Research Roundup: Surgery Benefits Elderly Patients With Lumbar Stenosis

The following is a roundup of three recently published medical studies that provide new insights into spinal procedures and patient outcomes:

Chondral Lesions Common in Younger, Retired NFL Players With Hip Pain
American Journal of Sports Medicine

A majority of young retired NFL players with persistent hip pain were diagnosed with chondral lesions, according to recently published data.

Researchers conducted a retrospective chart review of magnetic resonance imaging (MRI) scans of 62 hips in 50 retired NFL players treated for persistent hip pain from February 2011 to December 2012. Players’ mean age was 33.

Twenty-seven hips were evaluated using MRI and the other 35 were evaluated with MRI arthrogram. Both methods were assessed for labral tears, chondral leasions, ligamentum teres (LT) tears, bone cysts, osteophytes, loose bodies, trochanteric bursitis and alpha angle. Player demographis, position and number of seasons played also were recorded.

Chondral lesions were found in 98 percent of the patients, though labral tears (89 percent) and partial or complete LT tears also were common (81 percent). Researchers found no players with trochanteric bursitis or loose bodies. Subchondral bone cysts were found in 14.5 percent of players, and paralabral cysts and hips with osteophytes each were found in 5 percent of players, according to the researchers.

Patella Denervation Improves Patient Satisfaction Fexion Range After TKA
Journal of Arthroplasty

Patients who underwent circumferential denervation of the patella during primary total knee arthroplasty without patellar resurfacing experienced improved patient satisfaction and range of flexion two years post-operatively, according to recent study results.

Researchers randomly assigned 126 patients undergoing primary total knee arthroplasty to receive patella denervation or no patella denervation. The researchers performed assessment preoperatively and at three, 12 and 24 months post-operatively. Mean follow-up for patients in the denervation group was 26.5 months, and 26.3 months in the no denervation group.

Patients in the denervation group experienced significantly better patella scores in reference to anterior knee pain, as well as better VAS scores for anterior knee pain at three months, but not at 12 and 24 months, according to the study. The analysis also found a significantly better mean overall patellar score at three months in the denervation group, but not at 12 and 24 months. Patients in the denervation group expressed higher satisfaction with the procedure. Flexion also was higher at three, 12 and 24 months in the denervation group, the study concluded.

Surgery Benefits Elderly Patients With Lumbar Stenosis, Spondylolisthesis

Patients 80 years and older displayed better health outcomes from surgical treatment of lumbar stenosis and degenerative spondylolisthesis than with non-operative treatment, according to a recent study.

Jeffrey A. Rihn, M.D., and colleagues at the Rothman Institute in King of Prussia, Pa., performed an as-treated analysis of patients enrolled in the Spine Patient Outcomes Research Trial for lumbar stenosis and degenerative spondylolisthesis. Surgery patients 80 years or older were compared with patients younger than 80 years old. The researchers measured clinical outcomes at baseline and at regular follow-up intervals for up to four years.

No differences in the primary or secondary patient-reported clinical outcomes were reported at baseline.

At four-year follow-up, patients older than 80 years of age who opted for surgery had significantly better improvements from baseline for all primary and secondary outcome measures compared with patients who received non-operative treatment, according to the researchers.

Additionally, patients older than 80 years had no difference in intra- or postoperative complications or reoperation rates compared with patients younger than 80 years.