Cutting-edge knee surgery and pacesetting therapy for alzheimers

Cutting-Edge Knee Surgery … AND PACESETTING THERAPY FOR ALZHEIMER’S – Medical Minutes by John Schieszer

SELF-POWERED KNEE IMPLANTS

Researchers at State University of New York in the United States are now developing self-powered knee implants that could reduce the number of knee replacement surgeries. They are working on implants that can provide physicians with regular activity updates and are powered by the patient’s movement.

Knee replacement surgery is the most common joint replacement procedure, with the number of surgeries increasing every year. Many of these surgeries are done to replace an older implant or one that has worn out. Often, doctors don’t know if patients are over-exerting themselves until they begin to develop symptoms. By that point, the damage to the implant has already been done. For patients going through knee replacement surgery every five or 10 years, it is a daunting task.

Researchers decided it was time to create smarter knee implants that could monitor changes in activity as they happened. “We are working on a knee implant that has built-in sensors that can monitor how much pressure is being put on the implant so doctors can have a clearer understanding of how much activity is negatively affecting the implant,” said Sherry Towfighian, who is an assistant professor at Binghamton University in New York.

The sensors allow doctors to tell patients when a certain movement has become too much for the implant so patients can quickly adjust and avoid further damage to the implant. It helps them find the sweet spot of activity for each particular patient.

The researchers are using triboelectric energy, a type of energy that is collected from friction. Once someone walks, the friction of the micro-surfaces coming into contact with each other can be used to power the load sensors. These smart implants will not only give feedback to doctors but will help researchers in the development of future implants. “The sensors will tell us more about the demands that are placed on implants, and with that knowledge researchers can start to improve the implants even more,” said Towfighian.

WILL HYPERBARIC OXYGEN THERAPY HELP WITH ALZHEIMER’S DISEASE?

Researchers have the first PET scan-documented case of improvement in brain metabolism in Alzheimer’s disease in a patient treated with hyperbaric oxygen therapy (HBOT). There has been controversy about whether this approach really works or is a waste of money.

Dr. Paul Harch, clinical professor and director of hyperbaric medicine at LSU Health New Orleans School of Medicine, and Dr. Edward Fogarty, chairman of radiology at the University of North Dakota School of Medicine in the United States, report the first PET scan-documented case of improvement in brain metabolism in Alzheimer’s disease in a patient treated with HBOT.

The authors report the case of a 58-year-old woman who had experienced five years of cognitive decline, which began accelerating rapidly. Single photon emission computed tomography (SPECT) suggested Alzheimer’s disease. The diagnosis was confirmed by 18Fluorodeoxyglucose (18FDG) positron emission tomography (PET) brain imaging, which revealed global and typical metabolic deficits in Alzheimer’s.

The patient underwent a total of 40 HBOT treatments – five days a week over 66 days. Each treatment consisted of 1.15 atmosphere absolute/50 minutes total treatment time. After 21 treatments, the patient reported increased
energy and level of activity, better mood and ability to perform daily living activities, as well as working on crossword puzzles. After 40 treatments, she reported increased memory and concentration, sleep, conversation, appetite, ability to use the computer, more good days (5/7) than bad days, resolved anxiety, and decreased disorientation and frustration.

“We demonstrated the largest improvement in brain metabolism of any therapy for Alzheimer’s disease,” notes Dr. Harch. “HBOT in this patient may be the first treatment not only to halt but temporarily reverse disease progression in Alzheimer’s disease.”

The physicians report that, two months post-HBOT, the patient felt a recurrence in her symptoms. She was retreated over the next 20 months with 56 HBOTs (total 96) at the same dose, supplemental oxygen and medications. The first successful HBOT-treated case of Alzheimer’s disease was published in 2001. The present case report is the first patient in a series of 11 HBOT-treated patients with Alzheimer’s disease.

John Schieszer is an award-winning national journalist and radio and
podcast broadcaster of The Medical Minute.
He can be reached at medicalminutes@gmail.com.

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