Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders最新文献

英文中文

The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study 体重指数和胫骨斜角对男性膝关节前交叉韧带损伤风险的影响:一项病例对照研究

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2019-01-01 DOI: 10.1177/1179544119867922

V. Kızılgöz, A. K. Sivrioglu, H. Aydin, G. R. Ulusoy, T. Çeti̇n, K. Tuncer

Introduction: Tibial slope angles (TSAs) have been identified as potential risk factors of anterior cruciate ligament (ACL) injury in the literature. A higher body mass index (BMI) might increase the risk of ACL tear because of greater axial compressive force. The aim of this study was to determine the relationship of these factors and the combined effect of BMI and TSA in determination of risk potential for ACL injury. Methods: The preoperative magnetic resonance (MR) images of 81 ACL-injured male knees and of 68 male individuals with no ACL injuries were evaluated by 2 radiologists to measure the TSA. The Mann-Whitney U-test was performed to indicate the significant difference in height, weight, and BMI values. The independent samples t-test was used to determine the differences between ACL-injured and non-injured groups regarding TSA values. Odds ratios were calculated by logistic regression tests, and receiver operating characteristics (ROC) curves revealed the area under the receiver operating characteristics curve (AUC) values to compare the relationships of these parameters with ACL injury. Results: Body mass index, lateral tibial slope (LTS), and medial tibial slope (MTS) were predictive of ACL risk injury. Body mass index alone had the greatest effect among these parameters, and there were no statistically significant differences in coronal tibial slope values between the ACL-ruptured and control groups. The greatest AUC was observed for the combination of BMI, MTS, and LTS. Conclusions: Body mass index, LTS, and MTS angles were associated with ACL injury risk and BMI + MTS + LTS together revealed the greatest effect on ACL injury.

在文献中，胫骨斜角(TSAs)已被确定为前交叉韧带(ACL)损伤的潜在危险因素。较高的身体质量指数(BMI)可能会增加前交叉韧带撕裂的风险，因为轴向压缩力更大。本研究的目的是确定这些因素之间的关系以及BMI和TSA在确定ACL损伤风险潜力中的联合作用。方法:由2名放射科医师对81例ACL损伤的男性膝关节和68例未ACL损伤的男性膝关节术前磁共振(MR)图像进行评估，测量TSA。采用Mann-Whitney u检验来显示身高、体重和BMI值的显著差异。采用独立样本t检验确定acl损伤组与非损伤组TSA值的差异。通过logistic回归检验计算比值比，通过受试者工作特征(ROC)曲线显示受试者工作特征曲线(AUC)值下的面积，比较这些参数与ACL损伤的关系。结果:身体质量指数、胫骨外侧斜度(LTS)和胫骨内侧斜度(MTS)可预测ACL危险损伤。在这些参数中，仅身体质量指数的影响最大，acl破裂组与对照组的胫骨冠状面斜率值无统计学差异。BMI、MTS和LTS联合使用的AUC最大。结论:体重指数、LTS、MTS角度与ACL损伤风险相关，BMI + MTS + LTS对ACL损伤的影响最大。

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引用次数: 6

Xanthoma Combined With Gout Infiltration of the Achilles Tendon: A Case Report 黄斑瘤合并痛风侵袭跟腱1例

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2019-01-01 DOI: 10.1177/1179544119865261

Yuan Fu, Qiu-Li Huang

Xanthoma is a rare condition mostly caused by hyperlipidemia. The pathogenesis of gout is hyperuricemia, which is caused by a disorder of purine metabolism and/or a decrease in uric acid excretion. Xanthoma combined with gout is very rare. This case report presents magnetic resonance images of a case of xanthoma combined with gout infiltration of the Achilles tendon.

黄瘤是一种罕见的疾病，主要由高脂血症引起。痛风的发病机制是高尿酸血症，它是由嘌呤代谢紊乱和/或尿酸排泄减少引起的。黄瘤合并痛风是非常罕见的。本病例报告提出了一个病例黄斑瘤合并痛风渗透的跟腱磁共振图像。

引用次数: 3

Lyme Arthritis in Children on the Uptick in Western New York Area 纽约西部地区儿童莱姆病发病率上升

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2019-01-01 DOI: 10.1177/1179544119890851

Lauren Lucente, Aseel Abu-Dayya, T. Hennon, S. Islam, B. Wrotniak, Rabheh Abdul Aziz

Objective: This study explores a suspected increasing incidence of Lyme arthritis in the Western New York pediatric population. In addition, we aim to describe a clinical picture of Lyme arthritis and the clinical features that distinguish it from other forms of arthritis. Methods: Patients diagnosed with Lyme arthritis between January 2014 and September 2018 were identified using International Classification of Diseases—10th Revision (ICD 10) codes for Lyme disease and Lyme arthritis. Patients were included in the study if they (1) exhibited arthritis, (2) tested positive for Lyme antibodies, and (3) exhibited a positive Western blot. Results: A total of 22 patients were included in the study. There was a general trend toward an increasing number of cases of Lyme arthritis over the 45-month observation period. We identified 1 case in each 2014 and 2015, 4 cases in 2016, 7 in 2017, and 9 in the first 9 months of 2018. In total, 17 patients had arthritis as their only symptom at the time of diagnosis and 10 patients had a rash or a history that prompted suspicion of Lyme disease. The knee was the most frequent joint (86.4% of patients), and patients typically had 2 or fewer joints affected (86.4% of patients). Conclusions: A significant increase (P = .02) in Lyme arthritis cases was observed at Oishei Children’s Hospital of Buffalo. Lyme arthritis may clinically present similarly to other forms of arthritis, such as oligoarticular juvenile idiopathic arthritis, so health care providers should be aware of distinguishing clinical features, which include rapid onset of swelling and patient age. Because the geographic area of endemic Lyme disease is expanding, all health care providers need to be aware of Lyme arthritis as a possible diagnosis.

目的:本研究探讨了在纽约西部儿科人群中莱姆病发病率的可疑增加。此外，我们的目的是描述莱姆病的临床图片和临床特征，区别于其他形式的关节炎。方法:2014年1月至2018年9月期间诊断为莱姆病的患者使用国际疾病分类第十版(ICD 10)莱姆病和莱姆病关节炎代码进行鉴定。如果患者(1)表现出关节炎，(2)莱姆病抗体检测呈阳性，(3)Western blot阳性，则将其纳入研究。结果:共纳入22例患者。在45个月的观察期内，莱姆病的病例数量呈上升趋势。2014年和2015年各1例，2016年4例，2017年7例，2018年前9个月9例。总共有17名患者在诊断时唯一的症状是关节炎，10名患者有皮疹或怀疑患有莱姆病的病史。膝关节是最常见的关节(86.4%的患者)，患者通常有2个或更少的关节受影响(86.4%的患者)。结论:布法罗Oishei儿童医院莱姆病病例显著增加(P = 0.02)。莱姆病的临床表现可能与其他形式的关节炎类似，如少关节幼年特发性关节炎，因此卫生保健提供者应注意其区别临床特征，包括迅速发作的肿胀和患者的年龄。由于地方性莱姆病的地理区域正在扩大，所有卫生保健提供者都需要意识到莱姆病是一种可能的诊断。

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引用次数: 2

Parkinson’s Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly 帕金森病和症状性骨关节炎是老年人跌倒的独立危险因素

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2019-01-01 DOI: 10.1177/1179544119884936

Anneli Teder-Braschinsky, A. Märtson, M. Rosenthal, P. Taba

Objectives: Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group. Methods: A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures. Results: Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m. Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.

目的:帕金森病导致的功能恶化和活动能力丧失可能因骨关节炎而恶化，骨关节炎是最常见的关节疾病，导致疼痛和功能损害。与对照组相比，我们评估了帕金森病患者的症状性髋关节或膝关节骨关节炎、跌倒和行走能力之间的关系。方法:选取爱沙尼亚南部136例帕金森病患者和142例平均年龄分别为76.8岁和76.3岁的对照组进行回顾性病例对照研究。从帕金森病患者和对照组中收集了前一年跌倒和相关骨折的信息。协变量包括性别、年龄、活动能力、帕金森病持续时间和骨折。结果:与对照组相比，帕金森病患者摔倒的风险增加，骨折的风险也更高。症状性膝或髋关节骨关节炎是帕金森病患者和对照组跌倒的重要独立预测因子。在前一年骨折的高风险表现为有症状的骨关节炎。导致跌倒的危险因素还包括女性、服用安眠药以及无法行走500米。结论:症状性髋关节和膝关节骨关节炎是老年帕金森病患者跌倒和相关骨折的危险因素。不能行走500米可以作为老年人跌倒风险增加的一个简单预测因素。

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引用次数: 5

Two-Year Results of the PHANTOM High Flex Trial: A Single-Arm Study on the Atlas Unicompartmental Knee System Load Absorber in Patients With Medial Compartment Osteoarthritis of the Knee 为期两年的PHANTOM高屈曲试验结果:Atlas单室膝关节系统负荷吸收器在膝关节内侧骨关节炎患者中的单臂研究

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2019-01-01 DOI: 10.1177/1179544119877170

K. Slynarski, J. Walawski, R. Śmigielski, W. van der Merwe

The Atlas Knee System was designed to fill the gap between no longer effective conservative treatments and more invasive surgery for young patients with medial knee osteoarthritis (OA). This article reports on the 2-year results of a single-arm study of 26 subjects who previously reported favorable clinical outcomes 1 year post implantation. Western Ontario and McMaster Universities Osteoarthritis Index pain and function scores improved by a clinically meaningful amount relative to baseline, and subjects had a return to normal range of motion. This study confirmed that the benefit of a joint unloading device in the management of young patients with medial knee OA is maintained over 2 years. This trial was registered with ClinicalTrials.gov (NCT02711254).

Atlas膝关节系统的设计是为了填补年轻的膝关节内侧骨关节炎(OA)患者的保守治疗无效和侵入性手术之间的空白。本文报道了一项为期2年的单臂研究的结果，该研究纳入了26名受试者，这些受试者在植入后1年报告了良好的临床结果。西安大略省和麦克马斯特大学的骨关节炎指数疼痛和功能评分相对于基线有临床意义的改善，受试者恢复到正常的活动范围。本研究证实，关节卸压装置在治疗年轻膝关节内侧OA患者中的疗效可维持2年以上。该试验已在ClinicalTrials.gov注册(NCT02711254)。

引用次数: 7

Prevalence of Sarcopenia Obesity in Patients Treated at a Rural, Multidisciplinary Weight and Wellness Center 在农村多学科体重和健康中心治疗的患者中肌肉减少症的患病率

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2019-01-01 DOI: 10.1177/1179544119862288

J. Batsis, D. Gilbert-Diamond, Auden C. McClure, Aaron Weintraub, D. Sette, John N. Mecchella, Sivan Rotenberg, Summer B. Cook, R. Rothstein

Sarcopenic obesity portends poor outcomes, yet it is under-recognized in practice. We collected baseline clinical data including data on body composition (total and segmental muscle mass and total body fat), grip strength, and 5-times sit-to-stand. We defined sarcopenia using cut-points for appendicular lean mass (ALM) and obesity using body-fat cut-points. A total of 599 clinic patients (78.5% female; mean age was 51.3 ± 14.2 years) had bioelectrical impedance analysis (BIA) data (83.8%). Mean body mass index (BMI) and waist circumference were 43.1 ± 8.9 kg/m2 and 132.3 ± 70.7 cm, respectively. All patients had elevated body fat. There were 284 (47.4%) individuals fulfilling criteria for ALM-defined sarcopenia. Sarcopenic obese persons had a lower BMI (38.2 ± 6.4 vs 47.6 ± 8.6; P < 0.001), fat-free mass (113.0 kg ± 16.1 vs 152.1 kg ± 29.4; P < 0.001), fat mass (48.4% ± 5.9 vs 49.5% ± 6.2; P = 0.03), and visceral adipose tissue (216.8 ± 106.3 vs 242.7 ± 133.6 cm3; P = 0.009) than those without sarcopenic obesity. Grip strength was lower in those with sarcopenic obesity (25.1 ± 8.0 vs 30.5 ± 11.3 kg; P < 0.001) and sit-to-stand times were longer (12.4 ± 4.4 vs 10.8 second ± 4.6; P = 0.03). Sarcopenic obesity was highly prevalent in a rural, tertiary care weight and wellness center.

肌少性肥胖预示着不良后果，但在实践中尚未得到充分认识。我们收集了基线临床数据，包括身体组成(总肌肉量和节段肌肉量以及总脂肪量)、握力和5次坐立。我们用阑尾瘦质量(ALM)的切割点来定义肌肉减少症，用体脂切割点来定义肥胖。临床共599例，其中女性78.5%;平均年龄51.3±14.2岁)，有生物电阻抗分析(BIA)数据(83.8%)。平均体重指数(BMI)为43.1±8.9 kg/m2，腰围为132.3±70.7 cm。所有患者体脂均升高。284人(47.4%)符合alm定义的肌少症标准。肌肉减少型肥胖者BMI较低(38.2±6.4 vs 47.6±8.6;P < 0.001),无脂质(29.4±113.0±16.1 vs 152.1公斤;P < 0.001),脂肪量(48.4% vs 49.5%±6.2±5.9;P = 0.03)，内脏脂肪组织(216.8±106.3 vs 242.7±133.6 cm3;P = 0.009)。肌肉减少型肥胖患者握力较低(25.1±8.0 vs 30.5±11.3 kg;P < 0.001)，站立时间更长(12.4±4.4 vs 10.8±4.6;p = 0.03)。肌肉减少型肥胖在农村三级保健体重和健康中心非常普遍。

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引用次数: 3

Reviewers for Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders: 2018 临床医学见解:关节炎和肌肉骨骼疾病:2018年

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2019-01-01 DOI: 10.1177/1179544119829306

引用次数: 0

A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. 上肢和下肢撕脱性骨折的叙述综述。

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2018-11-01 eCollection Date: 2018-01-01 DOI: 10.1177/1179544118809050

Christopher Vannabouathong, Olufemi R Ayeni, Mohit Bhandari

Avulsion fractures compromise function and movement at the affected joint. If left untreated, it can lead to deformity, nonunion, malunion, pain, and disability. The purpose of this review was to identify and describe the epidemiology and available treatment options for common avulsion fractures of the upper and lower extremities. Current evidence suggests that optimal treatment is dependent on the severity of the fracture. Conservative efforts generally include casting or splinting with a period of immobilization. Surgery is typically indicated for more severe cases or if nonoperative treatments fail; patient demographics or preferences and surgeon experience may also play a role in decision making. Some avulsion fractures can be surgically managed with any one of various techniques, each with their own pros and cons, and often there is no clear consensus on choosing one technique over another; however, there is some research suggesting that screw fixation, when possible, may offer the best stability and compression at the fracture site and earlier mobilization and return to function. Physicians should be mindful of the potential complications associated with each intervention.

撕脱性骨折损害受累关节的功能和活动。如果不及时治疗，可能会导致畸形、骨不连、骨不连、疼痛和残疾。本综述的目的是确定和描述上肢和下肢常见撕脱骨折的流行病学和可用的治疗方案。目前的证据表明，最佳治疗取决于骨折的严重程度。保守的治疗方法通常包括用石膏或夹板固定一段时间。手术通常适用于更严重的病例或非手术治疗失败;患者的人口统计或偏好和外科医生的经验也可能在决策中发挥作用。一些撕脱性骨折可以用各种技术中的任何一种进行手术治疗，每种技术都有自己的优点和缺点，通常在选择一种技术时没有明确的共识;然而，有一些研究表明，在可能的情况下，螺钉固定可以在骨折部位提供最佳的稳定性和压缩性，并且可以更早地活动和恢复功能。医生应注意与每种干预措施相关的潜在并发症。

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引用次数: 7

Patient Discomfort and Resident Confidence After Knee Intra-articular Injection Simulation Training: A Randomized Control Trial Study. 膝关节关节内注射模拟训练后患者不适和住院医师信心:一项随机对照试验研究。

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2018-07-09 eCollection Date: 2018-01-01 DOI: 10.1177/1179544118782903

Adae O Amoako, George Ga Pujalte, Neha Kaushik, Timothy Riley

Teaching primary care providers how to perform musculoskeletal procedures has become increasingly important as more and more patients with orthopedic conditions present in primary care clinics. This study aims to evaluate whether targeted simulation model training in residency can increase residents' comfort level in performing intra-articular knee injections and decrease the pain of the procedure, as reported by patients injected. Residents were randomized into intervention and control groups. The comfort level of the residents as well as the pain levels from the procedures, as reported by patients, was recorded. The mean comfort level for the intervention group was 1.2, compared with that in the control group, which was 2.13; P value was .047. The mean pain level in the intervention group was 1.8, whereas in the control group was 3.63; P value was .156. Simulation training may boost residents' comfort level, but not necessarily decrease patient discomfort during intra-articular knee injections.

随着越来越多的骨科患者出现在初级保健诊所，教授初级保健提供者如何进行肌肉骨骼手术变得越来越重要。本研究旨在评估住院医师中有针对性的模拟模型培训是否可以提高住院医师在进行关节内膝关节注射时的舒适度，并减少注射患者报告的手术疼痛。居民被随机分为干预组和对照组。住院医生的舒适程度和病人报告的疼痛程度都被记录下来。干预组的平均舒适度为1.2，对照组的平均舒适度为2.13;P值为0.047。干预组患者的平均疼痛水平为1.8，对照组为3.63;P值为0.156。模拟训练可以提高住院医生的舒适度，但不一定能减少患者在膝关节内注射时的不适。

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引用次数: 2

Influence of HLA-B27 Subtypes on Ankylosing Spondylitis Phenotype: Comment on the Article by Akassou et al. HLA-B27亚型对强直性脊柱炎表型的影响:对Akassou等人文章的评论

IF 2.6 Q2 ORTHOPEDICS

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders

Pub Date : 2018-07-02 eCollection Date: 2018-01-01 DOI: 10.1177/1179544118785123

Sasan Fallahi

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders Volume 11: 1 © The Author(s) 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1 79544118785123

引用次数: 0

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