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Orthopaedics Topic Homepage
Orthopaedics Overview
The specialty of orthopaedics encompasses the surgical aspects of musculoskeletal and sports medicine. This broad specialty involves the treatment of patients of all ages, although the prevalence of specific disorders changes with age.
Paediatric orthopaedic surgery includes the treatment of congenital disorders; dysplasia of the hip, foot malformations (metatarsus adductus, metatarsus varus and clubfoot) and spinal deformities...
... (kyphosis and scoliosis).1 However, musculoskeletal trauma is the most common reason for children to require orthopaedic treatment. Fractures are more prevalent in children due to weaknesses at the epiphysial growth plates and they perform more physical activity than adults.2
The main cause of orthopaedic treatment in adults is trauma; more specifically patients involved in transport collisions. Among this group, the most frequent orthopaedic trauma injuries occurred in males under the age of 65.3
In elderly patients, diseases such as osteoarthritis and osteoporosis are more common. Osteoarthritis is the degeneration of articular cartilage in synovial joints causing bone hypertrophy. It affects 45% of women over 65 and is a major cause of disability in these people.4 Osteoporosis is a disease that affects post-menopausal women and men over the age of 50, and is more common in smokers than non-smokers.5,6 This bone demineralising disorder causes a higher proportion of fractures, of which hip fractures are the most common.5 The ageing worldwide population has therefore caused an increased need for total joint replacements, of which the most common are total hip and knee arthroplasty.7
1. Nemeth B. The Diagnosis and Management of Common Childhood Orthopedic Disorders. Current Problems in Pediatric and Adolescent Health Care. January 2011 ; 41 (1) : 2-28
2. Mencio G.A. et al. Pediatric Orthopedic Trauma. Ashcrofts Pediatric Surgery. Elsevier Inc. 2010 : 221-234
3. Urquhart D.M. et al. Characteristics of Orthopaedic Trauma Admitted to Adult Level 1 Trauma Centres. Injury. February 2006 ; 37 (2) : 120-127
4. Chasm R.M. et al. Pediatric Orthopedic Emergencies. Emergency Medical Clinics of North America. November 2010 ; 28 (4) : 907-926
5. Symmons D et al. Global Burden of Osteoarthritis in the Year 2000. Global Burden of Disease. 2006 : 1-26
6. Law M.R. et al. A Meta-Analysis of Cigarette Smoking, Bone Mineral Density and Risk of Hip Fracture: Recognition of a Major Effect. BMJ. June 1997 ; 315 (841) :
7. Wilsgaard T. et al. Lifestyle Impact on Lifetime Bone Loss in Woman and Men: The Tromso Study. Bone. May 2009 ; 44 (S1) : S38
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Drug News
Study of Prolia (Amgen/GSK) plus teriparatide shows significant benefits in Osteoporosis
19-05-2013A randomised, controlled trial of postmenopausal women with Osteoporosis shows that teriparatide and Prolia (denosumab), from Amgen/GSK, increased bone mineral densification (BMD) better than previously reported with any available treatment. Ninety four postmenopausal women were assigned in a 1:1:1 ratio to receive 20 ug teriparatide daily, 60 mg denosumab every 6 months, or both. BMD was...
EMA Pharmacovigilance Risk Assessment Committee recommends restrictions on Protelos (Servier) as a treatment for Osteoporosis
17-04-2013
The EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) recommended restrictions in the use of Protelos/Osseor (strontium ranelate) from Servier, following the evaluation of data showing an increased risk of heart problems, including heart attacks. It will adopt a final opinion at the next CHMP meeting of 22 to 25 April 2013.
...EU approves GelrinC (Regentis Biomaterials) for Cartilage Repair
20-03-2013Regentis Biomaterials has received European CE Mark approval for its GelrinC biodegradable implant, for Cartilage Repair. GelrinC is suitable for patients with traumatic knee injuries. It is inserted as a liquid to fill any shape of cartilage defect and it is then converted into a solid through exposure to ultra-violet light. GelrinC's matrix of synthetic polyethylene glycol diacrylate and...
Orthopaedics Drug Data - A-Z
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Recent Drug Updates
Binocrit
22-05-2013Treatment of symptomatic anaemia associated with chronic renal failure (CRF) in adult and paediatric patients: - Treatment of anaemia associated with chronic renal failure in paediatric and adult...
Eprex 2000, 4000 and 10000 IU/ml solution for injection in pre-filled syringe
23-10-2012Treatment of symptomatic anaemia associated with chronic renal failure (CRF) in adult and paediatric patients: • Treatment of anaemia associated with chronic renal failure in paediatric and...
Orgaran
02-10-2012• Prevention of deep vein thrombosis and its possible consequences in patients undergoing general or orthopaedic surgery. • Treatment of thrombo-embolic disorders in patients who...
Clinical Guidelines
Osteoporosis: assessing the risk of fragility fracture
Aug 2012Osteoporosis is a disease characterised by low bone mass and structural deterioration of bone..
... tissue, with a consequent increase in bone fragility and susceptibility to fracture. Osteoporosis leads to nearly 9 million fractures annually worldwide, and over 300,000 patients present with fragility fractures to hospitals in the UK each year.
Management of proximal femoral fractures 2011
Jun 2012Proximal femoral fractures present unique challenges for anaesthetic departments throughout Great..
... Britain and Ireland, involving the perioperative care of large numbers of older patients with significant comorbidities. Despite guidance since the early 1990s concerning best practice management for these vulnerable patients, there remains considerable variation in models of peri-operative care, rehabilitation and orthogeriatric input.
Online CME
Acute back pain: an up to date guide
Apr 2013
... present with acute back pain and when to refer them. The red flags in patients with back pain. The psychosocial factors associated with slow recovery from back pain. How to manage patients with acute back pain.
Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis
Apr 2013
... osteoarthritis of knee and hip. Recognise the components of individual studies that contributed to the observed effects. Recognise the characteristics of the study’s design.
Clinical Trials
Bone Healing in Healthy and Post-menopausal Osteoporotic Women
26-03-2013Both the pathogenesis and the treatment of osteoporosis may potentially interfere at different levels on the multi-stage complex cascade of events involved in bone healing/regeneration. To our knowledge no human studies have been performed to clarify the potential effect of osteoporosis on post-extraction alveolar..
... healing. The primary outcome of the study is to compare alveolar bone changes in width and height 3 months after tooth extraction in 15 post-menopausal osteoporotic women and 15 healthy pre or post menopausal women by the use of cone-beam computer tomography (CBCT) images. As secondary outcome the investigators put: changes in the external contour of the ridge together with periodontal parameters in the neighbouring teeth, tissue blood perfusion changes during the initial healing (assessed by laser doppler flowmetry) and levels of serum bone resorption/formation markers.
Mortality Following Surgery for Proximal Femoral Fractures (HipMo)
06-03-2013Proximal femoral fractures are most frequent traumatologic and orthopedic diagnoses undergoing surgery. It affect most seniors and accompanied by a series of complications. The aim of our retrospective clinical trial is to establish a thirty-day mortality rate after surgical solutions, mortality during hospitalization..
... and compare the types of anesthesia chosen during the performance (general vs. subarachnoid anesthesia).
Medical Videos
Medical Journal Abstracts
Drilling of bone: A comprehensive review
Journal of Orthopaedics, Trauma and Rehabilitation
Feb 2013
Background: Bone fracture treatment usually involves restoring of the fractured parts to their initial position and immobilizing them until the healing takes place. Drilling of bone is common to produce hole for screw insertion to fix the fractured parts for immobilization. Orthopaedic drilling during surgical process..
Managing Psychosocial Contributors in Low Back Pain Patients—A Randomised Controlled Trial
Journal of Orthopaedics, Trauma and Rehabilitation
Feb 2013
Introduction: The efficacy of integrated physiotherapy work rehabilitation program to occupational non-specific low back pain (NSLBP) patients triaged by Orebro Musculoskeletal Pain Questionnaire (OMPQ) for psychosocial risks was investigated. Methods: 47 subjects were recruited and randomly allocated to either the..
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Orthopedics Ebooks - Free
Social Media
What's the most ridiculous rule your hospital has enforced?
on doc2doc... Afterall in A&E we are not taking out tonsils or doing brain surgery so no risk of prion transmission that I can see. We also have a rules that ...
To vitamin D or not to D? That is the question!
on doc2doc... in many immune processes, and a good supply is not just needed for bone health but for many other body functions.3. The message must be: make sure you ...
How old would you define an elderly person?
on doc2doc... crumbly' and those of 90 who are sprightly.In my youth (orthopaedic House Surgeon) before routine hip replacements, I had under my care a lady who had ...
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