MedWorm: Orthopaedics Top 20

Biologic approaches to enhance rotator cuff healing after injury

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:37 +0100

Conclusions: Use of growth factors, stem cell therapy, and other tissue-engineering means serve to augment classical surgical rotator cuff repair procedures. The combination of stem cells and growth factors resulted in enhanced repair that emulated uninjured tissue, but the literature search reflected paucity of research in this field. Preclinical evidence from gene therapy and stem cell studies can be used as a start to move therapy from the experimental phase to clinical translation in patients.Level of evidence: Review Article. (Source: Journal of Shoulder and Elbow Surgery)

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Nocardia Spinal Epidural Abscess: 14-year Follow-up.

Orthopedics — Sat, 14 Jan 2012 15:24:05 +0100

This article describes an immunocompetent patient with a spinal abscess that developed from Nocardia asteroides. Nocardia is a rare etiology for spinal abscesses, especially in immunocompetent patients. Nocardia usually affects the lungs and brain of immunocompromised individuals. Few reports of Nocardia involving bones or the spine have been published.The patient had a history of chronic back pain and had several procedures to alleviate the pain. In August 1997, the patient had an epidural block and a subsequent infection that was treated with antibiotics. In October 1997, she developed increasing back pain greater than her baseline chronic low back pain. Additional presenting symptoms were fever, chills, and nausea. On admission, magnetic resonance imaging (MRI) revealed an epidural absc...

Modic type I change may predict rapid progressive, deforming disc degeneration: a prospective 1-year follow-up study

European Spine Journal — Tue, 17 Jan 2012 07:07:20 +0100

Conclusion Endplate deformation, decreasing disc height and change of disc signal intensity appear essential features of accelerated degenerative process associated with M1. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00586-012-2147-9Authors Liisa Kerttula, Department of Radiology, Helsinki University Central Hospital, Topeliuksenkatu 5, HUS, 00029 Helsinki, FinlandKatariina Luoma, Department of Radiology, Helsinki University Central Hospital, Topeliuksenkatu 5, HUS, 00029 Helsinki, FinlandTapio Vehmas, Institute of Occupational Health, Helsinki, FinlandMats Grönblad, Departments of Physical Medicine and Rehabilitation, Helsinki and Uudenmaa District University Hospitals, Helsinki, FinlandEeva Kääpä, Departments of Physical Medicine...

Evaluation of a simulated pivot shift test: a biomechanical study

Knee Surgery, Sports Traumatology, Arthroscopy — Fri, 04 Nov 2011 16:54:10 +0100

Conclusions We found that the coupled internal rotation and valgus torques best recreated the anterolateral subluxation that occurs in the pivot shift in vitro. This study describes an anterolateral subluxation test for ACL integrity in the laboratory setting. Content Type Journal ArticleCategory KneePages 1-5DOI 10.1007/s00167-011-1744-1Authors Lars Engebretsen, Department of Orthopaedic Surgery, Oslo University Hospital and Faculty of Medicine, Kirkeveien 166, 0407 Oslo, NorwayCoen A. Wijdicks, Steadman Philippon Research Institute, Vail, CO, USAColin J. Anderson, Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USABenjamin Westerhaus, Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USARobert F. LaPrade, Stea...

Single‐nucleotide polymorphism in Turkish patients with adolescent idiopathic scoliosis: Curve progression is not related with MATN‐1, LCT C/T‐13910, and VDR BsmI

Journal of Orthopaedic Research — Wed, 25 Jan 2012 05:00:00 +0100

In this study, we investigated the relationship between AIS and polymorphisms in MATN‐1, LCT C/T‐13910, and VDR BsmI genes. 53 Turkish adolescents with diagnosed AIS and 54 healthy adult individuals were included in the study. MATN‐1, LCT C/T‐13910, and VDR BsmI gene mutations were analyzed with real‐time PCR. We did not detect a statistically significant difference between AIS and control groups in respect to those three different gene polymorphisms (p < 0.05). We next evaluated the associations of all three SNPs with scoliosis curve severity. There was no significant difference between curve severity and gene polymorphisms (p < 0.05). In terms of gene polymorphisms, AIS patients with a family history of AIS did not significantly differ from AIS patients who did no...

Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol.

BMC Musculoskeletal Disorders — Fri, 20 Jan 2012 05:00:00 +0100

DiscussionThis prospective clinical observational cohort will combine self-reported data, comprehensive clinical and MRI assessment, together with qualitative enquiries, to describe the course, health care usage, patients' experiences and prognostic indicators in an adult population presenting in primary care with LBP and leg pain with or without nerve root involvement. (Source: BMC Musculoskeletal Disorders)

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Period of rapid BMD loss identified in middle-aged women

MedWire News - Bone Health — Wed, 18 Jan 2012 05:19:06 +0100

Results of a US study show that there is a period of rapid bone mineral density loss surrounding the final menstrual period in middle-aged women. (Source: MedWire News - Bone Health)

Skeletal Remodeling Following Clinically Relevant Radiation-Induced Bone Damage Treated with Zoledronic Acid

Calcified Tissue International — Mon, 14 Nov 2011 16:58:05 +0100

Abstract Our aim was to determine if zoledronic acid (ZA) changes 45Ca pharmacokinetics and bone microstructure in irradiated, ovary-intact (I) and irradiated, ovariectomized mice (OVX), two groups with different patterns of skeletal damage. The hind limbs of I and OVX BALB/c mice received a single 16-Gy radiation dose, simulating pre- and postmenopausal female cancer patients undergoing radiation treatment. All I and OVX mice were radiolabeled with 15 μCi 45Ca. Mice were treated with or without a 0.5 mg/kg injection of ZA. The time course of bone mineral remodeling was evaluated using a fecal 45Ca assay, measured by liquid scintillation. A group of nonirradiated, intact mice were used for the longitudinal evaluation of 45Ca biodistribution. Distal femur bone his...

A qualitative study on the role of cultural background in patients' perspectives on rehabilitation

BMC Musculoskeletal Disorders — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: LBP rehabilitation can be improved by addressing the following points. Early management of LBP should be activity-centred instead of pain-centred. It is mandatory to implement return to work management early, including return to adapted work, to improve rehabilitation for patients. Rehabilitation has to start when patients have been off work for three months. Using interpreters more frequently would improve communication between health professionals and patients, and reduce misunderstandings about treatment procedures. Special emphasis must be put on the process of goal-formulation by spending more time with patients in order to identify barriers to goal attainment. Information on the return to work process should also include the financial aspects of unemployment and disabili...

Cost-effectiveness of a classification-based system for sub-acute and chronic low back pain

European Spine Journal — Thu, 19 Jan 2012 07:01:31 +0100

Conclusion The classification-based treatment approach as used in this study was not cost-effective in comparison with usual physical therapy care in a population of patients with sub-acute and chronic LBP. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00586-011-2144-4Authors Adri T. Apeldoorn, Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, Amsterdam, 1081 BT The NetherlandsJudith E. Bosmans, Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The NetherlandsRaymond W. Ostelo, Department of Epidemiology and Biostatistics and the...

Evaluation of vertical traction radiography for predicting the outcome of moderate to severe rigid scoliosis correction

Orthopaedic Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Traction radiographic imaging is an effective, feasible preoperative assessment for determining which vertebrae are stable, designing the surgical strategy and choosing the UIV and LIV for correcting moderate to severe, rigid scoliosis. (Source: Orthopaedic Surgery)

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Pseudoseptic arthritis of the shoulder following pneumococcal vaccination.

Orthopedics — Sat, 14 Jan 2012 15:24:05 +0100

Authors: Floyd MW, Boyce BM, Castellan RM, McDonough EB Abstract Pseudoseptic arthritis is primarily described in rheumatoid arthritis and other systemic inflammatory conditions. To our knowledge, only 1 case report of pseudoseptic arthritis associated with intra-articular injection of a pneumococcal polyvalent vaccine (PPV) has been published. Here, a second case is presented in which a patient presented with swelling, pain, and erythema of the affected shoulder.A 59-year-old woman presented to the emergency department with a 3-day history of severe pain and decreased mobility of her left shoulder after receiving a PPV vaccination. Her clinical and laboratory workup was suspicious for septic arthritis; however, magnetic resonance imaging of the affected shoulder with and without c...

Spine stabilisation exercises in the treatment of chronic low back pain: a good clinical outcome is not associated with improved abdominal muscle function

European Spine Journal — Tue, 24 Jan 2012 07:32:44 +0100

Conclusion Neither baseline lateral abdominal muscle function nor its improvement after a programme of stabilisation exercises was a statistical predictor of a good clinical outcome. It is hence difficult to attribute the therapeutic result to any specific effects of the exercises on these trunk muscles. The association between changes in catastrophising and outcome serves to encourage further investigation on larger groups of patients to clarify whether stabilisation exercises have some sort of “central” effect, unrelated to abdominal muscle function per se. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00586-012-2155-9Authors A. F. Mannion, Spine Center Division, Department of Research and Development, Schulthess Klinik, Lenggha...

Predictive factors of cervical spondylotic myelopathy in patients with lumbar spinal stenosis

Archives of Orthopaedic and Trauma Surgery — Wed, 25 Jan 2012 18:07:45 +0100

Conclusion Torg-Pavlov ratio was the most important predictive factor of CSM in patients with LSS. Content Type Journal ArticleCategory Orthopaedic SurgeryPages 1-5DOI 10.1007/s00402-012-1465-zAuthors Hideki Iizuka, Department of Orthopaedic and Spinal Surgery, Saitama Mediclal University, Morohongo 38, Moroyama, Iruma, Saitama 350-0495, JapanKeisuke Takahashi, Department of Orthopaedic and Spinal Surgery, Saitama Mediclal University, Morohongo 38, Moroyama, Iruma, Saitama 350-0495, JapanShinya Tanaka, Department of Orthopaedic and Spinal Surgery, Saitama Mediclal University, Morohongo 38, Moroyama, Iruma, Saitama 350-0495, JapanKohei Kawamura, Department of Orthopaedic and Spinal Surgery, Saitama Mediclal University, Morohongo 38, Moroyama, Iruma, Saitama 350-0495, Jap...

Measurement of in vivo tendon function

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:34 +0100

Chronic tendon pathologies (eg, rotator cuff tears, Achilles tendon ruptures) are common, painful, debilitating, and a significant source of medical expense. Treatment strategies for managing tendon pathologies vary widely in invasiveness and cost, with little scientific basis on which to base treatment selection. Conventional techniques for assessing the outcomes of physical therapy or surgical repair typically rely on patient-based assessments of pain and function, physical measures (eg, strength, range of motion, or stability), and qualitative assessments using magnetic resonance imaging or ultrasound. Unfortunately, these conventional techniques provide only an indirect assessment of tendon function. The inability to make a direct quantitative assessment of the tendon’s mechanical ca...

Triggers for an episode of sudden onset low back pain: study protocol

BMC Musculoskeletal Disorders — Tue, 24 Jan 2012 05:00:00 +0100

This study uses a case-crossover design. One thousand adults with a sudden onset of low back pain presenting to primary care clinicians will be recruited. Basic demographic and clinical information including exposure to putative triggers will be collected using a questionnaire. These triggers include exposure to hazardous manual tasks, physical activity, a slip/trip or fall, consumption of alcohol, sexual activity, being distracted, and being fatigued or tired. Exposures in the case window (0-2 hours from the time when participants first notice their back pain) will be compared to exposures in two control time-windows (one 24-26 hours and another 48-50 hours before the case window).DiscussionThe completion of this study will provide the first-research based estimates of the increase in ris...

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Vitamin D levels in post-menopausal Korean women with a distal radius fracture

Injury — Sat, 14 Jan 2012 14:37:30 +0100

Abstract: Introduction: The purpose of this study was to investigate serum levels of vitamin D in post-menopausal Korean women with a distal radius fracture (DRF) and to determine if there is any association between vitamin D levels and bone-related variables such as bone mineral densities (BMDs), serum parathyroid hormone (PTH) levels and several bone turnover markers.Materials and methods: The data of 104 postmenopausal women surgically treated for a distal radius fracture (DRF group) and 107 age-matched control patients without a fracture (control group) were compared. Serum vitamin D levels (25-hydroxycholecalciferol, 25(OH)D3) were compared between the groups with consideration of age and seasonal variations. BMDs, serum PTH and several bone turnover markers, including serum osteocalc...

Relationship between calcaneal quantitative ultrasound and hip dual energy X-ray absorptiometry in young healthy men

Osteoporosis International — Fri, 06 Jan 2012 06:45:00 +0100

Abstract Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00198-011-1853-1Authors J. Rawal, Institute for Health and Human Performance, University College London, London, UKK. Eleftheriou, Institute for Health and Human Performance, University College London, London, UKJ. Skipworth, Institute for Health and Human Performance, University College London, London, UKZ. Puthucheary, Institute for Health and Human Performance, University College London, London, UKM. Loosemore, English Institute of Sport, Manchester, UKJ. Payne, Scottish National Advanced Heart Failure Service, Jubilee National Hospital, Clydebank, UKF. Dreno, Centre for Cardiovascular Genetics, University College London, London, UKM. World, Royal Centre for Defense Medicine, Sell...

360-degree osteosynthesis via a posterolateral transpedicular approach in high-risk patients

European Spine Journal — Tue, 10 Jan 2012 16:59:55 +0100

Conclusion The posterolateral transpedicular approach might be a safe, less-invasive and efficient alternative to anterior–posterior fusion. However, biomechanic efficacy and long-term outcome as compared to the transthoracic technique remains to be studied in a larger patient cohort. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00586-012-2150-1Authors Sven O. Eicker, Department of Neurosurgery, Heinrich-Heine-University, Moorenstraße 5, 40225 Düsseldorf, GermanyJan Frederik Cornelius, Department of Neurosurgery, Heinrich-Heine-University, Moorenstraße 5, 40225 Düsseldorf, GermanyHans-Jakob Steiger, Department of Neurosurgery, Heinrich-Heine-University, Moorenstraße 5, 40225 Düsseldorf, GermanyDaniel Hänggi, Department of Neuro...

A large‐scale replication study for the association of rs17039192 in HIF‐2α with knee osteoarthritis

Journal of Orthopaedic Research — Sat, 14 Jan 2012 14:26:47 +0100

This study aimed to evaluate the association of the SNP by a large‐scale replication study. A total of 8,457 subjects (3,129 OA cases and 5,328 controls) from seven independent cohorts from six countries (Japan, China, Taiwan, Korea, Greece, and Australia) were recruited and genotyped. The association of rs17039192 with knee OA was evaluated by meta‐analyses. The association of the HIF‐2α SNP was not replicated in any of the populations. Contrary to the previous report, the odds ratios (ORs) of the risk allele frequency were all less than 1. A combined analysis for the seven populations also showed no replication of the association (OR = 0.91, 95% confidence interval = 0.81–1.03). Our large‐scale meta‐analysis showed that the association of rs17039192 in HIF‐2α with...