Researchers at North Carolina State University have developed a "smart coating" that helps surgical implants bond more closely with bone and ward off infection. When patients have hip, knee or dental replacement surgery, they run the risk of having their bodies reject the implant. But the smart coating developed at NC State mitigates that risk by fostering bone growth into the implant. The coating creates a crystalline layer next to the implant, and a mostly amorphous outer layer that touches the surrounding bone. The amorphous layer dissolves over time, releasing calcium and phosphate, which encourages bone growth. "The bone grows into the coating as the amorphous layer dissolves, resulting in improved bonding, or osseointegration, " says Dr. Afsaneh Rabiei, an NC State associate professor of mechanical and aerospace engineering, associate faculty member of biomedical engineering and co-author of a paper describing the research. This bonding also makes the implant more functional, because the bonding helps ensure that the bone and the implant do a better job of sharing the load.
Clubfoot affects one in a thousand babies born in the United States, but with proper corrective treatment and follow-up, infants born with clubfoot can have feet compatible with an active, normal lifestyle. A new study in the February 2010 issue of the Journal of Bone and Joint Surgery (JBJS) compared two common treatment options for clubfoot - Ponseti method and surgical treatment. "While more conservative treatment methods have become popular in the United States over the last several years, surgical treatment has been the primary option in New Zealand until quite recently, " explained Matthew Halanski, MD, who authored the study with mentors at the Starship Children's Hospital in Auckland, New Zealand. "This is the first controlled prospective study to compare the short-term outcomes for clubfeet treated either surgically or with the Ponseti method, " continued Dr. Halanski. Fifty-five patients with 86 clubfeet were treated as part of the study. Forty patients' feet were treated with the Ponseti method.
NICE's Original Guidance On Preventing Fractures Due To Osteoporosis Still Stands Following Challenge
Following a legal challenge to the process used to produce NICE's existing guidance on prevention of osteoporotic fractures, the original recommendations remain unchanged in the updated guidance documents published last friday. This means that postmenopausal women with osteoporosis at risk of fractures will continue to have access to a range of drugs to help either prevent them suffering a first fracture (primary prevention) or prevent further fractures after they have suffered one (secondary prevention). The guidance documents have been updated to reflect the Appraisal Committee's consideration of the additional stakeholder comments received following a further consultation in line with the court judgement. The treatments NICE recommends for primary and secondary prevention of osteoporotic fractures are not affected, and the range of options still stands. In October 2008, the National Institute for Health and Clinical Excellence (NICE) published these pieces of guidance for the NHS on the use of drugs to prevent osteoporotic fractures in postmenopausal women.
As Olympians push their bodies to the extreme during the upcoming Winter Games in Vancouver, professional and amateur sports enthusiasts alike will be watching their favorite televised sports. Olympic athletes train year round for these Games, and have to balance strength, endurance and stamina throughout the duration of their featured games, while recreational athletes among us may be pushing their body to the limits while skiing, sledding and snowboarding. Hockey, ice skating, sledding, skiing, snowboarding and other cold-weather activities are a great way to get some fresh air and exercise during these long chilly months. The American Academy of Orthopaedic Surgeons (AAOS) has some helpful hints to avoid injury on the slopes, rinks and snowy trails. "Vigorous activity and exercise such as downhill skiing is both fun and important, but the cold temperatures and slippery surfaces of winter can produce significant injuries, especially for children, " said John D. Kelly, IV, MD, spokesperson for the AAOS and orthopaedic surgeon specializing in sports medicine.
The study, published in the Journal of Clinical Endocrinology & Metabolism, shows that hip fractures in grandfathers are linked to low bone density and reduced bone size in their grandsons. "This is the first time this risk factor for low bone mass has been demonstrated across two generations, " says associate professor Mattias Lorentzon, who led the research team at the Sahlgrenska Academy. "This new risk factor may be significant for the diagnosis of low bone mass and suggests possible mechanisms for the inheritance of low bone mass and fracture risk." The study looked at around 3, 700 grandparents and their grandsons from a national register. 270 of these grandsons had reduced bone density, in other words less bone mineral in their skeleton. All of these also had a grandparent who had broken their hip, as opposed to those who did not have any relatives who had broken a hip and had normal bone health. "We then divided these men with reduced bone density into two groups, " says Lorentzon.
Many American women are prescribed estrogen to combat the negative effects of menopause, such as bone loss and mood swings. Now, new evidence from a Tel Aviv University study suggests that hormone replacement therapy might also protect them - and younger women - from schizophrenia as well. Prof. Ina Weiner of Tel Aviv University's Department of Psychology and her doctoral student Michal Arad have reported findings suggesting that restoring normal levels of estrogen may work as a protective agent in menopausal women vulnerable to schizophrenia. Their work, based on an animal model of menopausal psychosis, was recently reported in the journal Psychopharmacology. "We've known for some time that when the level of estrogen is low, vulnerability to psychotic symptoms increases and anti-psychotic drugs are less likely to work. Now, our pre-clinical findings show why this might be happening, " says Prof. Weiner. A hormonal treatment to address a behavioral condition In their study, Weiner and Arad removed the ovaries of female rats to induce menopause-like low levels of estrogen and showed that this led to schizophrenia-like behavior.
If your grandfather has had a hip fracture, you too could be at risk. Researchers at the Sahlgrenska Academy at the University of Gothenburg, Sweden, have been able to show, for the first time, a link between hip fractures in elderly men and impaired bone health in their grandsons. The study, published in the Journal of Clinical Endocrinology & Metabolism, shows that hip fractures in grandfathers are linked to low bone density and reduced bone size in their grandsons. "This is the first time this risk factor for low bone mass has been demonstrated across two generations, " says associate professor Mattias Lorentzon, who led the research team at the Sahlgrenska Academy. "This new risk factor may be significant for the diagnosis of low bone mass and suggests possible mechanisms for the inheritance of low bone mass and fracture risk." The study looked at around 3, 700 grandparents and their grandsons from a national register. 270 of these grandsons had reduced bone density, in other words less bone mineral in their skeleton.
Zelos Therapeutics, Inc. has initiated dosing in a seven day clinical study of a nasal spray formulation of ZT-034 (teriparatide) that is being developed in collaboration with development partner Aegis Therapeutics, LLC. Nasal spray ZT-034 is being developed as an alternative to Eli Lilly and Company's Forteo (teriparatide [rDNA origin]) which generated approximately $800M in annual sales in 2009 for the treatment of osteoporosis and is administered by daily injection. Non-injectable formulations such as nasal spray ZT-034 could expand the market for parathyroid hormone (PTH) analogs to considerably more than $1 billion. The study design will include a Forteo treatment arm to provide an initial comparison with the marketed product. "PTH analogs such as teriparatide are an important but underutilized therapeutic option for osteoporotic patients at high risk of fracture, " stated Dr. Brian MacDonald, CEO of Zelos Therapeutics. "We believe that formulation of teriparatide as a nasal spray with comparable efficacy and safety to Forteo represents a simple, convenient approach to dosing that will make PTH therapy a better option for many more patients.
Society Of Interventional Radiology Supports Treatment For Painful Spine Fractures: Patient Selection Key
Given the current controversy over vertebroplasty -- a minimally invasive treatment performed by interventional radiologists in individuals with painful osteoporotic vertebral compression fractures that fail to respond to conventional medical therapy -- what's a patient to do? Trust your medical team to decide if you are an appropriate candidate for vertebroplasty and trust the experience of hundreds of thousands of other patients who have undergone the spine treatment successfully and received life-improving effects, says the Society of Interventional Radiology. "Hundreds of thousands of patients have greatly benefited from vertebroplasty with almost complete resolution of their pain; tens of thousands dependent on intravenous narcotics have been discharged from the hospital virtually pain- and drug-free following their treatment, " noted SIR President Brian F. Stainken, M.D., FSIR, who represents the national organization of nearly 4, 500 doctors, scientists and allied health professionals dedicated to improving health care through minimally invasive treatments.
Tornier, Inc., a global leader in extremities and sports medicine orthopaedics, and LifeCell™ Corporation, a KCI Company (NYSE: KCI), announced the first 13 patients have been enrolled in a multi-center clinical trial to document the clinical value of Conexa™ Reconstructive Tissue Matrix for the surgical repair of large rotator cuff tears. Conexa™ is a porcine-derived tissue matrix with both biologic and mechanical properties that are important to support the repair of injured or surgically reconstructed soft tissue. Launched by Tornier for orthopaedic applications in October of 2008, Conexa™ has been used successfully in approximately 1, 500 patients. The primary objective of the 65 patient, prospective Conexa™ clinical trial is to assess clinical outcomes following the surgical repair of large rotator cuff tears. In conjunction with these surgical procedures, Conexa™ is being utilized to reinforce the patient's rotator cuff tissue that, especially in the case of large tears, may be atrophied or otherwise compromised.