Orthopedics, Pain Research / 07.10.2024
When to Consider Joint Replacement: Key Signs You Shouldn’t Ignore
Our joints are pretty amazing, aren’t they? They keep us moving, bending, stretching, and dancing. But sometimes, the wear and tear of life catches up to us, and our joints begin to protest – loudly. When the pain becomes persistent, you might wonder, “Is it time for a joint replacement?” While this can feel like a big decision, knowing when to take that next step can make all the difference for your quality of life.
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The knees are equally essential for us all — athlete or not. It’s the single most important joint for basic mobility. But, for MMA practitioners, it means much more than that. Due to the dynamic nature of the sport, the knees go through immense strain during training and fights. From kicking, takedowns, and submission defense, the knees do the heavy lifting for it all. To make matters worse, a “leg kick” to the knee can sometimes be enough to cause a fracture then and there.
With all that in mind, it makes sense that ligament tears, strains, and knee sprains aren’t uncommon in this sport. Problems usually stem from insufficient rest or overuse, conditioning, poor technique, or just bad luck (for example if you’re fighting Justin Gaethje, the meanest leg-kicker).
Your best bet against these risk factors is to build and maintain optimal knee health all year round. Have a proactive approach by incorporating knee rehab and strengthening exercises. Even if your knees aren’t injured, they can still be inflamed or overworked, so some rehabilitation movements could go a long way.
Dr. Magruder[/caption]
Matthew Magruder, MD PGY3
Orthopaedic Residency Program
Department of Orthopaedic Surgery and Rehabilitation
Maimonides Medical Center
MedicalResearch.com: What is the background for this study?
Response: The prevalence of obesity and diabetes mellitus has reached epidemic proportions. Approximately 37.3 million people in the United States, accounting for 11.3% of the total population, have diabetes, and 100.1 million, or 41.9%, of all US citizens are obese. Furthermore, these numbers are only projected to increase in the coming decades. This is an issue for orthopaedic surgeons because diabetes and obesity have consistently been demonstrated to be risk factors for complications following total joint replacements, especially total hip replacements. Therefore, we are in desperate need of new and more effective tools in mitigating the risk of poor outcomes in our joint replacement patients.
Semaglutide, and other GLP-1 agonists, are potentially a new tool that can be used to help decrease the risks following joint replacement surgery. Initially a medication to treat diabetes, semaglutide has recently been approved by the FDA to treat obesity as well, as randomized controlled trials have consistently demonstrated significant weight loss with minimal side effects. The purpose of our study was to see what effect the use of semaglutide had on total hip arthroplasty patient outcomes.
Ridge Maxson[/caption]
Ridge Maxson
M.D. Candidate, Class of 2024
Johns Hopkins University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Dog walking is an increasingly popular mode of physical activity for adults in the US, but its injury burden and associated risk factors are not fully understood. This study found that the 3 most common injuries sustained by adult dog walkers in the US were finger fracture, TBI, and shoulder sprain or strain. Dog walking-related injuries sent approximately 423,000 adults to US EDs between 2001 and 2020, with an annual average of more than 21,000 visits. During that 20-year period, the estimated annual injury incidence increased by more than 4-fold. Among injured dog walkers, older adults and women were particularly vulnerable to serious injury, such as fracture and TBI.
Dr. Hussain[/caption]
Dr Monira Hussain
Dr. LeBoff[/caption]
Meryl S. LeBoff, MD
Dr. Manson[/caption]
JoAnn E. Manson, MD, DrPH
Professor, Epidemiology, Harvard T.H. Chan School Of Public Health
Michael and Lee Bell Professor of Women's Health, Medicine, Harvard Medical School
Chief, Preventive Medicine, Brigham And Women's Hospital
Co-Director, Womens Health, Brigham And Women's Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Osteoporosis is a major public health problem. Although supplemental vitamin D has been widely used to reduce the risk of fractures in the general population, studies of the effects of vitamin D on fractures, the most important bone health outcome, have been conflicting.
Randomized controlled trials, the highest quality studies, from around the world have shown benefit, no effect, or even harm of supplemental vitamin D on risk of fractures. Some of the trials used bolus dosing, had small samples sizes or short study duration, and co-administered calcium. No large RCTS of this scale tested whether daily supplemental vitamin D (without co-administration with calcium) prevented fractures in the US population.
To fill these knowledge gaps, we tested the hypothesis in this ancillary study to VITAL, whether daily supplemental vitamin D3 reduced the risk of incident total, non-spine and hip fractures in women and men in the US.
Prof. Monsonego Ornan[/caption]
Efrat Monsonego Ornan, Ph.D
Head of School of Nutritional Sciences
Institute of Biochemistry and Nutrition
The Robert H. Smith Faculty of Agriculture,
Food and Environment
The Hebrew University of Jerusalem
MedicalResearch.com: What is the background for this study?
Response: Food supplies in recent decades have been dominated by heavily processed, ready-to-eat products. Essentially, 75% of all world food sales are of processed foods. Over the past 30 years, children’s ultra-processed food intake has increased markedly, with 50% of the children in the US consuming these foods. Only in the US does UPF comprise 58% of energy intake, of which 90% is derived from added sugars. This reflects children’s excessive consumption of food and drink that are high in fat and refined sugars but do not provide appropriate levels of the proteins, vitamins and minerals required for growth.
The negative health outcomes of excessive consumption of Ultra-processed food are well known, include obesity, metabolic syndrome and diabetes, and considered as the current world epidemic; the fact that children, during their postnatal development period (birth to adolescent), are the target of the Ultra-processed food industry is very disturbing in terms of public health. Bone development and growth are the characteristic phenomena of the childhood period. Yet, in spite of the huge importance of nutrition to bone development, the impact of Ultra-processed food consumption on skeleton development during childhood has never been studied directly, and this was the purpose of our study.
To this end, we used young rats which are an excellent pre-clinical model for growth and fed them with either the recommended diet for their age or a diet comprised of a typical Ultra-processed meal (a roll, hamburger, tomatoes, lettuce, ketchup and French fries) and a caloric soft drink. 
Dr. Magnusson[/caption]
Karin Magnusson PT, PhD
Associate Researcher
Lund University and
Norwegian Institute of Public Health
MedicalResearch.com: What is the background for this study?
Response: Anterior cruciate ligament (ACL) injury is one of the most common knee injuries, for which very limited data has been presented on the genetic contribution. Based on our knowledge of the role of genetics in the development of ACL-rupture related traits, such as joint hypermobility and knee osteoarthritis, we hypothesized that heritability might play a role also in ACL injury.
Using the Swedish Twin Registry, which is the world's largest twin registry and in this study including more than 88.000 twins, we had unique data to for the first time reliably estimate the heritability for this common knee injury. 
Christos V. Chalitsios[/caption]
Christos Chalitsios B.Sc, M.Sc PhD student
Funded by British Medical Association (BMA)
School of Medicine
Division of Respiratory Medicine
University of Nottingham
City Hospital,Nottingham
MedicalResearch.com: What is the background for this study?
Response: Inhaled (ICS) and oral (OCS) corticosteroids play a crucial role in the control of airway inflammation in asthma. Given that the use of ICS in asthma is likely to increase with the recent change in GINA guidance recommending combined long-acting-β2-agonists with ICS at step 1 and the upward trend in prescribing of OCS, we sought to clarify the link between steroids, osteoporosis and FF in patients with asthma, stratifying the risk by dose, number of courses and type of steroids. The prevalence of patients receiving at least one bisphosphonate was also calculated.
Dr. Cavanaugh[/caption]
Alyson Cavanaugh, PT, PhD
Joint Doctoral Program in Epidemiology
University of California, San Diego/ San Diego State University
MedicalResearch.com: What is the background for this study?
Response: More than 700,000 total knee replacements are performed annually in the United States, but there is a racial disparity in outcomes after the surgery. If the knee replacement procedure is considered a highly effective treatment, why don't black women present with the same outcomes as whites?
Physical function when going into surgery has a large impact on the potential functional outcomes after surgery. Our hypothesis was that black women were presenting to surgery with poorer physical function, which was contributing to poorer functional outcomes after surgery.
