geoffrey modest medical blogs

  The 2023 American College of Rheumatology and the American Association of Hip and Knee Surgeons recently released guidelines specifically addressing the optimal timing for elective hip or knee arthroplasty (see  knee or hip replacement guidelines ArthCareRes2023  in dropbox, or  https://doi.org/10.1002/acr.25175 ). Patients were also involved in this collaboration   Details : -- this guideline pertains to patients who meet the following criteria:     -- have moderate to severe pain and loss of function     -- have moderate to severe radiographic osteoarthritis (OA) or advanced osteonecrosis (ON) with secondary arthritis     -- who have also completed at least one trial of an appropriate nonoperative therapy     -- and have had detailed discussions with the surgeon along with shared decision-making, agreeing to the surgery -- this consensus document required at least 70% agreement either for or against...

  An interesting analysis of the LoDoCo2 study (Low-Dose Colchicine 2) , a non-drug company sponsored study,  found that people randomized to colchicine 0.5mg/d had fewer total knee and hip replacement surgeries (see  colchicine dec hip knee replacements AIM2023  in dropbox, or doi:10.7326/M23-0289)   Details : -- 5478 people from Australia and the Netherlands with chronic coronary artery disease were randomized to colchicine 0.5mg/d vs placebo      -- this was a double-blind RCT finding significant benefit from colchicine on recurrent cardiovascular events in those with chronic coronary artery disease (see below)     -- this current assessment of needing total knee or hip replacement (TKRs and THRs) is an exploratory analysis, since this was not a specific outcome of this study -- mean age 66, 15% female, BMI 28 -- hypertension 51%, diabetes 18%, current smoker 12%, gout 8% -- country: Australia 34%, the Netherlands 66% [...