ORTHO NEWS

Experiencing joint pain? Try asking a robot for help!

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Have you ever thought twice about leaving the house because you don’t want to deal with pain in your knee or hip. It probably won’t surprise you that joint pain is a common reason for feeling that way. In fact, almost 25% of adults in the United States have arthritis, according to the Centers for Disease Control and Prevention.

Over half of people with arthritis are of working age, which means they may be limited in the type of work they do because it is too painful to walk from a parking lot to a building or climb the stairs to an office.

According to WebMD, even people in their 30s may begin to experience osteoarthritis, a type of arthritis associated with the natural wearing away of joint cartilage through daily use — so old age is not the only sign that aches and pains may be connected to arthritis.

“Potential signs could include chronic swelling or inflammation in the joint, among other symptoms,” said Joshua Johnston, an orthopedic surgery specialist with St. Clare Hospital in Lakewood. “The most important thing a patient can do is have a conversation with their doctor about joint health and the pain they may be experiencing.”

Advances in joint replacement

There are more than 1 million hip and knee replacement procedures performed every year in the U.S., with even higher numbers expected as Baby Boomers age, according to research in the Journal of Bone and Joint Surgery.

“We put a lot of wear and tear on our bodies, especially our joints and bones,” Johnston said. “Over the past few years, some individuals and their physicians may have delayed or deferred certain orthopedic procedures, such as knee and hip replacements. While understandable, these delays can have consequences, such as impaired mobility, persistent aches and pains, and increased use of medications.”

While joint replacements have been happening for over 100 years, the procedure is continually being improved upon by doctors and researchers. For example, the Mako SmartRobotics treatment from medical technology company Stryker has made joint replacements safer and more effective.

It uses three-dimensional CT scans to help a doctor see anatomy clearly and make a personalized surgery plan. It also uses a technology called AccuStop, which helps a surgeon cut precisely without unnecessary cuts to healthy bone.

“Mako has been associated with less pain, less need for opiate analgesics, less need for inpatient physical therapy, and a reduced length of hospital stay when compared to manual techniques,” Johnston said.

The procedure is highly effective, with 96% of Mako partial knee replacement patients reporting that they were satisfied or very satisfied in a three-year follow-up survey.

The data insights provided by Mako SmartRobotics also shows surgeons a comprehensive view of their performance over time and teaches ways to improve patient satisfaction. This information helps surgeons stay focused on patients and invested in their recovery.

Tacoma Rainiers fans can earn free tickets

Tacoma Rainiers fans — including Silver Sluggers members and anyone else who is interested — can learn more about how advanced technology like the Mako SmartRobotics treatment can keep people with joint pain active.

Johnston will teach a free seminar at Cheney Stadium on Sept. 15 from 6 p.m. to 7:30 p.m. Dinner will be provided, and everyone attending will receive an undated ticket voucher to be used for a future game during the 2022 Minor League Baseball regular season.

Seating is limited for the event, so learn more and register at stryker.link/tacoma to save a spot.

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Originally Appeared Here

Cutting-edge joint replacement options

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June 25, 2022

SETTING UP FOR A NEW KNEE—From left, Dr. Andrew Jeffers, medical director of the St. John’s Orthopedic Joint Program; physician assistant Andrew Duncan; and surgical services technician Alex Rosalez prepare for knee replacement surgery using the Zimmer Biomet’s ROSA system. Courtesy of Dignity Health

The St. John’s Orthopedic Center at St. John’s Hospital Camarillo offers two of the most advanced joint replacement surgical systems, Zimmer Biomet’s ROSA and Stryker’s Mako.

The first joint replacement using the ROSA was successfully performed by Dr. Andrew Jeffers, medical director of the St. John’s Orthopedic Joint Program, and the first Mako surgery was performed by Dr. Ryan Quinn, orthopedic surgery specialist.

ROSA, a hip and knee surgical system, and the Mako robotic-arm assisted system for knee replacements will provide patients with the latest robotic assisted technology equipped to customize joint replacements and are proven to deliver precise instrumentation.

For more information about the center, go to dignityhealth.org/stjohnscamarilloortho.

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The influence of HLA genotype on the development of metal hypersensitivity following joint replacement

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The Effects of Resistance Training on Muscular Performance – Athletic Health News

The results of resistance training on muscle growth are well documented. Skeletal muscle is the second most abundant tissue in the human body, composing ~40% of total body mass. It is a vital organ and has a major impact on overall health, fitness, and disease risk.

The most common reason for resistance training is to increase muscle size and/or strength. Resistance training programs can also improve flexibility, aerobic capacity, and body composition through fat loss.

Resistance training can be performed on multiple planes to work all the major muscles; however, each plane has its own unique features that affect performance. For example, exercises performed while seated or lying down mostly utilize the larger prime movers; in contrast, standing exercises engage many smaller stabilizing muscles as well as the prime movers.*

Plyometric training involves a rapid stretch of a muscle immediately followed by its contraction. This rapid stretching and contracting of a muscle causes it to lengthen and then shorten quickly. Because of this dynamic contraction and stretching, plyometric exercises cause more power development than ballistic exercise. Plyometric exercises include jump squats, box jumps, broad jumps, hurdle hops, vertical jumps, depth jumps from step or box, burpees, lateral bounds or side shuffles with hurdles (lateral bound), lateral

Resistance training is a broad term for exercise that develops strength or endurance by using the force of gravity or an external weight, such as in bodybuilding, weightlifting and strength training. Weightlifting is an example of resistance training that uses weights.

Toning the muscles (also known as shaping) is a form of resistance training, usually with free weights (dumbbells) or weight machines. Some toning exercises can be done at home, while others may require special equipment, such as elastic bands and weighted balls.

The result of resistance training on muscular performance is the creation of muscles that are larger, stronger, and leaner. This is accomplished through an increase in muscle fiber size as well as an increase in the number of muscle fibers. The ultimate result of resistance training with respect to muscular performance is the fact that the trained musculature is able to distribute greater force on a given load.

The larger the muscle, the more mitochondria, glycogen stores, and phosphocreatine. This is, in short, why larger muscles are known to produce greater force and power.

Resistance training is a huge benefit to the musculoskeletal system in general, and it also provides helpful hormonal, immunological, and metabolic effects.

Muscle tissue is made up of muscle fibers, which are comprised of single muscular cells. When an outside stimulus triggers a muscular response, the muscle cells work in tandem to contract the muscle.

Depending on the activity you’re engaging in, a specific energy system will dominate. Depending on the energy system that’s most active, a given amount of ATP will be required, produced, and stored for energy.

Resistance training is arguably one of the most beneficial and effective activities one can implement into their daily health and fitness regimen.

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An Athlete’s Guide to Exercise & Muscle Physiology

While exercise is commonly grouped into a rigid, singular activity, there are actually endless forms of exercise, each requiring its own set of unique muscular contractions, muscle fiber types, energy sources, and physiological demands.

When it comes to an athlete’s physiology, several factors influence the performance and health of the body. Moreover, the demands of a given sport or physical activity require a certain level of generated force and power by the musculoskeletal system.

Thus, many factors are linked to the makeup and functional capacity of the muscles that contribute to an athlete’s performance.

In what follows, we’ll be highlighting the basics of physiology and anatomy that apply to energy production, muscular contraction, and muscular performance of an athlete.

What is Exercise Physiology?

Physiology in general is defined as the study of the form and function within the human body.

Exercise physiology, which is often interchangeable with muscle physiology, is the study of the mechanics and musculoskeletal functions of the human body as it pertains to exercise and movement.

In order to gain a basic understanding of exercise or muscular physiology, it’s best to learn some basics about the cellular makeup and anatomy of the muscular system.

Cellular Makeup & Anatomy of the Muscular System

The purpose of this section is to provide you with an overview demonstrating the importance of muscle physiology and the role that it plays in exercise performance.

The muscular system or the musculoskeletal system is a body system similar to other body systems, such as the cardiovascular system, the skeletal system, the nervous system, and the digestive system.

By definition, the muscular system is responsible for controlling the movement of our body and internal organs, allowing for proper posture, and promoting healthy blood circulation.

The muscular system is made up broadly of three types of muscle, each containing hundreds of thousands of muscle fibers that are broken down further into three main subtypes.

The three main types of muscles are as follows: Skeletal, Cardiac (i.e., the heart), and Smooth (i.e., internal organs and eyes). In this content piece, we’ll be focusing on the skeletal muscles of the body.

The three main types of muscle fibers found in skeletal muscles are as follows: Type 1, Type 2A, and Type 2B. Type 1 is considered a Slow Twitch (ST) muscle fiber, while Type 2A and 2B are considered Fast Twitch (FT) muscle fibers.

The primary role of the muscles and muscle fibers of the body, especially in the context of an athlete, is muscle contraction. A muscle contraction refers to the ability of the muscle to shorten & lengthen, or put simply, to move.

The movement or contraction of a muscle is due to the singular muscle cells that are grouped together within muscle fibers. By working together, muscular cells are able to generate movement, and force and power are able to be exerted.

ATP Energy Production for Muscle Contraction

When it comes to producing muscular energy, there are three main systems at play depending on the muscle activity. The three energy systems are as follows:

ATP-PC System (Phosphagen System)
Glycolytic System
Oxidative System

During exercise, these individual systems are at work at different times during different exercises. In the following, we’ll take a deeper look into the roles of each. Before diving in, however, it’s important to define the following term, ATP (adenosine triphosphate).

ATP is simply the primary carrier of energy within the cells of our body. In the area of muscle physiology, it’s mainly responsible for sustaining muscle contractions. ATP is much more valuable during aerobic exercise versus anaerobic exercise.

ATP-PC System

This is an anaerobic energy system which is strongly associated with short-term, high-intensity activities. The term anaerobic means that the energy is produced without the use of oxygen. The phosphagen system, however, doesn’t have the capacity to produce or store ATP in large quantities.

Glycolytic System

When anaerobic activity lasts more than 20 to 30 seconds, the phosphagen system retires and the glycolytic system subs in.

Even though this is also an anaerobic system, it has the capacity to produce and store much more ATP for activity. In the glycolytic system, glycogen storage in muscles breaks down to glucose which helps make more ATP in the cells for energy.

Oxidative System

Distinct from the phosphagen and glycolytic systems, the oxidative system is 100% aerobic (uses oxygen). The oxidative system takes over for energy production at around the 3-minute mark of exercise. It is the main system for endurance activities.

While the oxidative system produces less ATP than the anaerobic systems, its use is much more efficient, making it an ideal energy system for long-distance runners.

Note that all three energy systems are always active at once, however, each has a time and place in which they’re dominantly active.

The Effects of Resistance Training on Muscular Performance

The larger the muscle, the more mitochondria, glycogen stores, and phosphocreatine. This is, in short, why larger muscles are known to produce greater force and power.

Resistance training is a huge benefit to the musculoskeletal system in general, and it also provides helpful hormonal, immunological, and metabolic effects.

Final Thoughts

Muscle tissue is made up of muscle fibers, which are comprised of single muscular cells. When an outside stimulus triggers a muscular response, the muscle cells work in tandem to contract the muscle.

Resistance training is arguably one of the most beneficial and effective activities one can implement into their daily health and fitness regimen.

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The Most Common Injuries in Track & Field Athletes – Athletic Health Guide

Track & Field is a sport that involves a combination of activities that require running, jumping, and throwing. Due to the broad scope of different activities within the sport as well as the physical demands required, competing athletes are at high risk for injury.

Even those that don’t compete at a high level but instead participate recreationally can still experience injury. In fact, 80% of injuries associated with running are simply caused by repetitive stress and overuse.

Other injuries can be caused by collision, impact, poor technique, and lack of strength. These injuries can range from mild to severe and even persist chronically if the proper treatment and preventative measures aren’t met.

In what follows, we’ll be discussing the most common injuries related to the sport of Track & Field. We’ll also discuss potential treatments and preventative protocol measures to combat such injuries.

Most Common Track & Field-Related Injuries

Like many true Track & Field athletes, those with the most rigorous of schedules are most likely to get injured. Unfortunately, because the sport requires so many skills across several athletic disciplines, rigorous training hours are required to compete at an elite level.

Even athletes that simply participate in long-distance running will typically log anywhere from 50 to 100 miles of training each week. Mileage can even be higher in athletes of the highest caliber.

As you can imagine, this takes quite a toll on the body, including the muscles, bones, joints, tendons, and ligaments. In order to simply sustain this high level of activity, hours of recovery and preventative exercises are required. In addition, several hours are needed for extra measures to prevent or limit the risk of injury.

In any sport, and most definitely in Track & Field, injuries are inevitable, even in the most prepared of athletes. The following are the most common and prevalent injuries seen in track & field athletes:

Patellofemoral Syndrome (Runners’ Knee)
Patellar Tendonitis (Jumpers’ Knee)
Plantar Fasciitis
Hamstring Tear
Achilles Tendonitis

Other common injuries prevalent in Track & Field, and more specifically sprinting and long-distance running, are shin splints, traumatic knee injuries, calf strain, ankle sprain, fractures, and IT band syndrome.

The large majority of track & field related injuries and, more specifically, running-related injuries are lower-extremity based.

Patellofemoral Syndrome

Otherwise known as runners’ knee, patellofemoral syndrome is most commonly caused by overuse. If you’re experiencing pain in the front of the knee or surrounding area, and you’re an avid runner, you may well be experiencing symptoms of runners’ knee.

Luckily, this type of injury can be non-invasively treated with guidance from your doctor and physical therapy.

Patellar Tendonitis

More commonly known as jumpers’ knee, patellar tendonitis is an injury of the patellar tendon, the ligament attaching the patella (kneecap) to the tibia. Patellar tendonitis is inflammation involving the patellar tendon due to repetitive impact and wear & tear.

Patellar tendonitis does have the rare complication of full ligament tear or rupture.

Plantar Fasciitis

One of the most common foot injuries in general, and certainly in Track & Field, plantar fasciitis is an overuse injury that causes discomfort and pain at the bottom of the foot (plantar surface). The injury occurs in cases of overuse and general wear and tear of the fascia at the plantar aspect of the foot and is best treated with rest.

While most cases are minor and can be treated at home, rare cases may need surgical treatment.

Hamstring Tear

Because the primary role of the hamstrings is to assist in deceleration, hamstring injuries are quite common in lower extremity power-based sports such as sprinting and long jump.

Hamstring injuries, though most often due to active injury, can also be the byproduct of tightness, weakness, and fatigue of the muscle itself. While hamstring tears that occur in sprinters are often more sudden and severe, those that occur in long-distance runners are typically slower to progress, developing from initial micro-tears and worsening over time.

Achilles Tendonitis

The Achilles tendon is a tendon attaching the calf muscle to the heel and is the largest tendon in the body. Because its primary function is to facilitate lower extremity movement of the leg and foot, Achilles injuries, both mild and severe, are quite common in track & field athletes.

While Achilles tendinitis can be a difficult condition, it can be treated effectively. Yet, it’s important to know that this condition can be a precursor to an even worse injury, such as Achilles tendon tear or rupture.

Unfortunately, an Achilles tendon tear or rupture is a common injury that can be seen in track & field athletes, and it will require surgery and months of rehabilitation.

Effective Treatment Options

If you’ve since been diagnosed with an injury or you’re experiencing symptoms that you presume may be a specific injury, it’s important to seek medical treatment immediately.

Effective treatment options commonly used for runner injuries include:

Contrast therapy (hot and cold exposure)
Physiotherapy
Anti-inflammatory medication
Muscle relaxants and pain relievers
Non-steroidal injections
Surgery

The type of treatment is dependent on the specific nature of the injury, and it’s best to seek personalized treatment specific to your injury. Your sports medicine specialist will be able to diagnose and recommend the best course of action for your injury.

Injury Prevention Tips for Track & Field Athletes

Although injuries can happen to anyone, especially competitive runners and track & field athletes, the nature of this sport is highly likely to yield injuries. It can be difficult in some cases to prevent such events from happening.

Preventative actions can still be implemented, and they are extremely helpful in reducing the chances of injury.

Below are the most effective preventative measures:

Stretching (warming up & cooling down)
Hydration
Don’t overtrain
Follow a slow progression plan (increase training volume strategically)
Listen to your body
Rest and recovery
Implement a complementary strength training program
Improve technique

The most common causes for injuries for runners and track & field athletes are overuse, overtraining, and lack of preventative rehabilitation and recovery. By following the recommended measures, athletes will put themselves in a much better position to prevent injuries.

Final Thoughts

Many track & field athletes and distance runners are likely to experience an injury at some point in their journey. The minute the symptoms of pain and discomfort develop, it’s best to seek early evaluation by a medical professional to ensure proper diagnosis and treatment.

Additionally, it helps to use other at-home treatment techniques, such as rest, contrast therapy, and stretching. Preventative measures can also be the key to a continuous healthy career as a track and field athlete.

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Everything You Should Know Before Getting Knee Replacement Surgery

If your goal is to postpone knee replacement surgery as long as possible, there are a number of things you can do to help manage your pain and stay active (via HealthPartners).

As counterintuitive as it may seem, exercising and moving your joints, in spite of the pain, can actually stimulate the flow of fluid around your knees, strengthen the muscles that support your knees, reduce stiffness, and increase flexibility. Stick to low-impact activities such as walking, swimming, strength training, and cycling. Any exercise that strengthens your core, hips, and legs, without damaging your knees any further, should help manage your pain.

Working with a physical therapist to get a personalized exercise plan you can do at home can also have long-term benefits — especially if you’re consistent about doing the exercises on your own. And if you’re even a little overweight, consider losing a few pounds. According to HealthPartners, even losing one pound eliminates four pounds of pressure on your knees, which is pretty impressive.

Cortisone shots and other injections that include hyaluronic acid (HA) help lubricate the inside of the knee and may provide short-term relief — up to about three months — from arthritis pain, says Johns Hopkins Medicine.

As for medications, steer clear of opioids if at all possible; they’re addictive, and aren’t proven to help long-term knee pain. And check with your doctor even before using over-the-counter drugs like ibuprofen and naproxen because they can have side effects.

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‘Covid recovered patients prone to orthopaedic complications’

Published: Published Date – 08:56 PM, Sun – 11 September 22

Hyderabad: Covid-19 recovered patients are prone to orthopaedic complications like osteonecrosis of the hip, which damages hip joint and could also cause severe arthritis, senior orthopaedic surgeons at a Arthroplasty Arthroscopy Summit-2022 (AAS), organised by Apollo Hospitals, Secunderabad, and Apollo Institute of Medical Sciences and Research (AIMSR), on Sunday, said.

Cases of osteonecrosis are being reported among individuals aged between 20 years and 30 years. “Hip replacement is a gold-standard for treating necrosis. However, since a majority of the patients are from a young age group, hip replacement is usually not recommended. There are modern techniques that provide safe alternatives to such patients,” senior joint replacement surgeons from Apollo Hospitals, Dr Aachi Mithin and Dr N Somashekhar Reddy, said.

In the training program, the faculty highlighted new therapeutics including pain portal injections, which involves injecting of safe local medications in small quantities at various spots to produce long lasting relief to patients. Such injections are giving good midterm to long term relief from pain, Dr L Prakash, Director and Chief of Orthopaedics, Institute for Special Orthopaedics, Palakkad, Kerala, said.

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Genetic Basis for Joint Replacement Failure

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Scientists from ExplantLab have identified a genotype that is associated with joint replacement failure in some patients. Based on these findings, the scientists developed a machine-learning algorithm called Orthotype, which uses a patient’s genotype and other factors to accurately predict the outcome of joint replacement surgery.

More than five million joint replacements are performed globally each year. Although most patients are satisfied with the results of their surgery, a significant number of joint replacements fail early, following adverse immune responses.

One of the most popular implant materials used in joint replacements is cobalt chrome (CoCr). When small particles from CoCr joints are released into the blood, it can lead to an immune response that results in pain and joint failure in some patients.

“Essentially, the immune system attacks the implant in a process similar to how a patient rejects an organ transplant,” explained David Langton, PhD, director of ExplantLab. “How quickly this happens is variable and unpredictable, but it appears to be dependent on the type of material, the amount of wear debris released, and other patient-specific factors.”

One of those patient-specific factors is their genes. The HLA genes play a central role in immune function, and Langton and his colleagues determined that patients with certain HLA genotypes are likely to develop responses to CoCr-containing implants. Their results were published in Communications Medicine.

Taking the research one step further, ExplantLab, working with bioengineers, medical staff, and patients from collaborating institutions, developed a machine-learning algorithm called Orthotype, which uses a patient’s genotype to provide a risk profile of that patient developing hypersensitivity to CoCr. Orthotype was developed and validated from the results from 606 patients implanted with metal hip replacements and resurfacings, each of whom had been followed for a mean duration of ten years.

This could herald a new era where it will become routine for patients to undergo genetic testing prior to receiving medical implants. Orthotype will identify patients more likely to have a reaction to a joint replacement made of CoCr components, helping surgeons select an implant based on the manufactured material most suited to the individual patient.

“This represents a significant advance in orthopedic care for patients,” said Langton, “with potentially significant financial repercussions for global healthcare systems, through the avoidance of repeat surgery.”

As populations around the world grow older and heavier, joint replacements are more common than ever. The number of joint replacement surgeries carried out globally is forecast to double over the next two decades.

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Intraosseous Morphine During Total Knee Arthroplasty Reduces Pain, Hospital Stay

Intraosseous (IO) infusion of medication during surgery has been shown to be a new and effective way to manage pain in patients undergoing total knee arthroplasty (TKA), according to a recent study.

To determine the safety and efficacy of injecting pain medication directly into the tibia during surgery and the impact that this method may have on pain levels and time spent in the hospital, the researchers performed a double-blind, randomized controlled study examining patients undergoing TKA (n = 48). The patients were divided into 2 groups: the experimental group (n = 24) who received both an IO antibiotic injection and 10 mg of morphine, and the control group (n = 24) who received only a standard IO injection of antibiotics.

The researchers assessed pain, nausea, and opioid use up to 14 days post-surgery for all patients. Additionally, the researchers examined morphine and interleukin-6 serum levels in a subgroup of 20 patients 10 hours post-surgery.

The researchers used the Visual Analog Scale to determine the level of pain each patient had postoperatively. Patients in the experimental group had a lower pain score at 1-, 2-, 3-, and 5-hours post-surgery (P = .0032, P = .005, P = .020, P = .10) when compared with the control group. The decrease in pain continued for postoperative day 1 (40% reduction, P = .01), day 2 (49% reduction, P = .036), day 8 (38% reduction, P = .025), and day 9 (33% reduction, P = .041).

Furthermore, the researchers saw a lower opioid consumption within the first 48 hours and the 2nd-week post-surgery among the experimental group when compared with the control group (P < .05). Serum morphine levels in were significantly less in the experimental group than in the control group 10 hours after IO injection (P = .049). The experimental group also has significant improvement (P < .05) in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores at 2- and 8-weeks post-surgery.

Overall, the experimental group showed significant improvement and outcome post-surgery.

“IO morphine combined with a standard antibiotic solution demonstrates superior postoperative pain relief immediately and up to 2 weeks,” the researchers concluded. “IO morphine is a safe and effective method to lessen postoperative pain in TKA patients.”

—Jessica Ganga

Reference:

Brozovich AA, Incavo SJ, Lambert BS, et al. Intraosseous morphine decreases postoperative pain and pain medication use in total knee arthroplasty: a double-blind, randomized controlled trial. J Arthroplasty. 2022;37(6):139-146. doi:10.1016/j.arth.2021.10.009.

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