Pub Date : 2021-06-30DOI: 10.3390/osteology1030012
Gerardo Cazzato, A. Colagrande, A. Cimmino, Mariella Silecchia, T. Lettini, L. Resta, G. Ingravallo
Angiomatoid fibrous histiocytoma is a rare neoplasm with an intermediate malignant potential, that mostly occurs in the subcutis and features varying proportions of epithelioid, ovoid and spindle cells in a nodular and syncytial growth pattern, with hemorrhagic pseudovascular spaces. Here, we report the clinical case of a 68-year-old man who presented with AFH on the right arm; the disease relapsed a few years after surgical excision. We also conduct a brief review of the literature, focusing on the biological and genetic characteristics and the differential diagnosis from other more or less similar entities.
{"title":"Angiomatoid Fibrous Histiocytoma: Case Presentation with Review of Literature","authors":"Gerardo Cazzato, A. Colagrande, A. Cimmino, Mariella Silecchia, T. Lettini, L. Resta, G. Ingravallo","doi":"10.3390/osteology1030012","DOIUrl":"https://doi.org/10.3390/osteology1030012","url":null,"abstract":"Angiomatoid fibrous histiocytoma is a rare neoplasm with an intermediate malignant potential, that mostly occurs in the subcutis and features varying proportions of epithelioid, ovoid and spindle cells in a nodular and syncytial growth pattern, with hemorrhagic pseudovascular spaces. Here, we report the clinical case of a 68-year-old man who presented with AFH on the right arm; the disease relapsed a few years after surgical excision. We also conduct a brief review of the literature, focusing on the biological and genetic characteristics and the differential diagnosis from other more or less similar entities.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89611068","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}
Pub Date : 2021-06-23DOI: 10.3390/osteology1030011
W. Daner, P. Ryan, G. Domson, A. Sima, J. Isaacs
Following closed reduction of distal radius fractures, formal radiographs are often obtained despite previous verification on fluoroscopy. A prospective collection of 60 consecutive distal radius fractures was obtained to compare the quality of the fluoroscopic images obtained from a mini C-arm versus formal radiographs. The images were reviewed by six orthopedic surgeons and one radiologist. The likelihood that further imaging was deemed necessary to guide treatment decisions was 1.9 times higher in the mini C-arm imaging cohort (95% CI: 1:34, 2.69). While mini C-arm remains a useful reduction aid, formal radiographs should still be obtained to document post-reduction alignment and to guide treatment decisions.
{"title":"Quality of Mini C-Arm Imaging in Post-Reduction Evaluation of Distal Radius Fractures","authors":"W. Daner, P. Ryan, G. Domson, A. Sima, J. Isaacs","doi":"10.3390/osteology1030011","DOIUrl":"https://doi.org/10.3390/osteology1030011","url":null,"abstract":"Following closed reduction of distal radius fractures, formal radiographs are often obtained despite previous verification on fluoroscopy. A prospective collection of 60 consecutive distal radius fractures was obtained to compare the quality of the fluoroscopic images obtained from a mini C-arm versus formal radiographs. The images were reviewed by six orthopedic surgeons and one radiologist. The likelihood that further imaging was deemed necessary to guide treatment decisions was 1.9 times higher in the mini C-arm imaging cohort (95% CI: 1:34, 2.69). While mini C-arm remains a useful reduction aid, formal radiographs should still be obtained to document post-reduction alignment and to guide treatment decisions.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76412305","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}
Pub Date : 2021-05-17DOI: 10.3390/OSTEOLOGY1020010
A. Kienzle, S. Walter, Y. Palmowski, S. Kirschbaum, Lara Biedermann, P. von Roth, C. Perka, Michael Müller
Background: Periprosthetic joint infection (PJI) is a common yet severe complication after total knee arthroplasty (TKA). Surgical intervention and antibiotic therapy are obligatory to achieve successful, infection-free outcome. Compared to the outcomes after primary TKA, prosthesis failure rates are drastically increased after PJI-dependent revision surgery. Recurrent PJI and aseptic loosening are the most common reasons for prosthesis failure after revision TKA. An open question is the influence of the patients’ gender on long-term prosthesis survival after revision surgery. Additionally, it is unknown whether gender-related parameters and risk factors or differences in treatment are responsible for potential differences in outcome after revision arthroplasty. Patients and Methods: In this report, 109 patients that received TKA revision surgery due to PJI were retrospectively analyzed. We used clinical, paraclinical and radiological examinations to study the influence of gender on the long-term complications aseptic loosening and recurrent PJI after PJI-dependent revision arthroplasty. Results: While overall prosthesis failure rates and risk of recurrent PJI did not differ between genders, the long-term risk of aseptic loosening was significantly elevated in female patients. Postoperative coronal alignment was significantly more varus for women later diagnosed with aseptic loosening. Besides coronal alignment, no gender-dependent differences in clinical presentation or treatment were observed. Conclusions: Female patients displayed a significantly increased risk for aseptic loosening after PJI-dependent revision TKA. The observed gender-dependent differences in long-term outcome in our study support theories surrounding the role of bone metabolism in the development of aseptic loosening. Our data suggest that further research on a female design for PJI-dependent revision prostheses is warranted.
{"title":"Influence of Gender on Occurrence of Aseptic Loosening and Recurrent PJI after Revision Total Knee Arthroplasty","authors":"A. Kienzle, S. Walter, Y. Palmowski, S. Kirschbaum, Lara Biedermann, P. von Roth, C. Perka, Michael Müller","doi":"10.3390/OSTEOLOGY1020010","DOIUrl":"https://doi.org/10.3390/OSTEOLOGY1020010","url":null,"abstract":"Background: Periprosthetic joint infection (PJI) is a common yet severe complication after total knee arthroplasty (TKA). Surgical intervention and antibiotic therapy are obligatory to achieve successful, infection-free outcome. Compared to the outcomes after primary TKA, prosthesis failure rates are drastically increased after PJI-dependent revision surgery. Recurrent PJI and aseptic loosening are the most common reasons for prosthesis failure after revision TKA. An open question is the influence of the patients’ gender on long-term prosthesis survival after revision surgery. Additionally, it is unknown whether gender-related parameters and risk factors or differences in treatment are responsible for potential differences in outcome after revision arthroplasty. Patients and Methods: In this report, 109 patients that received TKA revision surgery due to PJI were retrospectively analyzed. We used clinical, paraclinical and radiological examinations to study the influence of gender on the long-term complications aseptic loosening and recurrent PJI after PJI-dependent revision arthroplasty. Results: While overall prosthesis failure rates and risk of recurrent PJI did not differ between genders, the long-term risk of aseptic loosening was significantly elevated in female patients. Postoperative coronal alignment was significantly more varus for women later diagnosed with aseptic loosening. Besides coronal alignment, no gender-dependent differences in clinical presentation or treatment were observed. Conclusions: Female patients displayed a significantly increased risk for aseptic loosening after PJI-dependent revision TKA. The observed gender-dependent differences in long-term outcome in our study support theories surrounding the role of bone metabolism in the development of aseptic loosening. Our data suggest that further research on a female design for PJI-dependent revision prostheses is warranted.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"30 5 1","pages":"92-104"},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88111212","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}
Pub Date : 2021-05-13DOI: 10.3390/OSTEOLOGY1020009
S. Aitken
Knowledge of the normal length and skeletal proportions of the lower limb is required as part of the evaluation of limb length discrepancy. When measuring limb length, modern standing full-length digital radiographs confer a level of clinical accuracy interchangeable with that of CT imaging. This study reports a set of normative values for lower limb length using the standing full-length radiographs of 753 patients (61% male). Lower limb length, femoral length, tibial length, and the femorotibial ratio were measured in 1077 limbs. The reliability of the measurement method was tested using the intra-class correlation (ICC) of agreement between three observers. The mean length of 1077 lower limbs was 89.0 cm (range 70.2 to 103.9 cm). Mean femoral length was 50.0 cm (39.3 to 58.4 cm) and tibial length was 39.0 cm (30.8 to 46.5 cm). The median side-to-side difference was 0.4 cm (0.2 to 0.7, max 1.8 cm) between 324 paired limbs. The mean ratio of femoral length to tibial length for the study population was 1.28:1 (range 1.16 to 1.39). A moderately strong inverse linear relationship (r = −0.35, p < 0.001, Pearson’s) was identified between tibial length and the corresponding femorotibial ratio. The PACS-based length measurement method used in this study displayed excellent inter-observer reliability (ICC of 0.99). This study presents a normal range of values for lower limb length in adults and is the first to identify a linear relationship between tibial length and the femorotibial ratio.
作为评估肢体长度差异的一部分，需要了解下肢的正常长度和骨骼比例。当测量肢体长度时，现代站立式全长数字x线片具有与CT成像可互换的临床精度水平。本研究报告了753例患者(61%为男性)站立全身x线片下肢长度的一组规范值。测量1077例下肢长、股骨长、胫骨长及股胫比。测量方法的可靠性是用三个观察者之间的一致性的类内相关(ICC)来检验的。1077例下肢平均长度为89.0 cm (70.2 ~ 103.9 cm)。股骨平均长度为50.0 cm (39.3 ~ 58.4 cm)，胫骨平均长度为39.0 cm (30.8 ~ 46.5 cm)。324对四肢的中位侧差为0.4 cm(0.2 ~ 0.7，最大1.8 cm)。研究人群股骨长度与胫骨长度的平均比值为1.28:1(范围1.16至1.39)。胫骨长度与相应的股胫比之间存在中等强的逆线性关系(r = - 0.35, p < 0.001, Pearson’s)。本研究使用的基于pacs的长度测量方法显示出良好的观察者间信度(ICC为0.99)。这项研究提出了成人下肢长度的正常范围，并首次确定了胫骨长度与股胫比之间的线性关系。
{"title":"Normative Values for Femoral Length, Tibial Length, and the Femorotibial Ratio in Adults Using Standing Full-Length Radiography","authors":"S. Aitken","doi":"10.3390/OSTEOLOGY1020009","DOIUrl":"https://doi.org/10.3390/OSTEOLOGY1020009","url":null,"abstract":"Knowledge of the normal length and skeletal proportions of the lower limb is required as part of the evaluation of limb length discrepancy. When measuring limb length, modern standing full-length digital radiographs confer a level of clinical accuracy interchangeable with that of CT imaging. This study reports a set of normative values for lower limb length using the standing full-length radiographs of 753 patients (61% male). Lower limb length, femoral length, tibial length, and the femorotibial ratio were measured in 1077 limbs. The reliability of the measurement method was tested using the intra-class correlation (ICC) of agreement between three observers. The mean length of 1077 lower limbs was 89.0 cm (range 70.2 to 103.9 cm). Mean femoral length was 50.0 cm (39.3 to 58.4 cm) and tibial length was 39.0 cm (30.8 to 46.5 cm). The median side-to-side difference was 0.4 cm (0.2 to 0.7, max 1.8 cm) between 324 paired limbs. The mean ratio of femoral length to tibial length for the study population was 1.28:1 (range 1.16 to 1.39). A moderately strong inverse linear relationship (r = −0.35, p < 0.001, Pearson’s) was identified between tibial length and the corresponding femorotibial ratio. The PACS-based length measurement method used in this study displayed excellent inter-observer reliability (ICC of 0.99). This study presents a normal range of values for lower limb length in adults and is the first to identify a linear relationship between tibial length and the femorotibial ratio.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"11 1","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88714764","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}
Pub Date : 2021-04-19DOI: 10.3390/OSTEOLOGY1020008
M. Pääkkönen, T. Pelkonen, Guilhermino Joaquim, Luis Bernandino, T. Pöyhiä, I. Roine, H. Peltola
We reviewed the characteristics of children hospitalized for bone and joint infections in Luanda, Angola. In a retrospective chart review of 45 patients with childhood osteomyelitis or septic arthritis, 51% of the patients had sickle cell disease, and these patients presented with lower hemoglobin and needed blood transfusion more frequently (p < 0.05). Out of all patients, 64% underwent surgical procedures; a pathological fracture occurred in 31% of the patients.
{"title":"Bone and Joint Infections in Children and Adolescents in Luanda, Angola","authors":"M. Pääkkönen, T. Pelkonen, Guilhermino Joaquim, Luis Bernandino, T. Pöyhiä, I. Roine, H. Peltola","doi":"10.3390/OSTEOLOGY1020008","DOIUrl":"https://doi.org/10.3390/OSTEOLOGY1020008","url":null,"abstract":"We reviewed the characteristics of children hospitalized for bone and joint infections in Luanda, Angola. In a retrospective chart review of 45 patients with childhood osteomyelitis or septic arthritis, 51% of the patients had sickle cell disease, and these patients presented with lower hemoglobin and needed blood transfusion more frequently (p < 0.05). Out of all patients, 64% underwent surgical procedures; a pathological fracture occurred in 31% of the patients.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"2 1","pages":"80-85"},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81090976","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}
Pub Date : 2021-04-01DOI: 10.3390/OSTEOLOGY1020007
G. Klein
Surprisingly little is known about the factors released from bone during resorption and the metabolic roles they play. This paper describes what we have learned about factors released from bone, mainly through the study of burn injuries, and what roles they play in post-burn metabolism. From these studies, we know that calcium, phosphorus, and magnesium, along with transforming growth factor (TGF)-β, are released from bone following resorption. Additionally, studies in mice from Karsenty’s laboratory have indicated that undercarboxylated osteocalcin is also released from bone during resorption. Questions arising from these observations are discussed as well as a variety of potential conditions in which release of these factors could play a significant role in the pathophysiology of the conditions. Therapeutic implications of understanding the metabolic roles of these and as yet other unidentified factors are also raised. While much remains unknown, that which has been observed provides a glimpse of the potential importance of this area of study.
{"title":"The Products of Bone Resorption and Their Roles in Metabolism: Lessons from the Study of Burns","authors":"G. Klein","doi":"10.3390/OSTEOLOGY1020007","DOIUrl":"https://doi.org/10.3390/OSTEOLOGY1020007","url":null,"abstract":"Surprisingly little is known about the factors released from bone during resorption and the metabolic roles they play. This paper describes what we have learned about factors released from bone, mainly through the study of burn injuries, and what roles they play in post-burn metabolism. From these studies, we know that calcium, phosphorus, and magnesium, along with transforming growth factor (TGF)-β, are released from bone following resorption. Additionally, studies in mice from Karsenty’s laboratory have indicated that undercarboxylated osteocalcin is also released from bone during resorption. Questions arising from these observations are discussed as well as a variety of potential conditions in which release of these factors could play a significant role in the pathophysiology of the conditions. Therapeutic implications of understanding the metabolic roles of these and as yet other unidentified factors are also raised. While much remains unknown, that which has been observed provides a glimpse of the potential importance of this area of study.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"573 1","pages":"73-79"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78916488","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}
Pub Date : 2021-03-12DOI: 10.3390/OSTEOLOGY1010006
M. Tumedei, M. Petrini, A. Cipollina, Mariastella Di Carmine, A. Piattelli, A. Cucurullo, G. Iezzi
Background: Implant primary stability is determined by screw characteristics and surgical procedure. The aim of the present study was to evaluate, on a polyurethane model, the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) of multi-scale roughness dental implants of different diameters. Methods: Two implant sizes were tested on two polyurethane blocks (20 pounds per cubic foot (PCF) and 30 PCF): 3.0 diameter and 13 mm length and 5.0 diameter and 13 mm length. The IT, RT, and RFA were assessed. Results: A significant difference of IT and RT was present in favor of wider implants at both polyurethane densities. No statistical difference was present between the 5.0 diameter and 3.0 diameter implants at both polyurethane densities. A statistically increased RFA was reported for 5.0 implant 30 PCF polyurethane blocks. Conclusions: Multi-scale roughness dental implants of both diameters showed high insertion torque and primary stability on polyurethane blocks, which is valuable for implant loading protocols.
{"title":"Comparative Evaluation of Primary Stability between Different Diameters Multi-Scale Roughness Dental Implant by Solid Rigid Polyurethane Simulation","authors":"M. Tumedei, M. Petrini, A. Cipollina, Mariastella Di Carmine, A. Piattelli, A. Cucurullo, G. Iezzi","doi":"10.3390/OSTEOLOGY1010006","DOIUrl":"https://doi.org/10.3390/OSTEOLOGY1010006","url":null,"abstract":"Background: Implant primary stability is determined by screw characteristics and surgical procedure. The aim of the present study was to evaluate, on a polyurethane model, the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) of multi-scale roughness dental implants of different diameters. Methods: Two implant sizes were tested on two polyurethane blocks (20 pounds per cubic foot (PCF) and 30 PCF): 3.0 diameter and 13 mm length and 5.0 diameter and 13 mm length. The IT, RT, and RFA were assessed. Results: A significant difference of IT and RT was present in favor of wider implants at both polyurethane densities. No statistical difference was present between the 5.0 diameter and 3.0 diameter implants at both polyurethane densities. A statistically increased RFA was reported for 5.0 implant 30 PCF polyurethane blocks. Conclusions: Multi-scale roughness dental implants of both diameters showed high insertion torque and primary stability on polyurethane blocks, which is valuable for implant loading protocols.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73844572","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}
Pub Date : 2021-03-05DOI: 10.3390/OSTEOLOGY1010005
C. Biz, Giovanni Baldin, Claudia Cappelletto, N. Bragazzi, P. Nicoletti, A. Crimì, P. Ruggieri
In athletes, one of the most common injuries is a sprained ankle. If the energy of the trauma is particularly high, this type of injury can lead to an isolated medial dislocation of the subtalar joint (STJ), a rare condition poorly described in the literature. The aim of this study was to verify if a reliable conservative treatment and a specific physiotherapy rehabilitation protocol in isolated medial dislocation of the STJ in athletes is described in the literature. A systematic review of the published literature of the last 11 years was performed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using three databases: Pubmed, Scopus, and Web of Science. The keywords used were “(subtalar OR talocalcaneal) AND dislocation”. We considered only studies that included professional or amateur athletes (athletic patients). We used the American Orthopedic Foot and Ankle Society (AOFAS) scale, range of motion (ROM) of the subtalar and ankle joint, subtalar and talonavicular joint osteoarthritis, and patient feedback to evaluate their outcomes. A total of 12 studies were included in our review, with a total of 26 athletic patients. Sixteen of them had good results with the correlation between the duration of immobilisation and the outcomes. Nevertheless, due to the small number of patients included in the analysed studies on this subject in the literature, there is not yet a univocal clinical protocol to treat the isolated medial subtalar joint dislocation (STJD) warranting further research in the field.
在运动员中，最常见的伤病之一是扭伤脚踝。如果创伤的能量特别高，这种类型的损伤可导致孤立的距下关节内侧脱位(STJ)，这是一种罕见的情况，文献中很少描述。本研究的目的是验证文献中是否描述了运动员孤立性STJ内侧脱位的可靠的保守治疗和特定的物理治疗康复方案。应用系统评价和荟萃分析首选报告项目(PRISMA)指南，使用Pubmed、Scopus和Web of Science三个数据库，对过去11年的已发表文献进行了系统评价。使用的关键词是“(距下或距跟骨)和脱位”。我们只考虑了包括专业或业余运动员(运动患者)的研究。我们使用美国骨科足踝协会(AOFAS)量表、距下关节和踝关节、距下关节和距舟关节骨性关节炎的活动范围(ROM)以及患者反馈来评估他们的结果。我们的综述共纳入了12项研究，共有26名运动员患者。其中16例有良好的结果，固定时间与结果之间存在相关性。然而，由于文献中关于该主题的分析研究中纳入的患者数量较少，目前尚没有一个明确的临床方案来治疗孤立性距下关节脱位(STJD)，值得在该领域进一步研究。
{"title":"Isolated Medial Subtalar Joint Dislocation during Sports Activities: A Systematic Review of the Literature with Individual Participant Data Analysis","authors":"C. Biz, Giovanni Baldin, Claudia Cappelletto, N. Bragazzi, P. Nicoletti, A. Crimì, P. Ruggieri","doi":"10.3390/OSTEOLOGY1010005","DOIUrl":"https://doi.org/10.3390/OSTEOLOGY1010005","url":null,"abstract":"In athletes, one of the most common injuries is a sprained ankle. If the energy of the trauma is particularly high, this type of injury can lead to an isolated medial dislocation of the subtalar joint (STJ), a rare condition poorly described in the literature. The aim of this study was to verify if a reliable conservative treatment and a specific physiotherapy rehabilitation protocol in isolated medial dislocation of the STJ in athletes is described in the literature. A systematic review of the published literature of the last 11 years was performed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using three databases: Pubmed, Scopus, and Web of Science. The keywords used were “(subtalar OR talocalcaneal) AND dislocation”. We considered only studies that included professional or amateur athletes (athletic patients). We used the American Orthopedic Foot and Ankle Society (AOFAS) scale, range of motion (ROM) of the subtalar and ankle joint, subtalar and talonavicular joint osteoarthritis, and patient feedback to evaluate their outcomes. A total of 12 studies were included in our review, with a total of 26 athletic patients. Sixteen of them had good results with the correlation between the duration of immobilisation and the outcomes. Nevertheless, due to the small number of patients included in the analysed studies on this subject in the literature, there is not yet a univocal clinical protocol to treat the isolated medial subtalar joint dislocation (STJD) warranting further research in the field.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81239402","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}
Pub Date : 2020-12-31DOI: 10.3390/osteology1010004
C. Zale, Joshua Hansen, P. Ryan
Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS.
{"title":"Complex Regional Pain Syndrome: Current Practice Management and Referral Trends in a Closed Healthcare System","authors":"C. Zale, Joshua Hansen, P. Ryan","doi":"10.3390/osteology1010004","DOIUrl":"https://doi.org/10.3390/osteology1010004","url":null,"abstract":"Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"2 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78501556","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}
Pub Date : 2020-12-26DOI: 10.3390/osteology1010003
A. Berton, S. De Salvatore, V. Candela, G. Cortina, D. Lo Presti, C. Massaroni, S. Petrillo, V. Denaro
Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI.
{"title":"Delayed Rehabilitation Protocol after Rotator Cuff Repair","authors":"A. Berton, S. De Salvatore, V. Candela, G. Cortina, D. Lo Presti, C. Massaroni, S. Petrillo, V. Denaro","doi":"10.3390/osteology1010003","DOIUrl":"https://doi.org/10.3390/osteology1010003","url":null,"abstract":"Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"12 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91208303","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：