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5 September 2000 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue is available on the Internet at on September 5, 2000.

Young Adults with Knee or Hip Injuries at Risk for Arthritis Later

Young adults with knee or hip injuries are at greatly increased risk for osteoarthritis in the same joint later in life, a new, prospective, cohort study finds (Article, p. 321). Researchers followed 1,321 former medical students for a median follow-up of 36 years. Study participants with previous knee injuries were five times more likely to develop knee osteoarthritis and those with previous hip injuries were more than three times more likely to develop hip osteoarthritis than participants without these injuries. Researchers say that physicians should target patients with knee and hip injuries for primary prevention of osteoarthritis. Young people with recent injuries should consider using joint-stabilizing braces and cutting back on high-impact exercise to minimize further damage. Everyone with past injuries should use proper sports equipment under safe conditions, the authors say.

Models Poor Predictors of Heart Risk From Non-Heart Surgery

A study of 2,035 patients undergoing non-heart surgery found that four standard models used to predict risk for cardiac complications performed poorly (Brief Communication, p. 356). Since assessing risk for heart complications before surgery can lead to preventive therapy, such as beta-blockers, that can reduce that risk, predictive methods should be improved, the authors say. An editorial says that the four methods studied did not include factors such as the patients' functional status (Editorial, p. 834). Further, the patients studied were at extremely low risk for heart complications and, in fact, had few complications. The editorial concludes that the study shows the success of medical therapy in preventing complications rather than the failure of the risk models.

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