High Tibial Osteotomy May Reduce Need for Total Knee Replacement
Many patients with knee osteoarthritis who undergo high tibial osteotomy may not require a total knee replacement for at least a decade, a Canadian study suggests.
Researchers examined data on 556 adults who underwent a total of 643 high tibial osteotomy (HTO) procedures from 2002 to 2014 at a large academic teaching hospital in Ontario. Among these patients, the cumulative incidence of total knee replacement was 5% at 5 years and 21% at 10 years, researchers report in CMAJ.
Patients were most likely to require total knee replacement during follow-up when they had greater radiographic severity of knee osteoarthritis prior to HTO (adjusted hazard ratio 1.96). The chance of needing total knee replacement also increased with each additional 10 years of age (aHR 1.50), and each 5-point increase in BMI (aHR 1.31).
“This study suggests the vast majority of patients do not go on to get a total knee replacement within 10 years of undergoing HTO,” said lead study author Codie Primeau of the School of Physical Therapy and Bone and Joint Institute at the University of Western Ontario, in Canada.
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Lung Transplant Recipients at Heightened Risk of Colorectal Polyps
Lung transplant patients are at increased risk of developing colorectal adenomas in the first few years after transplantation, possibly warranting enhanced surveillance for colorectal cancer (CRC), a new study suggests.
“When we looked at our data, we saw that these patients are developing polyps faster,” lead author Dr. David Row of St. Joseph’s Hospital and Medical Center in Phoenix told Reuters Health by phone. “Even in patients who had a negative pre-transplant colonoscopy, a significant portion of them still had polyps at the one-year follow-up.”
Solid-organ-transplant recipients are known to be at elevated cancer risk, a link that could be mediated by their use of immunosuppressive medications, Dr. Row and colleagues explain in the Journal of the American College of Surgeons. Yet most CRC-screening recommendations for these patients do not differ from guidelines for the general population, they add.
Lung recipients in particular often require high levels of immunosuppression and so “may be at exceptional risk for developing colon and rectal malignancies,” the researchers write.