Source: Medical Xpress
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.
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.
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.
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.
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.
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.”
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.
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.
Although they are likely to continue to overburden their shoulders, recently published data suggest patients in wheelchairs due to a spinal cord injury may gain pain relief from rotator cuff repair.
Researchers clinically and functionally evaluated 38 patients with a spinal cord injury who were either paraplegic or quadriplegic and presented with rotator cuff pathologies between January 2005 and September 2013. Patients’ lesions were also examined.
A total of 38 shoulders in 28 patients were indicated for rotator cuff repair, which was then performed. Intraoperative lesion assessment showed more substantial injuries than were indicated via imaging.
Source: Medical News Today
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.