Mutant Gene Causes Muscles, Ligaments And Tendons To Turn Into Bones

According to recent research carried out at the University of Pennsylvania, USA, a mutant gene causes Fibrodysplasia Ossificans Progressiva (FOP), a rare incurable disorder which gradually turns muscles, ligaments and tendons into bone. A patient with FOP eventually becomes enveloped in a second skeleton and cannot move. The disorder usually begins in childhood.


About one in two million people suffer from FOP.


According to Frederick Kaplan, lead researcher "The discovery of the FOP gene is relevant to every condition that affects the formation of bone and every condition that affects the formation of the skeleton."


The gene in question is called ACVR1.


The researchers hope this new breakthrough may be the first step towards the development of an effective medication for FOP sufferers. It could also lead to better treatment for other bone related conditions and injuries.


You can read about this study in the journal Nature Genetics.


What is Fibrodysplasia Ossificans Progressiva?


Fibrodysplasia Ossificans Progressiva is also known as Myositis Ossificans Progressiva. It is a rare genetic disorder.


Muscles, tendons, ligaments and other connective tissue gradually turn into bone. As bone forms across joints it progressively restricts movement. Eventually the patient has an extra skeleton that immobilizes all the joints.


Symptoms


A newborn infant will appear normal, except for those with congenital malformations of the big toe. During their first ten or twenty years of life, patients develop painful fibrous nodules over the neck, back and shoulders. These nodules gradually turn into bone. The process of turning into bone is called heterotopic ossification.


The trunk and limbs are then affected. The body's muscles begin to be replaced with normal appearing bone. If surgeons try to remove the bone, it is replaced by even more than there was before. The upper regions of the body tend to be affected before the lower regions.

Latest Research Findings At The American Academy Of Orthopaedic Surgeons Annual Meeting

Leading orthopedic surgeons and other clinicians from Rush University Medical Center are presenting new basic and clinical research findings at the American Academy of Orthopaedic Surgeons annual meeting in Las Vegas, Nev., on February 25-28. Highlights from some of the educational sessions led by orthopedic experts from Rush as well as some of the podium and poster presentations to be made by physicians from Rush include:



Dr. Joshua Jacobs - Joint Reconstruction
Educational session: Current Controversies in Bearing Surface Science, Wednesday, February 25, 8 a.m.


Educational session: Technology 2009: Alternative Bearing Surfaces: The Good, Bad and Indifferent, Wednesday, February 25, 1:30 p.m.


Educational session: Revision in Total Hip Arthroplasty: Understanding and Management of Osteolysis, Thursday, February 26, 10:30 a.m.


Educational session: Worldwide Perspective on Hip Resurfacing, Thursday, February 26, 4 p.m.


Scientific session: Local Metal Reactions after Metal-Metal Hip Arthroplasty, Saturday, February 28, 8:29 a.m.

Dr. Howard An - Spine, Back and Neck
Educational session: Avoiding and Managing Complications in Cervical Spine Surgery, Wednesday, February 25, 10:30 a.m.

Dr. Bernard Bach - Sports Medicine
Scientific session: Instability: Bone Grafts and Complications - Normalization of Glenohumeral Articular Contact Pressures after Either Latarject or Iliac Crest Bone Grafting Procedure: Impact of Graft Type, Positions, and Coracoid Orientation, Saturday, February 28, 11:20 a.m.

Dr. Richard Berger - Joint Reconstruction
Educational session: Partial Arthroplasty of the Knee, Thursday, February 26, 8 a.m.


Podium presentation: Problems from Allowing Knee Replacement to be Discharged the Day of Surgery, Thursday, February 26, 12:06 p.m.


Educational session: MIS THA/TKA? Where Now, Where Next?, Friday, February 27, 4 p.m.

Dr. Charles Bush-Joseph - Sports Medicine, Knee, Shoulder and Hip
Scientific session: Revision ACL, Saturday, February 28, 8 a.m.


Podium presentation: Clinical outcome following hamstring over-the-top ACL reconstruction in skeletally immature patients, Wednesday, February 25, 5:12 p.m.

Dr. Brian Cole - Sports Medicine and Cartilage Restoration
Educational session: Arthroscopic Rotator Cuff repair: An Evolution of Techniques, Are Our Patients Really Benefiting?, Thursday, February 26, 4 p.m.


Educational session: Surgical Management of Articular Cartilage Defects of the Knee, Friday, February 27, 8 a.m.


Educational session: The Active Patient with GH Arthritis: How Do We Prevent It and How Do We Treat It?, Friday, February 27, 4 p.m.


Scientific session: Instability: Bone Grafts and Complications - The Presentation and Management of Post-Surgical Glenohumeral Chondrolysis in Young Adults, Saturday, February 28, 11:30 a.m.















Scientific session: Meniscal Injuries - "29881" Versus "29882": Where Are We?, Saturday, February 28,10 a.m.


Scientific session: Shoulder and Elbow Complications: The presentation and Management of Post-Surgical Glenohumeral Chondrolysis in Young Adults, Saturday, February 28, 2 p.m.


Scientific session: Meniscal Surgery Symposium - Spotlight Technique Video: Meniscal Transplantation, Saturday, February 28, 2 p.m.


Scientific session: Meniscal Surgery Symposium - Case Presentations and Panel Discussion, Saturday, February 28, 2:10 p.m.

Dr. Craig Della Valle - Joint Reconstruction
Educational session: Early Failures after Total Knee Arthroplasty: Strategies for Prevention, Wednesday, February 25, 1:30 p.m.
* Podium presentation: Cruciate-Retaining TKA Using a Four-Pegged Tibial Component: Minimum 10-Year Follow-up, Thursday, February 26, 8:48 a.m.


Podium presentation: A Prospective Randomized Trial of Mini Posterior and Two-Incision Total Hip Arthroplasty, Thursday, February 26, 11:24 a.m.


Educational session: Periprosthetic fractures Around Total Hip and Knee Replacement: A Problem on the Rise but Better Solutions, Thursday, February 26, 1:30 p.m.


Educational session: Revision Total Knee Arthroplasty: What the Practicing Orthopedic Surgeon Needs to Know, Friday, February 27, 8 a.m.

Dr. Gregory Nicholson - Shoulder and Elbow, Sports Medicine and Knee
Educational session: Shoulder Arthroplasty: What to Do, When and How, Wednesday, February 25, 10:30 a.m.


Educational session: Reverse Shoulder Arthroplasty, Thursday, February 26, 1:30 p.m.


Scientific session: Reverse Prosthesis: Recognizing and Treating Complications - Trabecular Metal Reverse Shoulder Arthroplasty and the Lack of Scapular Notching, Saturday, February 28, 1 p.m.


Scientific session: Technical Pearls to Improve Total Arthroplasty Results - Posterior Glenoid Bone Grafting in TSA for Posterior Glenoid Wear-Technique and Radiographic Outcome, Saturday, February 28, 3 p.m.

Dr. Wayne Paprosky - Hip and Knee Joint Reconstruction
Educational session: Complex Revision THA: An Advanced Course, Wednesday, February 25, 8 a.m.


Educational session: Bone Defects: When Are Ortho Biologics Indicated?, Friday, February 27, 10:30 a.m.


Educational session: How to do a Revision Total Hip Arthroplasty, Friday, February 27, 1:30 p.m.


Scientific session: Welcome address for the Hip Society/ American Association of Hip and Knee Surgeons, Saturday, February 28, 8 a.m.


Scientific session: Evolution of uncemented femoral fixation in Revision THA: Can we tailor prosthetic choice to each pattern of bone loss?, February 28, 10:15 a.m.

Dr. Frank Phillips - Spine, Back and Neck
Educational session: The Current State of Minimally Invasive Spine Surgery, Thursday, February 26, 1:30 p.m.

Dr. Anthony Romeo - Shoulder and Elbow, Sports Medicine
Educational session: Shoulder Arthroplasty: What to Do, When and How, Wednesday, February 25, 10:30 a.m.


Educational session: Challenging Problems in Shoulder Instability - How to Get It Right the First Time and What To Do If You Don't, Wednesday, February 25, 1:30 p.m.


Educational session: Arthroscopic Rotator Cuff repair: An Evolution of Techniques, Are Our Patients Really Benefiting?, Thursday, February 26, 4 p.m.


Scientific session: Shoulder and Elbow Complications: The presentation and Management of Post-Surgical Glenohumeral Chondrolysis in Young Adults, Saturday, February 28, 2 p.m.


Scientific session: Instability: Bone Grafts and Complications - Normalization of Glenohumeral Articular Contact Pressures after Either Latarject or Iliac Crest Bone Grafting Procedure: Impact of Graft Type, Positions, and Coracoid Orientation, Saturday, February 28, 11:20 a.m.


Scientific session: shoulder Instability Symposium, Saturday, February 28, 7:50 a.m.

Dr. Aaron Rosenberg - Joint Reconstruction
Educational session: Delivering Exceptional Care Experiences in Your Office and Hospital: Lessons Learned from Other Service Industries, Friday, February 27, 8 a.m.


Scientific session: Advances in Treatment of Previous Acetabular Fracture with Hip Arthroplasty, Saturday, February 28, 3:31 p.m.

Dr. Nikhil Verma - Sports Medicine, Knee, Elbow, and Shoulder
Scientific session: Rotator Cuff: Long-Term Outcome of Recurrent Defects After Rotator Cuff Repair, Saturday, February 28, 1:20 p.m.


Scientific session: Instability: Bone Grafts and Complications - Normalization of Glenohumeral Articular Contact Pressures after Either Latarject or Iliac Crest Bone Grafting Procedure: Impact of Graft Type, Positions, and Coracoid Orientation, Saturday, February 28, 11:20 a.m.





About Rush University Medical Center



Rush University Medical Center is an academic medical center that encompasses the more than 600 staffed-bed hospital (including Rush Children's Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,270 students, is home to one of the first medical schools in the Midwest, and one of the nation's top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.



Source: Deb Song


Rush University Medical Center

Surgeons Are "Overly Optimistic" in Predicting Results of Back Surgery

Surgeons predict at least moderate improvement for almost all patients undergoing back surgery, yet nearly 40 percent of
patients have little or no improvement one year after their operation, reports a study in the June 15 issue of the journal
Spine.


At least for some patients, the results suggest a "curabo effect," with physician expectations influencing treatment
outcomes.


Led by Dr. Bertrand Graz of University of Lausanne, Switzerland, the researchers analyzed 197 patients undergoing surgery for
low back pain or sciatica. Before the operation, surgeons were asked to predict how much the surgery would improve each
patient's quality of life. The surgeons predicted "a great deal of improvement" for 79 percent of patients and "moderate
improvement" for 20 percent.


However, patients were generally less satisfied than the surgeons had expected. Of patients whose surgeon predicted "a great
deal of improvement," 56 percent reported no significant improvement in their general health one year after surgery. Whereas
surgeons had predicted at least moderate improvement for 99 percent of patients, 39 percent achieved no "minimally clinically
important" difference.


In contrast, the surgeons' predictions were related to better outcomes for patients who were not necessarily appropriate
candidates for back surgery. Among patients whose surgery was deemed "inappropriate or equivocal"-based on strictly defined
criteria-higher surgeon expectations were linked to greater improvement on subjective measures of mental health and general
health.


The ability to make a correct individual prognosis is obviously important for doctors recommending any form of treatment,
especially surgery. Recent reports have suggested that surgeons predict the outcomes of surgery for sciatica as better than
they actually are.


The new study also suggests that surgeons tend to overestimate the benefits of surgery for low back pain and sciatica. On
average, patients do have significant improvement one year after back surgery; however, the overall impact on their lives may
not be as great as predicted by surgeons.


Ironically, the exception may be patients who don't meet strict criteria for back surgery. Dr. Graz and colleagues suggest
that this finding might be explained by a "curabo effect." As opposed to the well-known "placebo effect"-in which improvement
results from patients' confidence in treatment-the curabo effect is attributed to the doctor's confidence in his or her own
work. The curabo effect might be a kind of "self-fulfilling prophecy": physicians may invest more time and energy in their
work with a patient; patients may rate the final results higher when the physician has expressed higher expectations.



Other explanations are possible-in particular, surgeons may truly be able to predict which patients have a better than
average chance of cure, even if they're not "ideal" candidates for back surgery. Either way, it may be that physicians tend
to get the improvement they expect for some subjective outcomes, despite the fact that the treatment doesn't meet "objective"
criteria for appropriateness. "Physician expectation may have by itself an influence on patient outcome," the authors
conclude.


Lippincott Williams & Wilkins

530 Walnut St.

Philadelphia, PA 19106

United States

lww

Enobia Announces Completion Of Enrollment In Third Phase II Hypophosphatasia Study Of ENB-0040, A Bone Targeted Enzyme Replacement Therapy

Enobia Pharma Inc., announced that it has successfully completed enrollment in its Phase II study of ENB-0040, a bone targeted enzyme replacement therapy being investigated in adolescents and adults with hypophosphatasia (HPP), a serious, rare metabolic bone disorder. Upon anticipated completion of the study later this year, Enobia will have collected safety and efficacy data for ENB-0040 in HPP patients of all ages. If approved, ENB-0040 would represent the first available therapy for patients with HPP.


In advance of next week's Rare Disease Day, Michael Whyte, MD, Professor of Medicine, Pediatrics and Genetics, and Medical-Scientific Director, Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children, St. Louis, and principal investigator for the ENB-0040 studies, will provide an update on this potential advance for patients with HPP at the Sanford-Burnham Medical Research Institute's second annual Rare Disease Symposium being held in San Diego, CA this Friday, February 25. The event will highlight ENB-0040 and several other new approaches to treating rare diseases, and will bring together scientists, patients, parents and disease advocates to discuss how they can work together to find cures for rare diseases.


Deborah Sittig, who founded Soft Bones: The U.S. Hypophosphatasia Foundation after her son was diagnosed with HPP, will participate in the event, facilitating a question & answer session with attendees and presenters.


Dr. Whyte's presentation will be webcast from 11:55 am - 12:25 pm PST; the question and answer session will immediately follow, at approximately 12:25 - 1:00 pm PST.


"We are delighted with the steady progress of our development program for ENB-0040, and remain committed to our ultimate goal of delivering a safe and effective therapy to address the significant unmet clinical needs of patients suffering with HPP," said Robert Heft, Ph.D., President and Chief Executive Officer of Enobia. "All of Enobia is privileged to contribute to the development of treatments for rare metabolic bone disorders. We take this opportunity on Rare Disease Day to highlight the need for sustained research to ensure that rare diseases, and the patients and their families impacted by them, receive the attention and therapies they deserve."


About Rare Disease Day


Next Monday, February 28, will mark the fourth International Rare Disease Day coordinated by European Organization for Rare Diseases (EURORDIS) and organized with rare disease national alliances in 25 countries around the world, including the National Organization for Rare Diseases (NORD) in the U.S. Rare Disease Day aims to raise awareness of the approximately 6,000 - 8,000 known rare diseases, or those diseases which affect fewer than 200,000 people. It is estimated that 30 million Americans are affected by a rare disease, with millions more impacted around the world. For most rare diseases, there are limited to no treatment options available.


About ENB-0040


There are currently no therapies approved for HPP, a rare genetic disease characterized primarily by defective bone mineralization caused by a deficiency in the enzyme tissue non-specific alkaline phosphatase (TNSALP). ENB-0040 (asfotase alfa), an investigational treatment for HPP, is a subcutaneous enzyme replacement therapy of TNSALP fused to a bone targeting peptide. ENB-0040 is designed to directly target TNSALP to the bone in order to correct the enzyme deficiency, which could lead to restoration of normal bone mineralization. ENB-0040, awarded orphan designation in the U.S. and EU in 2008 and Fast Track status in 2009, is currently in Phase 2b clinical development.


In January, Enobia announced that its Phase II study of ENB-0040 in juveniles with HPP met its primary endpoint, demonstrating a statistically significant improvement in rickets when compared with historical matched cohort controls (p=0.002). Those results build on the successful completion of an earlier trial in infants, in which participants continue to demonstrate functional and respiratory improvements in longer-term follow-up.


About the Adolescent and Adult Phase II Study


The Phase II randomized, open-label, multicenter, multinational, dose-ranging, concurrent control study will evaluate the safety and efficacy of ENB-0040 in adolescents and adults with HPP. The study is expected to be completed in the second half of this year.


Source: Enobia Pharma Inc

Foot Injuries Plague Athletes During Fall Sports Season

With the 2008-09 football season still in its fledgling stages, storylines for many teams in the spotlight have evolved from the typical 'who to watch' to 'who's gone down now?' Chris 'Beanie' Wells, starting running back for the Ohio State University Buckeyes, continues to recuperate from a right toe injury suffered almost two weeks ago. National Football League (NFL) running back LaDainian Tomlinson, star of the San Diego Chargers, also limped from his team's opening game with a foot injury recently - which he quickly brushed off as 'turf toe.' But how many athletes in fall sports, like football, take these types of injuries too lightly?



According to the American Podiatric Medical Association (APMA), both professional and amateur athletes are at an extremely high risk for injuring their lower limbs during play. Whether performing hairpin turns on artificial turf or taking part in a powerful, high-speed collision with other players, foot and ankle injury risks for athletes run rampant - and participating in a favorite sport should always involve playing it safe.


" Stress fractures of the foot, ankle sprains and ligament injuries are all, unfortunately, quite common in popular fall sports such as football," said Dr. David Davidson, APMA member and podiatric medical consultant for the Buffalo Bills of the NFL. "From maintaining proper conditioning to wearing sport-specific footwear, athletes can function at peak performance much more often when constantly maintaining high levels of footcare safety."


The following are some of the most common acute injuries in fall sports, as well as treatments and preventative tips recommended by the APMA:


- Sprains - Hard sprinting often leads to stretched or torn ligaments, also known as sprains. Severe sprains may also cause ankle swelling, much like a fracture.


Treatment - Sprains that don't show improvement in three days should be seen by a podiatric physician immediately. Possible casting, immobilization and a rehabilitation regimen may all be prescribed.


Tips to Avoid Them - Take part in proper warm-up exercises before and after home workouts, practice and games. Spend five to 10 minutes stretching, holding and relaxing muscles.


- Fractures - Fractures occur when a bone has been broken.


Treatment - Casting, and sometimes even surgery performed by a podiatric surgeon, is required to properly immobilize fractures and set breaks. Ten to 12 weeks are usually required for rehabilitation.


Tips to Avoid Them - Look for sport-specific footwear that contains extra padding in cleated shoes, which helps to prevent stress fractures - incomplete fractures in bones are typically caused by overuse.


- Turf Toe - Named for the playing field on which it is common, turf toe is a painful hyperextension of the big toe joint. While competing on artificial turf is the leading cause of this condition, it can also occur on natural surfaces such as grass.


Treatment - Turf toe treatment usually includes the 'RICE' regimen, which stands for Rest, Ice, Compression and Elevation.
Tips to Avoid It - Wearing a stiffer shoe can prevent aggravating this injury further. Customized foot orthotics may also be worn during play to protect against turf toe.


For more information about sports-related injuries to the foot and ankle, visit apma/sports.


Founded in 1912, the American Podiatric Medical Association is the nation's leading professional society for foot and ankle specialists. The association has component societies in 53 locations in the U.S. and its territories and a membership of close to 11,500 doctors of podiatric medicine.

American Podiatric Medical Association

Cutting-Edge Surgery for Tennis Elbow, Traditional Treatment Lacking

Surgeons at Mount Sinai Medical Center have found that less cutting is more beneficial to patients undergoing
arthroscopic repair for lateral epicondylitis, also called 'tennis elbow.' Michael Hausman, MD, and researchers from the
Department of Orthopedics at Mount Sinai School of Medicine are presenting findings from a clinical study at the Annual
Meeting of the American Academy of Orthopedic Surgeons (AAOS), February 23-27, 2005, in Washington, DC.


Dr. Hausman and colleagues examined 30 patients who underwent the traditional method to repair tennis elbow. This method is
performed by cutting the main tendon, removing surrounding scar tissue and reconnecting the severed tendon. The new method
perfected by Dr. Hausman does not involve cutting the tendon. This method is technically more difficult, but patients have a
faster return to daily activities.


Dr. Hausman will be available for interviews via phone at the AAOS meeting and immediately upon his return.


The Mount Sinai Medical Center


The Mount Sinai Medical Center encompasses The Mount Sinai Hospital and Mount Sinai School of Medicine. The Mount Sinai
Hospital is one of the nation's oldest, largest and most-respected voluntary hospitals. Founded in 1852, Mount Sinai today is
a 1,171-bed tertiary-care teaching facility that is internationally acclaimed for excellence in clinical care. Last year,
nearly 48,000 people were treated at Mount Sinai as inpatients, more than 72,000 received care in the emergency department,
and the outpatient department recorded nearly 470,000 visits. Mount Sinai School of Medicine is internationally recognized as
a leader in groundbreaking clinical and basic-science research, as well as innovative approaches to medical education. Mount
Sinai ranks 9th among the nation's 125 medical schools in the percentage of graduates who go on to faculty positions in
medical schools across the country. Mount Sinai also is in the top 25 in receipt of National Institutes of Health (NIH)
grants with a total of more than $154 million during Fiscal Year 2003. Information about Mount Sinai can be found online at:
mountsinai and mssm

Osteoporosis-linked Fractures Have Risen Dramatically

The hospitalization rate of patients admitted for treatment of hip, pelvis and other fractures associated with osteoporosis increased by 55 percent between 1995 and 2006, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.


An estimated 10 million Americans suffer from osteoporosis, which causes bones to become brittle and weak. Fractures associated with osteoporosis can be slow to heal, and they also can cause debilitating pain, disability, deformities and occasionally death.


The federal agency's study also found that fractures associated with osteoporosis:


- Accounted for one-fourth of the roughly 1 million hospitalizations in 2006 of patients with osteoporosis.

- Cost hospitals $2.4 billion in 2006.

- Caused women to be six times more likely to be hospitalized than men.

- Involved mostly older patients: 90 percent of hospitalizations were for age 65 and older and 37 percent for patients age 85 and older.

- Were highest in the Midwest (107 per 100,000 people) and lowest in the West (68 per 100,000 people).


This AHRQ News and Numbers is based on data in U.S. Hospitalizations Involving Osteoporosis and Injury, 2006 (hcup-us.ahrq/reports/statbriefs/sb76.pdf). The report uses statistics from the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. The report also uses statistics from a special disparities analysis file created from the Healthcare Cost and Utilization Project 2006 State Inpatient Databases.


Editor's Note: For more information about osteoporosis, see Osteoporosis Treatments that Help Prevent Broken Bones: A Guide for Women after Menopause.

Source
AHRQ

Young Men And Elderly Women At Biggest Risk For Shoulder Dislocations

The shoulder joint is the most mobile joint in the body and consequently one of the most commonly dislocated joints.



An article published in the March 2010 issue of The Journal of Bone and Joint Surgery (JBJS) reveals that the majority of all shoulder dislocations occur during sports activities and young males are at a higher risk. The study also shows a high rate of shoulder dislocation in elderly women.



The overall incidence rate was 23.9 shoulder dislocations per 100,000 person years (the product of the number of years times the number of members of a population who have been affected by a certain condition). While this is more than double the previous rate reported for shoulder dislocations for the U.S. general population, it is still less than the rates of other common musculoskeletal injuries seen in emergency rooms, such as injuries to the lower back, knee and foot.



"Shoulder instability is one of the most common reasons young athletes see orthopaedic surgeons," explained Brett Owens, MD, study co-author, orthopaedic surgeon at Keller Army Hospital in West Point, New York and Associate Professor at the Uniformed Services University of the Health Sciences. "However little has been reported about the incidence of this injury."



Dr. Owens and his colleagues studied 8,940 shoulder dislocations in patients presenting to 100 hospital emergency rooms across the United States from 2002 to 2006. The purpose of the study was to identify the specific groups of individuals at risk, to help direct prevention efforts.



Of all dislocations, the study found:
71.8 percent were in men;


46.8 percent were in patients between 15-29 years;


48.3 percent occurred during sports or recreation; and


37 percent of all sports-related injuries were football or basketball related.

Dislocations most frequently resulted from a fall (58.8 percent), of which 47.7 percent of these falls occurring at home and 33.6 percent occurring at recreation or sports sites.



In women, higher dislocation rates were seen among those aged 80 to 90 years old. This increase was mostly due to falls at home.



"We were not too surprised to find the high number of young males dislocating their shoulders during athletic activity," commented Dr. Owens. "However, the rate of shoulder dislocations among elderly women was higher than we had previously assumed."



The shoulder joint can dislocate forward, backward or downward. The most common shoulder dislocation happens when the shoulder slips forward (anterior instability). The arm bone is moved forward and down and out of its joint.



Dislocated shoulder symptoms include:
pain;


swelling;


numbness;


weakness; and


bruising.

Often the dislocation will tear ligaments or tendons in the shoulder or even damage nearby nerves. To treat the dislocation, the doctor must manipulate the arm bone (the humerus) and replace it in the shoulder socket. This stops the severe pain and allows for the injured tissues to heal.



"Individuals who dislocate their shoulders should see an orthopaedic surgeon. While not all patients require surgery, an orthopaedist can best counsel patients on the treatment options and expected outcomes," said Dr. Owens.



Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.



The opinions presented by Dr Owens are his own and not the official positions of the US Army, Department of Defense, or US government.



Source:

Kristina Findlay


American Academy of Orthopaedic Surgeons

Bone Research That Grows On You

Rapid and guided healing of bones has moved a step closer with research by two biomedical engineering students who have found new ways to deliver bone growth enhancers directly to broken or weakened bones.



Major ongoing research at Queensland University of Technology focuses on biodegradable materials that carry bone growth enhancing substances to encourage bones to heal quickly with much less intervention.



The research is ultimately aimed at repairing fractured bones or replacing bone weakened or lost from osteoporosis, cancer or trauma with minimal intervention and without painful and expensive bone grafts or pins and plates.



Fourth year biomedical engineering student Wayne Shaw has developed tiny biodegradable spheres made from polymers that can be loaded with calcium phosphate compounds - known bone growth facilitators - and placed on bone defects.



"As the microspheres degrade the calcium phosphate compounds are absorbed and encourage the bone to grow quickly into the area and build new bone," Mr Shaw said.



"The microspheres, which are highly porous, range in size from 50 to 500 microns and have calcium phosphate abundantly deposited throughout the pores, can be used in a variety of ways.



"They could be used to fill bone defects or cavities, to coat load bearing implants, and to make scaffolds for the regeneration of bone."



Mr Shaw won joint best exhibit in the National 2006 Engineering and Physical Sciences in Medicine conference at Noosa in September.



Fellow fourth year biomedical engineering student Achi Kushnir has developed a load bearing ceramic material capable of carrying the same bone growth enhancing chemicals and of being absorbed by the body.



Mr Kushnir has integrated a dense ceramic core with a porous ceramic layer that can be used in place of metal implants for some clinical situations because it will attach to and integrate with bone and eventually degrade away in the body.



"The dense core has high compressive strength for load bearing applications such as for the long bones of the legs or arms," Mr Kushnir said.



"The unique core structure of the material will provide the mechanical properties needed for load bearing bones and the outside porous layer will assist with the bone repair."



"Bioactive ceramics are known to be body-friendly but until now they have been limited by lack of mechanical properties including compressive strength for carrying loads."






The students' work was supervised by Associate Professor Simon X. Miao who said their findings had advanced the search for simple, cost effective, and minimally invasive methods of healing bones.



This bone research has been supported by the Medical Device Domain of QUT's Institute of Health and Biomedical Innovation led by Professor Mark Pearcy.



Contact: Niki Widdowson


Queensland University of Technology

How Old Is Too Old To Repair The ACL?

Baby boomers and weekend warriors are staying active well into their later years, making them susceptible to injuring those aging frames especially vulnerable to tearing their anterior cruciate ligament (ACL). A new study presented at the 75th Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), found that "boomers" who undergo ACL surgery are about as likely to return to pre injury levels of activity as much younger people.


These encouraging findings have led researchers to conclude that age itself should not be a factor when determining candidates for the increasingly common knee ligament surgery.


"Twenty years ago we did not see older patients being so active later in life. ACL surgery was rarely considered for people in their 40s and 50s," said Diane Dahm, MD, assistant professor of orthopaedic surgery at the Mayo Clinic in Minnesota. "Older patients today want to continue to run, play basketball and be active late into life, so they need a level of knee stability that will support an active lifestyle."


The study followed the recovery of 34 patients aged 50 to 66 for an average of 48 months between 1990 and 2002 following ACL surgery at the Mayo Clinic. Patients with injuries to multiple knee ligaments were excluded.


The study found that after ACL surgery:


-- 83 percent were rated as normal or near-normal

-- 83 percent returned to playing sports

-- patients went from 4.3 before surgery to 8.3 postoperatively on the UCLA ( University of California at Los Angeles), activity score

-- five of the 34 patients required additional knee surgery


"Today's active baby boomers are pushing the envelope for when people are considered to be too old for ACL surgery," concluded Dr. Dahm. "When considering candidates for ACL surgery, people's fitness levels and their desire to return to an active lifestyle should be taken into account rather than looking at age."


The ACL is one of the most commonly injured ligaments of the knee. The incidence of ACL injuries is currently estimated at approximately 200,000 annually, with 100,000 ACL reconstructions performed each year. In general, the incidence of ACL injury is higher in people who participate in high-risk sports, such as basketball, football, skiing and soccer


American Academy of Orthopaedic Surgeons (AAOS)

6300 N. River Rd.

Rosemont, IL 60018

United States

aaos

Embryonic Stem Cell Research In The Toilet, According To Arthritis Treatment Center

The recent ruling by federal judge Royce C. Lamberth halting embryonic stem cell research may present a hurdle for some disease research but not necessarily for arthritis. A key note presentation, entitled "Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee" will be made on November 9, 2010 at the annual meeting of the American College of Rheumatology in Atlanta.


Osteoarthritis (OA) is a disease associated with the loss of cartilage, the gristle that caps the ends of long bones and which provides cushioning and shock absorption. When cartilage wears away, the end result is reduced joint function, and possibly, disability.


According to lead author Dr. Nathan Wei, "Osteoarthritis affects more than 20 million Americans, but our treatment options have been limited to symptom relief... No therapies solve the problem of cartilage loss."


He goes on to say, "Many people aren't aware that there are many different types of stem cells. Embryonic cells are only one type. Adult stem cells are readily accessible from bone marrow. Our study shows that adult stem cells may hold the key to successful cartilage regeneration. "


He adds, "We used a 'cocktail' mixture of adult stem cells, platelet rich plasma, better known as PRP, and fat. The PRP stimulates stem cell growth and the fat provides a framework and bulk for the stem cells to hold onto."


In the study, 22 patients underwent stem cell treatment for osteoarthritis of the knee. Data was available for 20 patients, ranging in age from 36 to 84 years. There were 15 men and 5 women.


Clinical assessments as well as ultrasound measurement of cartilage thickness were performed.


There were three treatment failures, defined as patients who did not improve above baseline.


Data was available at the time of abstract submission for 11 patients at 6 months and 8 patients at one year. Significant improvements in clinical measures and cartilage thickness were demonstrated.


Dr. Wei cautions, "This was an uncontrolled study. And, obviously further refinements of technique as well as many unanswered questions remain. Further studies are warranted."


Source: Arthritis Treatment Center

Investigational Therapy Denosumab Increased Bone Mineral Density With Twice-yearly Dosing

Amgen (NASDAQ: AMGN), the world's largest biotechnology company, announced today the publication of Phase 2 data demonstrating twice-yearly injections of denosumab (previously referred to as AMG 162), a RANK Ligand inhibitor, significantly increased bone mineral density (BMD) in the total hip, lumbar spine, distal 1/3 radius and total body compared to placebo. The results of this one-year study appeared in the Feb. 23, 2006 issue of the New England Journal of Medicine. Data results also included an open-label FOSAMAXВ® (alendronate)* arm of the same clinical trial.



Researchers reported that subcutaneous injections of denosumab significantly increased BMD at the total hip from 1.9 to 3.6 percent in women who were administered the therapy twice yearly as compared with a decrease of 0.6 percent in the placebo group (p







In the one-year trial results, researchers also reported twice-yearly subcutaneous injections of denosumab significantly increased lumbar spine BMD from 3.0 to 6.7 percent after 12 months as compared with a decrease of 0.8 percent in the placebo-treated patients (p

Hospital For Special Surgery To Host International Arthritis Summit In 2011

Hospital for Special Surgery (HSS) plans to host a two-day international Osteoarthritis Summit in June 2011. The Hospital, internationally recognized for its leadership in the fields of orthopedics and rheumatology, will bring together, for the first time, a truly comprehensive multidisciplinary group of world renowned scientists, thought-leaders and industry representatives from the United States, Canada, and Europe, to discuss all aspects of OA and develop a consensus document on future directions for OA research, prevention and treatment.


"Public health data indicate that the prevalence, impact, and economic consequences of osteoarthritis are expected to rise dramatically within the next several decades. Clearly, understanding and preventing this disease is an urgent research challenge," said Steven Goldring, M.D., chief scientific officer at Hospital for Special Surgery and co-director of the conference. Timothy Wright, Ph.D., Kirby Chair of Orthopedic Biomechanics at HSS, is also a co-director of the event.


Hospital for Special Surgery is at the forefront of the national movement focused on elevating awareness of OA as well as the research, patient care, and innovation necessary to improve the outcomes in patients suffering from osteoarthritis.


Osteoarthritis (OA) is one of the most urgent health care challenges of our time, affecting 27 million Americans.


Source:

Hospital for Special Surgery

Tiny Sea Creature And A New Medical Adhesive: New American Chemical Society Podcast

Scientists questing after a long-sought new medical adhesive describe copying the natural glue secreted by a tiny sea creature called the sandcastle worm in the latest episode in the American Chemical Society's (ACS) award-winning podcast series, "Global Challenges/Chemistry Solutions."



Such an adhesive is needed to repair bones shattered in battlefield injuries, car crashes and other accidents.



The traditional method of repairing shattered bones involves use of mechanical fasteners like pins and metal screws to support the bone during healing. But achieving and maintaining alignment of small bone fragments using screws and wires is challenging, according to researchers, who presented their study results at the ACS' 238th National Meeting in Washington, D.C.



The podcast is available without charge at iTunes and from ACS at acs/globalchallenges.



It features audio clips of Russell Stewart, Ph.D., a bioengineer at the University of Utah in Salt Lake City. Stewart says this synthetic glue is based on complex coacervates, an ideal but so far unused method for making injectable adhesives. Coacervates are tiny spherical droplets of assorted organic molecules (specifically, lipid molecules) that are held together by hydrophobic forces from a surrounding liquid.



He explains that the idea of using natural adhesives in medicine is an old one dating back to the first investigations of mussel adhesives in the 1980s. Yet almost 30 years later there are no adhesives based on natural adhesives used in the clinic.



Global Challenges/Chemistry Solutions is a series of podcasts describing some of the 21st Century's most daunting problems, and how cutting-edge research in chemistry matters in the quest for solutions. This sweeping panorama of global challenges includes dilemmas such as providing a hungry, thirsty world with ample supplies of safe food and clean water; developing alternatives to petroleum to fuel society; preserving the environment and assuring a sustainable future for our children; and improving human health.



Future podcasts will discuss improving human health, developing alternatives to petroleum, preserving the environment and assuring a sustainable future for our children. The series has won the Gold Medal as the best podcast in the national awards competition sponsored by Association TRENDS, the national newspaper for associations.



Source:
Michael Bernstein


American Chemical Society

Tel Aviv University Gives Preemies A Fighting Chance

When a child is born premature - and more than one in ten infants in the U.S. is - its future is already compromised. One of the common problems associated with premature births is "brittle bones," or osteopenia of prematurity (OOP). It can cause bone fractures and rickets in the infant, and osteoporosis later in life.



Tel Aviv University pediatric physicians are championing a training program that aims to make preemies' bones stronger. Dr. Dan Nemet and his partner Dr. Alon Eliakim, both associate professors of the Sackler School of Medicine at Tel Aviv University, have developed a proven protocol to prevent OPP.



Says co-researcher Dr. Dan Nemet, "About 12% of all births in the United States today are premature. It's unfortunate because it's in the last trimester when bones grow the most. More than 30% of preemies born before 30 weeks have some degree of OOP, but won't have any physical symptoms. It's critical to treat it before any symptoms are found."



In the last trimester of pregnancy, mothers transfer large amounts of calcium and phosphorus to the rapidly growing baby. It is also the time when babies exercise acquire muscle and strengthen bones in the womb. And when a child is born early, its physical activity is limited in the incubator. All of these factors contribute to OPP.



The researchers have shown that gentle exercises performed five times a day on the wrist, elbow, shoulder, ankle, knee, and hip joints (approximately 10 minutes for each session), and administered five times per week for four weeks, improved bone strength in preemies as measured using bone ultrasound. Daily interactive periods of holding and stroking the infant also influences bone growth and development, they conclude.



"We've had positive and encouraging results," says Dr. Nemet. "The preemies are definitely gaining more bone mass, their bones are growing stronger and subsequently the babies are gaining more weight. We can assume it means that the preemies are healthier and happier."



As part of a biannual course they teach, the physicians will demonstrate the benefits of their research during, "The Practitioners Guide to Pediatric Exercise," at the University of California-Irvine this January. The course is aimed at an international group of pediatric physicians, physiologists, trainers and teachers.



The intervention program involves extension and flexion exercises on preemies' arms and legs, and its efficacy has been reported in the Journal of Perinatology, Pediatrics, and the International Journal of Sports Medicine. Recently the duo presented current research at the 24th "Pediatric Work Physiology Meeting, Children and Exercise," in Tallinn, Estonia.



The National Institute of Health (NIH) has given a vote of confidence in the research by funding the physicians (together with a group led by Prof. Dan M. Cooper from the University of California-Irvine) to conduct a four-and-a-half year study of bone strength and exercise in preemies.



Mechanical strain is known to be a powerful stimulator of bone formation and growth. However, until now, no standard intervention program has been delivered. Normally, doctors attempt to treat the condition through calcium and phosphorus supplements, added to breast milk or IV fluids. But this treatment has not been found to be lead to optimization of bone strength, says Dr. Nemet, who is a specialist in pediatric health and who runs together with Dr. Eliakim a center in this field in Israel.



"Preemies have a disease which is manifested by fractures. We thought that if exercise works for strengthening the bones of older children and adults, then there's no reason why it can't work for preemies," says Dr. Nemet.







American Friends of Tel Aviv University supports Israel's largest and most comprehensive center of higher learning. It is ranked among the world's top 100 universities in science, biomedical studies, and social science, and rated one of the world's top 200 universities overall. Internationally recognized for the scope and groundbreaking nature of its research programs, Tel Aviv University consistently produces work with profound implications for the future.



Source:

George Hunka

American Friends of Tel Aviv University

Geisinger Orthopaedic Surgeon Awarded $97,000 Grant

A Geisinger orthopaedic surgeon recently received a $97,000 grant from the Orthopaedic Trauma Association for a pilot study that will expand Geisinger's ProvenHealth Navigator advanced medical home to include care for patients recovering from hip fractures.


Wade Smith, M.D., director, Geisinger's Orthopaedic Trauma program, was recognized with the highly competitive peer-reviewed grant to monitor the outcomes of hip fracture patients in a pilot ProvenHealth Navigator advanced medical home. The program provides integrated, clinical care coordination and support 24 hours a day, seven days a week. It emphasizes enhanced collaboration between specialists, hospital systems and primary care providers with the goal of providing high quality care while preventing hospital readmissions.


"We are incredibly pleased to receive this highly competitive peer-reviewed grant," noted Dr. Smith, "it's the first ever for Geisinger's orthopaedics department and is a collaboration between the Center for Health Research and Geisinger's Department of Orthopaedic Surgery."


Source

Geisinger Health System

Slow Exercise Is Better For Menopausal Women Than Fast Exercise

It's an inevitable truth: as we get older, our muscles deteriorate and we become weaker. Not only can this be an immensely frustrating change, but it can also have many other, more serious implications. We become clumsier and begin to have more falls, often resulting in broken bones or even more severe injuries. There is wide interest in this phenomenon, but to date, the majority of research has focussed on therapies for older patients with advanced symptoms. Now one study, led by Dr Alexandra Sänger from the University of Salzburg, is taking a new approach: scientists are examining the effects of different exercise regimes in menopausal women, with the aim of developing new strategies for delaying and reducing the initial onset of age related muscle deterioration. Results will be presented on Monday 7th July at the Society for Experimental Biology's Annual Meeting in Marseille [Poster Session A5].


Dr SГ¤nger's research group has investigated two particular methods of physical training. Hypertrophy resistance training is a traditional approach designed to induce muscle growth whereas 'SuperSlow®' is a more recently devised system which involves much slower movement and fewer repetitions of exercises, and was originally introduced especially for beginners and for rehabilitation. "Our results indicate that both methods increase muscle mass at the expense of connective and fatty tissue, but contrary to expectations, the SuperSlow® method appears to have the greatest effect," reveals Dr SГ¤nger. "These findings will be used to design specific exercise programmes for everyday use to reduce the risk of injury and thus significantly contribute to a better quality of life in old age."


The study focussed on groups of menopausal women aged 45-55 years, the age group in which muscle deterioration first starts to become apparent. Groups undertook supervised regimes over 12 weeks, based on each of the training methods. To see what effect the exercise had, thigh muscle biopsies were taken at the beginning and end of the regimes, and microscopically analysed to look for changes in the ratio of muscle to fatty and connective tissue, the blood supply to the muscle, and particularly for differences in the muscle cells themselves. "The results of our experiments have significantly improved our understanding of how muscles respond to different forms of exercise," asserts Dr Sänger. "We believe that the changes that this new insight can bring to current training systems will have a considerable effect on the lives of both menopausal and older women," she concludes.


-- Hypertrophy resistance training is a method of strength training that is designed to induce muscle growth, also known as hypertrophy.


-- SuperSlow® resistance training was developed by Ken Hutchins and is based on the same principle as hypertrophy resistance training, but involves slower movement and fewer repetitions of exercises, which is thought to improve the quality of muscle contraction and thereby strength.


This work will be presented on Monday 7th July at the Society for Experimental Biology's Annual Meeting (6th - 10th July 2008) at Parc Chanot, Marseille, France.


Society for Experimental Biology

BT Business Helps Flexible Workers With Launch Of 'Get Fit For Mobile Working'

BT Business has launched a practical guide - Get fit for mobile working - to help businesses tackle the problems encountered by some of the UK's 14 million mobile workers. The guide is designed to help mobile workers to avoid the back, neck and arm problems that can arise as a result of working in unfamiliar environments with a poor posture.


Official figures show that back, neck and arm problems are the most common occupational illnesses in the UK. Over a fifth (20.6%) of BT employees' sickness absence is caused by such illnesses. However, newly published research carried out by BT Business shows that less than half (46%) of mobile workers are receiving guidance about staying safe when working on the move. Furthermore, a quarter (25%) of workers are unaware that all businesses are legally responsible for their health and safety wherever they are working, whether or not they are in the office.


To show workers there is no reason to be suffering discomfort, BT Business has worked with Margaret Hanson, one of the UK's leading ergonomists, to publish a handy reference guide. Get fit for mobile working helps to identify common issues, their causes, and the solutions to ensure you steer clear of back, neck and arm problems both now and in the coming years. The advice will be communicated internally to more than 100,000 employees at BT itself.


Dr Paul Litchfield, BT's Chief Medical Officer said "Mobile working can liberate people by giving them more flexibility over their time and more control over their jobs - both are important in helping to make modern life less stressful. As with any technology, people can experience problems with mobile devices if they don't take note of simple, practical steps, such as those developed by BT Business, before they begin to use their equipment."


Recent years have seen an explosion in mobile working, and a demonstration of the benefits - 83% of us think flexible working brings competitive advantages in business, whilst 54% of managers believe flexible workers have a better quality of life.


Bill Murphy, Managing Director of BT Business said "Mobile and flexible working has transformed both business and personal lives. By observing a few general principles, workers can ensure they see all the benefits of mobile working, without any downside. Businesses need to be aware of their legal responsibility for the health and safety of employees, wherever they are working."


"There has been a lack of advice for employees about best practice mobile working, despite the explosion in mobile and remote working in the UK. This is why we have teamed up with leading ergonomist Margaret Hanson to produce the advice within Get fit for mobile working which we are making available to customers, and sharing with all BT employees.


Here are ten top tips from Get fit for mobile working on how you can avoid mobile misery:


1. Use the backrest of your chair. Don't slouch forwards. Keep shoulders in line with your hips.















2. Hold your head so ears are above shoulders. Don't stick your chin forward or bend or twist your neck.


3. Alternate between thumbs and fingers when typing on smartphones.


4. Don't rest wrists or forearms on the edge of desks.


5. Position items so you don't twist your back; screens should be at a comfortable viewing height in front of you. Ensure your back is supported.


6. Exercise your hands, wrists and neck regularly.


7. Make sure there is nothing underneath your workstation that restricts your posture.


8. Take regular breaks away from the keyboard and screen.


9. Don't hold the phone between ear and shoulder - you're likely to get a sore neck.


10. Adjust settings on your software so that the image and text are large enough for you to see comfortably.


The advice has been packaged in a handy, at-a-glance overview, as well as a detailed report. See both at bt/getfitformobileworking


About Margaret Hanson


Margaret Hanson, Principal Ergonomics Consultant, has 15 years experience of providing advice and support to organizations on how to reduce the risk of discomfort through the ergonomic design of workplaces and equipment. She has undertaken research for the Health and Safety Executive and the Scottish Government. She is a Fellow of the Ergonomics Society and a Chartered Member of the Institute of Occupational Safety and Health.


About BT


BT is one of the world's leading providers of communications solutions and services operating in 170 countries. Its principal activities include the provision of networked IT services globally; local, national and international telecommunications services to our customers for use at home, at work and on the move; broadband and internet products and services and converged fixed/mobile products and services. BT consists principally of four lines of business: BT Global Services, Openreach, BT Retail and BT Wholesale.


In the year ended 31 March 2008, BT Group's revenue was ВЈ20,704 million with profit before taxation and specific items of ВЈ2,506 million.


British Telecommunications plc (BT) is a wholly-owned subsidiary of BT Group plc and encompasses virtually all businesses and assets of the BT Group. BT Group plc is listed on stock exchanges in London and New York.


BT

Baby Boomers Getting More Hip Injuries

A serious bicycle accident left David Goodman with a severely shattered left hip.


But ever since Dr. Michael Stover of Loyola University Health System rebuilt Goodman's pelvis and replaced his hip, the 67-year-old Chicago resident has been able to do everything that he could before his accident -- without pain.


Goodman works out or does yoga six days a week. Four months after surgery, he climbed a mountain in Israel. Last summer, he rode his bicycle 442 miles across Iowa in a week, averaging 63 miles per day. This winter, he plans to go skiing.


Stover is seeing more hip and pelvic fractures in older patients who are injured in activities such as bicycling. "Our aging population is more active than it was before," he said.


Stover is an associate professor in the Department of Orthopaedic Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine.


Stover and his partner, Dr. Hobie Summers, use leading edge technologies to treat serious and sometimes life-threatening orthopedic conditions such as pelvic fractures, broken legs, foot and ankle injuries and dislocations. They also treat patients who have experienced multiple traumatic injuries.


Summers' areas of expertise include fractures that fail to heal, are slow to heal or heal improperly. "It's very rewarding to take a bone that doesn't heal and get it to heal so the patient can get back to his life," Summers said. "You can significantly improve patients' function, pain and disability, and get them back to work and to their normal activities. They are very happy." Summers is an assistant professor in the Department of Orthopaedic Surgergy and Rehabilitation at Stritch.


Stover and Summers have completed fellowships in orthopedic traumatology. Stover has additional fellowship training in pelvic and acetabular (hip socket) reconstruction. Stover's comprehensive hip and pelvis practice includes treatments for such conditions as hip arthritis, congenital problems, trauma and fractures that do not heal or heal improperly.


Stover specializes in cases that are complex and difficult. Goodman's case is a good example. In 2007, Goodman collided with a fellow bicyclist while doing a group ride on Lake Shore Drive in Chicago. The nearest hospital did not have the expertise to treat his injury, so Goodman was transferred to Loyola.


Stover performed surgery to repair Goodman's fractured left hip socket. The fracture healed, but Goodman later developed painful arthritis of the hip. In 2008, Stover performed a total hip replacement, and Goodman has been pain free ever since.


Another Stover patient, Jill Gillis of suburban Lockport, suffered an even more complex hip injury. She was riding her horse when the horse was spooked, reared up and fell backward on her. Her pelvis was shattered under the weight of the 1,500-pound horse. She was airlifted to Loyola, where Stover put her pelvis back together with plates and screws.


Gillis, 42, spent a month in the hospital and another two or three months at home in bed. She had a limp at first, but now walks normally. "People don't even know I was in an accident," she said. "Dr. Stover's team did miraculous work. I thank God for his hands."


Source
Loyola University Health System

Influence Of A 6-week Arm Exercise Program On Walking Ability And Health Status After Hip Arthroplasty: A 1-year Follow-up Pilot Study

This follow-up study of elderly patients after total hip arthroplasty (THA) examined the effect of our arm exercise program on health status and walking ability.


Though THA had a major effect on our patients' physical fitness and functional status, the added effects of the training were significant on those outcomes at both 2 months and 1 year after surgery.


In a 6-minute walk test, the training group (TG) walked significantly longer distance than the normal rehabilitation group with a faster speed, longer stride length, and higher step cadence.

Therefore, besides an improvement in fitness, the TG also might have improved gait efficiency. These preliminary results suggest the importance of endurance-type upper-body aerobic training after THA.


Download PDF file of this study


About the Journal of Rehabilitation Research and Development


JRRD has been a leading research journal in the field of rehabilitation medicine and technology for more than 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD's mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community.


Journal of Rehabilitation Research and Development

USA - UIC researchers create tissue-engineered joint from stem cells

Contact: Sharon Butler

sbutleruic

312-355-2522

University of Illinois at Chicago


Researchers at the University of Illinois at Chicago have successfully turned adult stem cells into bone and cartilage, forming the ball structure of a joint found in the human jaw with its characteristic shape and tissue composition.


Tested so far only in animals, the tissue-engineering procedure to create a human-shaped articular condyle could be used one day to regenerate the ball structure of joints in the jaw, knee and hip that have been lost to injury or diseases such as arthritis.



'This represents the first time a human-shaped articular condyle with both cartilage- and bone-like tissues was grown from a single population of adult stem cells,' said Jeremy Mao, director of the tissue engineering laboratory at UIC and associate professor of bioengineering and orthodontics.



'Our ultimate goal is to create a condyle that is biologically viable -- a living tissue construct that integrates with existing bone and functions like the natural joint.'



To create the articular condyle, Mao and Adel Alhadlaq, a doctoral student in anatomy and cell biology, used adult mesenchymal stem cells taken from the bone marrow of rats. Bone marrow is the inner, spongy tissue of long bones like the femur and tibia, the leg bones.



Under certain conditions, mesenchymal stem cells, present in a number of adult tissues, can potentially differentiate into virtually any kind of connective tissue -- including tendons, skeletal muscle, teeth, ligaments, cartilage and bone.



Using chemical substances and growth factors, the scientists induced the adult stem cells to develop into cells capable of producing cartilage and bone.



The cells were then stratified into two integrated layers, encapsulated in a biocompatible gel-like material, and shaped into an articular condyle using a mold made from the temporomandibular or jaw joint of a human cadaver.



After several weeks, Mao and his colleagues found that the tissue-engineered structures retained the molded shape of the human mandibular condyle, with bone-like tissue underneath and a layer of cartilage-like tissue on top -- an arrangement similar to that of a natural articular condyle.



Moreover, multiple tests confirmed that the newly grown tissues were indeed bone and cartilage, having the characteristic microscopic components: for bone, a matrix of collagen with deposits of calcium salts, and for cartilage, collagen and large amounts of substances called proteoglycans.



Mao stressed that much additional work is needed before tissue-engineered condyles are ready for therapeutic use in patients suffering from osteoarthritis, rheumatoid arthritis, injuries or congenital anomalies.



Nevertheless, he believes that with further refinements, the procedure could one day be adopted for total hip and knee replacements.



'Our findings represent a proof of concept for further development of tissue-engineered condyles,' Mao said.



The first in a series of reports on the tissue-engineered articular condyle will be published as a rapid communication in the December issue of the Journal of Dental Research.



Mao's tissue engineering laboratory is funded by multiple grants from the National Institutes of Health and the Whitaker Foundation.



For more information about UIC, visit uic.

Coalition Of Leading Medical Organizations Announce Launch Of National Initiative To Improve The Care Of Patients With Osteoporosis

The Johns Hopkins University School of Medicine, the National Osteoporosis Foundation, Baylor College of Medicine, the American Academy of Nurse Practitioners, and the University of Kentucky Colleges of Pharmacy and Medicine, along with Gullapalli & Associates announced today the development of the National Osteoporosis Educational Initiative (NOEI) a curriculum-based, performance improvement continuing medical education (PI-CME) initiative to educate and train a multidisciplinary group of healthcare providers on early diagnosis and management of osteoporosis. The foundation for the NOEI will be a Faculty Curriculum Development Summit, to be held in February 2009 on the Johns Hopkins medical campus.


"The bone health status of Americans today is in jeopardy, especially as the population ages. Osteoporosis and related bone diseases affect about 15 million Americans and cause approximately 2 million fractures annually, figures that will rise significantly in the decades ahead unless action is taken now," states Wen Shen, MD, MPH, FACOG, Assistant Professor of Medicine and Director of the Menopause and Women's Health Center at Johns Hopkins, and Course Director for the NOEI.


"The nature of the scope and design of the collaboration between the National Osteoporosis Foundation and these prestigious organizations will ensure that providers receive education that will enhance their overall approach and communication with patients at risk or living with osteoporosis," states Robert Recker, MD, president of the National Osteoporosis Foundation.


Through inter-organizational collaboration and the PI-CME component, the NOEI will empower various types of providers with the knowledge and know-how to continually assess the care they deliver, measure that care against national benchmarks, compare that care among their peers, and document their improvement over time. The overall initiative curriculum will focus on early diagnosis of osteoporosis, adopting appropriate fracture risk stratification and optimal management strategies for patients with osteoporosis.


"The uniqueness of the NOEI is not limited to the collaborative approach or the PI-CME component alone, but how they've been integrated, allowing for synergies that typically wouldn't be possible alone," states Dr. Venkat Gullapalli, CEO of Gullapalli and Associates, LLC. "Synergies such as better measurable outcomes, curricula that is specific to the needs of multiple providers in one rather than multiple initiatives, and cost-effective allocation of resources allow us to develop and provide as many activities and programs as possible to participants."


About Johns Hopkins University School of Medicine


In 2008, U.S. News & World Report ranked The Johns Hopkins Hospital #1 among American hospitals for the 18th consecutive year. Johns Hopkins remains the nation's leading medical school recipient of research funds from the National Institutes of Health (NIH). In 2006, the Johns Hopkins Office of CME received "Accreditation with Commendation" for 6 years, the highest ranking issued by the ACCME. Hopkins CME has been recognized as a center for "Best Practices" and as a resource to ACCME accredited providers.















For more information please visit hopkinscme.


About the National Osteoporosis Foundation


Established in 1984, the National Osteoporosis Foundation (NOF) is the nation's leading voluntary health organization solely dedicated to osteoporosis and bone health. Its mission is to prevent osteoporosis and related fractures, to promote lifelong bone health, to help improve the lives of those affected by osteoporosis and to find a cure through programs of awareness, advocacy, public and health professional education and research.


For additional information about the National Osteoporosis Foundation, please visit the Web site nof/


About Baylor College of Medicine


Baylor College of Medicine (BCM), Houston, Texas is the only private medical school in the greater southwest and is recognized as a premiere academic health science center known for excellence in education, research and patient care. For 2009, U.S. News and World Report ranked BCM 13th overall among the nation's top medical schools for research and 7th for primary care. BCM is also listed 13th among all U.S. medical schools for National Institutes of Health funding, and 2nd in the nation in federal funding for research and development in the biological sciences at universities and college by the National Science Foundation. During the reaccreditation proves in March 2007, BCM received "Accreditation with Commendation" for exemplary performance in fulfilling the accreditation requirements as a provider of continuing medical education.


For additional information about Baylor College of Medicine, please visit bcm or BaylorCME.


About Gullapalli and Associates, LLC


Gullapalli and Associates, LLC (G&A), is a leading consulting firm composed of a team of educational strategists who specialize in the identification, development and facilitation of collaborative educational initiatives. G&A works directly with healthcare organizations, societies, associations and centers of excellence to develop initiatives that address key gaps and barriers amongst specified healthcare providers. G&A's process ensures that the resulting education is driven directly by these organizations, enabling them to better provide their skill, knowledge and credibility to augment the overall outcomes of the initiatives for both healthcare providers and patients.

Gullapalli and Associates, LLC

69 Grants To Support A Broad Spectrum Of Scientific Research

Beth Israel Deaconess Medical Center (BIDMC) has been awarded $38.2 million in funding from the National Institutes of Health (NIH) as part of the American Recovery and Reinvestment Act of 2009 (ARRA). BIDMC scientists received a total of 69 grants across all medical-center departments, including surgery, neurology, pathology and a wide swath of divisions within the Department of Medicine including cardiology, hematology/oncology, nephrology, gastroenterology and geriatrics.



"This level of funding is a very impressive achievement and speaks to the high caliber of BIDMC's research program," says Chief Academic Officer Vikas Sukhatme, MD, PhD. "Virtually every BIDMC department and division received grants encompassing all types of research: basic, translational and clinical."



The NIH awarded a total of $5 billion in grants as part of the overall $100 billion federal stimulus package. "At a time when federal research dollars were declining significantly, this ARRA funding is a true stimulus to research productivity," adds Sukhatme. "These 69 new grants strengthen BIDMC's already strong research program, which has consistently ranked in the top four in NIH funding among independent hospitals nationwide for more than 10 years running."



Among the grants received by BIDMC was an award of $1.6 million to Dan Barouch, MD, PhD, Chief of BIDMC's Division of Vaccine Research to continue his investigations of novel HIV vaccine candidates. Also notable, Pier Paolo Pandolfi, MD, PhD, Associate Director of Research for BIDMC's Cancer Center was awarded a grant of $2.1 million a year for two years for his work developing a new paradigm for conducting clinical trials to test cancer therapies.



In addition, BIDMC scientists received a total of eight NIH Challenge Grants. These two-year grants were specifically created as part of the Recovery Act funding, and focus on "challenge topics" that address biomedical research challenges that will benefit from "jumpstart" funds.



"Like other funding in the federal stimulus package, these grants are designed to have broad applications to the population as a whole," notes Randy Mason, BIDMC Vice President of Research Operations. "The BIDMC projects that were funded represent a wide range of subject areas, from investigations into the causes of cancers and cardiac diseases to the development of new technologies to help individuals better manage sleep apnea and heal broken bones." (To see an entire list of BIDMC-funded projects visit projectreporter.nih/reporter_SearchResults.cfm.)



BIDMC's eight Challenge Grants include the following:
Mary Bouxsein, PhD, of BIDMC's Center for Advanced Orthopaedic Studies received a grant of more than $950,000 over two years to investigate the effects of perinatal calorie restriction or high-fat diet on the acquisition of bone mass and strength in mice to determine its influence on adult bone disease;
















Christopher Evans, PhD, Director of the Center for Advanced Orthopaedic Studies, received a grant totaling $980,186 over two years to work with BIDMC's Orthopaedic Trauma team to develop innovative ways to heal broken bones -- which are more efficient and less expensive than existing methods;



Pier Paolo Pandolfi, MD, PhD, Associate Director of Research of BIDMC's Cancer Center, was awarded a Challenge grant of $1 million over two years for his investigations of myelodysplastic syndrome (MDS), an incurable life-threatening disorder;



Jeffrey Saffitz, MD, PhD, Chairman of BIDMC's Department of Pathology, will study a heart disease that carries the greatest known risk of sudden cardiac death, a major public health plague. He was awarded a Challenge Grant of $975,551 over two years;



Martin Sanda, MD, Director of BIDMC's Prostate Cancer Program, has received two Challenge Grants of $1 million each over two years. The first grant will compare long-term side effects, cancer control, and health-care costs of different treatments for early-stage prostate cancer; the second will evaluate whether the use of robotic assistance improves quality and consistency of prostate cancer surgery;



Ralph Scully, MB, BS, PhD, of BIDMC's Division of Hematology/Oncology was awarded a two-year Challenge Grant totaling over $1 million to examine defects in double strand break (DSB) repair, which are known to be common in human cancers and offer a potential new target for cancer therapies. New tools developed in the Scully laboratory will allow investigators to rapidly screen the human genome for new genes that regulate DSB repair;



Robert Thomas, MD, of the Division of Pulmonary, Critical Care and Sleep Medicine received a two-year grant totaling $1 million to test a new method of assessing sleep quality based on changes in the speed of a person's heart beat and breathing-related factors. Thomas will assess the usefulness of this method as a monitor of sleep health among patients with complicated forms of sleep apnea and patients with heart failure.

Source:
Bonnie Prescott


Beth Israel Deaconess Medical Center

MabThera(rituximab) Is More Effective In Treating Rheumatoid Arthritis Than Switching Patients To A Second Anti-TNF

New data1 presented at the European League Against Rheumatism
(EULAR) annual meeting revealed that when rheumatoid arthritis (RA) patients do not respond to a
TNF inhibitor, a commonly used class of drugs in RA, it is more effective to treat them with MabThera
(rituximab), than to use a second TNF inhibitor therapy.1 This calls into question the practice of
'cycling' between anti TNFs, and provides evidence that supports preliminary NICE guidance where
anti TNF switching has not been recommended.


This data shows that MabThera,with a different mode of action to anti-TNFs, may benefit patients
earlier in their treatment pathway. Instead of having to take an alternative anti-TNF, a potentially less
effective treatment, using time and NHS budget and risking irreversible damage to their joints, they
could benefit from MabThera (rituximab).


The studyi was conducted among 300 patients who had previously not responded to TNF inhibitor
therapy. Data at six months showed that MabThera achieved a significantly larger reduction in disease
activity (DAS28) than a subsequent anti-TNF agent in patients who had ceased anti-TNF therapy due to
lack of efficacy (reduction in DAS28 by 1.55 versus 1.03).


"These findings confirm that switching to an alternative biological agent, such as rituximab, in the
subset of RA patients who don't respond to a first anti-TNF agent, can provide major benefits", said
Professor Rob Moots, Aintree University Hospitals "In patients with persistent active disease despite
anti-TNF therapy, these data suggest that switching to rituximab might be more effective than switching
to an alternative anti-TNF agent."


Inhibition of joint damage


New data from another study, REFLEX3, also presented at EULAR, demonstrate that MabThera
continues to significantly inhibit the progression of joint damage caused by RA over a period of two
years in those patients who do not respond to TNF inhibitor therapy4. X-ray evidence at two years
showed that the narrowing of joint spaces and appearance of new bone erosions were reduced by more
than 50% in patients receiving MabThera and methotrexate (a commonly used RA drug) compared to
patients receiving methotrexate alone (Total Sharp Score increase of 1.14 versus 2.81 respectively,
p







A new study has been described, assessing the preference (based on a range of treatment preferences
and key drivers of choice) for the benefits of a drug modelled on MabThera relative to those of drugs
modelled on entanercept Enbrel) and abatacept (Orencia) as a biologic therapy for the treatment of RA.
The new data presented at EULAR identified that RA patients prefer treatments with infrequent dosing.
The study found that patients favour a treatment model
led on MabThera which offers symptom control
with less frequency in needing to have treatment.6.


About Rheumatoid Arthritis and MabThera


Rheumatoid arthritis is an autoimmune disease characterised by inflammation that leads to stiff, swollen
and painful joints. Current treatments include disease-modifying drugs (DMARDS) and biologic
therapy such as the TNF inhibitor drugs.


MabThera is a first-in-class therapy that selectively targets B cells early in the inflammatory cascade of
rheumatoid arthritis. B cells are known to play a key role in the inflammation associated with
rheumatoid arthritis and MabThera breaks the inflammatory cascade of RA - a series of
reactions inflaming the synovia and leading to the cartilage loss and bone erosion that is characteristic of
the disease, and may provide an innovative new treatment even in patients with severe and longstanding
disease. MabThera has a strong heritage in the treatment of a form of lymphatic cancer called
non-Hodgkin's lymphoma (NHL) and the treatments safety profile has now been established in more
than a million patient exposures over the last nine years in oncology and more recently rheumatoid
arthritis.


MabThera is indicated, in combination with methotrexate, for the treatment of adults with severe
rheumatoid arthritis who cannot tolerate or do not respond to anti-TNF therapy.


Safety Profile


The majority of adverse events are mild to moderate in severity. In trials adverse drug reactions
occurred with at least a 2% difference compared to the control arm. The most frequent adverse events
are infusion reactions which occurred in 15% patients following the first infusion of rituximab and 5%
in placebo patients. Fewer reactions are observed with second and subsequent infusions. Severe infusion
reactions are uncommon and their frequency is reduced by the use of concomitant IV steroids.


About Roche in Rheumatoid Arthritis


Roche has prioritised research and development of new treatments for auto-immune diseases, including
rheumatoid arthritis. Following the launch of MabThera® (rituximab) for RA in 2006 there are a
number of projects in development ensuring a rich pipeline including compounds in Phase I, II and III
clinical trials. Tocilizumab is the first humanised interleukin-6 (IL-6) receptor inhibiting monoclonal
antibody and represents a novel mechanism of action to treat RA, a disease with a high unmet medical
need. This treatment is not yet licenced in Europe and is the result of a research collaboration by Roche
and Chugai , and is being co-developed globally. Ocrelizumab, a fully humanised anti-CD20 antibody,
is just entering Phase III development for RA.


About Roche in the UK


Roche aims to improve people's health and quality of life with innovative products and services for
the early detection, prevention, diagnosis and treatment of disease. Part of one of the world's leading
healthcare groups, Roche in the UK employs nearly 2,000 people in pharmaceuticals and diagnostics.
Globally Roche is the leader in diagnostics, and a major supplier of medicines for the treatment of
cancer, transplantation, virology, bone and rheumatology, obesity and renal anaemia. Find out more
at rocheuk


A summary of product characteristics is available at rocheuk


References


1 - Finckh, A et al. Which subgroup of rheumatoid arthritis patients benefit most from switching to rituximab versus alternative anti-TNF agents after previous failure to anti-TNF agent? Abstract OP-0249, EULAR 2008


2 - DAS28 is a measurement score used to assess whether a patient shows an improvement in disease activity. DAS28 provides a number on a scale from 0 to 10 which indicates the current activity of the disease.


3 - A Randomised Evaluation oF Long-term Efficacy of rituXimab in RA


4 - Cohen, S et al. Continued inhibition of structural damage in rheumatoid arthritis patients treated with rituximab at 2 tears:
REFLEX study. Abstract THU0167, EULAR 2008


5 - As measured by the mean increase from baseline in Total Sharp Score (TSS), an x-ray measurement of change in joint damage


6 - Ostor, AJK et al. Patient preference for rituximab as a treatment for rheumatoid arthritis: a study using discrete choice analysis. Abstract AB0375, EULAR 2008

rocheuk


View drug information on Enbrel; Orencia.

Are Scientists Making Progress In Being Able To Regenerate Bone Tissue?

In an article in PLoS Medicine, Gert Meijer (University Medical Centre Utrecht, The Netherlands) and colleagues discuss what kind of progress there has been in restoring the function of diseased or damaged bone by bone tissue regeneration.


Until recently, say the authors, the use of bone grafts from a different part of the patient's own body has been the number one choice for attempting to restore function. But there are major problems with such grafts-for example, removing bone from a different part of the body can lead to post-operative pain, infection, and abnormal sensations at the removal site. An alternative is to use bone given by a donor-but such bone grafts from donors are less successful and there is a risk of transmitting viruses from the donor to the recipient.


Given all these problems with bone grafts, scientists have attempted to engineer bone tissue. "Bone tissue engineering using bone marrow stem cells has been suggested as a promising technique for reconstructing bone defects," say Meijer and colleagues. Bone tissue engineering has shown success in animal studies.


In their article the authors review the available data on bone tissue engineering in human studies, including clinical research they themselves have conducted. They also discuss possible new directions that need to be exploited to make bone tissue engineering a clinical success.


Citation: Meijer GJ, de Bruijn JD, Koole R, van Blitterswijk CA (2007) Cell-based bone tissue engineering. PLoS Med 4(2): e9.


About PUBLIC LIBRARY OF SCIENCE


PLoS is a nonprofit organization of scientists whose aim is to make the world's scientific and medical research literature a public resource. We are funded by a grant from the Gordon and Betty Moore Foundation to develop a publishing program based on the Open Access business model, whereby the costs of publication are paid upfront so that anyone with an internet connection can have access to the content, in a free and unrestricted manner. Our immediate goal is to launch two top-tier journals - PLoS Biology (in October, 2003) and PLoS Medicine (in 2004).


PUBLIC LIBRARY OF SCIENCE

European Bioinformatics Institute

Wellcome Trust Genome Campus

CB10 1DS

plos

Codman's DURAFORM™ Implant Receives Two New Indications For Use In Europe

Codman, a Johnson & Johnson company, announced today that its DURAFORM™ Dural Graft Implant has been approved for two new uses in Europe. The collagen-based implant is now approved for use in spinal procedures and as an adhesion barrier to prevent peridural fibrosis.


DURAFORM™ implant was first approved by the British Standards Institution (BSI) in 2004 for procedures where the repair or substitution of the patient's dura mater is required. The additional indications are based on a study that showed equivalency to another dural graft that is already approved for spinal procedures and as an adhesion barrier.


"Now more patients can benefit from DURAFORM™ implant's unique combination of superior strength, handling and conforming capabilities," said P. Laxminarain, worldwide president, Codman. "These new indications provide a new choice for neurosurgeons and spine surgeons and should increase the use of DURAFORM™ implant throughout the European Union."


DURAFORM™ implant is manufactured using a patent-pending process that allows for better handling characteristics and greater tear resistance than other onlay dural graft materials.


DURAFORM™ implant is composed of a unique structural matrix that gives it enhanced wet handling capabilities and enhanced anatomical conformity to the contours of the brain. This minimizes undesirable creases and folds to help prevent leakage of cerebrospinal fluid (CSF).


DURAFORM™ implant is made of collagen-based biocompatible material that exhibits improved tensile strength and wet handling capabilities. The collagen used in its production is obtained from a geographical BSE risk level I source, the lowest risk category available.


DURAFORM™ implant is contraindicated in patients with known sensitivity to bovine-derived materials.


About Codman


Codman, a Johnson & Johnson company, develops and markets a wide range of diagnostic and therapeutic products for the treatment of central nervous system disorders. The company was founded in 1838 and has established a strong leadership position within the industry.


Johnson & Johnson company

jnj/home.htm

Fractures In Russia, Central Asia And Eastern Europe Lead To High Death And Disability Rates

Preliminary findings from an upcoming new report by the International Osteoporosis Foundation (IOF) show alarming projections and reveal the poor state of post-fracture care in the Russian Federation and many other countries in the region. The findings were announced at a press conference in St. Petersburg at the IOF Summit of Eastern European and Central Asian Osteoporosis Patient Societies.



Osteoporosis, a disease of the bone which leaves people at increased risk of fracture, is most common in the older population. Population projections for most countries in the region predict that by 2050 there will be a decrease of the total population, but a significant increase (up to 56%) in the percentage of people aged 50 and over. As a result, in the Russia Federation alone the number of people with osteoporosis is expected to increase by a third by 2050.



Despite the major public health burden of osteoporosis-related fractures, the disease suffers from severe under recognition - mainly due to the lack of solid epidemiological and economic data which would help convince health authorities of the urgency of osteoporosis prevention. There are no formal hip or fragility fracture registries in most countries within the region and data on vertebral fractures, the most common osteoporotic fracture, are completely lacking. IOF President John Kanis stated, "It is clear from the key findings that governments need to support wide scale epidemiological studies to collect data on the incidence of osteoporotic fractures."



DXA technology, diagnostic equipment which provides the most accurate method of diagnosis, is usually only accessible in main cities - yet in about one-third of the countries, more than 40% of the population lives in a rural area. In most countries, drug treatment for those at high risk of fracture is not, or is only partially, reimbursed - effectively making treatment unaffordable for the majority of citizens.



Low levels of calcium and vitamin D intake impact negatively on bone health. The average daily calcium intake in nearly all countries outlined in the report falls far below the FAO/WHO recommendations. In addition the majority of populations in the region suffer from severe vitamin D insufficiency. This not only affects fracture rates, but also causes rickets. In recent years the incidence of rickets (pediatric vitamin D deficiency) among Russian infants has ranged from 54% to 66% in some regions.



Although older people who sustain a hip fracture are at increased risk of death and suffer long term disability throughout the world, the report indicates that this problem is far more severe in the Russia Federation and in many other countries of the region. Professor Olga Lesnyak, Vice-President of the Russian Association on Osteoporosis and author of the report, called for action, "There is an urgent need for health care providers to improve post hip fracture surgical care, "she said. While in Western Europe most hip fracture patients receive operative treatment (the optimal standard of care), in the Russian Federation there is an extremely low rate of surgical treatment. Consequently there is high mortality rate after a hip fracture, reaching up to 45-52% during the first year after fracture in some Russian cities. Of the surviving hip fracture patients, 33% remain bed-ridden and 42% are capable of only very limited activities. Only 9% are able to return to the same level of daily activity as they had before their fracture.



IOF Chief Operating Officer Judy Stenmark stated, "Wider and more equitable access to diagnostic tests and appropriate medication are required to stem the growing tide of fractures in the region."



Notes:

The finalised report, Eastern European & Central Asian Regional Audit - Epidemiology, Costs & Burden of Osteoporosis in 2010, will be published in November 2010 here. It will include projections and data for 21 countries, including Armenia, Azerbaijan, Belarus, Bulgaria, Czech Republic, Estonia, Georgia, Hungary, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Poland, Romania, Slovakia, Slovenia, Russia, Tajikstan, Ukraine and Uzbekistan.


This report was supported by an unrestricted educational grant from Server and Amgen/GSK.



Source:

J. Stenmark


International Osteoporosis Foundation

Potential For Accelerated Bone Healing With Lithium

Researchers have described a novel molecular pathway that may have a critical role in bone healing and have suggested that lithium, which affects this pathway, has the potential to improve fracture healing. The study, led by Benjamin Alman from the Hospital For Sick Children, Toronto, investigated the role of the a-catenin signaling pathway, which activates T cell factor -dependent gene transcription, and which is known to have a key regulatory role in embryonic skeletal development.



By studying mice with fractures the researchers were able to show that Гў-catenin-mediated gene transcription was activated in both bone and cartilage formation during fracture repair. In mice that lacked Гў-catenin fracture healing was inhibited, whereas in mice expressing an activated form of Гў-catenin bone healing was accelerated. Treating mice with lithium activated Гў-catenin in the healing fracture, but healing was enhanced only when treatment was given after the fracture occurred, rather than before.



These results show that that Гў-catenin functions differently at different stages of fracture repair. Although the relevance of this study to human fractures remains to be determined, activation of Гў-catenin by lithium treatment has the potential to improve fracture healing, but probably only when given in later phases of fracture healing.







Citation: Chen Y, Whetstone HC, Lin AC, Nadesan P, Wei Q, et al. (2007) Beta-catenin signaling plays a disparate role in different phases of fracture repair: Implications for therapy to improve bone healing. PLoS Med 4(7): e249.



THIS LINK PROVIDES ACCESS TO THE PUBLISHED PAPER:



CONTACT:


Chelsea Novak

The Hospital for Sick Children

Communications Specialist - Research Institute Public Affairs

555 University Avenue

Toronto, Ontario

Canada, M5G 1X8



About PLoS Medicine



PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit plosmedicine/



About the Public Library of Science



The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit plos/



Source: Andrew Hyde


Public Library of Science

Bone Biologics Announces Significant Milestone For Spinal Fusion Surgery Using Recombinant Protein And Demineralized Bone Matrix

Bone Biologics, Inc. announced that it has successfully completed the initial primate trials validating the efficacy of the proprietary bone growth regeneration UCB-1 (NELL-1) protein in spinal fusion surgery. 100% fusion was obtained in a 3 month period. No cystic lesion was observed. The company is currently preparing Pre-IDE studies.


Bone Biologics has been developing the protein as a Platform Technology since 2004, leveraging the previous ten years of research in the lab performed by the founding scientists at UCLA. This Platform Technology is combined with DBX(R) demineralized bone matrix to promote bone growth in spinal fusion. Results have exhibited rapid bone growth, high quality of bone, and no ectopic bone growth.


The successful primate surgical outcomes used the DBX(R) demineralized bone matrix (scaffold) produced by the Musculoskeletal Transplant Foundation (MTF). "The Musculoskeletal Transplant Foundation is a world leader in tissue research and development, and has been both a financial and strategic partner to Bone Biologics over the past four years," said Bruce A. Hazuka, CEO of Bone Biologics.


"We are very pleased with the progress that Bone Biologics has made in achieving each of their development milestones over the past four years and look forward to their continued progress toward FDA approval and commercialization on the timelines projected by the company," Bruce Stroever, CEO of MTF said.


The platform technology will be subject to the FDA review and approval process, including clinical trials. It is not currently approved for use in humans.


About The Musculoskeletal Transplant Foundation


MTF is a non-profit service organization dedicated to providing quality tissue through a commitment to excellence in education, research, recovery and care for recipients, donors and their families. In 2008, MTF distributed over 400,000 tissue grafts.


About Bone Biologics, Inc


Bone Biologics is a convergence biotechnology company focused in the orthobiologics space. The company was founded in 2004 by the research scientists who had identified and validated the product in the lab over the previous ten years. The acquisition of an exclusive worldwide license and the financing from MTF was the genesis of the development of this recombinant protein.


Bone Biologics, Inc.

bonebiologics