain or pain medication use in either men or women, nor did a patient's level of acute anxiety. However, men with anxiety traits – a high level of anxiety unrelated to a stressful event – had higher post-operative pain ratings resulting in longer hospital stays. Women generally reported higher post-operative pain levels than men, and women were consistently less satisfied with pain control. Further research is needed to identify patients most likely to have difficulty with TKR pain management.

Antidepressant Use Linked with Less Patient Satisfaction after Hip Replacement

• Understanding a patient's mental health status before hip replacement surgery may improve education and care

Patients taking antidepressants up to three years prior to undergoing a total hip replacement (THR) were more likely to report greater pain  before and after surgery and less satisfaction with their procedure. In this investigation, 1,657 patients (13 percent of the study population) used antidepressants up to three years before surgery. The patients were surveyed before and one year after the THR. The investigators found that a patient's mental health status, assessed by the use of antidepressants before surgery, was a significant factor in predicting outcomes, as well as gender (men are more likely to report lower outcomes), advanced age and co-morbidity (other joint diseases or conditions which affect walking). According to the investigators, a patient's mental health status should be assessed prior to surgery and taken into consideration during post-operative care.

Excessive Sporting Activity May Impair Long-Term Success of Hip Resurfacing

• Patients should limit activities to maintain hip prosthesis

In hip resurfacing the femoral ball in the hip joint is not removed, but instead is trimmed and capped with a smooth metal covering.  Young and active patients with arthritis often choose hip resurfacing over total hip replacement to minimize the risk of hip dislocation and preserve bone for a revision surgery, should the primary resurfacing fail.  However, the long-term effects of sports on a resurfaced hip were unknown.  Investigators surveyed 445 patients between one and five years after hip resurfacing. Type of activity, frequency and duration of the sessions, and intensity of participation were documented. Over the next 10 years, each patient's hip status was monitored. The mean age of the patients was 48.7 years, and 74 percent were male. There was a correlation between higher activity scores and risk for surgical revision. Other independent risk factors for revision included small component size, low body mass index, and 1^st generation surgical technique. Patients with an Impact Score (IS) lower than 50 had a revision risk rate 3.8 times lower than the patients with an IS of 50 or greater. Survivorship for patients with a lower IS score at eight years was 96.4 percent versus 88.8 percent. Large amounts of high impact sporting activities – such as daily running or tennis– can be detrimental to the long-term success of hip resurfacing arthroplasty. Surgeons should advise patients to limit their physical activity to levels that the device can sustain.

Obese Children More Likely to Suffer Growth Plate Fractures

• Injuries in overweight and obese children more often from "low-energy" impact, and involve the growth plate

Obese children are 74 percent more likely to sustain a fracture of the growth plate, the softer end of the bone where growth occurs. The study involved 224 children visiting a Maryland hospital with a fracture. Information was collected on each patient regarding their sex, age, height, weight, fracture location and pattern. Patients ages 2 to 16 were divided into two groups for comparison: a "normal weight" group and an "obese/overweight" group for children with a body mass index (BMI) greater than the 85 percentile.  The overweight/obese group represented 41.3 percent of the fracture population, and had a statistically significantly higher rate of growth plate injuries (40 percent versus 23 percent). The study, which is ongoing, also looked at the type of incidents causing the fractures, and found that the obese/overweight children had a greater number of injuries resulting from "low-energy" contact or impact, such as falling from a standing position. The findings could provide greater insight into the inherent risks for overweight and obese children pertaining to exercise and physical activity.

Online Support Following Joint Replacement Surgery is Cost and Time Effective for Patients

• Fewer routine follow-up visits may improve physician access for critical care

Patients who have had a total joint replacement (TJR) are expected to return to their physician's office or clinic regularly for routine follow-up care. One year following TJR, 210 patients (with no known complications) either were asked to complete a Web-based follow-up, which included an online survey and an X-ray taken at the nearest Internet-enabled facility; or to return to the clinic/office for their regular appointment. The patients who chose the Web-based follow-up reported less travel-related costs ($4.00 versus $21.41), distance traveled (29.1 km versus 110.2 km), and time spent (44.6 minutes versus 55.6 minutes) on their routine follow-up care. In addition, patients in the usual care group missed 5.7 hours of work on average, and their caregivers, 6.4 hours. Web-based follow-up can provide significant time and cost savings to TKR patients without complications, and make the physician's office more accessible to new patients, patients awaiting surgery, and/or patients with post-surgical complications.

About the AAOS

With more than 37,000 members, the American Academy of Orthopaedic Surgeons, (www.aaos.org) or (www.orthoinfo.org) is the premier not-for-profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality of musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues. An advocate for improved care, the Academy is participating in the Bone and Joint Initiative (www.usbjd.org), the global initiative to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life.  The Academy's 2012 Annual Meeting is being held February 7 - 11, 2012 at the San Francisco Moscone Center in San Francisco.

SOURCE American Academy of Orthopaedic Surgeons