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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: 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.

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

    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.

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

    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.

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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

    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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