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.
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.
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.”
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.”
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.
Source: Science Daily
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.
Source: Science Daily
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.
Source: Science Daily
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.
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.
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.