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GLG News by this Author

Studies favor new Amgen drug for osteoporosis - will the patients like to inject denosumab?

April 14, 2008

Analysis of:Amgen Drug Helps Bones | online.wsj.com

Postmenopausal osteoporosis is a real problem for a huge number of the older aged patients, and the population is aging. In daily orthopaedic praxis, I see a lot of osteoporosis related fractures of the wrist, the hip, and the vertebral column. Just yesterday, I operated a pseudarthrosis in the femoral neck of an 89year old lady with an extremely thin osteoporotic cortical shell. Not only that osteoporosis makes fractures at the mentioned anatomic sites more probable, but also the risk for early or later failure of surgery is higher in osteoporosis patients.

A welcome improvement of the dynamic hip screw

July 25, 2007

Analysis of:DePuy Launches The Only Technology To Treat Intertrochanteric Hip Fractures Using Traditional Or Minimally Invasive Procedures | www.medicalnewstoday.com

Fractures of the upper end of the femur are daily challenge in orthopaedic and trauma surgery in the States, and in Europe. As much as 200000 patients suffer from intretrochanteric fractures, describing a specific site of the upper femur, alone. Thus it is a very relevant challenge in trauma surgery.

Potential risks of autologous chondrocyte implantation and alternative techniques

July 20, 2007

Analysis of:Genzyme Announces Positive Results from Carticel® Study at Major Sports Medicine Meeting | www.genzyme.com

Articular cartilage injury is a relevant problem in orthopaedic surgery as especially younger people have sports injuries. Articular cartilage injury is followed by a long history of joint problems most probably ending in arthritis of the envolved joint, most often the knee joint. The repair of articular cartilage defects remains one of the most challenging problems in orthopaedic surgery. Several techniques have been elaborated, and a very nicely performed prospective clinical study could show that microfracturing has an outcome comparable to that of autologous chondrocyte implantation (Journal of Bone and Joint Surgery, Volume 86-A, pages 455-64). The above article reports on a good method, but does not sufficiently outline potential risks, or alternative operation techniques in the opinion of this author who has been dealing with injured and degenerated joint for 10 years.

A good new tool

July 20, 2007

Analysis of:VAPR® S50 Suction Electrode Offers Optimal Access To Tight Anatomy During Arthroscopic Knee And Shoulder Surgery | www.medicalnewstoday.com

Having used the VAPR S90 Radiofrequency Electrode especially in subacromial decompression surgery, that means widening of space in part of the shoulder joint, I feel, the VAPR S50 may be an improvement. Especially in arthroscopic shoulder surgery, the anatomic space is tight. The better the instruments are designed, the easier surgery is to perform. However, I am not sure if all arthroscopic surgeons will throw out their VAPR S90 for installation of the S50 as the VAPR S90 is a very sufficient tool in my experience.

Benefits of autologous chondrocyte implantation versus potential risks

July 19, 2007

Analysis of:Findings from Four Year, Multi-Center Clinical Study on Autologous Chondrocyte Implantation Presented, Coincide with New Product Labeling | www.pipelinereview.com

Articular cartilage injury is common, and it is common especially in younger, sports active people. Articular cartilage injury is followed by a long history of joint problems most probably ending in arthritis of the envolved joint, most often the knee joint. The repair of articular cartilage defects remains one of the most challenging problems in orthopaedic surgery. Several techniques have been elaborated, and also evaluated in experimental, and prospective clinical studies. Still, all techniques hitherto developed have risks or only a little potential of leading to renewal of real, mechanically bearable joint cartilage. The above article reports on a good method, but does not sufficiently outline potential risks in the opinion of this author who has been dealing with injured and degenerated joint for 10 years.

The right initiative

July 16, 2007

Analysis of:Insurer offers healthy bonus | www.denverpost.com

In my opinion, this is the right way to go. Money incentives have proven to be the most efficient way to change peoples habits - the best example seems to be the rising petrol prize which seems to make Americans prefer smaller, more economic, less consuming cars.

A very useful improvement

December 5, 2006

Analysis of:Study Demonstrates One Administration of Synvisc Improves Osteoarthritis Pain | www.genzyme.com

Pain relief for a period of 26 weeks is significant. And this effect might be useful especially in patients who cannot take NSAID because of gastric ulcers.  The reduction to a single intraarticular injection is very significant because the absolutely relevant risk of infection is reduced.

Additionally, costs may be reduced.

Medical tourism can be problematic

November 27, 2006

Analysis of:SPOTLIGHT: The risks of medical tourism | www.fiercehealthcare.com

The article seems to be very relevant as we often see promotion campaigns for abroad medical treatment in inflight magazines or the internet, or national newspapers.  In different countries or even continents, different qualifications of physicians may be a problem.

Surgery in case of failed non-operative therapy

November 27, 2006

Analysis of:For Herniated Lumbar Disk, Medical Therapy Matches Surgery | www.medpagetoday.com

From our daily practice, we see a lot of patients with herniated lumbar disc. The article underlines that non-operative and surgical therapy seem to have near equal chances in the therapy of the condition.  The study design and methods appear to be appropriate to this orthopedic surgeon, and the problem is very relevant.

Back to diclofenac and omeprazole

November 20, 2006

Analysis of:AHA: Arcoxia (etoricoxib) May Not Increase Risk of Cardiovascular Events | www.medpagetoday.com

When Vioxx was shown to have cardiovascular risks, and had to be withdrawn, we returned to the use of diclofenac and omeprazole, the latter for gastric protection.

A relevant topic in daily orthopedic practice

November 20, 2006

Analysis of:ACAAI: Metal-Sensitive Patients May React to Orthopedic Implants | www.medpagetoday.com

This week, we had a female patient 76 years of age who suffered from arthritis of her right knee. At the outpatient clinic, she did not report on her allergies to cobalt and nickel, because she never had problems from these allergies, not even from any jewelry which might contain these metals. When the patient's history was taken the day before the planned surgery, the patient reported on her allergies, but stressed that she had never had problems with these allergies. Nevertheless, we decided to postpone surgery and to order a special knee implant containing titanium. It seems relevant for the author to ask especially for metal allergies or asthma already when planning alloplasty surgery, and to take a titanium implant when needed.

Coordination and costs are crucial

October 3, 2006

Analysis of:Goal Is Electronic Health Records. Path Is State by State. | www.nytimes.com

This article seems important for healthcare professionals all over the world.
We permanently see that tests or technical examinations are taken twice, because data are not accessible.

An advantage of electronic medical records within a regional network is the immediate accessibility at all computers within the network.
As several software systems are offered on the market, coordination seems crucial.

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