Orthopedic Reviews最新文献

Background: The complex nature of musculoskeletal diseases and the limitations of existing treatments have driven researchers to explore innovative solutions, particularly those involving stem cells and their derivatives. The utilization of the IPFP as a source of MSC-derived non-cellular products for the treatment of musculoskeletal diseases has gained recognition in recent years. This study aimed to identify the progress of IPFP-derived acellular biologics use in the treatment of orthopedic conditions such as osteoarthritis and ligament and/or tendon injuries.

Methods: A literature search was conducted through PubMed, Scopus and Google Scholar databases including studies over the past 10 years. This scoping review includes studies discussing the development of intercellular messenger signaling molecules (non-cellular products) in the form of exosomes, secretomes, and conditioned medium derived from the IPFP in the management of musculoskeletal diseases. The PRISMA-ScR guidelines were utilized in this review.

Results: Six studies met the inclusion criteria. Most studies reported the beneficial anti-inflammatory effects of IPFP-derived noncellular products in musculoskeletal conditions. The effects of IPFP-derived exosomes, secretomes, and conditioned medium administration are mostly reported in microscopic changes through cellular and matrix changes. Additionally, quantitative analyses involved assessing levels of anti-inflammatory and pro-inflammatory markers, proteins, fatty acids, and gene expression.

Conclusions: The use of IPFP-derived non-cellular products has shown significant promise in the regenerative therapy for musculoskeletal diseases. These agents have demonstrated beneficial effects, particularly in reducing inflammation, promoting cellular changes, and enhancing tissue regeneration. However, further research is needed to fully understand the characteristics and explore the potential applications of IPFP-derived non-cellular products in musculoskeletal cases.

Skeletal fractures are traumatic injuries that are widely accepted as requiring acute treatment to avoid long-term disability and dysfunction. There are a number of soft-tissue injuries or non-traditional fractures, frequently treated by sports medicine surgeons, which additionally require treatment in an expedited fashion in order to optimize healing and function. Sports medicine injuries of the lower extremity requiring acute treatment include, but are not limited to, irreducible shoulder dislocations, acute traumatic rotator cuff tears, posterior sternoclavicular joint dislocations, high grade acromioclavicular joint dislocations, pectoralis major tendon ruptures, distal biceps tendon ruptures, and triceps tendon ruptures. The purpose of this manuscript is to review the sports medicine injuries of the upper extremity which require acute/urgent management to facilitate optimal treatment.

Skeletal fractures are traumatic injuries that are widely accepted as requiring acute treatment to avoid long-term disability and dysfunction. There are a number of soft-tissue injuries or non-traditional fractures, frequently treated by sports medicine surgeons, which additionally require treatment in an expedited fashion in order to optimize healing and function. Sports medicine injuries of the lower extremity requiring acute treatment include, but are not limited to, multiligamentous knee injuries, proximal hamstring ruptures, quadriceps tendon ruptures, patellar sleeve avulsions, patellar tendon ruptures, tibial spine avulsions, posterior cruciate ligament avulsions, bucket handle meniscus tears, and achilles tendon ruptures. The purpose of this manuscript is to review the sports medicine injuries of the lower extremity which require acute/urgent management to facilitate optimal treatment.

Anterior Cruciate Ligament (ACL) injuries rank among the most prevalent and severe types of injuries, significantly impacting both athletes and non-athletes alike. These injuries not only result in immediate physical impairment, such as intense pain, substantial swelling, and a marked loss of mobility, but also carry long-term health consequences that can alter a person's quality of life. Chronic pain, persistent instability, and an increased risk of developing osteoarthritis are among the lasting effects that can follow an ACL injury. An in-depth understanding of the biophysics behind ACL injuries is paramount for devising effective prevention and treatment protocols. Biophysics, which combines principles from physics with biological systems, provides crucial insights into the mechanical and structural integrity of the ACL and its susceptibility to injury under various conditions. This systematic review aims to collate and synthesize the current knowledge surrounding the biophysical mechanisms that underlie ACL injuries.

Cervical radicular pain following anterior cervical discectomy and fusion (ACDF) is a challenging condition, particularly in the presence of hardware complications. This case report discusses the successful use of a cervical interlaminar steroid injection to alleviate radicular pain in a patient who presented with a fractured screw following C6/7 ACDF. The patient's symptoms, treatment plan, and outcome are reviewed, highlighting the success of an interlaminar steroid injection in managing radicular pain until the patient could receive corrective surgery.

Background: Memorizing mounds of facts without having an effective conceptual framework to store them is often an unsuccessful learning style because memory frequently fails without understanding. To accomplish this goal, we offer a framework of ideas called "concept maps". Of the many strategies for metacognition (that is, thinking about thinking), concept mapping is proven to improve meaningful and independent learning. We used this approach to guide understanding of common orthopaedic infections. This paper is not meant to serve as an approach on how to treat, but rather as a storage system with the ability to assist in understanding orthopaedic infections.

Methods: Concept maps are constructed using information from over 30 sources of orthopaedic or infectious disease literature. The sequential levels of each concept map are referred to as levels of hierarchy. Boxes of each level of hierarchy are designed to be a point of differentiation between a similar concept. Branches form lower levels of hierarchy to further divide specific concepts.

Results: 5 concept maps were constructed. One map is an overview of all concepts, and the key concept for each of the following map are as follows: osteomyelitis, synovial infection, myositis, and foreign material infection.

Conclusion: A conceptual approach is a way of learning material in a manner that allows effective storage and retrieval. This approach will ultimately lead to a better understanding of orthopaedic infections.

Chronic knee pain from osteoarthritis (OA) is a leading cause of disability, with limited treatment options for patients who fail conservative management and intra-articular (IA) injections. Genicular nerve blocks (GNBs) have emerged as a promising treatment for chronic knee pain, especially in patients who are not candidates for total knee replacement (TKR). This case series discusses six patients with chronic knee pain from OA who failed conventional treatments, including IA injections, and found significant relief with GNBs.

Patellofemoral or anterior knee pain is a common cause of medical evaluation around the globe. It affects one in four individuals and is more frequent in females. It is considered a multifactorial disease in which conservative management must focus on the alterations found in the physical exam and radiologic images. Recurrence is high, as 39-40% of the patients continue with symptoms in one year of follow-up. Surgical management should be considered when symptoms persist after six months of conservative measures and when evident malalignments are identified. This article aims to establish and summarize the possible causes, involve the importance of the physical examination and the radiologic images suggested, as to consider the different treatment options that may be used to treat such a frequent and irregular pathology.

The authors present the case of a six-year-old boy with a fractured right distal radius and ulna, causing mildly comminuted displaced angulated fractures of the right distal radial and ulnar metaphyses. Pediatric wrist fractures are amongst the most common fractures seen in children, making up 25% of all pediatric fractures. These fractures disrupt growth patterns and can lead to long-term adverse effects.

Nerve blocks hold an important place in medicine. They are used to help with surgeries, allowing a painless surgical procedure without requiring the patient to be on full anesthesia. They can also provide a faster recovery period and apply to almost any body part. This paper summarizes how the nerve block became a procedure, the history of the drugs used and developed for it, and how machinery has allowed nerve blocks to progress to the point they are at today.