Orthopedists' Respond!
Orthopaedic community demonstrates its resilience, compassion in face of Hurricanes Harvey, Irma, and Maria
The Atlantic hurricane season was unusually intense in 2017, spawning five major hurricanes. Hurricanes Harvey, Irma, and Maria, in particular, were especially destructive due to their intensity, duration, and sheer physical size.
Although so many different geographic regions were severely impacted by devastating winds and flooding, the hurricanes did not cause high numbers of musculoskeletal injuries. Nonetheless, the orthopaedic community responded in droves to provide both medical and nonmedical support.
Within an archived special coverage section, AAOS Now presents accounts of individual and collective heroics, selflessness, and compassion, ranging from orthopaedic surgeons traveling by boat to rescue patients from flood waters to surgeons using pool noodles for makeshift reduction. These stories only represent a fraction of what occurred but illustrate how the orthopaedic community steps to the fore when catastrophe visits.
Although so many different geographic regions were severely impacted by devastating winds and flooding, the hurricanes did not cause high numbers of musculoskeletal injuries. Nonetheless, the orthopaedic community responded in droves to provide both medical and nonmedical support.
Within an archived special coverage section, AAOS Now presents accounts of individual and collective heroics, selflessness, and compassion, ranging from orthopaedic surgeons traveling by boat to rescue patients from flood waters to surgeons using pool noodles for makeshift reduction. These stories only represent a fraction of what occurred but illustrate how the orthopaedic community steps to the fore when catastrophe visits.
How Sports Empower Women
Bert R. Mandelbaum, MD, DHL (Hon)
In opening new opportunities for female athletes, Persian Gulf countries, including Saudi Arabia and Kuwait, have taken a step forward for democracy as well as sports. Sports physicians should encourage this trend.
Saudi Arabia announced last month that women will be allowed as spectators and journalists in some of its largest sports stadiums. The move follows the kingdom's decision in 2012 to send its first female athletes to the Olympic Games. Girls in the kingdom will take physical education classes in school for the first time starting in 2018.
Meanwhile, Kuwait has launched women's basketball, table tennis, and athletic leagues for the first time.
These steps fall short of allowing equal participation in sports for women, but they show that progress is continuing to reverse a pattern of discrimination that stretches back over 2000 years.
History of Women's Participation in Sports
The Olympic Games of ancient Greece banned women both as participants and spectators, and men competed nude. The modern Olympic Games also excluded women when they started in 1894. But increased participation by women has paralleled advances in women's political rights. Women competed in tennis, sailing, croquet, equestrian sports, and golf in the Olympics of 1900, 11 years before the first-ever International Women's Day.
In 1928, athletic and gymnastic events opened to women in the Olympics, 8 years after women won the right to vote in the United States. Finally in 2012, when boxing was opened to them, women had access to all the sports available to men in the Olympics.
But the most important event in the history of women's sports in the United States came in 1972, when the Title IX law prohibited sex discrimination in all educational programs receiving federal funds.[1]
That movement to educate and empower women continues to grow around the world, even in the face of resistance. The Malala Fund is one organization carrying on that work. It was named for Malala Yousafzai, who survived an assassination attempt as a teenager after advocating for girls' education in Pakistan. The fund has supported female athletes, such as Pakistani squash player Noorena Shams.
In opening new opportunities for female athletes, Persian Gulf countries, including Saudi Arabia and Kuwait, have taken a step forward for democracy as well as sports. Sports physicians should encourage this trend.
Saudi Arabia announced last month that women will be allowed as spectators and journalists in some of its largest sports stadiums. The move follows the kingdom's decision in 2012 to send its first female athletes to the Olympic Games. Girls in the kingdom will take physical education classes in school for the first time starting in 2018.
Meanwhile, Kuwait has launched women's basketball, table tennis, and athletic leagues for the first time.
These steps fall short of allowing equal participation in sports for women, but they show that progress is continuing to reverse a pattern of discrimination that stretches back over 2000 years.
History of Women's Participation in Sports
The Olympic Games of ancient Greece banned women both as participants and spectators, and men competed nude. The modern Olympic Games also excluded women when they started in 1894. But increased participation by women has paralleled advances in women's political rights. Women competed in tennis, sailing, croquet, equestrian sports, and golf in the Olympics of 1900, 11 years before the first-ever International Women's Day.
In 1928, athletic and gymnastic events opened to women in the Olympics, 8 years after women won the right to vote in the United States. Finally in 2012, when boxing was opened to them, women had access to all the sports available to men in the Olympics.
But the most important event in the history of women's sports in the United States came in 1972, when the Title IX law prohibited sex discrimination in all educational programs receiving federal funds.[1]
That movement to educate and empower women continues to grow around the world, even in the face of resistance. The Malala Fund is one organization carrying on that work. It was named for Malala Yousafzai, who survived an assassination attempt as a teenager after advocating for girls' education in Pakistan. The fund has supported female athletes, such as Pakistani squash player Noorena Shams.
Do Older Women Who Use Bisphosphonates Need Fewer Knee Replacements?
NEW YORK (Reuters Health) - The rate of knee replacement surgery among older women with knee osteoarthritis is lower in those who take bisphosphonates than in those who don't, according to a database study.
Knee osteoarthritis accounts for 97% of all knee replacement surgeries. Trials of bisphosphonates in knee osteoarthritis have yielded conflicting results.
To learn more, Dr. Tuhina Neogi and colleagues from Boston University School of Medicine, in Massachusetts, used data from The Health Improvement Network in the UK to assess the relationship between bisphosphonate use and knee replacement surgery in 2,006 propensity score-matched pairs of older women (mean age, 76) with knee osteoarthritis. Mean follow-up was about 3 years.
The findings were published online October 7 in Annals of the Rheumatic Diseases.
In all, 138 biphosphonate initiators and 170 non-initiators had knee replacement surgery, yielding a significantly lower incidence rate among the initiators (22.0 vs. 29.1 per 1,000 person-years). Even after adjustment for potential confounders, bisphosphonate initiators were 26% less likely to undergo knee replacement surgery.
"Our findings were consistent across several sensitivity analyses that were performed to address potential residual confounding, missing data and selection bias, suggesting that it is unlikely for unaddressed biases to result in bisphosphonate initiation to have a detrimental effect," the researchers note.
"These findings, taken together with other studies' findings, support the ongoing evaluation of bone modulation as a potentially promising therapeutic target for knee osteoarthritis," they conclude.
Dr. Neogi did not respond to a request for comment.
Knee osteoarthritis accounts for 97% of all knee replacement surgeries. Trials of bisphosphonates in knee osteoarthritis have yielded conflicting results.
To learn more, Dr. Tuhina Neogi and colleagues from Boston University School of Medicine, in Massachusetts, used data from The Health Improvement Network in the UK to assess the relationship between bisphosphonate use and knee replacement surgery in 2,006 propensity score-matched pairs of older women (mean age, 76) with knee osteoarthritis. Mean follow-up was about 3 years.
The findings were published online October 7 in Annals of the Rheumatic Diseases.
In all, 138 biphosphonate initiators and 170 non-initiators had knee replacement surgery, yielding a significantly lower incidence rate among the initiators (22.0 vs. 29.1 per 1,000 person-years). Even after adjustment for potential confounders, bisphosphonate initiators were 26% less likely to undergo knee replacement surgery.
"Our findings were consistent across several sensitivity analyses that were performed to address potential residual confounding, missing data and selection bias, suggesting that it is unlikely for unaddressed biases to result in bisphosphonate initiation to have a detrimental effect," the researchers note.
"These findings, taken together with other studies' findings, support the ongoing evaluation of bone modulation as a potentially promising therapeutic target for knee osteoarthritis," they conclude.
Dr. Neogi did not respond to a request for comment.