Kevin M. Kaplan, MD, FAAOS - Orthopaedic Surgeon Jacksonville Orthopaedic Institute (JOI)
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Kevin M. Kaplan, MD - Orthopaedic Surgeon :(904) 346-3465
Kevin M. Kaplan, MD - Orthopaedic Surgeon
Kevin M. Kaplan, MD - Orthopaedic Surgeon
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Divergent trends seen in meniscal and cartilage injuries between primary and revision ACL repair
Source
: Healio

In a community-based sample, the prevalence of articular cartilage injury increased between primary and revision ACL repair, whereas the prevalence of meniscal injury decreased, according to recent study findings.

Researchers studied 261 patients who underwent both primary and revision ACL reconstruction (ACLR) between February 2005 and September 2011 via community-based registry. Patient data (sex, age, race and BMI), procedure characteristics and descriptive statistics (medians, interquartile ranges, frequencies and proportions) were the metrics used for evaluation.

Overall, 256 patients required revision ACLR due to instability, and the remaining five were due to infection.

Cartilage injuries nearly doubled (14.9% to 31.8%) from primary to revision ACLR, whereas meniscal tears decreased overall from 54.8% at primary ACLR to 43.7% at revision. This trend was also reflected in lateral meniscus tears (32.2% at primary, 18.4% at revision), though medial meniscus tears were observed to be the same (32.6%) at both primary and revision ACLR, according to the researchers.

A 70.8% prevalence of meniscus tear in revision was observed in patients who had meniscus fixation during primary ACLR.

Disclosure: The authors have no relevant financial disclosures.

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Female athletes at highest risk for first-time noncontact ACL tear
Source
: Healio

Although multiple factors influence first-time noncontact ACL injuries, female athletes are most at risk to sustain them, according to recently published data.

Researchers reviewed first-time noncontact ACL injury data from 320,719 collegiate athletes and 873,057 high school athletes between fall 2008 and spring 2012. Athlete exposure was determined retrospectively using team-reported schedule and roster data. Effects of competition level, sport and sex on ACL injury risk were estimated by Poisson regression.

Athlete incidence rate was 0.150 per 1,000 person-days among collegiate athletes and 0.061 per 1,000 person-days among high school athletes. When adjusted for differences in sport and gender, the researchers found college athletes were significantly more likely to sustain a first-time noncontact ACL injury than high school athletes.

Overall injury incidence rate was 0.112 in female athletes and 0.063 for males. When adjusted for sport and level of play, females were more than two times more likely than males to have a first-time noncontact ACL injury.

Among all athletes, rugby and soccer players ran the highest risk of these ACL injuries (2.23 and 1.77 times more likely, respectively), according to the researchers.

Disclosure: This work was supported by the National Institutes of Health (R01 AR050421) and the Department of Energy (SC00017).

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Similar clinical outcomes found with, without acromioplasty after rotator cuff repair
Source
: Healio

After rotator cuff repair, study results showed no difference in clinical outcomes with or without acromioplasty at 2 years postoperatively.

Researchers randomly assigned 114 patients undergoing arthroscopic repair of full-thickness rotator cuff tears into acromioplasty or non-acromioplasty groups. Along with physical examination, which included range of motion and dynamometer strength testing, the researchers collected the Simple Shoulder Test, American Shoulder and Elbow Surgeons, Constant, University of California — Los Angeles and SF-12 health assessment scores and recorded intraoperative data, including tear size, repair configuration and concomitant procedures.

The researchers reviewed preoperative imaging to classify the acromial morphologic type, acromial angle and lateral acromial angulation.

Overall, 95 patients were available for a minimum of 2-year follow-up. Study results showed no significant differences in baseline characteristics, including number of tendons torn, repair configuration, concomitant procedures and acromion type and angles. All functional outcome scores improved significantly from preoperatively to all follow-up time points in both groups.

Additionally, there were no significant differences in functional outcomes between the two groups or between patients with different acromial features at any time point, according to the researchers.

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.

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Early alteration after distal radius fracture casting not associated with loss of alignment
Source
: Healio

Although cast alteration after casting for distal radius fractures is common, early cast alteration was safe and not associated with loss of alignment, according to study results.

Researchers retrospectively reviewed patient records for 296 adult patients who presented with distal radius fracture and were treated with a below-elbow circumferential plaster cast at a tertiary care hospital from 2006 to 2009. Outcome measures included patient demographics, polytrauma at the time of injury, subspecialty of the physician performing the reduction and type of cast alteration.

The researchers used radiographs to assess initial fracture characteristics and secondary displacement of reduction over time, and an analysis was performed to identify predictive variables for the early cast alteration and determine the alterations’ effects on fracture alignment.

Study results showed 22.2% of patients underwent cast alteration during the early treatment, with splitting as the most common alteration performed, followed by application of new cast and cast trimming.

Upon stratifying by fracture classification, the researchers found patients with type A fractures had an alteration frequency of 23% compared with 22% in patients with type B fractures and 21% in patients with type C fractures.

Among patients treated by orthopedic residents, 22% had their cast altered compared with 21% of patients treated by emergency room physicians.

According to study results, 36% of patients with multiple injuries had their cast altered, whereas 21% of patients with isolated distal radius fractures had their cast altered.

No type of cast alteration was found to be significantly predictive of loss of fracture alignment at 2 or 6 weeks, according to the researchers.

Disclosure: The authors have no relevant financial disclosures.

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Cayenne Medical launches new all-suture anchor system
Source:
Healio

Cayenne Medical recently announced the launch of the SureLock All-Suture Anchor System.

Indicated for use in shoulder and extremity procedures, the SureLock system is designed to provide a predictable fixation method while eliminating manual tension that can lead to pull-out or displacement of the anchor as well as partial anchor deployment.

The system minimizes bone loss and anchor footprint by requiring a smaller pilot hole compared with traditional anchors. It is also deployed through an inserter-controlled method, ensuring a greater level of control over placement, according to a company press release.

“Cayenne Medical has seen great clinical success with the SureLock All-Suture Anchor System since its limited market release earlier this year, and we are excited to announce a full market launch that allows us to open up domestic and international markets,” Dave Springer, president and CEO of Cayenne Medical, said in the press release.

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Autografts may improve ACL reconstructions
Source:
Medical News Today

Anterior Cruciate Ligament (ACL) reconstructions occur more than 200,000 times a year, but the type of material used to create a new ligament may determine how long you stay in the game, say researchers who presented their work at the Annual Meeting of the American Orthopaedic Society of Sports Medicine (AOSSM).

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Identifying risk factors for ACL re-injury
Source:
Medical News Today

Re-tearing a repaired knee Anterior Cruciate Ligament (ACL) happens all too frequently, however a recent study being presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting suggests that identification and patient education regarding modifiable risk factors may minimize the chance of a future ACL tear.

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Exercise intensity often overestimated
Source:
Medical News Today

Do you work out for health benefits and feel you are exercising more than enough? You might be among the many Canadians who overrate how hard they work out or underestimate what moderate intensity exercise means, according to a recent study out of York University's Faculty of Health.

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Risk factors identified for little league shoulder
Source:
MedicalNewsToday

As cases of Little League Shoulder (LLS) occur more frequently, the need for additional information about the causes and outcomes of the condition has become clear. Researchers presenting at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting shared new data identifying associated risk factors, common treatment options and return to play.

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NFL players return to the game after stabilizing shoulder surgery
Source: MedicalNewsToday

Shoulder instability is a common injury in football players but the rate of return to play has not been regularly determined following surgery. A new study, discussed at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting, details that return rates for NFL players is approximately 90 percent no matter what the stabilization procedure (open vs. arthroscopic).

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Anatomic features not tied to pain in rotator cuff tears
Source:
MedicalXpress

Anatomic features associated with the severity of atraumatic rotator cuff tears are not associated with pain level, according to a study published in the May 21 issue of The Journal of Bone & Joint Surgery.

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Extended capsular release unnecessary for shoulder stiffness in arthroscopic surgery
Source:
Healio

Although arthroscopic capsular release is a known treatment for shoulder stiffness, posterior extended capsular release might not be necessary in arthroscopic surgery, according to study results.

Researchers enrolled 75 patients who underwent arthroscopic capsular release for shoulder stiffness. The patients were randomly assigned to one of two groups: those in whom capsular release, including release of the rotator interval and anterior and inferior capsule, was performed (n = 37), and those in whom capsular release was extended to the posterior capsule (n = 38).

The researchers used American Shoulder and Elbow Surgeons scores, Simple Shoulder Test, VAS pain scores and range of motion (ROM) for evaluation before surgery, at 3, 6 and 12 months postoperatively, and at the last follow-up. Mean follow-up was 18.4 months.

ROM increased significantly among both groups at the last follow-up compared with preoperative scores (P < .05). However, there were no statistical differences between the two groups in American Shoulder and Elbow Surgeons scores, Simple Shoulder Test and VAS pain scores at the last follow-up (P > .05), according to the researchers.

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Shoulder activity not associated with severity of atraumatic rotator cuff tear
Source:
Healio

Among patients with atraumatic rotator cuff tears, shoulder activity was not associated with severity of the tear, but was affected by patients’ age, sex and occupation, according to study results.

Researchers prospectively enrolled patients with an atraumatic rotator cuff tear on MRI in the Multicenter Orthopaedic Outcomes Network shoulder study of nonoperative treatment. Patients were asked to complete a previously validated shoulder activity scale; 434 patients completed the scale and were included in the analysis. Mean patient age was 62.7 years.

The researchers performed a regression analysis to assess the association of shoulder activity level to rotator cuff tear characteristics, including tendon involvement and traction, as well as patient factors such as age, sex, smoking and occupation.

Shoulder activity was not associated with severity of the rotator cuff tear, according to the researchers. However, shoulder activity was negatively associated with age and female sex. According to the regression model, 69-year-old patients with rotator cuff tears were 1.5 points less active on the 20-point scale vs. identical 56-year-old patients; female patients were 1.6 points less active vs. similar male patients. Occupation was also a significant predictor of shoulder activity level, with unemployed patients predicted to be 4.8 points less active compared with employed patients.

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Elbow surgery risk may be increased by early entry to Major League Baseball
Source:
Medical News Today

The common elbow surgery made famous by Major League Baseball (MLB) pitcher, Tommy John, definitely does its job to return pitchers to the mound, but risks for having the surgery may be able to be recognized earlier in a player's career, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting. The study was the largest cohort of MLB pitchers, to date, that have undergone UCL reconstruction.

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In 'tennis elbow' tendon stimulation is the key to repair
Source:
Medical News Today

New data presented at the European League Against Rheumatism Annual Congress (EULAR 2014) show that ultrasound-guided injections of growth factors-containing platelet-rich plasma (PRP) are no more effective in treating recently developed epicondylitis than injections of saline.

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Prior TKR or revision THR causes increased periprosthetic fractures
Source:
Healio

Periprosthetic fractures are especially common in patients with prior total knee replacement or revision total hip replacement a decade after primary total hip replacement, according to study results.

Researchers identified 58,521 Medicare beneficiaries who had elective primary total hip replacement (THR) for non-fracture diagnoses between July 1995 and June 1996 and followed them using Medicare Part A claims data through 2008. Using ICD-9 codes, researchers identified periprosthetic femoral fractures occurring from 2006 to 2008. The incidence density method was used to calculate the annual incidence of periprosthetic femoral fractures, and Cox proportional hazards models were used to identify risk factors for periprosthetic fracture. The risk of hospitalization during the subsequent year was also calculated.

Overall, 55% of patients who had elective primary THR between July 1995 and June 1996 survived until January 2006, with 0.7% of these patients developing a periprosthetic femoral fracture between 2006 and 2008. The researchers found an annual incidence of periprosthetic fractures of 26 per 10,000 person-years among these individuals.

According to Cox proportional hazards models, patients had a greater risk of periprosthetic fracture after having a total knee replacement or a revision total hip replacement between the primary THR and 2006. The researchers found a three-fold higher risk of hospitalization in the subsequent year among THR patients who sustained periprosthetic femoral fracture compared with patients without fractures.

“These data will help clinicians as they portray to patients and their families the long-term concerns associated with living with a hip implant,” the researchers wrote. “The message is that periprosthetic fractures are relatively rare, though more frequent in patients with multiple implants. Further, these fractures are typically associated with the need for considerable subsequent medical care, as they are accompanied by a much greater risk hospitalization in the subsequent year than experienced by THR recipients who did not have hip fracture.”

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Obesity may be driving increasing need for knee and hip replacements in steadily younger patients
Source:
dailyRx

The impact of being overweight has far reaching health implications — implications that may be taking a toll at an earlier age.

In a new study, researchers found that packing on the pounds may be setting the stage for total knee or hip replacement at increasingly younger ages.

Further, the scientists found that being overweight or obese had a greater impact on the knee than the hip.

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ACL injury risk reduced in young athletes by universal neuromuscular training
Source:
Medical News Today

The ACL is a critical ligament that stabilizes the knee joint. An ACL injury, one of the most common sports injuries, often requires surgery and a lengthy period of rehabilitation before an athlete can return to sport and other activities. Recent research has found that screening tools, such as "hop" or isokinetic (computer/video) tests to identify neuromuscular deficits, as well as neuromuscular training programs, may reduce ACL injuries.

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Shoulder

Shock therapy improves pain and function in patients with chronic calcific shoulder tendinitis
Source:
MedicalNewsToday

Shock therapy improves pain and function in patients with chronic calcific shoulder tendinitis, according to an article published in Annals of Internal Medicine. Rotator cuff tendonitis is one of the most common causes of shoulder pain and may present with or without calcifications. There is little evidence to suggest that conventional therapies, such as rest, ice, nonsteroidal anti-inflammatory drugs, physical therapy, and subacromial corticosteroid injections can effectively ease pain or restore function. Calcific tendinitis, in particular, may be more difficult to manage and may require surgery. Extracorporeal shockwave therapy (ESWT), which uses sound waves of high or low energy that impart rapid fluctuations of pressure to tissues, has been suggested as an alternative treatment to expensive and risky surgical interventions.

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Physical therapy instructional video may be as good as an in-person visit for shoulder rehabilitation exercises
Source:
ScienceDaily

A rehab video may get the same results as an in-person visit for shoulder rehabilitation exercises, a new study suggests. "These results are significant for two reasons," said the lead researcher. "First, having an additional tool to augment what the patient learns at an initial physical therapy visit may help with exercise accuracy and hopefully therefore improve outcomes. Additionally as access to physical therapy becomes more limited due either to cost or insurance, identifying new tools to better help out patients will be essential."

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Elbow

Year-round play contributes to 10-fold increase of ulnar collateral ligament reconstruction among youth
Source:
Medical News Today

Baseball season is back and so are the injuries. But, elbow injuries, once seen as a problem for professional athletes, are becoming more prevalent among high school and middle school athletes due to increased play and competition at the youth level. Repetitive stress to a pitcher's ulnar collateral ligament (UCL) - an important stabilizing ligament of the elbow joint - can lead to pain and eventually to the inability to pitch and throw.

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In pitching injuries, the elbow is connected to the hip bone
Source:
Medical Xpress

New University of Florida research suggests that a pitcher's elbow injury could be linked to movement in the hips. Dr. Kevin W. Farmer, an assistant professor in the UF department of orthopaedics and rehabilitation, presented research at the March meeting of the American Academy of Orthopaedic Surgeons that shows a limited range of motion in a pitcher's hips could be a risk factor in injury to his elbow.

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Knee

Collagen for the knee: Gel-like implant invented
Source:
ScienceDaily

Millions of people suffer cartilage damage to the knee every year. Cartilage injuries are not only painful; they can lead to osteoarthritis decades later. In the course of the disease, the protective shock absorbing cartilage that covers the bone within the joint slowly is removed until the bone is finally exposed, typically requiring an artificial joint replacement. A biotechnology company has developed a one-step minimally-invasive surgical procedure for the treatment of cartilage defects: a gel-like implant.

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'A glass of milk a day' may delay knee osteoarthritis in women
Source:
Medical News Today

A degenerative disease causing pain and swelling of the knee joints, knee osteoarthritis currently has no cure. But researchers say drinking milk every day has been linked to reduced progression of the disease.

Publishing their results in the American College of Rheumatology journal Arthritis Care & Research, the researchers say while their findings show that women who regularly drank fat-free or low-fat milk experienced delayed progression of knee osteoarthritis (OA), those who ate cheese actually experienced an increase in progression of the disease.

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Study: UCL reconstruction surgery likely to put major league pitchers back on the field
Source:
Healio

Major League Baseball pitchers who undergo ulnar collateral ligament reconstruction have a strong likelihood of resuming their professional baseball careers after surgery, according to results of a recently published study.

“When compared with demographic-matched controls, patients who underwent [ulnar collateral ligament] UCL reconstruction had better results in multiple performance measures,” Brandon J. Erickson, MD, and colleagues stated in the study. “Reconstruction of the UCL allows for a predictable and successful return to the [Major League Baseball] MLB.”

The study analyzed 179 MLB pitchers who underwent UCL reconstruction. Overall, 174 (97.2%) resumed pitching in professional organized baseball and 148 (83%) returned to the MLB level. Mean time to return to MLB was 20.5 months and the average career after surgery was 3.9 years, however, 56 pitchers were still pitching at the start of the 2013 MLB season.

Pitchers had fewer losses, lower earned run average, losing percentage, hits per inning and fewer walks, hits and home runs allowed after UCL reconstruction than before surgery.

“There is a high rate of [return to pitching] RTP in professional baseball after UCL reconstruction,” Erickson and colleagues concluded. “Performance declined before surgery and improved after surgery.” -by Christian Ingram

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High-demand patients returned to work quickly after arthroscopic treatment of a dislocated elbow
Source:
Healio

Investigators found patients returned to work 2.7 weeks after acute arthroscopic repair of the radial ulnohumeral ligament for elbow dislocation.

Michael J. O’Brien, MD, and colleagues retrospectively reviewed the results of surgeries they performed in 14 consecutive high-demand patients. The investigators defined high-demand patients as those who needed both hands to work or play a competitive sport. One patient in the series was a surgeon.

Few guidelines exist about return to work after elbow dislocation, according to O’Brien, who presented the results at the American Academy of Orthopaedics Surgeons Annual Meeting, here.

In this series, “All patients returned to their pre-injury level of function,” he said.

The investigators followed the patients for an average of 30 months after either acute or subacute treatment of the radial ulnohumeral ligament (RUHL).

O’Brien said all patients achieved a Mayo Elbow Performance Score that was excellent and ranged from 95 points to 100 points.

According to the paper abstract, results using a goniometer showed a final range of motion from -3 º in full extension to full flexion that exceeded 130 º.

O’Brien said the return to work was longer — at about 4.6 weeks — in the patients who underwent arthroscopic stabilization subacutely.

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Ask a Sports Medicine Doc: Hip injuries among youth
Source:
VailDaily

Q: My 14 year old daughter is a competitive ski racer and has been having hip pain. Could she have a labral tear?

A: Hip injuries are on the rise in adolescent athletes. This is due to the increasing number of young athletes participating in organized sports as well as advances in technology that have improved clinician’s diagnostic ability.

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Smith & Nephew DYONICS(TM) PLAN brings first-of-its-kind, individualized surgical planning to hip arthroscopy
Source:
The Wall Street Journal

Smith & Nephew (NYSE:SNN;LSE:SN), the global medical technology business, will launch its DYONICS PLAN Hip Impingement Planning System at this week's American Academy of Orthopaedic Surgeons (AAOS) annual meeting in New Orleans. Unlike standard imaging tools, DYONICS PLAN is a revolutionary 3D software system that allows surgeons to visualize, assess and generate a comprehensive surgical report for each patient's unique Femoroacetabular impingement (FAI) surgery before that patient ever enters the operating room.

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Genetics may explain high-functioning senior athletes with hip abnormalities
Source:
Science Daily

Genetics may explain why some senior athletes are high functioning despite having one or both hip abnormalities typically associated with early onset osteoarthritis: developmental dislocation of the hip (dysplasia), a loose hip joint; or femoroacetabular impingement (FAI), a condition in which the hip bones are abnormally shaped.

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Silk-based surgical implants could offer a better way to repair broken bones
Source:
Science Daily

Using pure silk protein derived from silkworm cocoons, investigators have developed surgical plates and screws that offer improved remodeling following injury and can be absorbed by the body over time. When a person suffers a broken bone, current treatment calls for the surgeon to insert screws and plates to help bond the broken sections and enable the fracture to heal. These "fixation devices" are usually made of metal alloys. But metal devices may have disadvantages: Because they are stiff and unyielding, they can cause stress to underlying bone, among other problems.

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Trials to begin on new degradable surgical implant
Source:
BBC News Health

Researchers in Oxford have developed a degradable implant which they say has huge potential to improve surgical success rates.

The protective patch, which wraps round soft tissue repairs, will be trialled in patients with shoulder injuries.

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82% of college football players return to field after ACL surgery, shows study
Source:
News Medical

High-level college football players frequently return to the field after an ACL reconstruction, according to research presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day. The study added to earlier research by exploring specific factors that affected return to play, including player standing on rosters and year in school.

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Houston Methodist sports medicine experts discuss important facts about mouthguards
Source:
News Medical

After every play, we all see the athletes adjusting their mouthguards, but what do they actually protect? Houston Methodist sports medicine experts discuss important facts about mouthguards.

Can wearing a mouthguard prevent a concussion?

"No, mouthguards cannot prevent a concussion," said Dr. Vijay Jotwani, a sports medicine-focused primary care physician with Houston Methodist Orthopedics & Sports Medicine. "Mouthguards do not affect the movement of the brain within the skull and cerebrospinal fluid, so they are ineffective at reducing the forces on the brain that cause concussions."

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How to Prevent Winter Sports Injuries
Source:
US News

Get out and enjoy winter but take steps to protect yourself from common ski- and snowboard-related injuries such as sprains, strains, dislocations and fractures, an orthopedist says.

"No matter your skill level, everyone is susceptible to injury on the slopes," said Dr. Allston Stubbs, an associate professor of orthopedics at Wake Forest Baptist Medical Center, said in a center news release. "Most of these injuries happen at the end of the day, so you may want to think twice before going for 'one last run,' especially when you're tired."

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Study highlights differences in use of popular upper extremity procedures

Source: Healio

Researchers from Boston have found wide variation in the use of common upper extremity procedures such as rotator cuff repair, shoulder arthroscopy and carpal tunnel release.

“Our data shows substantial age and demographic differences in the utilization of these commonly performed upper extremity ambulatory procedures,” Nitin Jain, MD, MSPH, and colleagues wrote in their study. “While over one million upper extremity procedures of interest were performed, evidence-based clinical indications for these procedures remain poorly defined.”

Jain and researchers combined U.S. Census Bureau and National Survey of Ambulatory Surgery data to estimate the number of carpal tunnel releases, rotator cuff repair, non-rotator cuff repair shoulder arthroscopies and non-carpal tunnel release wrist arthroscopies performed in 2006.

Overall, carpal tunnel release had the highest rate of use, ranging from 44.2 per 10,000 persons for patients aged 75 years and older to 37.3 per 10,000 persons for patients aged 45 years to 64 years. For rotator cuff repairs, patients aged 65 years to 74 years had the highest use (28.3 per 10,000 persons).

While the most common reported indications for shoulder arthroscopy not related to rotator cuff repair included impingement, bursitis and SLAP tears; wrist arthroscopy for non-carpal tunnel cases was frequently performed for articular cartilage disorders and diagnostic reasons.

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Research to Revolutionize Indications for Knee Surgery

Source: ScienceDaily

The Finnish Degenerative Meniscal Lesion Study (FIDELITY) compared surgical treatment of degenerative meniscal tears to placebo surgery. A year after the procedure the study participants, both those in the group who underwent surgery and the ones in the placebo group, had an equally low incidence of symptoms and were satisfied with the overall situation of their knee.

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Stem Cell Therapy Following Meniscus Knee Surgery May Reduce Pain, Restore Meniscus

Source: ScienceDaily

A single stem cell injection following meniscus knee surgery may provide pain relief and aid in meniscus regrowth, according to a novel study appearing in the January issue of the Journal of Bone and Joint Surgery (JBJS).

In the first-of-its-kind study, "Adult Human Mesenchymal Stem Cells (MSC) Delivered via Intra-Articular Injection to the Knee, Following Partial Medial Meniscectomy," most patients who received a single injection of adult stem cells following the surgical removal of all or part of a torn meniscus, reported a significant reduction in pain.

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What Patients Need to Know About Revision Surgery After Hip or Knee Replacement

Source: ScienceDaily

Hundreds of thousands of hip and knee replacement surgeries are performed in the United States each year, and they are highly successful in eliminating pain, restoring mobility and improving quality of life.

Over the past two years, Dr. Westrich has seen a sharp increase in the number of people coming in for a second hip or knee replacement, called a revision surgery. When the implant wears out or another problem develops, people often need a second surgery in which the existing implant or components are taken out and replaced.

Dr. Westrich says patients should be aware of warning signs that there may be a problem, such as pain that comes on suddenly or trouble getting around. They also may have decreased range of motion. Anyone with a joint replacement experiencing these symptoms should see their doctor immediately, Dr. Westrich adds.

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Study highlights importance of Bankart lesion size for arthroscopic repair techniques
Source:
Healio

One of the first studies to analyze the outcomes of arthroscopic repair according to lesion size suggests small-sized bony Bankart lesions should be treated with a different procedure than lesions measuring 12.5% to 25% of the inferior glenoid width.

“In small Bankart lesions, restoration of capsulolabral soft tissue tension alone may be enough,” whereas in medium lesions, the osseous architecture of the glenoid should be reconstructed for more functional improvement and less pain,” Young-Kyu Kim, MD, and colleagues wrote in their study.

The researchers conducted a minimum 24-month follow-up of 34 patients with small- and medium-sized lesions that were measured by CT and treated arthroscopically. Surgeons performed capsulolabral repair using suture anchors without excision of the bony fragment for 16 small-sized lesions (<12.5% of the inferior glenoid width) and anatomic reduction and fixation using suture anchors for 18 medium-sized lesions (12.5% to 25% of the inferior glenoid width).

Overall, the investigators found the Visual Analog Scale score improved from 1.7 preoperatively to 0.5 at final follow-up (24 months). The mean modified Rowe score also improved from 59 to 91. In the medium-sized lesion group, the mean postoperative Rowe scores increased from 60 to 95 in cases of anatomic reduction compared with an increase from 56 to 76 in cases of nonanatomic reduction.

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Early motion shows results comparable to immobilization after arthroscopic rotator cuff repair
Source:
Healio

In a 30-month follow-up of young patients who underwent arthroscopic rotator cuff repair, researchers found no significant differences in shoulder function between those who had early passive range of motion and patients who were immobilized.

“There is no apparent advantage or disadvantage of early passive range of motion compared with immobilization with regard to healing or functional outcome,” Jay D. Keener, MD, and colleagues from Washington University wrote in their abstract.

The investigators studied 124 patients younger than 65 years who underwent arthroscopic repair of full-thickness rotator cuff tears and were randomized to either an early range of motion rehabilitation process or to an immobilization group that had range of motion delayed for 6 weeks. The investigators evaluated the patients using the Visual Analog Scale (VAS) for pain, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, relative Constant score and strength measurements. There were 114 patients available for final follow-up.

At 3 months postoperatively, the immobilization group had significantly better mean active range of motion into elevation and external rotation compared with the early motion cohort. “After 3 months, there were no significant differences in VAS pain score, active range-of-motion values, shoulder strength measures, or any of the functional scales between the groups at the time of the 6-month, 12-month, or final follow-up evaluation,” wrote Keener and colleagues wrote in their study.

Although the investigators’ research did not study patient satisfaction, “Immobilization did not appear to lead to greater risks of shoulder stiffness,” they wrote. There was also no difference in terms of tendon healing between groups.

“Either early passive motion or a period of early immobilization is equally safe and effective after surgical rotator cuff repair in this cohort,” the researchers wrote.

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Improper way of working out may do more harm than good
Source:
News Medical

With the coming of the new year, many people will vow to get in shape after overindulging during the holidays. However, not knowing the proper way to work out might do more harm than good.

Nearly 500,000 workout-related injuries occur each year. One reason is people want to do too much too fast and overuse their muscles. These injuries occur gradually and are often hard to diagnose in the bones, tendons and joints. Another reason is poor technique during weight and other training.

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Knee Braces for Osteoarthritis Treatment
Source:
DailyRx

Osteoarthritis is the most common joint issue for middle-aged and older adults. The good news is that there may be a simple solution to help patients deal with the pain.

A recent study examined the effectiveness of wearing a patellofemoral (the joint connecting the back of the knee cap and the thigh bone) knee brace for reducing knee pain and damaged bone marrow (tissue inside the bones).

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Surgeons Describe New Knee Ligament
Source:
Medical News Today

At the Belgian University Hospitals Leuven, two knee surgeons have for the first time given a full anatomical description of a new ligament that they term the anterolateral ligament (ALL).

At the Belgian University Hospitals Leuven, two knee surgeons have for the first time given a full anatomical description of a new ligament that they term the anterolateral ligament (ALL).

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Healing and Surviving After Knee and Hip Replacements
Source:
DailyRx

For some people with aching bones and joints, knee or hip replacement surgery may be a treatment option. But pre-existing conditions may affect how a patient responds to surgery.

A recent study found that joint replacement patients with certain pre-existing conditions had a greater risk of having a second surgery or not surviving the next one to 10 years than patients without such disorders.

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Researchers Recommend Wellness Programs for Increased Number of Young TJR Patients with Obesity
Source:
Healio

Results from a new total joint replacement database show that the increase in young patients with obesity contributes to increased rates of total joint replacement in the United States, and researchers recommend hospitals and private practices implement wellness programs to improve patient outcomes.

“Postoperative rehabilitation and support programs should target improved physical activity and diet to promote weight loss and a healthier lifestyle. We should focus on standard best practices for physical therapy and health management after joint replacement surgery,” David C. Ayers, MD, chair of the Department of Orthopaedics and Physical Rehabilitation and director of the Musculoskeletal Center of Excellence at the University of Massachusetts Medical School, told Orthopedics Today. “Such standards currently do not exist. Figuring those out, and how to lose weight, should be a priority. It has to be about more than just fixing joint pain. It has to be about long-term health, function and quality of life.”

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Socially Isolated Patients with Arthritis have more Pain After THR
Source:
Healio

SAN DIEGO – Socially isolated patients with osteoarthritis are nearly three times more likely to experience serious ongoing pain after total hip replacement than patients with good social ties, according to researchers from Hospital for Special Surgery.

“Previous studies have shown that social isolation is a risk factor for poor health outcomes,” Lisa A. Mandl, MD, MPH, from Hospital for Special Surgery, stated. “Studies show that people who don’t have good social ties are at increased risk of suffering a heart attack or stroke, and even dying, compared to those who enjoy the social support of family, friends and the community.”

In the study, social isolation was defined based on whether the patients were married, were members of any community or religious groups or had fewer than six friends or relatives. Mandl and colleagues noted that, although the 132 rheumatoid arthritis (RA) patients and 392 osteoarthritis (OA) patients had similar demographics and proportions of socially isolated patients, the OA patients had a statistically significant association with postoperative decreased WOMAC scores and social isolation, according to the abstract.

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Obesity May Limit Overall Function Two Years After Shoulder Replacement Surgery
Source:
ScienceDaily

Patients with obesity undergo a disproportionately higher number of elective orthopaedic surgeries in the U.S.

Total shoulder arthroplasty is an excellent procedure for pain relief and functional improvement in patients with shoulder arthritis.

A total shoulder replacement was able to provide this patient population (normal BMI) with improved shoulder function which resulted in a better physical function.

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Reason for Seeking Treatment Influences Preoperative Expectations of Arthroscopic Shoulder Surgery
Source:
 Healio

Researchers from the Steadman Philippon Research Institute analyzed patient expectations before arthroscopic shoulder surgery and found that while the main expectation of all patients was return to sport, secondary expectations varied in importance depending on the reason why patients sought treatment.

“Elevated importance of specific expectation questions did not universally correlate with worse preoperative subjective scoring systems,” Ryan J. Warth, MD, and colleagues from the Steadman Philippon Research Institute in Vail, Colo., wrote in the study. “Whereas return to sport was the most important expectation overall, the importance of other expectations varied by patients’ reasons for seeking treatment. The current questionnaire may have limited use in patients with shoulder instability.”

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Hours spent in Organized Sports may Predict Young Athlete Injury
Source:
Medical News Today

Athletes ages 8 to 18 who spend twice as many hours per week in organized sports than in free play, and especially in a single sport, are more likely to be injured, according to an abstract presented at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando.

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Pain Processes in Tennis Elbow Illuminated by PET Scanning
Source:
Science Daily

Physiological processes in soft tissue pain such as chronic tennis elbow can be explored using diagnostic imaging methods. This is demonstrated by researchers from Uppsala University and the results are now being published in the prestigious journal PLOS ONE. The pain physician and researcher Magnus Peterson is presenting a new use of positron emission tomography (PET) and a tracer for the signal receptor NK1 for visualising a physiological process associated with pain.

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Combating Sports-Related Concussions: New Device Accurately and Objectively Diagnoses Concussions from the Sidelines
Source:
Science Daily

In the United States there are millions of sports-related concussions each year, but many go undiagnosed because for some athletes, the fear of being benched trumps the fear of permanent brain damage, and there is no objective test available to accurately diagnose concussions on the sidelines.

Balance tests are a primary method used to detect concussion. The current means of scoring these tests relies on the skill of athletic trainers to visually determine whether or not a concussion has occurred.

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Lower degrees of dominant humeral torsion results in severe upper extremity injuries for pitchers
Source:
Healio

Major League Baseball pitchers with lower degrees of dominant humeral torsion had more severe upper extremity injuries, and pitchers with lower side-to-side differences in torsion experienced more severe dominant upper extremity injuries, according to results of this recently published study.

In the study, 25 professional pitchers from a single Major League Baseball organization underwent CT on dominant and nondominant humeri. Image data were processed with a 3-D volume-rendering post-processing program. Researchers then modified the software program to model a simplified throwing motion to measure potential internal impingement distances in number of days missed from pitching as a measure of injury severity and incidence.

Overall, the mean dominant humeral torsion was 38.5°, while the mean nondominant humeral torsion was 27.6°. Overall, 45% of pitchers were injured during follow-up. Five players had shoulder injuries, seven players had elbow injuries and two players had finger injuries.

According to the study results, dominant humeral torsion was a statistically significant predictor of severe injuries, but not of milder injuries. Researchers found a strong correlation between a high number of days missed because of injury and lower degrees of dominant humeral torsion and smaller differences between dominant and nondominant humeral torsions. Study results showed no significant association between the incidence of shoulder injury and minimum glenoid-tuberosity distance in the dominant or nondominant shoulder or degree of dominant glenoid version.

As these results show, the interplay of dominant humeral torsion, torsion difference and shoulder injury is complex,” the researchers wrote.

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Contact-sport brain trauma may affect personality and cognition
Source:
Medical News Today

Scientists have discovered that repeated brain trauma, which commonly occurs in athletes, may affect behavior, mood and thinking abilities, according to a study published in the journal Neurology.

All athletes had been diagnosed with chronic traumatic encephalopathy (CTE) following death. CTE is a brain disease linked to repeated brain trauma - most commonly found in athletes.

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Knee osteoarthritis risk unaffected by moderate exercise
Source:
Medical News Today

A new study suggests that the risk of middle-aged and older adults developing knee arthritis is unaffected by doing up to 150 minutes per week of moderate physical activity, the level recommended by the US government.

Osteoarthritis occurs when the cartilage and underlying bone in a joint break down, leading to bony overgrowth, pain, swelling and stiffness. The joints most affected are the knees, hips and those of the hands and spine. The condition, for which there is currently no cure, develops gradually, usually in the over-40s.

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Women more likely to tear ACL due to 'knock knees'
Source:
Medical News Today

Researchers say that women are nearly four times more likely to suffer from a tear to the ACL (anterior cruciate ligament) in the knee than men, but that it may be prevented by a different "landing strategy."

ACL injuries are defined as a tearing of the anterior cruciate ligament inside the knee joint. The injury causes the knee to swell, and the joint becomes too painful to bear weight.

These injuries are very common in sports where the participants are required to do many "jump stops and cuts." This includes basketball, soccer, tennis and volleyball.

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Painful frozen shoulder generally resolves, but return to mobility takes time
Source:
The Vancouver Sun

Nearly a decade has passed since Lynne Robson's first encounter with frozen shoulder. But she remembers in exquisite detail the limitations it imposed and the pain it caused her.

Frozen shoulder — also known as adhesive capsulitis — is a condition in which the capsule of connective tissue that encases the shoulder thickens and tightens around the joint. The process is extremely painful and results in a virtual immobilization of the joint, leaving the sufferer with an arm that barely functions. On average, about two-to-three per cent of people will develop frozen shoulder at some point in their lives, says orthopedic surgeon Dr. Stephen Thompson.

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How to Know If Shoulder Pain Might Be Rotator Cuff Disease
Source:
Medscape

A positive painful arc test and a positive external rotation resistance test in a patient with shoulder pain has a high likelihood of being rotator cuff disease (RCD). And a positive lag test (external or internal rotation) likely means a full-thickness rotator cuff tear.

That's according to a meta-analytic review of relevant studies. Dr. Job Hermans from Erasmus Medical Center, Rotterdam, the Netherlands and colleagues say they did the analysis to identify the most accurate clinical examination findings for RCD.

The studies they included involved patients referred to a specialist (orthopedist, rheumatologist, or sports medicine physician) for evaluation of shoulder pain. As a result, the prevalence of RCD was high - 33% to 81%, compared to a general population prevalence of 2.8% to 15%, they noted in JAMA August 28. Among five studies with level 1-2 quality scores, a positive painful arc test result was the only finding with a positive likelihood ratio (LR) greater than 2.0 for RCD (LR 3.7). A normal painful arc test result had the lowest negative LR (0.36).

Among strength tests, a positive external rotation lag test and internal rotation lag test had the highest positive LRs (7.2 and 5.6) for full-thickness tears.

With an LR of 3.3, a positive drop arm test result "might help identify patients with RCD," the investigators say, whereas a normal internal rotation lag test result was most accurate for identifying patients without a full-thickness tear (LR 0.04).

There is a lack of data from primary care settings for findings that could be used to diagnose RCD among patients with shoulder pain," Dr. Hermans and colleagues say.

And they caution, "Because specialists performed all the clinical maneuvers for RCD in each of the included studies with no finding evaluated in more than three studies, the generalizability of the results to a nonreferred population is unknown."

Also, they say, it's unclear whether examinations performed by generalist physicians would have the same results as those performed by specialists, because differences may be attributable to the skill of the examiner as well as to the patient populations. Yet, they believe the tests "could be mastered with practice by the generalist physician."

"The approach we present of pain provocation tests, strength tests, and composite tests provides a framework for thinking about the physical examination findings and for interpreting the results," the researchers conclude.

For a patient with shoulder pain, they suggest the physician could perform a single pain provocation test (painful arc test), three strength tests (internal rotation lag test, external rotation lag test, and drop arm test), and one composite test (external rotation resistance test).

Using the general population prevalence of RCD, which increases with age, the posterior probability of disease would be 9.6% (for patients older than 30 years) to more than 40% (for patients 70 years and older), the investigators say. Among patients referred to shoulder specialists, the presence of pain during the painful arc test confers a more than 60% probability of disease.

On the other hand, general medical patients with no pain during the painful arc test would have a low probability of RCD (1%-6%). Because of the high probability of disease among patients referred to shoulder specialists, the absence of pain during a painful arc test in a referred patient does not rule out RCD, because the probability could still be as high as 13%, the investigators say. They did not respond to request for comment by press time.

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Breg Introduces New T Scope Hip Brace
Source:
PR Newswire

Breg Inc., a premier provider of sports medicine products and services, announced today the introduction of an innovative new T Scope® Hip Brace that delivers enhanced comfort, support and protection during post-operative hip rehabilitation. Hip arthroscopy is fast growing, with an estimated 70,000 procedures performed in the United States each year1. This new brace positions Breg to become a valued partner to medical professionals in this growing category.

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Orthopedists Name Needless Kinds of Care
Source:
dailyRx

American Academy of Orthopedic Surgeons issues list of unnecessary treatments. Knowing which medical treatments are needed and which aren't plays an important role in personal wellness and in creating an efficient healthcare system. Now, individuals with arthritis and other difficulties getting around have a shortlist of procedures many of them can do without.

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Athletes Need to Be Careful to Monitor Diet, Weight to Maintain Muscle Mass
Source:
ScienceDaily

Athletes seeking a healthy performance weight should eat high fiber, low-fat food balanced with their training regimen in order to maintain muscle while still burning fat, according to a report by an Oregon State University researcher.

"Depending on the sport, athletes sometime want to either lose weight without losing lean tissue, or gain weight, mostly lean tissue," she said. "This is very difficult to do if you restrict caloric intake too dramatically or try to lose the weight too fast. Doing that also means they don't have the energy to exercise or they feel tired and put themselves at risk of injury."

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Stress Fracture Risk May Be Modifiable
Source:
ScienceDaily

The incidence rate for stress fracture injuries among females was nearly three times greater when compared to males. Knee rotation and abduction angles when landing were both associated with the rates of lower-extremity stress fractures, as were reduced knee and hip flexion angles, and increased vertical and medial ground reaction forces.

"Lower extremity movement patterns and strength have previously been associated with stress fractures and overuse injuries; however, our study is one of the first to identify dynamic knee rotation and frontal plane angles as important prospective risk factors for lower extremity stress fractures.

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Passing the Ball May Also Pass Disease
Source:
ScienceDaily

UC Irvine researchers have demonstrated that basketballs and volleyballs can spread potentially dangerous germs among players. Their findings may bring a new awareness to athletes, coaches, trainers and parents regarding safe sanitation practices for athletes.

Staphylococcus aureus, a germ known for causing staph infections in athletes, was selected for the study. Methicillin-resistant Staphylococcus aureus, commonly referred to as MRSA, is a kind of staph that is particularly worrisome because of its resistance to many antibiotics. Athletes with MRSA infections often must endure emergency room visits, costly outpatient follow-ups, and time away from games and practice.

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A Popular Myth About Running Injuries
Source:
The NY Times

Almost everyone who runs (or has shopped for running shoes) has heard that how your foot pronates, or rolls inward, as you land affects your injury risk. Pronate too much or too little, conventional wisdom tells us, and you’ll wind up hurt. But a provocative new study shows that this deeply entrenched belief is probably wrong and that there is still a great deal we don’t understand about pronation and why the foot rolls as it does.

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Monitoring Nutrient Intake Can Help Vegetarian Athletes Stay Competitive
Source:
ScienceDaily

"Vegetarian athletes can meet their dietary needs from predominantly or exclusively plant-based sources when a variety of these foods are consumed daily and energy intake is adequate," Ghosh wrote in his presentation.

Vegetarians should find non-meat sources of iron, creatine, zinc, vitamin B12, vitamin D and calcium because the main sources of these typically are animal products and could be lacking in their diets. Vegetarian women, in particular, are at increased risk for non-anemic iron deficiency, which may limit endurance performance. In addition, vegetarians as a group have lower mean muscle creatine concentrations, which may affect high-level exercise performance.

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Running Is in the Knees and Ankles
Source:
DailyRx.com

A lot of hardcore runners have proper running form on the mind. Another concern they may have is foot posture. Does foot posture make a difference in staying injury-free?

A recent study found that runners with pronated feet, or feet that fall slightly inward towards the middle of the body, were less likely to get injured while running than people with other kinds of feet.

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Elbow injuries in major league baseball pitchers likely predicted by range of motion
Source:
Medical News Today

Certain elements of a pitcher's throwing mechanics can increase the risk for elbow injuries, according to information presented by researchers at the American Orthopaedic Society for Sports Medicine's Annual Meeting in Chicago, IL.

The researchers examined 296 MLB pitchers throughout eight seasons from 2005-2012. Pitchers with a deficit of more than five degrees in total range of motion (TRM) in their dominant shoulder had a 2.3 times higher risk of injury, while pitchers with a deficit of five or more degrees in shoulder flexion of the dominant shoulder had a 2.8 times higher risk of injury.

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After elbow surgery, successful long-term results enjoyed by baseball players
Source:
Medical News Today

Baseball players undergoing ulnar collateral ligament (UCL) surgery are able to return to the same or higher level of competition for an extended period of time, according to research presented at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting in Chicago, IL.

"Previous studies showed successful return to play after UCL surgery, but we were also able to evaluate each athlete's career longevity and reason for retirement," commented lead author, Daryl C. Osbahr, MD of MedStar Union Memorial Hospital in Baltimore. "These players typically returned to play within a year of surgery and averaged an additional 3.6 years of playing time, a significant amount considering the extensive nature of this surgery in a highly competitive group of athletes. They also typically did not retire from baseball secondary to continued elbow problems."

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Arthroscopic approach controls posterior shoulder instability
Source:
Medscape News

Arthroscopic capsulolabral posterior reconstruction offers advantages in posterior shoulder instability, according to researchers.

More than 90% of athletes treated for the condition in this manner are able to return to sports, Dr. James P. Bradley told Reuters Health by email.

While glenohumeral instability is relatively common, affecting 2% of the general population, posterior instability is much rarer, affecting 2% to 10% of all unstable shoulders, according to a 2011 paper in Sports Medicine (see http://1.usa.gov/15g2OcX). Posterior glenohumeral instability is mainly seen in athletes.

In a June 26 online paper in The American Journal of Sports Medicine, Dr. Bradley of the University of Pittsburgh Medical Center and colleagues observe that there are few reports of arthroscopic treatment of unidirectional posterior shoulder instability.

For the current paper, the team expanded on an earlier evaluation to include 200 shoulders in 183 athletes. All had unidirectional recurrent posterior glenohumeral instability treated with arthroscopic posterior capsulolabral reconstruction.

At a mean of 36 months postoperatively, the mean American Shoulder and Elbow Surgeons (ASES) score increased from 45.9 to 85.1. There were also significant improvements in subjective measures of stability, pain, and function.

Overall, 188 shoulders (94%) had excellent or good results on the ASES scale at the latest follow-up, and similar proportions of patients had excellent or good results on subjective measures of stability, and in terms of patient-described subjective satisfactory or full range of motion.

When a subset of 117 shoulders of contact athletes was compared with the whole cohort of 200 shoulders, no significant differences were seen.

Return to play was significantly more common among the 156 patients who had anchored plications than among the 44 with anchorless intraoperative soft tissue fixation (92% versus 84%). The anchored plication group also had higher mean ASES scores

In total, 90% of patients were able to return to sports and 64% were able to return to the same level postoperatively.

Although most articles on open repair do not address sports return, Dr. Bradley pointed out, one reported that 29% of patients were unable to return to recreational sports.

Overall, he concluded, "the data clearly demonstrate that the arthroscopic approach is superior to open techniques when compared to the historic open literature."

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When Athletic Shoes Cause Injury
Source:
NY times

Sometimes innovative science requires innovative machinery, like a moveable, four-legged robotic sled that can wear shoes, a contraption recently developed and deployed by researchers at the University of Calgary to test whether grippy athletic shoes affect injury risk.

It's well known, of course, that shoe traction influences athletic performance, especially in sports that involve sprinting or cutting, meaning abrupt rapid shifts in direction. In broad terms, more traction leads to better results.

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Additional oblique MRI improved diagnosis of ACL tears
Source:
Healio

The accuracy of diagnosing an ACL tear and efficacy in detecting ACL remnant tissue was improved with the additional use of oblique MRI, according to recently published study.

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Better posture can help ease shoulder pain from impingement
Source:
UT Sandiego

Shoulder pain from impingement occurs frequently as the rotator cuff tendons and sometimes a bursal sac get pinched under the roof of the shoulder blade or the acromion. People with a downward slope of the acromion, or who have developed bone spurs from arthritis in the adjacent acromioclavicular (AC) joint, are more susceptible to developing such impingement.

The mechanism causing this disorder may be a gradual or sudden elevation of the ball of the shoulder joint, squishing the described soft tissues against the acromion roof. The rotator cuff muscles are responsible for keeping the ball of the shoulder joint down and away from the roof as we elevate the arm.

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Relief for Rotator Cuff Tears -- Research Summary
Source:
Ivanhoe.com

The rotator cuff is made up of tendons and muscles in the shoulder.  The tendons and muscles connect the upper arm bone with the shoulder blade and they hold the ball of the upper arm bone in the shoulder socket.  The combination means greater range of motion of any joint in the body.  A rotator cuff injury can include any type of irradiation or damage to the tendons and muscles.  Causes of an injury can include lifting, falling, and repetitive arm activities (usually those that are done overhead like throwing a baseball).  About 50 percent of rotator cuff injuries can heal with self-care or exercise therapy.

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Neuraxial anesthesia improves outcomes in patients undergoing hip or knee replacement
Source:
News-Medical.Net

A highly underutilized anesthesia technique called neuraxial anesthesia, also known as spinal or epidural anesthesia, improves outcomes in patients undergoing hip or knee replacement, according to a new study by researchers at Hospital for Special Surgery. The study, which appears in the May issue of the journal Anesthesiology, found that neuraxial anesthesia, a type of regional anesthesia, reduced morbidity, mortality, length of hospital stay and costs when compared with general anesthesia.

Using neuraxial anesthesia over general anesthesia reduced the risk of pulmonary compromise by twofold in knee replacement patients and over threefold in hip replacement patients.

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Embrace the Knee Brace
Source:
dailyRx

It's been established that braces for the knees can provide relief from pain and protection from injury. But until now, not much was known on whether knee braces can pinpoint pain in the kneecap.

Knee braces can ease pain from osteoarthritis specifically in the kneecap, according to a study recently presented at a conference.

The findings show that the brace is a step forward from relying on painkillers and reducing the chances of needing joint surgery, according to researchers.

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Fat cells in knee secrete a protein linked to arthritis
Source:
News-Medical.Net

Scientists have discovered that fat cells in the knee secrete a protein linked to arthritis, a finding that paves the way for new gene therapies that could offer relief and mobility to millions worldwide.

"We found that fat in the knee joints secretes a protein called pro-factor D which gives rise to another protein known as factor D that is linked to arthritis," said Nirmal Banda, Ph.D., associate professor of medicine in the Division of Rheumatology at the University of Colorado School of Medicine. "Without factor D, mice cannot get rheumatoid arthritis."

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Knee osteoarthritis patients have improved knee loads when using specialized mobility shoe
Source:
Daily Rx

When patients with knee osteoarthritis are walking, their knees may jut out to the side. Shoes that imitate barefoot walking can help with that.

A recently published study found that wearing a "mobility" shoe keeps the knee joint more aligned in knee osteoarthritis patients.

Using flat, flexible footwear can significantly reduce knee loading in patients with the joint condition, according to researchers.

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Which knees need the knife?
Source:
Daily Rx

Jeffery Katz, MD, of Orthopedic and Arthritis Center for Outcomes Research Brigham and Women's Hospital, Boston, and colleagues led the study to determine if patients with a meniscal tear and knee osteoarthritis had better outcomes with surgery plus physical therapy or just physical therapy.

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Cartilage damage helps detect osteoarthritis?
Source:
ivanhoe.com

Osteoarthritis is the most common joint disorder and affects about one-third of older adults. New research suggests that cartilage damage from exercise may aid in early detection of osteoarthritis.

"We discovered that GAG-depleted tissue is most vulnerable to high rates of loading and not just the magnitude of the load. This finding suggests that people with early degradation of cartilage, even before such changes would be felt as pain, should be careful of dynamic activities such as running or jumping,” Grodzinsky was quoted as saying.

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3-D system could prevent shoulder injuries in baseball pitchers
Source:
Science Daily

A new 3-D motion detection system could help identify baseball pitchers who are at risk for shoulder injuries, according to a new study. The system can be used on the field, and requires only a laptop computer. Other systems that evaluate pitchers' throwing motions require cameras and other equipment and generally are confined to indoor use.

Loyola University Medical Center sports medicine surgeon Pietro Tonino, MD, is a co-author of the study, published in the journal Musculoskeletal Surgery.

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Ask well: exercises for shoulder pain
Source:
NY Times

You are certainly right that sore shoulders are common, especially as a person ages. About half of all middle-aged tennis players suffer from shoulder pain, according to a 2012 study in The British Journal of Sports Medicine, and youngsters aren’t immune either. The same study reported that about a quarter of competitive tennis players under 20 hurt their shoulders every year.

Many of these injuries involve the rotator cuff, the group of muscles and tendons at the back of the shoulder that stabilize the joint. Studies show that forces equivalent to at least 120 percent of a person’s body weight slam through the rotator cuff during a typical tennis serve or baseball pitch. To withstand that pounding, the rotator cuff needs to be strong.

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Outcomes in tennis elbow significantly improved by PRP
Source:
Medical News Today

Eighty-four percent of patients suffering from chronic tennis elbow (lateral epicondylar tendinopathy) reported significantly less pain and elbow tenderness at six months following platelet rich plasma (PRP) treatment, according to results from the largest, multi-center study, to date, on PRP and tennis elbow, presented at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Tennis elbow is a common, painful condition affecting approximately 1 to 2 percent of the population. In this study, 230 patients suffering from chronic tennis elbow who had failed traditional therapies were treated at 12 U.S. medical centers. Patients were randomized and received either an injection of PRP made from their own concentrated blood platelets, or a placebo, administered with an analgesic at the site of pain.

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Teen baseball players benefit from docking technique to repair torn elbow ligament
Source:
Medical News Today

A study at Hospital for Special Surgery (HSS) found that a surgical procedure known as the "docking technique" to repair a torn elbow ligament in teenage athletes yielded favorable results. The outcomes were better than those in previously published reports on reconstruction of the ulnar collateral ligament (UCL), also known as Tommy John surgery, in this age group and may be attributed to technique-specific factors, according to the study authors.

The paper, titled, "The Docking Technique for Elbow Ulnar Collateral Ligament Insufficiency: Two-Year Follow Up in Adolescent Athletes," was presented at the annual meeting of the American Academy of Orthopaedic Surgeons in Chicago.

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Toss the vitamin D and calcium?
Source:
DailyRx.com

Preventing the risk of fractures as you grow older is important. Previously, vitamin D and calcium supplements were thought to help reduce that risk – but recommendations have changed.

The Task Force actually recommends against vitamin D in daily doses of 400 IU or less and calcium in daily doses of 1000 mg or less because it can increase the risk of kidney stones. At those doses, supplements do not prevent fractures in younger men and women.

However, the Task Force continues to recommend vitamin D supplements to prevent falls in adults 65 and older who are at higher risk for falls.

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Why so idle with knee OA?
Source:
DailyRx.com

Being obese or overweight can make osteoarthritis worse. Staying physically active is one of the best ways to avoid putting on extra pounds. However, many osteoarthritis patients remain inactive.

These findings suggest that there may be a serious need to improve physical activity among patients with knee osteoarthritis. According to the authors, increasing physical activity among these patients will likely involve weight management, healthy diet and improving pain and disability.

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Treatment with platelet-rich plasma shows potential for knee osteoarthritis
Source:
Medical News Today

Several treatments for osteoarthritis exist, including exercise, weight control, bracing, nonsteroidal anti-inflammatories, Tylenol, cortisone shots and viscosupplementation, a procedure that involves injecting a gel-like substance into the knee to supplement the natural lubricant in the joint. A new treatment that is being studied by a small number of doctors is PRP injections. PRP, which is produced from a patient's own blood, delivers a high concentration of growth factors to arthritic cartilage that can potentially enhance healing.

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Vitamin K for healthy knees
Source:
DailyRx.com

Vitamin K supports bones and cartilage. So researchers wanted to know if low vitamin K was linked to joint damage and osteoarthritis.

The study found that people who had low levels of vitamin K in their blood were about 33 percent more likely to develop knee osteoarthritis.

Also, people with low vitamin K levels were about two times more likely to show signs of damaged cartilage in their knees.

The authors suggested that vitamin K may be important for keeping knees healthy.

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ACL insurance insight
Source:
Ivanhoe.com

ACL injuries have increased 400% in teens and adolescents in the last ten years. They’re also on the rise among baby boomers. To make sure you don’t have to pay out-of-pocket to fix the injury, doctors are using a new tool to show surgery works.

That’s where the gait-rite system comes in. This 26 foot carpet contains sensors to assess gait after injury and again after surgery to show how patients are doing.

Dr. Maloney says that, “We will have seen that their gait has been restored to what we consider normal and safe and allow them to progress.”

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FDA clears Soft Tissue Regeneration’s STR GRAFT
Source:
News Medical

Soft Tissue Regeneration, an early stage orthopedic device company that has developed a breakthrough tissue engineering platform used to regenerate ligaments and tendons, announced today that it has received FDA clearance to market its STR GRAFT, a biodegradable scaffold used for soft tissue augmentation and rotator cuff repair.

Developed by Cato T. Laurencin , M.D., Ph.D., an orthopedic surgeon and the company's founder, the STR GRAFT is a three-dimensional braided engineered matrix that Laurencin likens to a patch. During surgery, surgeons can drape this biodegradable patch over the tendon that sits on the shoulder bone, anchoring it with sutures to keep it in place while the tendon, bones and nearby tissues heal. Unlike currently available devices, which are made of weaker cadaver or animal tissue that can cause sutures to pull, the STR GRAFT is thinner—about 1 millimeter—and stronger, which lessens pain, speeds recovery time and drastically reduces surgical failure rates. 

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Heavy loads on the shoulders can cause nerve damage in the hands and fingers
Source:
  Medical News Today

Trudging from place to place with heavy weights on our backs is an everyday reality, from schoolchildren toting textbooks in backpacks to fire fighters and soldiers carrying occupational gear. Muscle and skeletal damage are very real concerns. Now Tel Aviv University researchers say that nerve damage, specifically to the nerves that travel through the neck and shoulders to animate our hands and fingers, is also a serious risk.

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Steroid injections for tennis elbow are out
Source:
HEALTH NEWS OBSERVER

Tennis elbow is also known as lateral epicondylitis. In tennis elbow, the tendons that attach the forearm muscles to the outer part of the elbow degenerate, become inflamed and develop tears. Tennis players often irritate this area during backhand strokes. Anyone who uses a twisting motion is at risk including painters, carpenters, plumbers, cooks, weight lifters, and butchers. It may also develop by some who are constantly using a computer keyboard and mouse.

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Fractures take high toll on high school athletes
Source:
MedicineNet.Com

Fractures account for about 10 percent of all injuries suffered by U.S. high school athletes, and can have a major physical, emotional and financial impact on the young competitors, according to a new study.

The findings highlight the need for fracture prevention programs in high school sports, the Ohio State University researchers said.

Researchers analyzed 2008-2009 and 2010-2011 data from the National High School Sports-Related Injury Surveillance System. Fracture rates were highest in boys' sports -- including football, ice hockey and lacrosse -- and boys suffered 79 percent of all fractures reported.

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Increase in dance-related injuries in children and adolescents
Source:
Science Daily

Dance is a beautiful form of expression, but it could be physically taxing and strenuous on the human body, particularly for children and adolescents. A new study by researchers at the Center for Injury Research and Policy of The Research Institute at Nationwide Children's Hospital examined dance-related injuries among children and adolescents 3 to 19 years of age from 1991 to 2007. During the 17-year study period, an estimated 113,000 children and adolescents were treated in U.S. emergency departments for dance-related injuries.

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Osteoarthritis: new light shed on how painful joint wear and tear develops
Source:
Science Daily

The cause of osteoarthritis -- other than known risk factors such as age or earlier injury -- is not yet known. The researchers at the MedUni Vienna have discovered, however, that certain proteins known as lectins, and in particular galectins, have a role to play in the painful wear and tear of the joints.

These new findings, according to the vision of the MedUni Vienna researchers, could lead to galectins in future being used both in the treatment and, as bio-markers, in the disease prediction of osteoarthritis.

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17 Ways to fight osteoporosis
Source:
Health.com

Most people know calcium strengthens bones. But there are more than a dozen other ways to fight osteoporosis, the silent, bone-thinning condition that can lead to fractures, back and neck pain, and a loss of up to 6 inches of height over time.

Taking preventive measures is key, as many people with osteoporosis will get bone fractures before they even know they have the disease.

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Shoulder complaint linked to diabetes diagnosis
Source:
News Medical

Study findings confirm suspicions that patients with diabetes have an increased risk for adhesive capsulitis of the shoulder (ACS).

Using insurance claims data for 96% of the Taiwanese population between 2000 and 2003, the researchers compared the incidence of ACS in 78,827 patients with at least ambulatory visits for diabetes and 236,481 age- and gender-matched individuals without diabetes.

After a median of 31.87 months of follow-up, 1.20% of diabetes patients and 0.95% of controls were diagnosed with ACS, at rates of 4.92 and 3.67 cases per 1000 person-years, respectively, say Shin-Liang Pan (National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei) and co-workers.

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Bursitis flare ups can be painful
Source:
Daily News

Today’s column will focus on bursitis. It is not the condition that someone laughingly told me that was something that occurred here every year in January when the temperatures dip below zero. Rather it is an inflammatory condition of one or more of the 150 bursae in the body.

A bursa is a fluid-filled sac that acts to reduce friction between the bone and a gliding tendon. This bursa helps the tendon by a joint move more efficiently by acting as a cushion. The most common bursae that are irritated and inflamed are the ones involving the elbows, the lateral aspect of the hips, and the anterior aspect of the knees. The bursal sac becomes inflamed or irritated in many different ways. It can become inflamed with diseases such as rheumatoid arthritis or gout. Repetitive injuries, such as kneeling, also known as housemaid’s knee, can often cause inflammation of the bursa. Trauma can also cause the bursae to become enlarged, swollen, red, and painful. Finally, infection can also cause bursal swelling and pain as well.

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Female Athletes Three Times More Likely to Suffer from Anterior Cruciate Ligament Ruptures
Source:
Science Daily

Female athletes are three times more likely to suffer from anterior cruciate ligament (ACL) ruptures, one of the most common knee injuries, compared to male athletes. The ACL is one of the four main ligaments within the knee that connect the femur (upper leg bone) to the tibia (lower leg bone). Recent research highlights the unique anatomical differences in the female knee that may contribute to higher injury rates, and should be taken into consideration during reconstructive surgery and sports training, according to a review article in the January 2013 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

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Go Ahead and Jump: Learning How to Properly Jump and Land Can Help Female Athletes Avoid Serious Knee Injuries
Source:
Science Daily

Female athletes tear their anterior cruciate ligament (ACL) six to eight times more than male athletes who play the same sport. A leading sports medicine surgeon believes incorporating a jumping and landing program into a regular training regimen can help keep women on the field and out of the operating room.

McCulloch says many women land with their knees straight and their kneecaps pointing inward and this puts an incredible amount of stress on the ACL, while men tend to land with their feet further apart with more bend in the knees. He believes a jumping/landing program involving plyometric exercises can help women train their muscles to develop a "muscle memory" that will alert their hamstrings to fire off at the right time and help them land with a bend in their knees.

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Stop elbow pain before it’s chronic
Source:
The Province

One body part where there are a number of common issues is the elbow joint. Terms like tennis elbow and golfer’s elbow get thrown around regularly when people have pain in their elbows.

Related conditions, like carpal tunnel syndrome, also involve the elbow joint and muscles of the forearm. One of the problems with elbow injuries is that this area is constantly in use. People with elbow pain commonly list simple activities like typing, driving, writing, shaking hands or turning doorknobs as movements that aggravate their condition.

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Tennis Elbow - What is Tennis Elbow?
Source:
News medical

Tennis elbow is a condition where the outer part of the elbow becomes sore and tender. It is commonly associated with playing tennis and other racquet sports, though the injury can happen to almost anybody.

The condition is also known as lateral epicondylitis ("inflammation of the outside elbow bone"), a misnomer as histologic studies have shown no inflammatory process. Other descriptions for tennis elbow are lateral epicondylosis, lateral epicondylalgia, or simply lateral elbow pain.

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Embracing the brace
Source:
Daily Rx

Knees are only meant to bend forward and backward. If a knee pops and locks up with major pain, something serious is going on there, and it's most likely an ACL injury.

The injuries often need surgery to reconstruct the ligament, followed by therapy to help rehabilitate the knee.

It does not lower pain, protect from reinjuring the knee or improve the stability of the knee. Rather, braces add an unnecessary expense to the recovery. Vitamins and other supplements also don't help in the healing process.

Beginning physical therapy shortly after surgery, ideally within a few days after, can bring great outcomes for patients.

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More magnesium, less arthritis
Source:
Daily Rx

What you put in your body can affect your risk of disease, even your risk of osteoarthritis. If you're trying to prevent this "wear-and-tear" type of arthritis, you may want to eat more almonds and spinach.

Eating more magnesium - a mineral found in many green vegetables, beans and nuts - it may lower the risk of knee osteoarthritis.

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Most damage, most gain in knee replacement
Source:
Daily Rx

If you have knee osteoarthritis, you can take steps to prevent permanent damage. For those with the damage done, joint replacement surgery may relieve pain and boost knee function.

Osteoarthritis patients with the most joint damage before surgery may be the most likely to benefit from total knee replacement.

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MRI may spot arthritis unseen by X-ray
Source:
Daily Rx

Osteoarthritis happens when joints and joint tissues wear down over time. Usually, doctors use X-ray imaging to see this joint damage. But another imaging technique may give doctors a better picture.

Magnetic resonance imaging (MRI) spotted many signs of knee osteoarthritis in patients that had no signs of knee osteoarthritis in X-ray images.

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Quit the bottle to build happy bones
Source:
Daily Rx

Avoiding alcohol combined with regular exercise can help men build the bones lost from alcoholism, a new study has found.

The amount of osteocalcin, which is a protein in the bones and teeth, increased over the eight-week period as men continued to avoid alcohol.

This means that there was a "higher rate of bone formation during continuous abstinence," the authors said in their study.

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Global efforts necessary to prevent fragility fractures due to osteoporosis
Source:
Medical News Today

The International Osteoporosis Foundation (IOF) has released a new report, revealing approximately 80 percent of patients treated in clinics or hospitals following a fracture are not screened for osteoporosis or risk of future falls. Left untreated, these patients are at high risk of suffering secondary fractures and facing a future of pain, disfigurement, long-term disability and even early death.

The report 'Capture the Fracture - A global campaign to break the fragility fracture cycle' calls for concerted worldwide efforts to stop secondary fractures due to osteoporosis by implementing proven models of care.

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Reverse surgical solution for a painful shoulder
Source:
Science Centric

A standard shoulder replacement, a decades old treatment for severe shoulder arthritis, would likely not have worked for her due to her deficient rotator cuff. However, a recently developed - and radically different - prosthesis, called a reverse total shoulder, offered the best chance of decreasing her pain and improving shoulder function.

'A normal shoulder is a ball-and-saucer joint, with its stability and motion governed to a large extent by the surrounding rotator cuff musculature,' said Dr Omer Ilhai, an orthopedic surgeon at The Methodist Hospital in Houston. 'In arthritis, the smooth cartilage overlying and cushioning the surface of the bones is worn away, leaving rough, exposed bone surfaces to rub against each other. This bone-on-bone contact is very painful and usually associated with joint stiffness.'

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Recurring Shoulder Instability Injuries Likely Among Young Athletes Playing Contact Sports
Source:
Science Daily

Summer is a peak season for many sports and with that comes sport-related injuries. Among those injuries is shoulder joint dislocation. According to a literature review in the August 2012 issue of the Journal of the American Academy of Orthopedic Surgeons, most incidents of shoulder joint instability are the result of traumatic contact injuries like force or falling on an outstretched arm; a direct blow to the shoulder area; forceful throwing, lifting or hitting; or contact with another player.

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Sports medicine physician recommends two high-tech tools to enhance patient care
Source:
News Medical

Research shows that the average person only retains 15 to 20 percent of what he or she is told during a medical appointment. According to Matt Roth, MD, associate medical director for ProMedica Sports Care, when patients have the opportunity to view actual images of their anatomy and diagnosis, their understanding and retention improves.

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Experts offer tips to help keep fall sports injury free
Source:
USnews.com

Fall sports such as soccer, football and volleyball are in high gear and players need to take steps to prevent injuries, experts say.

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Arthroscopic surgery for torn shoulder muscles in elderly patients can reduce pain
Source:
News Medical

Repairing torn shoulder muscles in elderly patients is often discouraged because of fears of complications. But a new study conducted at Rush University Medical Center has shown that minimally invasive, or arthroscopic, surgery can significantly improve pain and function.

The study has just been published online in Arthroscopy: The Journal of Arthroscopic and Related Surgery and will appear in the October issue.

"In people over the age of 70, pain is the main issue, and pain relief is a fairly reliable outcome after surgery," said orthopedic surgeon Dr. Nikhil Verma, who led the study. "Patients do not require that their shoulder function be fully restored. They just want the pain to be gone." Verma is assistant professor of orthopedic surgery at Rush.

With that requirement, Verma said, "age is not a contraindication" for the surgery.

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PCL repair surgery did not lead to growth problems in pediatric, adolescent patients
Source:
Healio.com

Following failed conservative treatment, PCL repair or reconstruction is a safe and viable treatment option for pediatric and adolescent patients with multiligament or isolated PCL injuries, according to recent study results.

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Young Athletes: Injuries and Prevention
Source:
MedicalNewsToday

High profile events like the Olympics bring the hope that witnessing and celebrating dedicated athletes at the top of their game, will inspire young people to take up sport and physical activities that help them develop confidence, lead more satisfying lives, and not least, secure long-term health by reducing their risk for developing chronic illness like diabetes, obesity, cancer and cardiovascular diseases.

But unfortunately, if they don't take appropriate measures, young athletes can instead, end up in pain, on a different path to poor health, due to avoidable sport injury.

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Study suggests new screening method for sudden death in athletes
Source:
Medical News Today

A new study suggests that echocardiography be included as part of screenings to help identify student athletes with heart problems that could lead to sudden death.

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What you need to know about thoracic outlet syndrome symptoms
Source:
carpaltunnelsymptoms

Thoracic outlet syndrome symptoms might present as a burning, tingling and numb feeling felt within the arm, hands, and fingers. In thoracic outlet syndrome (also referred to as compression syndrome), the nerves and blood vessels are compressed or squeezed as they exit the neck space and journey into the shoulder and arm. If a nerve is compressed, you will notice weakness in your grip. If a vein is compressed, your hand may well feel cold, or flip pale or bluish. This text can take a deeper check into the signs related to this ailment, causes, diagnostic tests and medical treatments.

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Autograft hip reconstruction provides good outcomes for athletes
Source:
Medical News Today

A common, painful hip condition in elite athletes may be able to be repaired with an improved surgical technique, according to researchers presenting their work at the American Orthopaedic Society for Sports Medicine's Annual Meeting in Baltimore, Maryland.

"In our review of 21 male, elite athletes who had hip pain and instability issues (hypoplastic or labrum tear), 81 percent returned to play at a similar level as before they were hurt, after receiving an arthroscopic reconstruction technique using an ipsilateral iliotibial band autograft," said research author, Marc J. Philippon, MD, of the Steadman Philippon Research Institute in Vail, Colorado.

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Cartilage damage treated safely with platelet-rich plasma therapy
Source:
Medical News today

When it comes to treating cartilage tears in athletes, Platelet Rich Plasma (PRP) therapy is a safe and effective method of treatment, according to research presented at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting in Baltimore.

"As athletic participation has grown," Kon noted, "new problems like cartilage lesions, or tears, continue to emerge. Finding the right approach to treatment is difficult, but PRP has emerged as a viable option according to our research."

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Knee ligament injuries may be more common in men: study
Source:
Reuters

Men have a greater number of knee ligament injuries than women, despite research suggesting that women's knees are more prone to anterior cruciate ligament (ACL) tears and surgeries to fix them, according to a Swedish study.

The report, published in the American Journal of Sports medicine, counted the injuries across the entire Swedish population, not just among players of particular sports or in certain regions.

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Muscle wasting caused by aging and heart failure can be slowed by exercise
Source: MedicalNewsToday

Exercise can counteract muscle breakdown, increase strength and reduce inflammation caused by aging and heart failure, according to new research in Circulation, an American Heart Association journal. The benefits for heart failure patients are similar to those for anyone who exercises: there's less muscle-wasting, and their bodies become conditioned to handle more exercise. Age of the patients didn't matter, either, researchers found.

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It’s baseball season -- and also shoulder-injury season
Source: NYDailyNews

As the pros warm up during spring training in Florida and Arizona, it’s a good time for recreational baseball and softball players also to consider how they can avoid injury.

“Unfortunately, as they’re gearing up for the spring season, some people always lose out due to injury,” says Parsons. “Throwing injuries and overuse often lead to shoulder pain, which for weekend warriors is most often due to a strain of the rotator cuff.

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Treating traumatic shoulder injuries: new standards to improve patient care
Source: Medical NewsToday

Traumatic shoulder injuries that result in a patient visit to the ER often contain a secondary injury that can cause pain and discomfort in that part of the body after the primary injury has healed. By focusing on the primary injury, radiologists sometimes miss the secondary injury, which can compromise treatment effectiveness. Trainees in the Brigham and Women's Hospital Radiology Residency Program developed new protocols aimed at drawing ER radiologists' attention to the potential presence of secondary shoulder injuries. Better identification of these injuries could lead to improved patient outcomes.

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Effect of timing of surgery in partially injured ACLs
Source: Healio.com

This study demonstrates an important and clinically relevant finding, adding support to the theory that early surgical reconstruction of partially injured ACLs is beneficial for protecting the intact bundle and menisci and promotes patients resuming a normal life. The results of the current study indicate that as the time between partial injury of the ACL and surgery increases, the risk of secondary loosening of the intact bundles and associated lesions increased gradually; therefore, the ruptured band of the ACL should be reconstructed early, which may not result in arthrofibrosis.

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Knee injuries in women linked to motion, nervous system differences
Source: Healio.com

The reason women are more prone to knee injuries than men may go beyond differences in muscular and skeletal structure, according to researchers from Oregon State University.

“There are some muscular and skeletal differences between men and women, but that doesn’t explain differences in injury rates as much as you might think,” study author Samuel T. Johnson stated in an Oregon State University news release. “No one has really studied the role of the nervous system the way we have in explaining these differences, specifically the way sensory information is processed and integrated with motor function in the spinal cord.”

“We’re finding differences in nervous system processing,” Johnson stated. “The causes for those differences are unclear, but it may be due to either a biological difference, such as hormones, or a cultural difference such as different exercise and training patterns.”

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Indications and techniques for hip arthroscopy continue to evolve
Source: Healio.com

"Hip arthroscopy is an evolving science," Charles A. Bush-Joseph, MD, of Midwest Orthopaedics at Rush in Chicago, told Orthopedics Today. "We are clearly better able to more accurately diagnose hip and groin conditions. Industry is catching up. There has been dramatic innovation in the equipment surgeons use to perform these types of procedures, making them more reliable and reproducible."

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High impact sports reduce durability of hip implants
Source: Healio.com

French researchers have confirmed that high-impact sport, such as jogging or soccer, increases the risk of total hip arthroplasty mechanical failure, according to a study published in Clinical Orthopaedics and Related Research.

“Since participation in sport is now a reality for a significant number of total hip arthroplasty (THA) patients, surgeons may need to adapt their choices of bearing surfaces in implants to accommodate this growing trend,” the authors wrote.

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Is carpal tunnel syndrome really just a wrist problem?
Source: EzineArticles

Most conventional carpal tunnel treatments focus solely on the wrist. This approach is, of course, designed to attempt to reduce symptoms of hand pain, numbness and/or weakness. However, the true cause is rarely sought after, hence, these treatments are often times worthless and, in the case of surgery, can actually make matters worse.

There are many factors that will often contribute to median nerve inflammation, which is primarily responsible for the symptoms seen with carpal tunnel syndrome. It can actually be due to problems or dysfunctions in the structures in and around the neck, the shoulder, the elbow, the wrist and/or hand. This is yet another case of a specific painful condition actually caused by something called a kinetic chain disorder pattern. A fancy name for dysfunctional movement issues anywhere along a chain. In this case the chain being the neck, shoulder, elbow, wrist and hand.

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My rehab facility is now using Laser Therapy.
Source - LiteCure

Laser Therapy is an FDA cleared modality that reduces inflammation and ultimately results in pain reduction. Laser Therapy is effective in treating acute pain, chronic conditions and post-op pain.

Laser therapy treatment is safe, painless and fast. Deep Tissue Laser Therapy treatments are administered in 5 to 10 minutes. Typically patients see results after 3 to 5 treatment sessions. Deep Tissue Laser Therapy utilizes your body's own healing powers by stimulating celluar activity. Despite fast treatment times, laser therapy treatments initiate a healing process that continues to actively reduce inflammation for up 24 hours after treatment.

LiteCure Medical is the preferred brand of professional athletic trainers and is a clinically proven modality. LiteCure Medical is the leader in scientific research and education.

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Increasing exercise capacity by cooling hands
Source - MedicalNewsToday

In the study, obese women who exercised while using the AvaCore Rapid Thermal Exchange (RTX palm cooling device) improved their exercise tolerance and cardiovascular fitness.

The cooling devices cooled the palms of the hand and circulating blood, thus pulling heat off the body.

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Exercise linked to change in DNA
Source - MedicalNewsToday

The researchers explain that although the genetic makeup is not altered, DNA molecules change structurally and chemically when a person exercises. An example of this is the DNA gaining more or losing parts of methyl groups that are found on sequences of DNA families.

During the study, DNA within skeletal muscle was taken from people who had just experienced a round of exercise. The DNA showed less methyl groups than it had before the person's work out. The changes were found in the areas of DNA which work as stopping places for a certain kind of enzymes, called transcription factors. These enzymes are very important in terms of muscles and exercise.

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Trampoline Advice Issued By Orthopedic Surgeons
Source - MedicalNewsToday

"Although trampolines can be fun for both kids and adults, they pose a high risk for injuries, especially when two or more people jump at one time. Orthopedic surgeons recommended that trampolines not be used in home environments or in outdoor playgrounds because of the high risk of injuries from this activity."

The AAOS has created an audio public service message as well as a position statement regarding trampoline safety in order to prevent injuries sustained from trampolines, rather than treat them.

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In children with ACL injuries, surgery delay can cause irreparable meniscus tears
Source - MedicalNewsToday

For children aged 14 and under, delaying reconstructive surgery for anterior cruciate ligament (ACL) injuries may raise their risk of further injury, according to a new study by pediatric orthopaedic surgeons. If surgery occurs later than 12 weeks after the injury, the injury may even be irreparable.

ACL injuries have increased among children and young adults in recent years, possibly because of increased participation in high-level sports such as football, skiing, lacrosse, hockey and soccer, all of which place a high demand on the knees, where the ACL is located.

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Pediatricians sound alarm on overuse sports injuries
Source - ScienceDaily

Children are prone to sport-specific trauma to the growth plates. For example, dancers, skaters and cheerleaders are vulnerable to ankle damage, while baseball and football players tend to injure their shoulders and elbows. Runners suffer shin pain and knee problems, while gymnasts are prone to wrist damage from repetitive weight bearing.

"The combination of repetitive use and skeletal immaturity puts these youngsters at high risk for injuries, some of them long-lasting, so it is really important that young children have whole-body conditioning and engage in a variety of athletic activities rather than one sport," Valasek says.

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Stand Up: Your life could depend on it
Source - MedicalNewsToday

Standing up more often may reduce your chances of dying within three years, even if you are already physically active, a study of more than 200,000 people published in Archives of Internal Medicine shows.

The study found that adults who sat 11 or more hours per day had a 40% increased risk of dying in the next three years compared with those who sat for fewer than four hours a day. This was after taking into account their physical activity, weight and health status.

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Can surgery help you stay in the game?
Source - Boston.com

Demand for joint replacement surgery, once confined largely to patients well past retirement age, has been growing rapidly among a class of people doctors have dubbed the "young actives'' - those in the 45 to 64 age group who are determined to stay fit.

Still, even with the rise of obesity and longer lives, public health researchers say the rate of joint replacement failures requiring revisions is about 1 percent a year, mostly in the relatively younger patients who "outlive'' the 10-to-20-year working life spans of their replacement joints. And as technique and technology have improved, the rates of infection, dislocations, and other complications have declined.

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New method will increase likelihood of success in cartilage grafting procedures
SourceMedical News Today

For years, doctors have been able to treat defects in joint cartilage by grafting cartilage donated from cadavers into patients' bad joints. Using current methods, donated cartilage can be stored for 28 days for a transplant before the tissue becomes too degraded to transplant into a patient. Now, researchers from the University of Missouri have found a way to store donated cartilage more than twice as long.

In a study due to be published in the Journal of Knee Surgery, Cook and Aaron Stoker from MU's Comparative Orthopaedic Laboratory, Clark Hung and Eric Lima from Columbia University, and James Stannard, the J. Vernon Luck Sr. Distinguished Professor in Orthopaedic Surgery in the MU School of Medicine, tested tissue using their patented system, which includes storing the tissue at room temperature in a specially designed container and storage solution. The researchers found that their system preserved transplant-quality tissue for as long as 63 days. The collaborative team of researchers also developed a way to monitor the quality of the stored tissue simply by testing a few drops of their patented storage solution.

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New treatment for tennis elbow
Source: eorthopod.com

Steroid injections are no longer routinely recommended for lateral epicondylitis (tennis elbow). Instead, physical therapists offer an alternative treatment in the form of something called iontophoresis.

In this article, the use of steroid injection is compared with iontophoresis delivered in two different ways. Iontophoresis uses a small electric current to drive steroid medication through the skin. It is a noninvasive method of reducing the pain of tennis elbow.

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Prevent back, neck and shoulder pain from prolonged sitting and bad posture
Source - Natural News. com

Back, neck and shoulder pain is the natural result of prolonged sitting at work behind a computer, as is bad posture. This can cause headaches and excessive tension in neck, shoulders, arms, forearms, wrists, back, hips, thighs and legs.

Preventing back and neck pain while sitting is not an exact science as there are many differing opinions on the subject. However, there are some common denominators on which most chiropractors and other medical professionals agree

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Treatment of traumatic anterior shoulder dislocation in patients older than 60 years
Source - MD Linx

The accurate diagnosis of associated injuries after traumatic anterior shoulder dislocation in patients older than 60 is critical for the recovery of shoulder function because more than half of patients had rotator cuff tears or anterior capsulolabral lesions, which may lead to recurrent shoulder dislocation.

Satisfactory clinical outcomes without recurrence were obtained after early detection of abnormalities and different treatment modalities based on associated injuries and the number of dislocations experienced.

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Monitored heart bracelets may prevent sudden death in sport
Source: Science Daily

The use of heart bracelets connected via ICT (Information and Communication Technologies) to a system of tracking and monitoring could prevent cases of sudden death in sports activities. It could also enable an early detection of cardiac abnormalities, the prevention of certain muscle injuries and the improvement in health care times to the athlete.

The possibility of sudden death can begin to take shape with cardiac abnormalities detectable until 60 minutes before cardiac arrest occurs. The use of these bracelets enables to control these anomalies, and other aspects such as cardiac abnormalities generated by the consumption of doping substances, thus improving the completeness and reducing the costs of today's sport controls.

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PRP treatment aids healing of elbow injuries say researchers
Source: Medical Xpress

As elbow injuries continue to rise, especially in pitchers, procedures to help treat and get players back in the game quickly have been difficult to come by. However, a newer treatment called platelet rich plasma (PRP) may pose hope, according to researchers presenting their findings at the American Orthopaedic Society for Sports Medicine's Specialty Day meeting in San Francisco.

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Some seniors at greater risk of falls and hip fractures due to undiagnosed neurological disorders
Source: Medical News Today

Hip fractures are a common cause of morbidity and mortality in elderly patients. Cervical myelopathy is a common neurological condition that can diminish balance and coordination. Undiagnosed neurological disorders may predispose patients to falls and fractures. Screening for cervical myelopathy should be standard care for all hip fracture patients, to reduce the risk for additional falls and fractures.

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More new knees for baby boomers
Source — Dailyrx Relevant Health News

When traditional treatments do not work, many osteoarthritis patients turn to joint replacement surgery. Even though this surgery is common, there is little information on how many younger patients go through with it.

The rates of partial and total knee replacement surgery for those under 60 years of age have increased over the past few decades, according to a recent Finnish study. Throughout the study, women had higher rates of knee replacement than men.

According to Dr. Leskinen, "Given that younger patients may be at higher risk of artificial knee joint failure and thus in need of a second replacement surgery, long-term data are needed before widespread use of total knee arthroplasty is recommended for this patient population."

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Biomet receives FDA clearance for two new products: E1® humeral bearing for the comprehensive® reverse shoulder system and the comprehensive® segmental revision system
Source — Freshnews.com

The E1® humeral bearing with exclusive Antioxidant-Infused Technology is the first Vitamin E advanced bearing option for reverse shoulder applications. Biomet first applied the clinically successful1 E1® technology to its hip and knee products. The integration of E1® technology into the Comprehensive® Reverse Shoulder portfolio will provide surgeons and patients with an advanced bearing surface with oxidative stability, high strength and low wear.

The FDA also cleared Biomet’s Comprehensive® Segmental Revision System (SRS), a humeral replacement system designed to address significant bone loss, both proximally and distally. The Comprehensive® SRS offers oncologic options, soft tissue attachments, and multiple sizing options, and is compatible with the Comprehensive® Shoulder system and the Discovery® Elbow system.

“This system is particularly helpful for surgeons specializing in revision shoulder or elbow surgery where modularity and intra-operative flexibility is critical,” said Quin Throckmorton, MD, orthopaedic surgeon, Memphis, Tennessee. 

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