American Academy Of Orthopaedic Surgeons Release: Healing Common Hip And Knee Fractures With Special Orthopaedic Care

WASHINGTON, Feb. 24 /PRNewswire/ -- Innovative surgical techniques and devices are helping to raise success rates in healing common fractures, including debilitating hip fractures in the elderly, as reported today at the 72nd Annual Meeting of the American Academy of Orthopaedic Surgeons.

Of the more than 352,000 hip fractures that occur each year in the United States, 90 percent or more are due to osteoporosis. According to Cory A. Collinge, MD, orthopaedic surgeon at Harris Methodist Hospital, Fort Worth, Tex., this bone-thinning disease makes the treatment of hip fractures more challenging. Patients with osteoporosis are at higher risk of the bone pulling away from the screw and metal implant used to hold the broken bone in place during healing.

Although the treatment of hip fractures has advanced tremendously over the years, there is still room for further improvement. Nearly 25 percent of patients who suffer a hip fracture die within one year because of complications post-surgery. These include medical problems such as pneumonia, blood clots and bed sores, and also orthopaedic-related issues such as pain, joint stiffness, leg length inequality, slow fracture healing, hardware failure and loss of functional ability or independence. "Treatment failure means more surgery, greater potential for complications and decreased quality of life," Dr. Collinge said.

In patients highly susceptible to bone detaching from the implant, orthopaedic surgeons may use an improved technique, in which a metal rod is inserted within the narrow space of the bone. These high-risk patients may also receive a newer type of bone cement, which resorbs -- or goes away -- over a period of one to two years. "In the short term, the resorbable bone cement augments fixation of the screw," explained Dr. Collinge, "but it's easier to inject into the correct place in the hip than non-resorbable bone cement."

Another advancement in the treatment of hip fractures is increased recognition and treatment of the usual underlying cause, osteoporosis. "Five years ago, people were being treated for hip fractures, but not osteoporosis. These days, that is no longer the case," Dr. Collinge said. "A hip fracture may be the first sign that a person has osteoporosis, so this injury often provides an opportunity to treat the disease."

Fractures around an artificial hip or knee are less common, but are harder to treat and occur increasingly more often today, according to William M. Ricci, MD, orthopaedic surgeon at Washington University/Barnes Jewish Hospital, St. Louis.

"Fractures around an artificial joint prosthesis are becoming more common, partly because of the growing number of joint replacements performed on the U.S. population," said Dr. Ricci. The most common fracture site after a fall in someone who had a hip or knee replaced is the femur, also called the thigh bone. Orthopaedic surgeons insert screws and metal implants called plates into the broken bone to hold it in place. New plate fixation devices for treating fractures around an artificial knee use screws that lock into the plate, preventing the plate from loosening, offering improved stability.

Historically, a bone graft also was performed on many of these fracture patients, using bone from cadavers. Thanks to surgical advances, a bone graft is no longer needed, which eliminates any risk of possible disease transmission from outside tissue. Healing is also faster with the latest surgical techniques. "As a result of surgical advances, success rates for healing fractures around the prosthesis have improved to approximately 90 percent for the knee and to above 90 percent for the hip," Dr. Ricci explained. "There is more hope for people with these difficult-to-treat fractures."

Extending beyond the hip and knee, outcomes from the treatment of other common fractures have improved and complications have decreased in the care of broken bones in the ankle, shoulder and forearm, added Dr. Ricci.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

With 28,000 members, the American Academy of Orthopaedic Surgeons ( ) or ( ) is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals, and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade ( ) the global initiative in the years 2002-2011 to raise awareness of musculoskeletal health, stimulate research, and improve people's quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade in support of these objectives. The Academy's Annual Meeting is being held February 23-27, 2005, at the Washington Convention Center in Washington, DC.

American Academy of Orthopaedic Surgeons

CONTACT: Carlye Fallon, +1-847-384-4035, , orKory D'Angelo, +1-847-384-4034, , both of AAOS

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