Simple things are often beautiful. The image is CC, a work by: Ferran Jordà / bw-color.com .

The gap between regular health care and research can sometimes be overwhelming. The researchers have the tools, the hospital change routines all the time, but they almost never meet. I’m therefore pleased to see Åstrand et al’s simple article, a follow-up of a screening program for osteoporosis that showed a decrease fracture risk about 50 %. Continue reading →

Do tourniquets leave a sour aftertaste? The image is CC by Capsicina.

Total knee arthroplasties are common procedures, about 12-13 000 primary procedures are performed each year in Sweden (population 9 million). Since over 90 % of Swedish surgeons operate in a bloodless field (applying a tourniquet to the leg prior to incision), it is interesting to see research questioning our use. Could 2013 be the beginning of the end for the tourniquet in knee arthroplasties? Continue reading →

Squash is one of my favorite sports, although unfortunately plagued by frequent achilles tendon ruptures as all racket sports. The image is CC by penguincakes.

A recent meta-analysis comparing treatments for achilles tendon ruptures caught my eye. This is probably one of the most commonly debated injuries among young orthopaedic surgeons; “what would you do if you’re achilles ruptured?”. After a few beers we can keep at it for hours… Maybe we can finally move to more interesting topics after Soroceanu et al’s excellent article. Continue reading →

Keeping the venous blood flowing after knee arthroplasty is vital. The image is CC by Dominik Starosz

As always it is interesting with a randomized controlled trial (RCT). I recently stumbled upon Westrich et al’s RCT on prophylaxis after knee arthroplasties. They randomized between aspirin and enoxaparin (LMWH) where both groups received mechanical pumps immediately after surgery. The difference in DVT:s was really small, 14% vs 18% in favor for enoxaparin. This was not significant in 275 patients. Continue reading →

MRI images can be hard to interpret, especially the meaning of different findings. The image is CC by Becky Stern

In my daily clinical work I’m often confronted with long descriptions of MRI exams by radiologists, and frequently my final conclusion is: nothing out of the ordinary. It is therefore nice to see articles from Felson’s team, where they try to shed some light onto the issue.

Englund et al showed previously that an ostearthritic knee early on has degenerative meniscal changes, and the MRI-findings of these often cause distress among both GP:s and patients. Guermanzi et al’s study goes even further, and examines knees without osteoarthritis (Kjellgren-Lawrence 0) to see what an MRI can say about a painful knee in patients above 50 years of age.

Continue reading →