News April 2007 Issue

In The News: 04/07

Exercise Before Joint-Replacement Surgery Aids Recovery

Exercise before knee or hip replacement surgery provides multiple benefits, including faster recovery and less pain, according to a study published in the October 15, 2006 issue of

Arthritis & Rheumatism. Seventy-eight arthritis patients were assigned to an exercise or education group before undergoing surgery. For the next six weeks, the exercise group participated in weight-lifting, water exercises, stretches, and cardiovascular training. Sixty-five percent of those in the exercise group were discharged directly to their homes after surgery, compared to 44 percent of those in the control group. Participants in the exercise program also reported that they were able to function better and had less pain.

Sacroplasty Offers Relief From Back Pain

Sacroplasty can dramatically reduce lower-back pain caused by fractures in the sacrum (the large triangular-shaped bone made up of the five vertebrae in the lumbar region), according to a study released during the 2006 annual meeting of the North American Spine Society. In this procedure, similar to kyphoplasty—a minimally invasive surgery used for treating vertebral fractures caused by osteoporosis—a cement-like substance (polymethylmethacrylate) is injected into the sacrum to stabilize the vertebrae. In the study of 25 patients with osteoporosis, one in seven experienced complete relief within 30 minutes of the procedure, and nearly 25 percent were pain-free within two weeks. A third of the patients reported the same results a month after the procedure, and all but two patients said they were 75 to 100 percent satisfied with the treatment one year later.

Smoking Increases Pain, Cartilage Loss In Knee OA

Male smokers who suffer from knee osteoarthritis (OA) experience greater cartilage loss and more severe pain than men who do not smoke, according to a report in the January 2007 issue of

Annals of the Rheumatic Diseases. The study examined 159 men, 19 of whom were between age 62 and 69 and were smokers when the study began (other participants either never smoked or formerly smoked). Although the impact of smoking on cartilage loss is not understood, the study’s authors cited three factors that may be at play: the inhibition of cell proliferation, decreased oxidant stress, or the elevation of carbon monoxide in the blood. The findings were considered unique, since earlier studies showed no association between smoking and knee OA, with some even suggesting that smoking offered a protective benefit.

 

Women May Be Able To Discontinue Osteoporosis Drug Without Risk

The osteoporosis drug alendronate (Fosamax), if taken for five years, may have a lasting effect on the incidence of nonvertebral fractures, according to a report in the December 27, 2006 issue of the

Journal of the American Medical Association. A study examined 1,099 postmenopausal women and evaluated the effects on bone-mineral density of either continuation of alendronate (5 or 10 mg daily for 10 years) or discontinuing the drug after approximately five years. Researchers found that after five years the risk of fractures was not significantly different between those continuing and discontinuing the drug. However, they pointed out, women at high risk of vertebral fractures, or women with very low bone-mineral density, may benefit by continuing to take the drug beyond five years.

 

Antidepressants May Increase Bone-Fracture Risk

Pills designed to ward off depression may raise the risk of bone fracture in older adults. In a study appearing in the January 2007 issue of

Archives of Internal Medicine, people age 50 and older who took antidepressants faced double the risk of breaking a bone compared to those who didn’t use the drugs. Animal research, said the study’s authors, suggests that antidepressants may directly impact bone cells, lessening bone strength. Researchers further suggested that potential fracture risks should be weighed against the drugs’ effectiveness at treating depression, which can also be debilitating.