Bone graft is often needed during orthopedic surgery. Bone removed from one site and grafted to another in the same patient is called autologous . Autologous bone graft is a good option for reconstruction of bone defects and breaks that don't heal. The iliac crest is the most commonly used site of donor bone. This is the boney bump felt in front of the hip. It's easy accessibility makes it a good choice. The down side is the possible side effects. Pain at the donor site is the most common problem. Reducing postoperative pain helps give patients a faster recovery time. In this study, researchers try using a continuous local anesthetic at the donor site to manage pain. Two groups of patients are compared. All patients received systemic medications for pain control. The morphine-based drug was delivered through a self-controlled pain pump. Everyone also had an infusion pump placed directly into the wound. This device was put in place during the operation as the wound was closed. Delivery ...
Question: I had a total knee replacement on the right knee on 17 January 2006, fractured a tibia in July of 2006. I was immobilized in a brace for two weeks, then a full cast for full weeks. The pain and swelling is daily, and my quality of life is affected. Are these kinds of complications common for total knee replacements? Should I expect the pain and problems to continue? Answer: Tibia fracture following knee replacement is distinctly unusual, and not usually regarded as a complication of arthroplasty . Speak with your physician about coexisting osteoporosis as it is unlikely to experience lower extremity fracture with weight-bearing in the postoperative setting. Another suggestion as something to discuss with your physician is pathologic fracture in the setting of malignancy. Although quite unlikely, when one has coexisting cancer of bone (primary or spread from another source); fracture with minimal exertion is not uncommon. Please be sure to speak with your physician ...
Recently, the pharmaceutical company Amgen (the makers of
Enbrel ) announced that the results of a Phase 3 trial had been published which
studied the drug denosumab in postmenopausal osteoporosis.
Denosumab treatment significantly increased bone density in
the lumbar spine compared to placebo, in addition to the hip, the wrist and the
total body. In another study, the drug also seemed to protect bone from erosion
in rheumatoid arthritis patients.
Denosumab is a monoclonal antibody which targets RANK
Ligand, a cell mediator that break down bone. RANK Ligand is found in many parts of bone.
What I find interesting is that Amgen is also looking at the
effect of denosumab on bone erosions in rheumatoid arthritis in a Phase 2
study. RANK Ligand-driven osteoclast
activity — osteoclasts being those cells which erode the bones — has been
implicated in the destructive bone erosions which are characteristic of rheumatoid
arthritis and other forms of er...
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