Taking the Shots out of Orthopedic Surgery

As anyone who’s had knee or hip replacement surgery knows, post-op recovery can be long and painful. There’s the learning to walk again, the physical therapy and the dreaded daily injections in the belly.

While great strides have been made in surgery for degenerative joint disease, preventing post-op complications such as deep vein thrombosis (DVT) and pulmonary embolism (PE) remains problematic. Conventional antithrombotic agents (heparin and low-molecular-weight heparin) have to be given by injection into fatty subcutaneous tissue, usually into the leg or abdomen, for days or weeks after surgery and discharge from the hospital. Not surprisingly, acceptance of, and compliance with, thromboembolic prophylaxis is limited by the need for injections, the bruising and associated risks for bleeding.

Now it seems the days are numbered for injection therapy.  A recent meta-analysis of 22 randomized trials comparing oral factor Xa inhibitors with low-molecular-weight heparin injections in adults who underwent total hip or knee replacement has just been published in the Annals of Internal Medicine.

The results showed that new generation oral antithrombotic agents, including apixaban, edoxaban, and rivaroxaban, that do not require monitoring, actually led to fewer symptomatic deep venous thrombosis.

Furthermore, there was no difference between the groups in terms of mortality, non-fatal PE, major bleeding, or bleeding leading to reoperation. The study authors therefore predict that these oral agents will likely replace low-molecular-weight heparins.

As a likely candidate for future joint replacement, thanks to a family history of osteoarthritis, and joints wrecked by years of gymnastics and running, I for one am very grateful.

Spanx Takes a Spanking

Spanx has been in the news a lot lately. First, Forbes magazine announced that Sara Blakely, founder of the women’s slimming undergarments company, had joined the billionare’s club this year. At age 41, and having started her business at home with just $5,000, Blakely is now the world’s youngest self-made female billionaire.

Last month, Oscar winning actress Octavia Spencer, hit the headlines when she revealed, what she’d not been revealing!  Turns out, when she took home the SAG Award for Outstanding Actress in a Supporting Role for The Help, she’d been wearing three pairs of Spanx under her gown.

Now it seems the trend has spread from the red carpet to the green turf. This week, ConsumerReports.org warned of the dangers of teens in Spanx. The on-line watchdog reported the tale of a 15-year-old high school soccer player who was recently referred to her doctor because of numbness, tingling, and discomfort in her left thigh that had bothered her for a few weeks. The diagnosis: a compressed nerve in her pelvis. The likely cause: Spanx. While doctors have previously warned of the health dangers associated with skinny jeans, such as  fertility problems , bladder infections , and blood clots the doctor in question was surprised that a girl so young and fit would wear Spanx. It turns out that her entire team wears them under their soccer uniforms.

Body slimmers are the latest fad to hit the athletic fields. Sold in an assortment of bright colors, they appeal to teenage girls who play soccer, lacrosse, and softball. However, in an attempt to conceal their spandex, these girls are rolling down the waistline of their Spanx and unwittingly pressing a tight band of Lycra into their groins. The result: injuries normally associated with direct trauma or repetitive stretching and contraction of the groin muscles. The treatment: in this case, the doctor advised his patient to ditch the Spanx, and retire her skinny jeans. Not that Sara Blakely needs to worry, according to Forbes, her billion dollar business is set to at least double in size in the coming years.