In The News: 10/07
Effectiveness of Hip Protectors Questioned
Use of a hip protector does not necessarily provide protection against a hip fracture. Researchers at Harvard Medical School tested the effectivenesss of energy-absorbing hip protectors in reducing fractures among 1,042 residents of 37 nursing homes. After a 20-month follow-up, they found that fractures on protected hips (3.1 percent) did not differ noticeably from those on unprotected hips (2.5 percent). An earlier study found that hip protectors used by 299 nursing-home residents had a preventive potential of only 50 percent, a finding based on residents wearing the hip protector in the correct position each day.
Five Percent Weight Drop Can Reduce Knee OA Pain, Disability
If you need more evidence that maintaining proper weight is important in relieving the pain of knee osteoarthritis (OA), a Danish study reports that shedding just five percent of body weight within a 20-week period is enough for overweight people to feel and function better. The study, which included 454 patients, also found that disability was significantly improved when weight was reduced by more than five percent. Researchers concluded that weight loss is most effective when combined with exercise, especially walking and weight training. They also acknowledged that although a five percent weight loss may improve pain and function, it does not slow the progression of OA. A new five-year study—IDEA (Intensive Diet and Exercise for Arthritis)—is being undertaken to determine whether a 10-15 percent weight loss can slow the progression of knee OA.
Low-Dose Steroids May Slow RA Progression
Low-dose glucocorticoids such as beclomethasone, prednisone, prednisolone, cortisone, and hydrocortisone given with standard disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, significantly slow the progression of rheumatoid arthritis (RA)—at least for up to two years. Researchers at the Cochrane Collaboration examined 15 trials involving 1,414 RA patients from 1955 to 2005 and found that glucocorticoids—using a mean annual cumulative dose of 2,300mg of prednisone—improved RA joint erosions after one year by 60 percent and by 58 percent at two years. Although the study’s authors deemed it likely that patients with RA for three or four years would also benefit, they were reluctant to extrapolate their findings without more evidence of benefit. They also found that although low-dose glucocorticoids did not increase the risk of glucose intolerance or cardiovascular disease, they may increase the risk of osteoporosis and weight gain.
Men Experience Faster Recovery After Knee Surgery
In terms of knee pain and function, men recover more quickly than women in the first year after "keyhole" surgery (performed through a small incision using endoscopic instruments) to repair a damaged meniscus. In a study conducted at the Yale University School of Medicine, 126 patients underwent arthroscopic partial meniscectomy. Researchers found that although patient age, body mass, and the amount of tissue involved and resected had no impact on recovery, female gender did. Authors of the study said the reasons are unknown, but indicated it might be related to gender differences in hormones or the biomechanics of the knee.
Gout May Increase Cardiovascular Mortality
Men with gout are more likely to die of a heart attack than men without gout. After a 16-year follow-up of 9,105 men between the ages of 41 and 63, a research group at the University of Pittsburgh found that men with gout were nearly 50 percent more likely to die of acute myocardial infarction (MI). Researchers suggested that uric acid may be a marker for oxidative stress, which can lead to a heart attack. The study pointed to the need for aggressive screening of gout patients for cardiovascular risk factors, suggesting that a physician’s approach to gout should be similar to that for diabetes, ensuring that the patients’ eyes and cholesterol are normal and that they exercise.