Blog

• Linked total elbow arthroplasty associated with low complication rates at 4-year follow-up

  Posted on: 05 October, 2016

  Orthopedic surgeons from Liverpool, United Kingdom, who prospectively studied a linked elbow arthroplasty system in 100 consecutive patients found an acceptable rate of major complications at a mean follow-up of 4 years.
  Simon Frostick, MD, who presented the findings at the American Academy of Orthopaedic Surgeons Annual Meeting, here, said that the follow-up of these patients was ongoing.
  Frostick and colleagues treated these patients, who had various pathologies, with the Discovery Elbow System (Biomet; Warsaw, Ind.) in primary and revision procedures.
  “The Liverpool Elbow Score improved in all main pathology groups,” Frostick said, and those groups included patients with osteoarthritis, rheumatoid arthritis and fractures.
  The outcomes were assessed by an independent entity.
  The rate of infection in the series was 2%, and the 4% loosening rate that the investigators reported at the last follow-up was from 60 patients.
  “The ulnar neuropathy rate was comparable to other series,” Frostick said.

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

  Posted on: 05 October, 2016

  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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• Kids Who Played Sports Made Healthy Food Choices

  Posted on: 05 October, 2016

  Playing a sport is a healthy physical activity for kids, but does it promote healthy food and drink choices as well? Over 75 percent of boys and 69 percent of girls in middle elementary grades play sports. It has already been shown that high school kids who play sports eat more fruits and vegetables than those who don’t play sports, but food and drink habits in elementary kids who play sports have not been well studied.

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• How to Prevent Winter Sports Injuries

  Posted on: 05 October, 2016

  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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• Reducing the risk of falls by motivating older people to do preventative exercise

  Posted on: 05 October, 2016

  Simple strength and balance training can effectively help to prevent falls, but Bournemouth University research shows only a minority of older people will carry out these exercises.

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• New MRI Technique Illuminates Wrist in Motion

  Posted on: 05 October, 2016

  If a picture is worth 1,000 words then a movie is worth far more, especially when it comes to diagnosing wrist problems.
  UC Davis radiologists, medical physicists and orthopaedic surgeons have found a way to create “movies” of the wrist in motion using a series of brief magnetic resonance imaging scans. Called “Active MRI,” the technique could be useful in diagnosing subtle changes in physiology that indicate the onset of conditions such as wrist instability.

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• Study highlights differences in use of popular upper extremity procedures

  Posted on: 05 October, 2016

  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.–by Christian Ingram

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• Wrist Fractures May Increase Risk of Hip Fractures

  Posted on: 05 October, 2016

  Certain types of bone fractures have the potential to put you at risk for further bone fractures — even on a different part of your body. Wrist and hip fractures are one of these combinations.
  A recent study found that patients who have suffered a Colles’ wrist fracture are at a significantly higher risk of experiencing a hip fracture, compared to people who have not had a Colles’ fracture. The researchers found that osteoporosis (bone disease) is a risk factor associated with hip fracture, especially if a patient has had a Colles’ fracture and has osteoporosis.

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• Childhood Fractures May Indicate Bone-Density Problems

  Posted on: 05 October, 2016

  Broken bones may seem like a normal part of an active childhood. About 1 in 3 otherwise healthy children suffers a bone fracture. Breakage of the bone running from the elbow to the thumb side of the wrist (distal forearm fracture) is the most common. It occurs most often during the growth spurt that children typically undergo in early adolescence.

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• Use of L-PRF in arthroscopic rotator cuff repair leads to higher vascularization

  Posted on: 05 October, 2016

  Placing leukocyte- and platelet-rich fibrin between the tendon and the bone during arthroscopic rotator cuff repair was linked to a higher vascularization response at 6 weeks compared to repair without the biologic, according to the results of this pilot study.
  “Arthroscopic rotator cuff repair with the application of [leukocyte- and platelet-rich fibrin] L-PRF is technically feasible and yields higher early vascularization. Increased vascularization may potentially predispose [patients] to an increased and earlier cellular response and an increased healing rate,” the investigators wrote in their study abstract.
  They randomly assigned 20 patients with chronic rotator cuff tears to either a test or control group. The test group had L -PRF added during arthroscopic rotator cuff repair, while the control group received the same arthroscopic treatment without biologic augmentation. The groups were assessed using the Visual Analog Scale, Constant and Simple Shoulder Test Scores and power Doppler ultrasonography.
  The investigators found comparable clinical results between the groups at 6 weeks and 12 weeks. The L-PRF group had a significantly higher mean vascularization index of the surgical tendon-to-bone insertions compared with their contralateral healthy shoulders. Although the L-PRF group showed a higher vascularization at 6 weeks compared with the control group, researchers found no difference after 12-weeks follow-up.
  According to study results, there have been no postoperative complications and 89% of the repaired cuffs had watertight healing.

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• Use of L-PRF in arthroscopic rotator cuff repair leads to higher vascularization

  Posted on: 05 October, 2016

  Placing leukocyte- and platelet-rich fibrin between the tendon and the bone during arthroscopic rotator cuff repair was linked to a higher vascularization response at 6 weeks compared to repair without the biologic, according to the results of this pilot study.
  “Arthroscopic rotator cuff repair with the application of [leukocyte- and platelet-rich fibrin] L-PRF is technically feasible and yields higher early vascularization. Increased vascularization may potentially predispose [patients] to an increased and earlier cellular response and an increased healing rate,” the investigators wrote in their study abstract.
  They randomly assigned 20 patients with chronic rotator cuff tears to either a test or control group. The test group had L -PRF added during arthroscopic rotator cuff repair, while the control group received the same arthroscopic treatment without biologic augmentation. The groups were assessed using the Visual Analog Scale, Constant and Simple Shoulder Test Scores and power Doppler ultrasonography.
  The investigators found comparable clinical results between the groups at 6 weeks and 12 weeks. The L-PRF group had a significantly higher mean vascularization index of the surgical tendon-to-bone insertions compared with their contralateral healthy shoulders. Although the L-PRF group showed a higher vascularization at 6 weeks compared with the control group, researchers found no difference after 12-weeks follow-up.
  According to study results, there have been no postoperative complications and 89% of the repaired cuffs had watertight healing.

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• Study highlights importance of Bankart lesion size for arthroscopic repair techniques

  Posted on: 05 October, 2016

  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. – by Christian Ingram

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• Study highlights importance of Bankart lesion size for arthroscopic repair techniques

  Posted on: 05 October, 2016

  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. – by Christian Ingram

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• Overuse Injuries, Burnout in Youth Sports Can Have Long-Term Effects

  Posted on: 05 October, 2016

  As an emphasis on competitive success in youth sports has led to intense training, frequent competition and early single sport specialization, overuse injuries and burnout have become common. Given these concerns, the American Medical Society for Sports Medicine (AMSSM) has released a new clinical report that provides guidance to physicians and healthcare professionals who provide care for young athletes.

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• Improper way of working out may do more harm than good

  Posted on: 05 October, 2016

  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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• Women More Likely To Tear ACL Due To ‘Knock Knees’

  Posted on: 05 October, 2016

  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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• Combating Sports-Related Concussions: New Device Accurately And Objectively Diagnoses Concussions From The Sidelines

  Posted on: 05 October, 2016

  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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• How To Know If Shoulder Pain Might Be Rotator Cuff Disease

  Posted on: 05 October, 2016

  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.

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• Rotator Cuff Tears

  Posted on: 05 October, 2016

  This Update looks at the anatomy, assessment and management of rotator cuff tears.
  The rotator cuff is a set of tendons that surround the humeral head and seat the head in the glenoid which in turn allows overhead function. They are crucial tendons and commonly injured. The most commonly injured of the four tendons is the supraspinatus, particularly, at its insertion into the greater tuberosity on the humeral head.

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• Painful Frozen Shoulder Generally Resolves, But Return To Mobility Takes Time

  Posted on: 05 October, 2016

  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.
  
  Pulling on a winter coat was excruciating. Robson could only wear clothing with front closures, because reaching behind her back to hook a bra, for instance, required a range of movement she no longer had.
  
  Blow-drying her hair — pretty much a requirement for a TV reporter, which Robson was at the time — was impossibility.

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