Articles Posted in Orthopedics & Sports Medicine

footballrest-150x150Even before the school bells ring to bring kids back to classes, young athletes have taken to steamy fields and other facilities for fall training — making this an ideal time to remind coaches, trainers, players, and parents to ensure important steps are taken for safety’s sake.

While injury prevention of all kinds must be paramount in school sports — programs that must focus on young folks’ recreation and enjoyment as much as competition — two problems persist and require great diligence as players ramp up their conditioning: heat injury and head trauma.

Susan Yeargin, an associate professor of athletic training at the University of South Carolina and co-author of the National Athletic Trainers Association’s position statement on heat illness, told the Washington Post that it takes all people, but especially younger players, time to adjust to the heat and humidity of late summer and early fall:

kneeinjectionSince the 1970s, some doctors have treated arthritic knees by injecting them with hyaluronic acid, a substance originally derived from the combs of roosters. Specialists have zealously promoted this therapy, costing patients a few hundred dollars a pop and repeated so widely that Medicare alone pays $300 million annually for it. Doctors argue it reduces pain and increases joint mobility.

It hardly lives up to this billing, though, offering patients scant more relief than a placebo (saline, or salt water), researchers found after scrutinizing a half century’s worth of data from 169 clinical trials involving more than 20,000 patients.

The highly popular viscosupplementation procedure, as reported by Stat, a medical and scientific news site, showed an average effect “about 2 points beyond placebo effect on a pain scale that runs from 1 to 100.” The researchers from Canada, Britain, and China concluded this from their study, as published in BMJ, a respected medical journal of the British Medical Association:

dunfee-150x150jcaspiankang-150x150What do big wave surfing and the National Football League playoffs and upcoming Super Bowl have in common? They share the challenges of confronting the significant health harms that can occur with head trauma, especially repeated impacts and outright concussions.

The rich, powerful, and influential NFL also may be illustrating how preventable damage to athletes, their lives, and loved ones can be glossed over into resignation and acceptance. As commentator Jay Caspian Kang observed in a New York Times column:

“Of all the disappearing stories in the American consciousness, none has receded from the public eye quite like football concussions. It’s hard to remember now, but less than a decade ago, President Barack Obama said that if he had a son, he would have to think ‘long and hard’ before letting him play football. Stories were published about parents pulling their children from youth and high school football; obituaries were written for the future of the sport.

dcautowreck32821wusa-300x1942021 has become a torment for the safety of the nation’s roads, as the country between January and June hit its largest six-month percentage increase in fatalities in the half-century U.S. officials have kept such records.

In the first half of ‘21, 20,160 people died in vehicle wrecks — an 18.4% increase over the comparable period in the year before.

That six-month vehicular death toll, which only now is becoming official, also was the highest recorded in 15 years.

medscrewsuw-171x300Patients, regulators, hospitals, and doctors themselves need to open their eyes and ask tougher questions about the eyebrow-raising trend occurring among a specialized set of “sawboneses” — orthopedists and neurosurgeons.

Hundreds of them are profiting handsomely, not on their  medical skills  but rather their investments in and relationships with surgical hardware. The specialists also are increasingly reliant, in dubious fashion, on medical device salespeople.

Fred Schulte, an investigative reporter with the independent, nonpartisan Kaiser Health News service, has written a pair of detailed news articles raising yet more questions about medical devices, specifically the $3 billion that floods a peculiar pipeline between those who operate on patients’ backs, knees, hips, and shoulders and the companies that provide the surgical hardware for the procedures.

davincirobot-300x176Hospitals finally are saying bull feathers to the leading maker of surgical robots that cost institutions millions of dollars annually to buy and maintain. New lawsuits against Intuitive Surgical dispute the company’s business practices, including the exclusivity it demands for its costly services and products.

But will the civil claims also crack open the door to bigger questions about daVinci robots and other such medical devices and whether they benefit patients or just add backbreaking costs to their hospital bills?

Intuitive has declined to comment on the suits filed against it in federal courts in California by the Franciscan and Kaleida health systems. The company has denied one aspect of the media reports about the suits — that it shut down its robots remotely in the middle of a patient’s operation, forcing a surgeon and his team to improvise and finish the procedure (without problems) using standard techniques.

cookmizzoudmv-150x150It’s long been routine, if often controversial, for operating rooms to welcome medical device sales people and surgical trainees to watch the work of surgeons and nurses. But now the University of Missouri health system may have reset the bar with its $16.2 million settlement with almost two dozen patients over questionable knee surgeries.

The contested procedures were performed in part by a veterinarian.

That vet, James Cook, is listed on the university’s web site as the William & Kathryn Allen Distinguished Chair in Orthopaedic Surgery. The explanatory text online and a posted video has him describing how his chief role at the school focuses on research in people and animals in joint disorders. He says he is experimenting with techniques, notably in dogs, in which live materials can be used to replace problem joints.

crackdownushealthscams-300x200With the Covid-19 pandemic ensuring that even more dollars are flooding into health care than ever, nefarious parties — including doctors, nurses, and other licensed professionals — have targeted ordinary Americans and the federal government in big-time scams. U.S. prosecutors have punched back with a nationwide fraud crackdown.

They announced that they have charged 345 individuals for “submitting more than $6 billion in false and fraudulent claims to federal health care programs and private insurers, including more than $4.5 billion connected to telemedicine, more than $845 million connected to substance abuse treatment facilities, or ‘sober homes,’ and more than $806 million connected to other health care fraud and illegal opioid distribution schemes across the country.”

The biggest part of the federal busts targeted bunko crimes in telemedicine, the medical care option that burgeoned in popularity as patients fearful of infection with the novel coronavirus sought distanced treatment.

escooterzerali-300x201As visitors and workers in the Washington, D.C., area slowly return from the Covid-19 home-stay restrictions, they may be hit with a worry about a different kind of distancing: Keeping themselves safe on byways more heavily trafficked by bicycles and scooters, notably rental models whose mechanical soundness is under increasing question.

It is difficult to predict precisely how a new normal will settle over what had become for many a difficult and sometimes distressing trip to and from the office, or for throngs of tourists, visits to sites scattered across the metropolitan area.

But transportation experts know that health precautions may force a lightening of the load on public transit, whether trains, buses, or the subway. More people may crush into the District of Columbia in cars, worsening the commuting nightmares. That also may push workers and travelers into heavier reliance on bikes and scooters — a practice that District officials had sought to foster before the coronavirus struck. They had started to thin the number of startups renting e-scooters with apps and credit cards, promising to supervise the enterprises’ activities more closely and to crackdown on the businesses’ related hazards.

dcscooter-300x150In the cooler, rainier autumnal weather, transportation officials may be planting the seeds of significant change for the health, safety, and way that residents and visitors get around Washington, D.C. They may allow a smaller number of private companies to double the number of scooters zipping around the nation’s capital by the new year. By the spring, the devices may quadruple in number.

This could mean the estimated 5,000 or more scooters in the district now would increase to 10,000 by January and to 20,000 by June.

District officials say they’re responding to a spike in demand from the public for convenient ways to get around and to do so with needing to use multiple clumsy and confusing smart phone apps.

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