Orthopedic Reviews最新文献

{"title":"Perioperative blood management programme in Jehovah’s witnesses undergoing total knee arthroplasty: clinical results and cost-benefit analysis","authors":"Giovanni Vicenti, Giuseppe Solarino, Domenico Zaccari, Davide Bizzoca, Michelangelo Delmedico, Massimiliano Carrozzo, Guglielmo Ottaviani, Filippo Simone, Giacomo Zavattini, Biagio Moretti","doi":"10.52965/001c.87746","DOIUrl":"https://doi.org/10.52965/001c.87746","url":null,"abstract":"Introduction Total knee arthroplasties have the purpose to improve quality of life from joint-related pain. On the other hand, it may represent a risky surgical procedure in people who refuse blood products due to their religious beliefs, such as Jehovah’s Witnesses (JW). Preoperative optimization protocols of these patients allow performing arthroplasties in a safer manner avoiding allogeneic blood transfusion. Methods In our retrospective study, 2 groups of patients were evaluated. Group 1, included JW patients who underwent a preoperative Hb optimisation programme; group 2 included non-JW patients authorizing transfusion in case of necessity. Results Differences in Hb levels were: before surgery (JW 13,63±1,26 vs. non-JW 12,83±1,21, p-value=0,22), after surgery (day 1 Hb: JW 12,26±1,47 vs. non-JW 10,88±1,87, p-value=0,1; day 3 Hb: JW 10±2,97 vs. non-JW 9,23±1,07 p-value=0,64). In the JW group the mean Hb concentration decreased from 13,63±1,26 g/dL preoperatively to 12,26±1,47 g/dL (day 1) while in non-JW group fell from 12,83± g/dL to 10,88± g/dL. There was no statistically-difference between the 2 groups. Moreover, cost-effectiveness strategies were evaluated in both groups. Conclusion Our findings support that PBM programs represent a safe and good strategy in knee prosthetic surgery, decreasing costs, risks and transfusion overuse.","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136107279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current concepts of natural course and in management of medial epicondylitis: a clinical overview.","authors":"Wojciech Konarski, Tomasz Poboży, Kamil Poboży, Julia Domańska, Klaudia Konarska","doi":"10.52965/001c.84275","DOIUrl":"10.52965/001c.84275","url":null,"abstract":"<p><p>Medial epicondylitis (ME), called \"golfer's elbow\", is not frequent or serious disease but can cause symptoms that are bothersome in everyday life. Therefore knowledge about this condition may improve diagnostic-therapeutic process. In this article detailed information concerning pathophysiology and symptomatology of ME was described. Great attention was paid to issues related to the diagnosis of the disease both in terms of differentiation with other elbow disorders as well as examination techniques. Finally, current therapeutic options were presented in detail and their efficacy was discussed based on the available data.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"84275"},"PeriodicalIF":1.4,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495044/pdf/orthopedicreviews_2023_15_84275.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review: Discogenic Back Pain: Update on Treatment.","authors":"Edgar Remotti, Chinoso Nduaguba, Parker A Woolley, Ryan Ricciardelli, Anh Phung, Rosa Kim, Ivan Urits, Alan David Kaye, Jamal Hasoon, Thomas Simopoulos, Cyrus Yazdi, Christopher L Robinson","doi":"10.52965/001c.84649","DOIUrl":"10.52965/001c.84649","url":null,"abstract":"<p><strong>Purpose of review: </strong>Lower back pain (LBP) has a lifetime prevalence of 80% in the United States population. Discogenic back pain (DBP), a subcategory of LBP, occurs as a result of the interverbal disc degeneration without disc herniation. Diagnosis relies on history, physical exam, and imaging such as MRI, provocative discography, or CT discography.</p><p><strong>Recent findings: </strong>Treatment of DBP involves a multifaceted approach with an emphasis on conservative measures including behavioral modification, pharmacologic management, and other non-pharmacologic interventions with invasive therapy reserved for select patients. Due to the paucity of data on the treatment of DBP, treatment also relies on data derived from treatment of chronic LBP (CLBP).</p><p><strong>Summary: </strong>Despite the scarcity of data for the treatment of DBP, treatments do exist with varying efficacy for DBP. Novel techniques such as the use of biologics may provide another avenue for treatment though further studies are needed to better evaluate the most efficacious regimen for both novel and existing treatments.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"84649"},"PeriodicalIF":1.4,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460631/pdf/orthopedicreviews_2023_15_84649.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Nerve Stimulation of the Lesser Occipital and Greater Auricular Nerve for Post Herpetic Neuralgia in a Case of Ramsay Hunt Syndrome: Case Report.","authors":"Brooks Johnson, Stephen Covington, Mostafa Maita, Natalie Strand","doi":"10.52965/001c.85149","DOIUrl":"10.52965/001c.85149","url":null,"abstract":"<p><strong>Background: </strong>Post-herpetic neuralgia (PHN) is a painful condition that presents after herpes zoster reactivation in the peripheral and central nervous system. When medical treatment fails, options are limited, and patients may suffer with chronic pain indefinitely.</p><p><strong>Case presentation: </strong>We present the case of a gentleman with a 3-year history of PHN in the distribution of the right lesser occipital and greater auricular nerves that failed to respond to medical treatment. He underwent a trial of neuromodulation, and post-operative pain scores improved by 80%, and at 60 days post-operatively his average pain score was 0 out of 10.</p><p><strong>Conclusions: </strong>PNS is an effective and safe option for the treatment of chronic pain, and we present a report of successful treatment of PHN in a particularly difficult anatomic distribution. PNS of the lesser occipital and greater auricular nerves is a novel treatment for PHN and shows promise as an effective, safe therapy when other treatment fails.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"85149"},"PeriodicalIF":1.4,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460630/pdf/orthopedicreviews_2023_15_85149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10467192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal Oncology Fellowship Websites: A Comprehensive Assessment and Cross-Sectional Content Analysis.","authors":"Mahfujul Haque, Moaid Shaik, Ameen Suhrawardy, Shahrin Khan, Drew Moore, Aws Hammad","doi":"10.52965/001c.84506","DOIUrl":"10.52965/001c.84506","url":null,"abstract":"<p><p>This manuscript evaluates the utility of Musculoskeletal Oncology (MSK Oncology) fellowship program websites and identifies areas for improvement. This study identified 20 MSK Oncology programs using two public databases, allocated 45 criteria domains into 6 categories, and evaluated each program independently. MSK Oncology programs had limited information (34%) on their websites, particularly under the \"People\" category. It is recommended that programs include more information about current fellows and their training background, faculty publications, and alumni descriptions. MSK Oncology program websites should contain necessary information for prospective applicants, particularly considering the increased virtual world during and after the COVID-19 pandemic. Websites should be more comprehensive for applicants in their process of choosing their preferred programs and submitting their rank order lists.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"84506"},"PeriodicalIF":1.4,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386907/pdf/orthopedicreviews_2023_15_84506.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MENISCAL ALLOGRAFT TRANSPLANTATION COMBINED WITH ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A SYSTEMATIC REVIEW.","authors":"Dario Candura, Gianluca Ciolli, Federico Chiriacò, Luigi Cianni, Marina Marescalchi, Vincenzo Brancaccio, Katia Corona, Domenico Alessandro Santagada, Giulio Maccauro, Simone Cerciello","doi":"10.52965/001c.84277","DOIUrl":"10.52965/001c.84277","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the clinical and functional outcomes of meniscal allograft transplantation (MAT) with anterior cruciate ligament reconstruction (ACLR) in a single surgical stage through a systematic review of the currently available evidence.</p><p><strong>Methods: </strong>A systematic search of the PubMed and Google Scholar databases, with no publication date limit, until December 2022 was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Follow-up studies and case series published in English involving patients undergoing a combination of ACLR and MAT were included. The quality of these studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. A systematic review of the International Knee Documentation Committee (IKDC), Lysholm and Tegner activity scores was conducted.</p><p><strong>Results: </strong>Seven studies involving 154 patients were included. The mean follow-up was 5,3 years. The mean age at the time of the surgery was of 35.3 years. All studies used the Lysholm Knee score, IKDC score or Tegner activity score to measure clinical outcomes post-operatively and the mean improvements were 26.7, 24.7, and 1.8 respectively. The rate to return to sport was 75.5 %. No intra-operative complications were reported. The post-operative complication rate was 11.6%.</p><p><strong>Conclusions: </strong>MAT combined with ACLR procedure showed good clinical results up to an average of 5 years of follow-up. More studies need to be conducted that can better understand the long-term effects of this combined procedure.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"84277"},"PeriodicalIF":1.4,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386908/pdf/orthopedicreviews_2023_15_84277.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hoffmann parallax: a prospective study to determine the benefit of Hoffmann's sign.","authors":"Eric H Gruenberger, Sohrab K Vatsia, Rourke M Stay, Cameron Kersey, Mudassar A Khan, Douglas W Pahl","doi":"10.52965/001c.77875","DOIUrl":"10.52965/001c.77875","url":null,"abstract":"<p><strong>Background: </strong>Degenerative cervical myelopathy (DCM) is the most common cause of age-related spinal cord dysfunction worldwide. Despite the widespread use of provocative physical exam maneuvers in the workup of DCM, the clinical significance of Hoffmann's sign is controversial.</p><p><strong>Objective: </strong>The purpose of this study was to prospectively assess the diagnostic performance of Hoffmann's sign for DCM in a cohort of patients treated by a single spine surgeon.</p><p><strong>Materials & methods: </strong>Patients were divided into two groups based on the presence of a Hoffmann sign on physical examination. Advanced imaging studies were independently reviewed by four raters for confirmation of a diagnosis of cervical cord compression. Prevalence, sensitivity, specificity, likelihood, and relative risk ratios for the Hoffmann sign were calculated, with subsequent Chi-square and receiver operator characteristic (ROC) analysis to further characterize correlative findings.</p><p><strong>Results: </strong>Fifty-two patients were included - of whom, thirty-four (58.6%) patients presented with a Hoffmann sign, and eleven (21.1%) patients demonstrated cord compression on imaging. The Hoffmann sign demonstrated a sensitivity of 20% and a specificity of 35.7% (LR = 0.32; 0.16-1.16). Chi-square analysis revealed that imaging findings positive for cord compression were proportionally greater for patients lacking a Hoffmann sign than those with a confirmed Hoffmann sign (<i>p</i> =0.032) ROC analysis demonstrated that a negative Hoffmann sign performed moderately well in predicting cord compression (AUC.721; <i>p</i> =0.031).</p><p><strong>Conclusions: </strong>The Hoffmann sign is an unreliable marker for cervical cord compression, and the lack of a Hoffmann sign may be more predictive of cervical cord compression.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"77875"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317513/pdf/orthopedicreviews_2023_15_77875.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10179303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip Resurfacing Arthroplasty: Past, Present and Future.","authors":"Talal Al-Jabri, Mohamed Ridha, Robert Allan McCulloch, Babar Kayani, Anse Arif, Mohamed Habad, Dennis Kosuge, Chethan Jayadev, James Donaldson, John A Skinner","doi":"10.52965/001c.77745","DOIUrl":"10.52965/001c.77745","url":null,"abstract":"<p><p>The history of hip resurfacing arthroplasty (HRA) has faced numerous challenges and undergone decades of evolution in materials and methods. These innovations have been translated to the successes of current prostheses and represent a surgical and mechanical achievement. Modern HRAs now have long term outcomes with excellent results in specific patient groups as demonstrated in national joint registries. This article reviews the key moments in the history of HRAs with specific emphasis on the lessons learnt, current outcomes and future prospects.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"77745"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317512/pdf/orthopedicreviews_2023_15_77745.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10179302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do cemented standard-length femoral stems have enough longevity for the pathological fractures of the femoral neck with metastatic lesions? A retrospective study.","authors":"Pakjai Tuntarattanapong, Khanin Iamthanaporn, Kraisong Watatham, Chanon Sookjarern, Theerawit Hongnaparak, Varah Yuenyongviwat","doi":"10.52965/001c.77877","DOIUrl":"10.52965/001c.77877","url":null,"abstract":"<p><strong>Background: </strong>Cemented long-stem hip arthroplasty is a treatment of choice for the pathological fractures of the femoral neck with metastatic lesions and the prevention of further fracture caused by metastasis progression.</p><p><strong>Objective: </strong>The present study was an evaluation of the outcome after treatment of metastatic femoral neck fractures with cemented standard-length hemiarthroplasty.</p><p><strong>Methods: </strong>We retrospectively studied 23 patients in whom the pathological fractures of the femoral neck with metastatic lesions were diagnosed. All patients underwent hemiarthroplasty with cemented standard-length femoral stems. The demographic data of the patients and clinical outcomes were obtained from an electronic medical database. Metastasis progression-free survival time was analyzed via the Kaplan-Meier curve.</p><p><strong>Results: </strong>The mean age of the patients was 51.5 ± 11.7 years. The median duration of follow-up was 6.8 months (interquartile range, 5-22.6 months). Four patients exhibited tumor progression according to radiographic evaluation, but no patients had new fractures in the same bone or needed reoperation. The Kaplan-Meier curve revealed that 88.2% (74.2,100) of femurs demonstrated 1 year radiographic progression-free survival and 73.5% (49.4,100) demonstrated 2 year progression-free survival.</p><p><strong>Conclusions: </strong>Our study demonstrated that the use of cemented standard-length stems in hemiarthroplasty for pathological fractures of the femoral neck with metastatic lesions is safe, and the rate of reoperation was low. We believe that this prosthesis is optimum for treatment in this group of patients because the length of survival in patients is expected to be short and the rate of metastasis progression in the same bone is low.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"77877"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317508/pdf/orthopedicreviews_2023_15_77877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10179304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of bone loss in revision total knee arthroplasty and current treatment options.","authors":"Monu Jabbal, A Hamish Rw Simpson, Phil Walmsley","doi":"10.52965/001c.75359","DOIUrl":"10.52965/001c.75359","url":null,"abstract":"<p><strong>Purpose: </strong>Primary total knee arthroplasty (TKA) is an effective treatment which is increasing in use for both elderly and younger patients. With the overall increasing life span of the general population, the rate of revision TKA is projected to increase significantly over the coming decades. Analyses from the national joint registry of England and Wales support this prediction with an increase in primary TKA of 117% and an increase in revision TKA of 332% being forecast by 2030. Bone loss presents a challenge in revision TKA so an understanding of the aetiology and principles behind this is essential for the surgeon undertaking revision. The purpose of this article is to review the causes of bone loss in revision TKA, discuss the mechanisms of each cause and discuss the possible treatment options.</p><p><strong>Methods: </strong>The Anderson Orthopaedic Research Institute (AORI) classification and zonal classification of bone loss are commonly used in assessing bone loss in pre-operative planning and will be used in this review. The recent literature was searched to find advantages and limitations of each commonly used method to address bone loss at revision TKA. Studies with the highest number or patients and longest follow-up period were selected as significant. Search terms were: \"aetiology of bone loss\", \"revision total knee arthroplasty\", \"management of bone loss\".</p><p><strong>Results: </strong>Methods for managing bone loss have traditionally been cement augmentation, impaction bone grafting, bulk structural bone graft and stemmed implants with metal augments. No single technique was found to be superior. Megaprostheses have a role as a salvage procedure when the bone loss is deemed to be too significant for reconstruction. Metaphyseal cones and sleeves are a newer treatments with promising medium to long term outcomes.</p><p><strong>Conclusion: </strong>Bone loss encountered at revision TKA presents a significant challenge. No single technique currently has clear superiority treatment should be based on a sound understanding of the underlying principles.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"15 ","pages":"75359"},"PeriodicalIF":1.4,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317505/pdf/orthopedicreviews_2023_15_75359.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10179305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}