Spring 2013

 
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66th Annual Mtg

VOS 66th Annual Meeting
May 3-5, 2013
Mandarin Oriental Hotel
WashinGton, DC




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Clinical News
 

By Quanjun "Trey" Cui, MD
VOS Newsletter Editor

Important: Food and Drug Administration (FDA) Safety Communication on
Metal-on-Metal Hip Implants

The U.S. Food and Drug Administration (FDA) issued a Safety Communication on metal-on-metal hip implants which includes recommendations on imaging a patient with a metal-on-metal hip implant. The FDA is providing updated safety information and recommendations to health care providers. This new information is based on the FDA’s current assessment of metal-on-metal hip implants, including the benefit-risk ratio derived from available data, evaluation of the published literature, and the results of the June 2012 Orthopaedic and Rehabilitation Devices Advisory Panel meeting.


Read more: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm335775.ht

Johnson & Johnson Analysis Estimated Failure Rate of ASR® Hips at 37 Percent
in Less than Five Years

Bloomberg reports that according to an internal analysis conducted by Johnson & Johnson, 37 percent of the company’s DePuy ASR® XL metal-on-metal (MoM) hip implants would fail within 4.57 years. The analysis was conducted in 2011, after an August 2010 recall of the ASR system. In announcing the recall, the company cited unpublished data from the United Kingdom showing that within 5 years, 13 percent of ASR XL Acetabular System hips had failed and needed revision, and 12 percent of ASR Hip Resurfacing Systems had failed. However, in March 2011, the British Orthopaedic Association and the British Hip Society said preliminary data put the ASR XL’s failure rate in the United Kingdom as high as 49 percent after 6 years.

Read more:
http://www.bloomberg.com/news/2013-01-23/j-j-study-showed-37-percent-hip-failure-rate-records-found.html

Medicare Payment Contractors Increase
Scrutiny of Physician Claims

According to American Medical News, Medicare payment contractors have begun to scrutinize physician claims for patient office visits more closely, due to concern over increased billing of higher-level evaluation and management (E&M) services. A contractor that oversees payments on the West Coast has launched prepayment reviews of high-intensity new patient office visits billed by certain specialties in California, Hawaii, and Nevada, while another has begun reviewing subsequent hospital care E&M services on a prepayment basis in North Carolina, South Carolina, Virginia, and West Virginia. A spokesperson for the American Academy of Family Physicians states that the increased audit activity has placed an administrative burden on physician practices.

Read more:
http://www.ama-assn.org/amednews/2013/02/04/gvsb0204.htm

Study: Hip Fracture Risk Increases When Initiating Blood Pressure Medication
According to data presented at the annual meeting of the American Society for Bone and Mineral Research, antihypertensive drugs, particularly angiotensin II–converting enzyme (ACE) inhibitors and beta-adrenergic blockers, may be associated with an immediate increase in hip fracture risk during the initiation of treatment in hypertensive community-dwelling elderly. The research team conducted a population-based, self-controlled case series study of 301,591 patients from healthcare administrative databases in Ontario, Canada, from April 1, 2000 through March 31, 2009. The researchers identified 1,463 hip fractures during the observation period. Hypertensive elderly initiated on an antihypertensive drug had a 43 percent increased risk of hip fracture during the first 45 days following treatment initiation relative to the control periods.

Read more: http://www.asbmr.org/Meetings/AnnualMeeting/AbstractDetail.aspx?aid=0898984c-2fb4-49b5-9fca-1224177b7b01

Orthopaedic Research Society
2013 Annual Meeting Presentation Highlights by UVA Orthopaedic Research Laboratories

Francis Shen Lab:  Brian Werner, MD and his colleagues presented their research entitled, "Implications of adipose-derived stromal cells in a 3D culture system for osteogenic differentiation: an in vitro and in vivo investigation." The study has shown that Human adipose-derived stromal cells (hADSCs) cultured by the hanging droplet technique successfully formed multi-cellular aggregates (MAs) at the air-fluid interface. Adipose-derived stromal cells cultured in monolayer or as 3D MAs retain their ability to self-replicate and undergo multilineage differentiation as confirmed by increased runx2/Cbfa2, ALP, and OCN and increased matrix mineralization on histologic sectioning. Multi-cellular aggregate cells expressed increased differentiation potential and extracellular matrix production over the same human ADS cells cultured in monolayer. Furthermore, MAs reseeded onto monolayer retained their stem cell capabilities. When implanted in vivo, significantly greater bone volume and extracellular matrix were present in the implanted specimens of MAs confirmed on both microCT and histological sectioning. The study also won the 2012 Outstanding Paper: Runner-up in The Spine Journal.

Nicole Deal Lab: Veda Madhu, PhD and her colleagues presented their study entitled, "Dual inhibition of BMP and TGF-β signaling pathways in human adipose derived stem cells promotes neuronal differentiation." The study revealed that hADSCs treated with TGF-β and BMP inhibitors when implanted subcutaneously in mice demonstrated axon sprouting and that a PCL/RBM scaffold promotes neurite extension of PC12 cells (neuron like cells) more effectively as compared to a PCL scaffold alone. The strategy of TGF/BMP signaling inhibition has not been investigated using hADSCs or any other adult stem cells.

Quanjun (Trey) Cui Lab:  Xinlin Yang, PhD and his colleagues presented their NIH- funded studies entitled, "Nano-fullerol enhances osteogenic differentiation of multipotent stem cells." It is well recognized that osteoporosis and osteonecrosis are major adverse consequences of corticosteroid use. Increased adipogenesis and decreased osteogenesis are observed in corticosteroid-treated bone marrow stem cells in vitro and after the administration of corticosteroids in animals and humans. Studies from Cui Lab have shown that nano-fullerol, a powerful antioxidant, inhibits adipogenesis while enhancing osteogenesis in murine and human mesenchymal cells. The findings represent a novel therapeutic approach that can prevent or reverse corticosteroid-induced osteoporosis and osteonecrosis.