In The News: May 2019
Most Knee and Hip Replacements Last 25 Years
Joint replacement surgery is an option for people with severe osteoarthritis in the hip or knee that can no longer be helped with nonsurgical measures. The surgery has a high success rate. However, over time the implants eventually fail due to loosening, infection, instability and other reasons. Two studies published in The Lancet (February 2019) reviewed a large number of studies in order to estimate how long a hip or knee replacement can be expected to last. One of them analyzed results from studies that included a total of 6,490 people who had total knee replacement and 742 who had partial knee replacement. About 82 percent of the total knee replacements lasted 25 years, as did 70 percent of the partial replacements. In a separate review, which included studies with a total of 13,212 total hip replacements, 58 percent of them lasted 25 years.
Jawbone Problems Rare in Women Taking Osteoporosis Drugs
A potential side effect of osteoporosis drugs that many people fear is jawbone deterioration (called osteonecrosis of the jaw [ONJ]). This rare side effect has been reported with the class of drugs called bisphosphonates (alendronate [Fosamax®], risedronate [Actonel®], zoledronic acid [Reclast®] and ibandronate [Boniva®]) and the drug denosumab (Prolia®). A study published in the Journal of Clinical Endocrinology & Metabolism (February 2019) examined data from a study of women who used Prolia for up to 10 years. The rate of ONJ was higher among those who reported having had an invasive dental procedure (such as an implant, tooth extraction or jaw surgery) or tooth loss. (Teeth cleaning, cavities and crowns are not invasive.) The rate was still extremely low. Over 10 years, 0.68 percent of those who had an invasive dental procedure developed ONJ, compared with 0.05 percent of those who did not have such a procedure.
High-Protein, Low-Calorie Diet Helps Weight Loss, Bone Health
Overweight and obese older adults must be careful about how they go about losing weight to avoid muscle and bone loss. A study published in four journals, including the American Journal of Clinical Nutrition (February 2019) compared a weight-loss diet to weight stability in 96 adults over age 65. As directed by the researchers, the weight-loss group consumed a low-calorie, nutritionally complete diet that included 1 gram of protein per 1 kilogram (kg) of body weight. (1 kg = 2.2 lbs.) The weight-stability group attended health education classes, and members were encouraged to maintain their weight. After six months, those in the weight-loss group lost an average of 18 pounds and preserved muscle mass. The weight-stability group lost an average of one-half a pound. Despite weight loss, those in the weight-loss group maintained bone density and quality. Bone density in the lower spine increased.
Yoga as Adjunct to Drug Treatment May Help Rheumatoid Arthritis
Studies have shown that yoga can ease pain and reduce disability for people with osteoarthritis and back pain. New research, published in the journal Restorative Neurology and Neuroscience (February 2019), suggests yoga may be helpful for people with rheumatoid arthritis as well. The primary treatment for rheumatoid arthritis, which is an autoimmune disease, is disease-modifying antirheumatic drugs (DMARDs), which target inflammatory cells of the immune system. Nondrug strategies should also be part of treatment. Yoga is a mind-and-body practice that combines breathing, meditation and motion. For the study, 72 people with rheumatoid arthritis were divided into two groups. Both groups took DMARDs. One group also had eight weeks of yoga classes. The yoga group had a greater decrease in severity of symptoms and a drop in symptoms of depression compared to the control group.