News February 2014 Issue

In The News: February 2014

Knee Replacement Postponed with Injections
Injections of hyaluronic acid may help delay total knee replacement in patients with knee osteoarthritis (OA), according to a study presented at the annual meeting of the American College of Rheumatology (Oct. 31, 2013). Among those who had total knee replacement due to severe OA, patients who received hyaluronic acid injections had the surgery up to 2.6 years later than those who didn’t have injections, the research reported. After analyzing data from more than seven million individuals, the researchers found that of the 26,627 patients diagnosed with OA and had total knee replacement, 7,000 had received at least one injection of hyaluronic acid. A total of 79 percent had undergone a single injection, 16 percent had two, 4 percent had three, and 1 percent had four or more. The study showed that the more injections a person received, the longer he or she was able to delay total knee replacement: 162 days for one injection, 343 for two, 584 for three, and four injections allowing a delay of 740 days. More studies are needed to determine the role of hyaluronic acid injections on delaying total knee replacement.

10 Percent of Adults Physically Limited by Arthritis
More than 50 million Americans have arthritis, and almost half of them cannot perform normal daily activities, officials from the Centers for Disease Control and Prevention (CDC) reported in Morbidity and Mortality Weekly Report (Nov. 8, 2013). The CDC researchers found that of those 52.5 million affected by some form of arthritis, 22.7 million have limited mobility as a result. The report includes those with osteoarthritis (OA), rheumatoid arthritis (RA), lupus, gout or fibromyalgia. Results from the study found that about half of adults with heart disease or diabetes also had arthritis. For more than one-quarter of these adults, arthritis limited their mobility. Obese adults accounted for one-third of those with arthritis, 15 percent of whom were physically limited by the condition.

Fibromyalgia Patients Process Pain Differently, Study Suggests
New research gives insight as to why fibromyalgia patients are not able to prepare for pain as well as their healthy counterparts. A study reported online in Arthritis & Rheumatism (Nov. 6, 2013), showed that patients with fibromyalgia exhibit disrupted brain responses during both anticipation of pain and anticipation of relief. This study identifies that those with the condition show less activation in brain responses to pain-related “punishment and reward” anticipatory signaling on functional MRI tests. Compared with fibromyalgia patients, research controls had significant increases in signaling in the right ventral tegmental area (VTA)—an area where a grouping of neurons communicate the anticipation of pain and a tendency for greater signal activation when experiencing pain. The results suggest that patients with fibromyalgia experience blunting of anticipatory pain and relief responses, giving a possible explanation as to why they have diminished responses to painful stimuli in so-called reward regions of the brain. This may also account for why those with the condition don’t typically respond to opioid-induced analgesia, the research notes.

Gout: A Family Affair
A cross-sectional study confirms that gout clusters within families, with increased risks being seen for individuals with affected close relatives. Among those with affected first-degree relatives—parents, offspring or siblings—the relative risk of gout for men was 1.91 (95 percent) and 1.97 (95 percent) for women, according to research reported online in Annals of the Rheumatic Diseases (Nov. 25, 2013). For those with affected second-degree relatives—grandparents, uncles and aunts, and nieces and nephews—men had a risk of 1.27 (95 percent) and women a risk of 1.40 (95 percent). Risks rose additionally when more than one relative had a diagnosis of gout.