Current Reviews in Musculoskeletal Medicine最新文献

{"title":"Management of Horizontal Cleavage Meniscus Tears.","authors":"Zachary R Burnett, David C Flanigan","doi":"10.1007/s12178-024-09940-9","DOIUrl":"https://doi.org/10.1007/s12178-024-09940-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>The management of horizontal cleavage meniscus tears (HCT) has evolved in recent years. Historically, HCTs have been treated with partial meniscectomy, but multiple studies have shown the long-term risks of development of arthritic changes in the knee following meniscectomy. These findings have renewed interest in meniscal preservation whenever possible, even in older patients not previously considered for meniscus repair. This article provides an overview of current management of horizontal cleavage meniscus tears and describes modern surgical techniques for repair of HCTs.</p><p><strong>Recent findings: </strong>Current research studies have continued to emphasize the benefits of meniscal preservation on long-term function. Recent data has demonstrated similar success rates following repair of HCTs compared to repair of other types of meniscus tears. Additionally, multiple recent studies have demonstrated the potential benefit of biologic augmentation in decreasing failure rate after meniscal repair. Modern surgical techniques and biologic augmentation have improved outcomes of meniscal repair. However, consideration of a patient's individual goals, activity level, and expectation are important to achieve a successful outcome regardless of treatment modality. While not every patient is a candidate for meniscal repair, current data has shown it should be considered for a growing number of patients.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteomyelitis and Septic Arthritis of the Upper Extremity in Pediatric Patients.","authors":"Nnaoma M Oji, Coleen S Sabatini","doi":"10.1007/s12178-024-09938-3","DOIUrl":"https://doi.org/10.1007/s12178-024-09938-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>For pediatric osteomyelitis and septic arthritis, 10-24% of cases occur in the upper extremity (UE). Due to delays in presentation and diagnosis, UE infections are often more complex and severe than infections of the lower extremity (LE). This review evaluates the literature from the past 6 years related to pediatric osteomyelitis and septic arthritis of the UE and provides a guide for professionals managing these conditions in children.</p><p><strong>Recent findings: </strong>The shoulder and elbow are the most commonly affected joints, and the humerus is the most commonly affected bone. As with the LE, diagnosis of UE osteoarticular infections is based on clinical evidence, laboratory data, and diagnostic imaging. While Staphylococcus aureus is the primary bacteria identified in UE infections, there is an underappreciation of the burden from Kingella kingae as a causative organism in culture-negative patients where PCR is not performed. Septic joints should be treated with irrigation and debridement urgently, with subsequent antibiotic therapy for a minimum of 2-4 weeks. For acute osteomyelitis without abscess or concomitant septic joints, antibiotic therapy is standard of care. Methicillin-resistant Staphylococcus aureus is associated with more severe infection requiring more surgeries. Various strategies exist for managing segmental bone loss in chronic osteoarticular infections. Osteomyelitis and septic arthritis tend to occur less frequently in the UE than the LE but have a devastating impact on the health and quality of life of children around the world. Complete resolution of disease can be achieved through an individualized approach to antibiotic and operative management. Further study is needed to assess the efficacy of aspiration as a primary treatment strategy in UE joints.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Platelet Dose on Outcomes after Platelet Rich Plasma Injections for Musculoskeletal Conditions: A Systematic Review and Meta-Analysis.","authors":"William Berrigan, Frances Tao, Joel Kopcow, Anna L Park, Isabel Allen, Peggy Tahir, Aakash Reddy, Zachary Bailowitz","doi":"10.1007/s12178-024-09922-x","DOIUrl":"10.1007/s12178-024-09922-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This study aims to systematically review platelet dosage in platelet rich plasma (PRP) injections for common musculoskeletal conditions.</p><p><strong>Recent findings: </strong>Notable heterogeneity exists in the literature regarding platelet dosage. Clinical studies indicate that a higher dosage may lead to improved outcomes concerning pain relief, functional improvement, and chondroprotection in knee osteoarthritis (OA). However, the impact of dosing on other musculoskeletal pathologies remains uncertain. Our investigation identifies a potential dose-response relationship between platelet dose and PRP effectiveness for knee OA treatment, pinpointing an optimal threshold of greater than 10 billion platelets for favorable clinical outcomes. Notably, this effect appears more pronounced for functional outcomes than for pain relief. For other conditions, a lower dosage may suffice, although the existing literature lacks clarity on this matter. PRP dosage may significantly influence treatmentoutcomes, particularly in knee OA. Further research is warranted to elucidate optimal dosages for varying conditions.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"570-588"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis Management for Shoulder Surgeons.","authors":"Kelsey M Healy, Jacob Ritter, Emily Barr, Jessica L Churchill, Nicholas A Trasolini, Brian R Waterman, Alan W Reynolds","doi":"10.1007/s12178-024-09927-6","DOIUrl":"10.1007/s12178-024-09927-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>The aim of this review is to aggregate currently available literature as it pertains to treating surgical shoulder pathology in patients with osteoporosis.</p><p><strong>Recent findings: </strong>Emerging data surrounding perioperative use of anti-osteoporosis medications for patients undergoing shoulder surgery have not shown definitively favorable or unfavorable outcomes. Similar evaluations in animal studies have shown promising results as a biologic augment to tendon and bone healing, especially with newer, anabolic agents. The mainstay of bone health management remains pre-operative evaluation, using opportunistic radiographic and CT based validated measurements, along with optimization of risk factors. Surgical techniques continue to incorporate implants that perform well in osteopenic bone. Promising pre-clinical studies have identified anabolic anti-osteoporosis medications as viable biologic augments to shoulder surgery, which has not been borne out in any clinical studies at this time.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"559-569"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline Hip Dysplasia - Best Treated with Hip Arthroscopy or Periacetabular Osteotomy?","authors":"Erin S Wilson, Kyle R Wagner, Andrea M Spiker","doi":"10.1007/s12178-024-09928-5","DOIUrl":"10.1007/s12178-024-09928-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>As the field of hip preservation evolves, the diagnosis of borderline dysplasia (defined as a lateral center edge angle between 18°-25°) has shown itself to be one of the more challenging diagnoses to treat. As the nuances of acetabular coverage have come to light, the question of whether borderline hip dysplasia is best treated with isolated hip arthroscopy, periacetabular osteotomy, or whether a combined procedure is best, is now top of mind. The goal of these procedures is to not only improve patient symptoms, but to correct underlying pathology and ideally slow the development of hip osteoarthritis. The purpose of this review is to summarize the recent literature and clinical findings regarding both isolated hip arthroscopy and periacetabular osteotomy in the surgical management of borderline hip dysplasia.</p><p><strong>Recent findings: </strong>Current research demonstrates improved postoperative clinical outcome scores for both patients who had isolated hip arthroscopy in the setting of borderline hip dysplasia and for those patients who underwent periacetabular osteotomy. Mid-term outcomes for patients in both groups have showed low rates of conversion to total hip arthroplasty. No gold standard in the surgical management of borderline hip arthroscopy exists. Improved clinical outcomes have been seen postoperatively in patients who undergo hip arthroscopy and in patients who undergo periacetabular osteotomy. Successful clinical outcomes seem to rely on treatment of the underlying clinical pathology and are largely based on the appropriate surgical indications and appropriate surgical techniques. Surgical decision making in this patient population should be individualized based on a comprehensive evaluation of the patient.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"538-547"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humeral Stem Design in Reverse Total Shoulder Arthroplasty.","authors":"Andrew C Lehman, Favian Su, Brian T Feeley","doi":"10.1007/s12178-024-09931-w","DOIUrl":"10.1007/s12178-024-09931-w","url":null,"abstract":"<p><strong>Purpose of the review: </strong>There have been tremendous modifications to the humeral component since Paul Grammont first introduced the reverse total shoulder arthroplasty in 1985. The purpose of this article is to review historical design features and their drawbacks and to summarize the clinical outcomes of modern designs.</p><p><strong>Recent findings: </strong>Decreasing the neck-shaft angle and increasing humeral lateralization have helped address problems of scapular notching and limited internal and external rotation that were common with traditional designs. Advancements in proximal porous coatings have also facilitated the development of short-stem and stemless implants, which decreases the need for cement fixation and allows preservation of bone stock. Moreover, a reduction in stem length with smaller metaphyseal and diaphyseal filling ratios may limit stress shielding. Current humeral implants have an aseptic loosening rate less than 1%. Despite promising results, many of these new humeral design features do not have long-term data and continued surveillance of their performance is necessary. The humeral stem design significantly influences clinical and radiographic outcomes. Surgeons should be mindful of these design variables to increase impingement-free range of motion, minimize scapular notching, reduce stress shielding, and improve implant survivorship.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"616-624"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Non-Operative Interventions for Anterior Knee Pain.","authors":"Nicole B Katz, Nicholas Tsitsilianos, Andrew S Nowak, Stephanie R Douglas, Adam S Tenforde, Joanne Borg-Stein","doi":"10.1007/s12178-024-09930-x","DOIUrl":"10.1007/s12178-024-09930-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review presents evidence for advanced non-operative interventions, including extracorporeal shockwave therapy (ESWT), prolotherapy, platelet-rich plasma (PRP), adipose tissue-derived cells, bone marrow aspirate concentrate, various additional non-corticosteroid injectates, and needle-based interventions for common causes of anterior knee pain in the adult population. These etiologies include osteoarthritis of the knee, patellofemoral pain syndrome, chondromalacia patella, Hoffa fat pad impingement syndrome, patellar/quadriceps tendinopathy, and prepatellar bursitis. This review discusses patient care options using a case-based understanding of interventions by condition while recognizing strength of evidence.</p><p><strong>Recent findings: </strong>ESWT and PRP are the most robustly studied and have greatest evidence for treating tibiofemoral osteoarthritis and for long-term benefit in treating patellar tendinopathy. PRP may have evidence for treatment of chondromalacia and prolotherapy for management of tibiofemoral arthritis; both have limited evidence. Botulinum neurotoxin type A has strong evidence to support use in treating patellofemoral pain syndrome. There is limited evidence to support the use of viscosupplementation, percutaneous needle tenotomy, and medicinal signaling cell-based therapies beyond platelet-rich plasma for anterior knee pain. There is limited research on the management of quadriceps tendinopathy, prepatellar bursitis, patellofemoral osteoarthritis, and Hoffa's fat pad impingement syndrome. Further research and standardization of protocols are necessary to fully assess these treatments' efficacy. ESWT, cell-based, and needle-based interventions, may serve as effective treatment options for patients with anterior knee pain. Selection of each intervention requires understanding the evidence, level of risk, and appropriate application based on a patient's level of activity to enable clinicians to enhance patient outcomes and quality of life.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"589-615"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Evaluation of the Hip.","authors":"Samuel I Rosenberg, Steven B Soliman, Alex L Gornitzky, Ira Zaltz, Matthew J Hartwell","doi":"10.1007/s12178-024-09929-4","DOIUrl":"10.1007/s12178-024-09929-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Non-arthritic hip pain is a common presentation among the general population, with many possible contributing etiologies. While radiographs, computed tomography, and magnetic resonance imaging are all within the standard diagnostic workup, ultrasonography has emerged as a facile tool given its low cost, lack of radiation, and dynamic application. This article reviews the utility of ultrasound (US) in evaluation of non-arthritic hip pain and its ability to detect pathology both statically and dynamically in comparison and as an adjunct to standard imaging modalities.</p><p><strong>Recent findings: </strong>Current research highlights applications of US to commonly treated hip pathologies including femoroacetabular impingement, labral tears, hip microinstability, and various other extra-articular phenomena. While static evaluation seems to add similar value to that of radiography, several novel protocols have been developed that allow for dynamic evaluation of joint biomechanics, including extent and onset of impingement and femoral head translation, that cannot be assessed with more standard imaging modalities.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"548-558"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Musculoskeletal Oncology.","authors":"Abigail Koons, Elyse Smith, Jeffrey C Stephens, Natilyn H McKnight, Jennifer Barr, Izuchukwu K Ibe","doi":"10.1007/s12178-024-09925-8","DOIUrl":"10.1007/s12178-024-09925-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Disparities within the healthcare system serve as barriers to care that lead to poor outcomes for patients. These healthcare disparities are present in all facets of medicine and extend to musculoskeletal oncology care. There are various tenets to health disparities with some factors being modifiable and non-modifiable. The factors play a direct role in a patient's access to care, time of presentation, poor social determinants of health, outcomes and survival.</p><p><strong>Recent findings: </strong>In musculoskeletal oncologic care, factors such as race, socioeconomic factors and insurance status are correlated to advanced disease upon presentation and poor survival for patients with a sarcoma diagnosis. These factors complicate the proper delivery of coordinated care that is required for optimizing patient outcomes. Healthcare disparities lead to suboptimal outcomes for patients who require musculoskeletal oncologic care in the short and long term. More research is required to identify ways to address the known modifiable and non-modifiable factors to improve patient outcome.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"527-537"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Expectations and Satisfaction in Pediatric Orthopedics.","authors":"Alejandro Cazzulino, Katherine Bach, Rafael Cordero, Ishaan Swarup","doi":"10.1007/s12178-023-09869-5","DOIUrl":"10.1007/s12178-023-09869-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of the current review is to analyze the current literature regarding the tools available to evaluate patient expectations and satisfaction. There have been an increasing number of tools that have been developed and validated for various orthopedic procedures. Despite the growing number of tools, there are a limited number of tools available for pediatric patients.</p><p><strong>Recent findings: </strong>Several tools have been developed in orthopedics to evaluate patient expectations. However, there are no tools that have been validated in the pediatric population. In addition, pediatric patient expectations should be collected in conjunction with parent/caregiver expectations. Although not specifically validated for pediatric patients, there are several tools available that may pertain to pediatric patients including the HSS ACL Expectations Survey, HSS Shoulder Expectations Survey, HSS Knee Surgery Expectations Survey, HSS Foot and Ankle Surgery Expectation Survey, Sunnybrook Surgery Expectations Survey, Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) Instruments, Quick DASH, and DASH. In terms of patient satisfaction, there are even fewer tools available. Several tools have been developed to evaluate patient satisfaction and five additional tools within orthopedics. Of these tools, there are two that have been validated for pediatric patients: The Swedish Parents Satisfaction Questionnaire and the Scoliosis Research Society-22. There are a growing number of tools to evaluate patient's expectations and satisfaction in the orthopedic literature. Given most of these tools pertain to adult patients, there is a need for further development of tools specifically validated for pediatric patients and their parents/caregivers. Through the measurement of expectations and satisfaction, medical professionals can hope to improve satisfaction and outcomes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"518-525"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}