Pharmaceutical Grade Chondroitin Sulfate As First-Line Treatment of Osteoarthritis

MedicalResearch.com Interview with:

Jean-Yves Reginster M.D.,PH.D. Professor of Epidemiology, Public Health and Health Economics Head of the Bone and Cartilage Metabolism Unit University of Liège

Dr. Reginster

Jean-Yves Reginster M.D.,PH.D.
Professor of Epidemiology, Public Health and Health Economics
Head of the Bone and Cartilage Metabolism Unit
University of Liège

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Whereas several recommendations, issued by scientific societies, recommend to use Symptom-Modifying Slow Acting Drugs (SYSADOAs) for the symptomatic and structural management of osteoarthritis, no medication is currently registered, in this particular indication, by the European Medicines Agency (EMA) or by the Food and Drug Administration (FDA).

This study is the first study, conducted, with a SYSADOA which fully complies with the requirements of the EMA for the assessment of drugs to be used in the treatment of osteoarthritis, i.e. a six-month duration, two co-primary endpoints (pain and function) and a three-arm design, with a placebo and an active comparator. The main findings are that pharmaceutical grade chondroitin sulfate provides an improvement in pain and function, which is greater than placebo and not distinguishable from celecoxib, a non-steroidal anti-inflammatory drug currently licensed for the symptomatic management of osteoarthritis.

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RepliCel Developing Autologous Cell Therapies For Skin, Hair and Tendon Regeneration

MedicalResearch.com with:

Lee Buckler, CEO
RepliCel Life Sciences

MedicalResearch.com: What is the background for this your company, RepliCel.com?

Response: RepliCel Life Sciences is a Canadian regenerative medicine company based in Vancouver, British Columbia that was founded in 2006. The company focuses on the development of cell therapies using a patient’s own cells (autologous cell therapy). It is developing treatments targeted at healing chronic tendon injuries that have failed to heal properly, hair restoration, and the treatment of damaged and aged skin.

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Low Magnesium May Be Linked To Increased Risk of Hip Fractures

MedicalResearch.com Interview with:

Dr Setor Kunutsor Ba(Legon), MBChB(Legon), MA(Cantab), PhD(Cantab) Research Fellow Musculoskeletal Research Unit University of Bristol

Dr. Kunutsor

Dr Setor Kunutsor Ba(Legon), MBChB(Legon), MA(Cantab), PhD(Cantab)
Research Fellow
Musculoskeletal Research Unit
University of Bristol

MedicalResearch.com: What is the background for this study?

Response: Bone fractures are one of the leading causes of disability and ill health especially among the ageing population and are a burden to health care systems. There is established evidence that calcium and vitamin D play an important role in bone health.

Magnesium is an essential trace element, being the second most abundant intracellular cation after potassium and the fourth most abundant cation in the body. It serves several important functions in the body, which include protein synthesis, nucleic acid synthesis, enzymatic reactions, and has also been shown to be cardio-protective. It is also an important component of bone, with majority (67 percent) of total body magnesium known to be found in the bone tissue. There have been suggestions from both human and animal experiments that magnesium may have a beneficial effect on bone health; however, its relationship with fractures is not very certain.

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Evaluation of Athletic Hip Injuries

MedicalResearch.com Interview with:

Christopher M. Larson, M.D. Minnesota Orthopedic Sports Medicine Institute Twin Cities Orthopedics Edina, MN

Dr. Christopher Larson

Christopher M. Larson, M.D.
Minnesota Orthopedic Sports Medicine Institute
Twin Cities Orthopedics
Edina, MN  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Until recently Athletic Hip and Pelvis disorders and the appropriate treatment strategies have not received the same attention as other sports related disorders.  There is significant overlap between intra-articular and extra-articular hip disorders that make this a challenging area of sports medicine from a diagnosis and treatment standpoint.

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Radiation Exposure in the Pediatric Patient: What Every Orthopaedist Should Know

MedicalResearch.com Interview with:
Ayesha Rahman, MD

Chief Orthopaedic Surgery Resident
NYU Langone Medical Center.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Children are more vulnerable and susceptible to lifetime adverse events from radiation exposure, caused by imaging . We reviewed literature and found certain pediatric orthopaedic patients are at greater risk for radiation exposure, namely those who have surgery for hip dysplasia, scoliosis, and leg length discrepancy, as they are among those most likely to undergo CT imaging. After reviewing all types of imaging studies performed in orthopedics and how much radiation is involved in each test, we developed several recommendations that pediatric orthopaedic surgeons should follow.

Among those recommendations are: utilize low-dose CT protocols or technology that uses less imaging (like EOS), limit CT scans of the spine and pelvis, know that female patients are more susceptible to adverse risk and plan accordingly, and follow the the “as low as reasonably achievable,”principle to limit exposure to parts of the body that are necessary for diagnosis.

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Knee Replacement Would Be More Cost Effective If Limited To Those With Severe Symptoms

MedicalResearch.com Interview with:

Bart S Ferket, MD, PhD Assistant Professor, Population Health Science and Policy Icahn School of Medicine at Mount Sinai

Dr. Bart Ferket

Bart S Ferket, MD, PhD
Assistant Professor, Population Health Science and Policy
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study?

Response: The annual rate of total knee replacement in the US has doubled since 2000, and especially in those aged 45-65 utilization of this procedure has increased. The increase in practice cannot fully be explained by an increase in the prevalence of osteoarthritis and population growth, and has been partly attributed to expansion to people with less severe symptoms. The total number of procedures performed each year now exceeds 640,000. The evidence for the benefit of total knee replacement has been based on studies without a comparison group of no total knee replacement, and so far only one randomized clinical trial has been published. Although the published literature shows large improvements of pain, physical functioning and overall quality of life following the procedure, patients included in these studies generally had severe preoperative symptoms. A number of studies have suggested, however, that up to a third of recipients of total knee replacement show no benefit, and that those with poor physical functioning before surgery may show larger improvements. Therefore, the current US patient population undergoing total knee replacement might show less significant improvement in symptoms on average as compared with a hypothetical scenario in which eligibility is limited to those with more severe symptoms.   Continue reading

Dabigatran is Associated With a Lower Risk of Osteoporotic Fractures Compared to Warfarin

MedicalResearch.com Interview with:
Wallis CY Lau BSc

Centre for Safe Medication Practice and Research
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
The University of Hong Kong

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Warfarin is a vitamin K antagonist (VKA) oral anticoagulant used for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), a common heart rhythm disorder. It works by interfering with vitamin K-dependent reactions in the process of blood clot formation. As these reactions also play a role in bone mineralization, there is concern that warfarin use may be linked with osteoporotic fracture. Despite the concerns for fracture risk, warfarin had been an inevitable treatment choice for over 50 years as there were no other alternatives available.

Dabigatran is the first non-VKA oral anticoagulant (NOAC) approved for use in patients with NVAF. Recently, an animal study reported that use of dabigatran is associated with a better bone safety profile compared to warfarin in rats, suggesting a potential for a lower risk of osteoporotic fractures over warfarin. However, the actual risk of osteoporotic fractures with dabigatran use in human remains unclear. Therefore, we conducted a population-based cohort study to compare the risk of osteoporotic fractures in patients with NVAF treated with dabigatran and warfarin.

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Psoriasis Patients At Higher Risk for Multiple Pathological Fractures

MedicalResearch.com Interview with:
Dr. Jonathan L. Silverberg MD PhD MPH

Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Response: Psoriasis is associated with a number of potential risk factors for developing osteoporosis and pathological fractures, including including low vitamin D, chronic inflammation, higher rates of cigarette smoking and systemic corticosteroid usage. We hypothesized that adults with psoriasis have higher rates of osteoporosis and pathological fractures.

We examined data from the 2002-2012 National Inpatient Sample, which contains a representative 20% sample of all hospitalizations in the United States. We found that psoriasis was associated with higher odds of osteopenia, osteoporosis, osteomalacia, ankylosing spondylitis, and pathological fractures. In particular, psoriasis was associated with vertebral, pelvic, femoral and tibial/fibular fractures. The associations between psoriasis and pathological fractures were more pronounced in women than men.

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Regular, Long-term Resistance Training or Jump-Training Increases Bone Mass

MedicalResearch.com Interview with:

Pamela S. Hinton, Ph.D. Associate Professor & Director of Graduate Studies Department of Nutrition and Exercise Physiology Columbia MO 65211

Dr. Hinton

Pamela S. Hinton, Ph.D.
Associate Professor & Director of Graduate Studies
Department of Nutrition and Exercise Physiology
Columbia MO 65211

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study builds on our previous work showing that weight-bearing, high-impact physical activity throughout the lifespan is associated with greater bone mass in men.  We previously conducted a 12-month randomized trial of the effectiveness of resistance training versus jump training to increase bone mass in men with low bone density of the hip or lumbar spine.

The current study is a follow up study investigating how exercise might work to increase bone mass.

The main findings are that exercise reduced circulating levels of a bone protein that inhibits bone formation (sclerostin) and increased levels of insulin-like growth factor-I (IGF-I), a hormone with osteogenic effects.

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Patients Can Expect To Return To Normal Function Relatively Quickly After Knee Arthroscopy

MedicalResearch.com Interview with:

Patients Can Expect To Return To Normal Function Relatively Quickly After Knee Arthroscopy MedicalResearch.com Interview with: Alexis Colvin, MD Associate Professor, Orthopaedics Icahn School of Medicine at Mount Sinai James N. Gladstone, MD Co-Chief, Sports Medicine Service, The Mount Sinai Hospital Associate Professor, Orthopaedics, Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Knee arthroscopy is one of the most commonly performed procedures in the U.S. There is minimal literature on when patients can expect to return to daily activity. We sought to help patients understand when they could expect to return to a number of basic activities, specifically in an urban environment where patients need to be mobile early. MedicalResearch.com: What are the main findings? Response: Our findings included: • Patients are off narcotics within 7 days, • Patients stop use of a cane/crutches at 8 days • Patients can drive after 14 days • Patients can go up subway stairs at 20 days • Patients sit on a toilet comfortably at 14 days • Patients return to work at 15 days MedicalResearch.com: What should readers take away from your report? Response: Patients can expect to return to relatively normal function within a short amount of time. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: We will also be looking at what other factors, such as age, BMI, medical co-morbidities, etc. can also influence how fast patients recover from this very common surgery. MedicalResearch.com: Is there anything else you would like to add? Response: MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: 2017 AAOS abstract Return to Daily Life After Meniscectomy Alexis C. Colvin, MD, New York, NY James Dieterich, BA, New York, NY James N. Gladstone, MD, New York, NY Diana Patterson, MD, New York, NY Arthroscopic meniscectomy is a frequently performed procedure, but minimal guidelines exist for counseling patients on functionality during the recovery period or time to return to daily activities. http://www.aaos.org/uploadedFiles/2017%20Final%20Program_compressed.pdf Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. More Medical Research Interviews on MedicalResearch.com

Dr. Colvin

Alexis Colvin, MD
Associate Professor, Orthopaedics
Icahn School of Medicine at Mount Sinai

James N. Gladstone, MD Co-Chief, Sports Medicine Service, The Mount Sinai Hospital Associate Professor, Orthopaedics, Icahn School of Medicine at Mount Sinai

Dr. Gladstone

James N. Gladstone, MD
Co-Chief, Sports Medicine Service, The Mount Sinai Hospital
Associate Professor, Orthopaedics, Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study?

Response: Knee arthroscopy is one of the most commonly performed procedures in the U.S. There is minimal literature on when patients can expect to return to daily activity.

We sought to help patients understand when they could expect to return to a number of basic activities, specifically in an urban environment where patients need to be mobile early.

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Tennis Elbow: Is the Problem the Joint or the Tendon?

MedicalResearch.com Interview with:

Michael Hausman, MD Chief, Hand and Upper Extremity Surgery, Mount Sinai Health System; Professor, Orthopaedics, Icahn School of Medicine at Mount Sinai

Dr. Michael Hausman

Michael Hausman, MD
Chief, Hand and Upper Extremity Surgery
Mount Sinai Health System
Professor, Orthopaedics
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study? What are the main findings?


Response
: Lateral epicondylitis has traditionally been thought of as a tendon problem, but tendon pathology has not been well documented. Our study supports our hypothesis that the problem lies within the elbow joint, rather than in the tendon outside the joint.

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The Opioid Epidemic and Orthopaedic Pain Management

MedicalResearch.com Interview with:

Dr. Hammoud

Dr. Sommer Hammoud

Dr. Sommer Hammoud MD
ABOS Board Certified Assistant Professor of Orthopedic Surgery
Thomas Jefferson University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The background for this exhibit stemmed from the growing problem of prescription opioid abuse in the United States.  As we saw this issue developing, we aimed to investigate the history behind this epidemic, what information we have now to fight it, and what information we need in the future to improve care our patients.

Our main findings for each of those aims are the following:

1) It would appear that a large push at the end of the last century led to a lower threshold to prescribe opiates in the effort to control pain, leading to the current opioid epidemic
2) Mulitmodal methods of pain control and the expanding skill of regional anesthesia can be used to help decrease narcotic use and thus limit exposure to narcotics, and
3) Future research needs to focus on the psychologic aspect of patients’ ability to manage pain and we should strive to be able to categorize patients in order to create an individualized pain management protocol which will most effectively manage pain.

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