Arthroscopic rotator cuff repair (ARCR) is a minimally invasive surgical technique. However, it is challenging to control postoperative pain. This study aimed to investigate the difference between a single-shot interscalene block and a combined continuous block for ARCR.
Methods
Ninety-four patients who underwent ARCR were included in this study. In the preceding period, 43 patients received a single-shot interscalene block and continuous postoperative intravenous opioid infusion (Single group). In the posterior period, 51 patients received a single-shot interscalene block preoperatively and a continuous block postoperatively (Continuous group). Their mean age at surgery was 64.9 years (range, 43–83 years). The mean follow-up period was 25.4 months (range, 24–54 months). The numerical rating scale (NRS) of pain was evaluated immediately after the surgery, at rest, and at night for 1–4 days after the surgery. One day postoperatively, the amount of food taken was assessed from 0 % (no food intake) to 100 % (all food taken). The University of California at Los Angeles (UCLA) shoulder score, range of motion (ROM), and isometric shoulder strength were evaluated.
Results
NRS at rest in the Continuous group on the day of surgery was 3.7 ± 2.5. This was significantly lower than in the Single group (5.2 ± 1.8) (P = 0.002). NRS at rest in the Continuous group on the second day after surgery was 3.0 ± 2.1, significantly lower than in the Single group (3.9 ± 1.8) (P = 0.04). The amount of food taken in the morning in the Continuous group was 61 % ± 37 %, which was significantly greater than in the Single group (35 % ± 41 %) (P = 0.004). The ROM of extension at 6 months postoperatively in the Continuous group was 47 ± 7°, which was significantly greater than in the Single group (43 ± 6°) (P = 0.02). The postoperative strength of the external rotator at 6 months in the Continuous group was 95 ± 33 N, significantly greater than in the Single group (78 ± 28 N) (P = 0.01). There was no significant difference in UCLA score at any time.
Conclusion
The continuous interscalene block with ultrasound guidance in ARCR effectively relieved pain. The recovery of ROM for extension and the strength of the external rotator was better in the Continuous group.
{"title":"The effect of continuous interscalene brachial plexus block for arthroscopic rotator cuff repair","authors":"Tomohiro Uno , Nariyuki Mura , Issei Yuki , Ryuta Oishi , Michiaki Takagi","doi":"10.1016/j.asmart.2024.01.004","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Arthroscopic rotator cuff repair (ARCR) is a minimally invasive surgical technique. However, it is challenging to control postoperative pain. This study aimed to investigate the difference between a single-shot interscalene block and a combined continuous block for ARCR.</p></div><div><h3>Methods</h3><p>Ninety-four patients who underwent ARCR were included in this study. In the preceding period, 43 patients received a single-shot interscalene block and continuous postoperative intravenous opioid infusion (Single group). In the posterior period, 51 patients received a single-shot interscalene block preoperatively and a continuous block postoperatively (Continuous group). Their mean age at surgery was 64.9 years (range, 43–83 years). The mean follow-up period was 25.4 months (range, 24–54 months). The numerical rating scale (NRS) of pain was evaluated immediately after the surgery, at rest, and at night for 1–4 days after the surgery. One day postoperatively, the amount of food taken was assessed from 0 % (no food intake) to 100 % (all food taken). The University of California at Los Angeles (UCLA) shoulder score, range of motion (ROM), and isometric shoulder strength were evaluated.</p></div><div><h3>Results</h3><p>NRS at rest in the Continuous group on the day of surgery was 3.7 ± 2.5. This was significantly lower than in the Single group (5.2 ± 1.8) (<em>P</em> = 0.002). NRS at rest in the Continuous group on the second day after surgery was 3.0 ± 2.1, significantly lower than in the Single group (3.9 ± 1.8) (<em>P</em> = 0.04). The amount of food taken in the morning in the Continuous group was 61 % ± 37 %, which was significantly greater than in the Single group (35 % ± 41 %) (<em>P</em> = 0.004). The ROM of extension at 6 months postoperatively in the Continuous group was 47 ± 7°, which was significantly greater than in the Single group (43 ± 6°) (<em>P =</em> 0.02). The postoperative strength of the external rotator at 6 months in the Continuous group was 95 ± 33 N, significantly greater than in the Single group (78 ± 28 N) (<em>P</em> = 0.01). There was no significant difference in UCLA score at any time.</p></div><div><h3>Conclusion</h3><p>The continuous interscalene block with ultrasound guidance in ARCR effectively relieved pain. The recovery of ROM for extension and the strength of the external rotator was better in the Continuous group.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 6-12"},"PeriodicalIF":2.1,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000049/pdfft?md5=8baa9211d10237229461c1aeefddff57&pid=1-s2.0-S2214687324000049-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674140","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}
Normal knee kinematics during flexion and extension activities over the whole range of motion remains unknown. This study aimed to clarify in vivo kinematics during knee flexion and extension activities of normal knees by comparing continuous flexion and extension activities up to a high flexion angle.
Methods
Twenty knees of 10 Japanese volunteers were enrolled in this study. Each volunteer performed a continuous squatting motion under fluoroscopy, and a two- or three-dimensional registration technique was used. Rotation and anteroposterior translation of the medial and lateral sides of the femur relative to the tibia at each flexion angle were evaluated.
Results
Femoral external rotation was significantly smaller from 10° to 40° flexion during extension activities than during flexion activities. However, the femoral external rotation was larger from 120° to 130° flexion during extension activities than during flexion activities. From 10° to 60° of flexion, the medial side was significantly more posteriorly located during extension activities than during flexion activities. Furthermore, the lateral side was significantly more posteriorly located at 130° of flexion during extension activities than during flexion activities.
Conclusion
In vivo kinematics of normal knees during extension activities differ from those during flexion activities in early and high flexion.
{"title":"In vivo three-dimensional kinematic comparison of normal knees between flexion and extension activities","authors":"Kenichi Kono , Takaharu Yamazaki , Shuji Taketomi , Hiroshi Inui , Sakae Tanaka , Tetsuya Tomita","doi":"10.1016/j.asmart.2024.01.003","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.01.003","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Normal knee kinematics during flexion and extension activities over the whole range of motion remains unknown. This study aimed to clarify in vivo kinematics during knee flexion and extension activities of normal knees by comparing continuous flexion and extension activities up to a high flexion angle.</p></div><div><h3>Methods</h3><p>Twenty knees of 10 Japanese volunteers were enrolled in this study. Each volunteer performed a continuous squatting motion under fluoroscopy, and a two- or three-dimensional registration technique was used. Rotation and anteroposterior translation of the medial and lateral sides of the femur relative to the tibia at each flexion angle were evaluated.</p></div><div><h3>Results</h3><p>Femoral external rotation was significantly smaller from 10° to 40° flexion during extension activities than during flexion activities. However, the femoral external rotation was larger from 120° to 130° flexion during extension activities than during flexion activities. From 10° to 60° of flexion, the medial side was significantly more posteriorly located during extension activities than during flexion activities. Furthermore, the lateral side was significantly more posteriorly located at 130° of flexion during extension activities than during flexion activities.</p></div><div><h3>Conclusion</h3><p>In vivo kinematics of normal knees during extension activities differ from those during flexion activities in early and high flexion.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 1-5"},"PeriodicalIF":2.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000037/pdfft?md5=461452910d70e30cb9d1c2bd548eb04e&pid=1-s2.0-S2214687324000037-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674139","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}
This study aimed to investigate the effect of high tibial osteotomy (HTO) on medial meniscus extrusion (MME) and the association between the changes in limb alignment and MME under weight-bearing (WB) conditions after HTO.
Methods
We included 17 patients with knee osteoarthritis (OA) who underwent HTO. MME was evaluated using ultrasonography in supine and unipedal standing positions. Knee alignment was evaluated radiographically using WB, whole-leg radiographs with the hip-knee-ankle angle (HKAA), percentage of the mechanical axis (%MA), medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA). All measurements were performed serially at four time points: preoperative and 3, 6, and 12 months postoperative. Clinical outcomes were assessed by knee injury and osteoarthrosis outcome score (KOOS) and visual analogue scale (VAS) value for pain.
Results
Mean MME in the WB position was significantly greater than that in the supine position in the preoperative condition; however, MME in both supine and WB positions was significantly lowered postoperatively. The ΔMME, difference of MME between supine and WB positions, was significantly lowered postoperatively and maintained for up to 1 year. MME change in the WB position between preop and postoperative conditions was significantly correlated with change in HKAA and %MA at 1 year postoperative. KOOS and VAS score were significantly improved after HTO.
Conclusions
HTO correcting varus alignment can decrease MME in WB position and minimise the change in MME between supine and WB positions. The changes in MME after HTO were correlated with changes in the mechanical alignments.
{"title":"Effect of limb alignment correction on medial meniscus extrusion under loading condition in high tibial osteotomy","authors":"Yosuke Ishii , Masakazu Ishikawa , Goki Kamei , Yuko Nakashima , Yoshitaka Iwamoto , Makoto Takahashi , Nobuo Adachi","doi":"10.1016/j.asmart.2023.08.010","DOIUrl":"10.1016/j.asmart.2023.08.010","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to investigate the effect of high tibial osteotomy (HTO) on medial meniscus extrusion (MME) and the association between the changes in limb alignment and MME under weight-bearing (WB) conditions after HTO.</p></div><div><h3>Methods</h3><p>We included 17 patients with knee osteoarthritis (OA) who underwent HTO. MME was evaluated using ultrasonography in supine and unipedal standing positions. Knee alignment was evaluated radiographically using WB, whole-leg radiographs with the hip-knee-ankle angle (HKAA), percentage of the mechanical axis (%MA), medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA). All measurements were performed serially at four time points: preoperative and 3, 6, and 12 months postoperative. Clinical outcomes were assessed by knee injury and osteoarthrosis outcome score (KOOS) and visual analogue scale (VAS) value for pain.</p></div><div><h3>Results</h3><p>Mean MME in the WB position was significantly greater than that in the supine position in the preoperative condition; however, MME in both supine and WB positions was significantly lowered postoperatively. The ΔMME, difference of MME between supine and WB positions, was significantly lowered postoperatively and maintained for up to 1 year. MME change in the WB position between preop and postoperative conditions was significantly correlated with change in HKAA and %MA at 1 year postoperative. KOOS and VAS score were significantly improved after HTO.</p></div><div><h3>Conclusions</h3><p>HTO correcting varus alignment can decrease MME in WB position and minimise the change in MME between supine and WB positions. The changes in MME after HTO were correlated with changes in the mechanical alignments.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"34 ","pages":"Pages 1-8"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/81/main.PMC10493499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228392","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}
Pub Date : 2023-10-01DOI: 10.1016/j.asmart.2023.08.008
Xiaoxi Ji , Lingchao Ye , Yinghui Hua , Xiaobo Zhou
Background
Failure to fix the fractured fragment can result in bony fragment resorption and consequent glenoid bone loss. Current arthroscopic repair techniques might lead to insecure fixation and refracture. The purpose of this study was to evaluate the effectiveness of the transosseous sling-suture technique for bony Bankart lesions, and to compare the clinical outcomes for acute and chronic bony Bankart lesions treated with this technique.
Methods
A retrospective case series consisting of 46 patients with bony fracture of the glenoid rim following traumatic injury was identified from May 2015 to August 2020. The patients were divided into the acute lesion group and the chronic lesion group according to the time from first injury to surgery. The size of bone fragment was used to group the patients into the small and the medium sized fragment groups. All the patients underwent arthroscopic repairs using the transosseous sling-suture technique. Preoperative and postoperative evaluations including Rowe score, West Ontario Shoulder Instability Index (WOSI), Visual Analogue Scale (VAS) for pain scores, ROMs and number of dislocations were recorded. No significant differences were found in the comparisons of postoperative ROMs ang functional outcomes regarding between the small and the medium sized fragment groups.
Results
No dislocations occurred for both groups postoperatively. At the last follow-up, all the ROMs (including anterior flexion, abduction, external rotation and internal rotation at the side), the Rowe score, the WOSI score and the VAS score for pain in the both groups were significantly improved compared to the preoperative evaluations (all Ps < 0.001). In the comparisons between the acute and the chronic lesion groups, significantly greater anterior flexion (158.9 ± 8.9° vs. 153.0 ± 6.4°, P = 0.037), abduction (167.7 ± 10.1° vs. 161.0 ± 7.0°, P = 0.035) and external rotation at the side (88.3 ± 6.4° vs. 83.5 ± 5.5°, P = 0.024) were found in the acute lesion group. The comparisons of the Rowe score (86.0 ± 7.5 vs. 87.5 ± 10.6, P = 0.319), the WOSI score (223.5 ± 56.3 vs. 185.0 ± 79.9, P = 0.062), the VAS score for pain (0.4 ± 0.2 vs. 0.3 ± 0.2, P = 0.324) and the internal rotation at the side (74.6 ± 13.2° vs. 80.5 ± 11.1°, P = 0.116) between these two groups did not demonstrate significant differences between the two groups.
Conclusion
This arthroscopic transosseous sling-suture repair technique for shoulder anterior instability with acute and chronic bony Bankart lesion can restore joint stability, improve clinical outcomes and range of motion postoperatively. The acute bony Bankart lesion using the current technique can produce better range of motion compared to the chronic lesion.
{"title":"Arthroscopic repair with transosseous sling-suture technique for acute and chronic bony Bankart lesions","authors":"Xiaoxi Ji , Lingchao Ye , Yinghui Hua , Xiaobo Zhou","doi":"10.1016/j.asmart.2023.08.008","DOIUrl":"10.1016/j.asmart.2023.08.008","url":null,"abstract":"<div><h3>Background</h3><p>Failure to fix the fractured fragment can result in bony fragment resorption and consequent glenoid bone loss. Current arthroscopic repair techniques might lead to insecure fixation and refracture. The purpose of this study was to evaluate the effectiveness of the transosseous sling-suture technique for bony Bankart lesions, and to compare the clinical outcomes for acute and chronic bony Bankart lesions treated with this technique.</p></div><div><h3>Methods</h3><p>A retrospective case series consisting of 46 patients with bony fracture of the glenoid rim following traumatic injury was identified from May 2015 to August 2020. The patients were divided into the acute lesion group and the chronic lesion group according to the time from first injury to surgery. The size of bone fragment was used to group the patients into the small and the medium sized fragment groups. All the patients underwent arthroscopic repairs using the transosseous sling-suture technique. Preoperative and postoperative evaluations including Rowe score, West Ontario Shoulder Instability Index (WOSI), Visual Analogue Scale (VAS) for pain scores, ROMs and number of dislocations were recorded. No significant differences were found in the comparisons of postoperative ROMs ang functional outcomes regarding between the small and the medium sized fragment groups.</p></div><div><h3>Results</h3><p>No dislocations occurred for both groups postoperatively. At the last follow-up, all the ROMs (including anterior flexion, abduction, external rotation and internal rotation at the side), the Rowe score, the WOSI score and the VAS score for pain in the both groups were significantly improved compared to the preoperative evaluations (all <em>P</em>s < 0.001). In the comparisons between the acute and the chronic lesion groups, significantly greater anterior flexion (158.9 ± 8.9° vs. 153.0 ± 6.4°, <em>P</em> = 0.037), abduction (167.7 ± 10.1° vs. 161.0 ± 7.0°, <em>P</em> = 0.035) and external rotation at the side (88.3 ± 6.4° vs. 83.5 ± 5.5°, <em>P</em> = 0.024) were found in the acute lesion group. The comparisons of the Rowe score (86.0 ± 7.5 vs. 87.5 ± 10.6, <em>P</em> = 0.319), the WOSI score (223.5 ± 56.3 vs. 185.0 ± 79.9, <em>P</em> = 0.062), the VAS score for pain (0.4 ± 0.2 vs. 0.3 ± 0.2, <em>P</em> = 0.324) and the internal rotation at the side (74.6 ± 13.2° vs. 80.5 ± 11.1°, <em>P</em> = 0.116) between these two groups did not demonstrate significant differences between the two groups.</p></div><div><h3>Conclusion</h3><p>This arthroscopic transosseous sling-suture repair technique for shoulder anterior instability with acute and chronic bony Bankart lesion can restore joint stability, improve clinical outcomes and range of motion postoperatively. The acute bony Bankart lesion using the current technique can produce better range of motion compared to the chronic lesion.</p></div><div><h3>Study design</h3><p>Retrospective case series; Level of evidence, 4.</p","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"34 ","pages":"Pages 9-14"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/a2/main.PMC10511304.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161568","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}
Pub Date : 2023-10-01DOI: 10.1016/j.asmart.2023.09.001
Hong Li , Wei Yao , Xiao'ao Xue , Yunxia Li , Yinghui Hua
Background
The treatment for Achilles tendinopathy varies widely, and there is no consensus regarding the optimal treatment for both non-insertional and insertional Achilles tendinopathy. The purpose of this study was to evaluate the clinical efficacy of extracorporeal shock wave therapy (ESWT) in the treatment of insertional and non-insertional Achilles tendinopathy (AT).
Methods
Sixty patients with AT were invited to participate in this study. Patients were allocated to one of two groups according to the site of the AT, including an insertional AT (IAT) group and a non-insertional AT (NIAT) group. ESWT was performed once a week for five weeks for both groups. The Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) score and the visual analog scale (VAS) were used five times to evaluate the clinical outcomes, including before treatment, immediately after treatment, as well as one month, three months, and five years after treatment.
Results
At three months after treatment, the IAT group exhibited a significantly higher VISA-A score (82 ± 6 vs. 76 ± 11; p = 0.01) and a significantly lower VAS score (1 ± 1 vs. 2 ± 1; p < 0.001) when compared with the NIAT group. At the five-year assessment, the IAT group (1 ± 1) had a significantly lower VAS score than the NIAT group (2 ± 1) (p = 0.02), while no significant difference for the VISA-A score was observed between the groups (84 ± 8 vs. 84 ± 10; p = 0.98).
Conclusions
Extracorporeal shock wave treatment can improve the symptoms of both insertional and non-insertional AT. The IAT patients experienced better clinical outcomes compared with the NIAT patients.
{"title":"Therapeutic effects following extracorporeal shock wave therapy for insertional and non-insertional Achilles tendinopathy","authors":"Hong Li , Wei Yao , Xiao'ao Xue , Yunxia Li , Yinghui Hua","doi":"10.1016/j.asmart.2023.09.001","DOIUrl":"10.1016/j.asmart.2023.09.001","url":null,"abstract":"<div><h3>Background</h3><p>The treatment for Achilles tendinopathy varies widely, and there is no consensus regarding the optimal treatment for both non-insertional and insertional Achilles tendinopathy. The purpose of this study was to evaluate the clinical efficacy of extracorporeal shock wave therapy (ESWT) in the treatment of insertional and non-insertional Achilles tendinopathy (AT).</p></div><div><h3>Methods</h3><p>Sixty patients with AT were invited to participate in this study. Patients were allocated to one of two groups according to the site of the AT, including an insertional AT (IAT) group and a non-insertional AT (NIAT) group. ESWT was performed once a week for five weeks for both groups. The Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) score and the visual analog scale (VAS) were used five times to evaluate the clinical outcomes, including before treatment, immediately after treatment, as well as one month, three months, and five years after treatment.</p></div><div><h3>Results</h3><p>At three months after treatment, the IAT group exhibited a significantly higher VISA-A score (82 ± 6 <em>vs.</em> 76 ± 11; <em>p</em> = 0.01) and a significantly lower VAS score (1 ± 1 <em>vs.</em> 2 ± 1; <em>p</em> < 0.001) when compared with the NIAT group. At the five-year assessment, the IAT group (1 ± 1) had a significantly lower VAS score than the NIAT group (2 ± 1) (<em>p</em> = 0.02), while no significant difference for the VISA-A score was observed between the groups (84 ± 8 <em>vs.</em> 84 ± 10; <em>p</em> = 0.98).</p></div><div><h3>Conclusions</h3><p>Extracorporeal shock wave treatment can improve the symptoms of both insertional and non-insertional AT. The IAT patients experienced better clinical outcomes compared with the NIAT patients.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"34 ","pages":"Pages 38-45"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/5c/main.PMC10582256.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685600","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}
The Functional Internal Rotation Scale is an excellent clinical tool for evaluating patients with shoulder arthroplasty, but it has not been adapted to the Thai version. The objectives of this study were to translate the English version and culturally adapt the Functional Internal Rotation Scale to the Thai version and to examine the psychometric properties of the Thai Functional Internal Rotation Scale among Thai participants having shoulder arthroplasty.
Methods
The Functional Internal Rotation Scale was translated to Thai, including cross-cultural adaptations, following standard guidelines. Psychometric properties were evaluated with shoulder arthroplasty patients. Content validity was evaluated using the content validity index (CVI). Criterion validity was assessed using the Pearson correlation coefficient. An Independent t-test was used to evaluate construct validity. Internal consistency reliability was assessed using Cronbach's alpha coefficient. Intraclass correlation coefficient (ICC) was used to determine test-retest reliability over a 14-day interval.
Results
Of 45 participants, 20 total shoulder arthroplasty (TSA) patients and 25 reverse shoulder arthroplasty (RSA) patients, the majority of participants were female (69%) and retired (91%) with a mean age of 72.9 years (SD 9.1). CVI evaluation was acceptable, with a total CVI of 0.92. The correlation of the Thai Functional Internal Rotation Scale with the Thai version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (Thai ASES) and the internal rotation subscale (IR subscale) of the Thai ASES was 0.73 (P < 0.001) and 0.75 (P < 0.001), respectively. For construct validity, TSA patients scored, on average, 10.8 points higher than RSA patients (43.7 vs. 32.9, P < 0.001, 95% confidence interval 6.3–15.3). Cronbach's alpha coefficient of the Thai Functional Internal Rotation Scale was 0.95. The test-retest reliability revealed excellent reliability (ICC 0.99).
Conclusion
The Thai Functional Internal Rotation Scale has good validity and excellent reliability in assessing internal rotation function in Thai shoulder arthroplasty patients.
{"title":"Validity and reliability of the Thai functional internal rotation scale for shoulder arthroplasty","authors":"Nattha Kulkamthorn , Tharit Inkaratana , Pattanaket Cheewakongkiat","doi":"10.1016/j.asmart.2023.08.007","DOIUrl":"10.1016/j.asmart.2023.08.007","url":null,"abstract":"<div><h3>Background</h3><p>The Functional Internal Rotation Scale is an excellent clinical tool for evaluating patients with shoulder arthroplasty, but it has not been adapted to the Thai version. The objectives of this study were to translate the English version and culturally adapt the Functional Internal Rotation Scale to the Thai version and to examine the psychometric properties of the Thai Functional Internal Rotation Scale among Thai participants having shoulder arthroplasty.</p></div><div><h3>Methods</h3><p>The Functional Internal Rotation Scale was translated to Thai, including cross-cultural adaptations, following standard guidelines. Psychometric properties were evaluated with shoulder arthroplasty patients. Content validity was evaluated using the content validity index (CVI). Criterion validity was assessed using the Pearson correlation coefficient. An Independent <em>t</em>-test was used to evaluate construct validity. Internal consistency reliability was assessed using Cronbach's alpha coefficient. Intraclass correlation coefficient (ICC) was used to determine test-retest reliability over a 14-day interval.</p></div><div><h3>Results</h3><p>Of 45 participants, 20 total shoulder arthroplasty (TSA) patients and 25 reverse shoulder arthroplasty (RSA) patients, the majority of participants were female (69%) and retired (91%) with a mean age of 72.9 years (SD 9.1). CVI evaluation was acceptable, with a total CVI of 0.92. The correlation of the Thai Functional Internal Rotation Scale with the Thai version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (Thai ASES) and the internal rotation subscale (IR subscale) of the Thai ASES was 0.73 (P < 0.001) and 0.75 (P < 0.001), respectively. For construct validity, TSA patients scored, on average, 10.8 points higher than RSA patients (43.7 vs. 32.9, P < 0.001, 95% confidence interval 6.3–15.3). Cronbach's alpha coefficient of the Thai Functional Internal Rotation Scale was 0.95. The test-retest reliability revealed excellent reliability (ICC 0.99).</p></div><div><h3>Conclusion</h3><p>The Thai Functional Internal Rotation Scale has good validity and excellent reliability in assessing internal rotation function in Thai shoulder arthroplasty patients.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"34 ","pages":"Pages 15-19"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/a5/main.PMC10522889.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41158616","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}
Pub Date : 2023-10-01DOI: 10.1016/j.asmart.2023.08.004
Yufeng Zhang , Zirong Bai , Zhiye Zhang , Peng Yuan , Yilin Xu , Zun Wang , David Sutton , Jun Ren , Eamonn Delahunt , Dan Wang
Objective
Joint stiffness results from the coupling of the nervous system and joint mechanics, and thus stiffness is a comprehensive representation of joint stability. It has been reported that moxibustion can alleviate general weakness and fatigue symptoms and subsequently may influence joint stiffness. This study investigated whether moxibustion could enhance knee joint stiffness in recreational athletes pre- and post-fatigue.
Methods
Eighteen participants were randomized into intervention (5 males: 20.6 ± 1.5 yr; 4 females: 20.8 ± 1.5 yr) and control groups (5 males: 19.4 ± 0.9 yr; 4 females: 20.5 ± 0.6 yr). The intervention group received indirect moxibustion applied to acupoints ST36 (bilateral) and CV4 for 30 min every other day for 4 consecutive weeks. The control group maintained regular exercise without moxibustion. Peak torque (PT) of right knee extensor, relaxed and contracted muscle stiffness (MS) of vastus lateralis, and knee extensor musculoarticular stiffness (MAS) was assessed with an isokinetic dynamometer (IsoMed 2000), myometer, and free oscillation technique, respectively. Measurements were taken at three time points: pre-intervention, post-intervention/pre-fatigue, and post-fatigue.
Results
MAS (P = 0.006) and PT (P = 0.007) in the intervention group increased more from pre-to post-intervention compared with the control group. Post-fatigue MAS (P = 0.016) and PT (P = 0.031) increased more in the intervention group than in the control group.
Conclusion
Moxibustion enhanced PT and knee MAS, suggesting that this intervention could be used in injury prevention and benefit fatigue resistance in young recreational athletes.
{"title":"Effect of moxibustion on knee joint stiffness characteristics in recreational athletes pre- and post-fatigue","authors":"Yufeng Zhang , Zirong Bai , Zhiye Zhang , Peng Yuan , Yilin Xu , Zun Wang , David Sutton , Jun Ren , Eamonn Delahunt , Dan Wang","doi":"10.1016/j.asmart.2023.08.004","DOIUrl":"10.1016/j.asmart.2023.08.004","url":null,"abstract":"<div><h3>Objective</h3><p>Joint stiffness results from the coupling of the nervous system and joint mechanics, and thus stiffness is a comprehensive representation of joint stability. It has been reported that moxibustion can alleviate general weakness and fatigue symptoms and subsequently may influence joint stiffness. This study investigated whether moxibustion could enhance knee joint stiffness in recreational athletes pre- and post-fatigue.</p></div><div><h3>Methods</h3><p>Eighteen participants were randomized into intervention (5 males: 20.6 ± 1.5 yr; 4 females: 20.8 ± 1.5 yr) and control groups (5 males: 19.4 ± 0.9 yr; 4 females: 20.5 ± 0.6 yr). The intervention group received indirect moxibustion applied to acupoints ST36 (bilateral) and CV4 for 30 min every other day for 4 consecutive weeks. The control group maintained regular exercise without moxibustion. Peak torque (PT) of right knee extensor, relaxed and contracted muscle stiffness (MS) of vastus lateralis, and knee extensor musculoarticular stiffness (MAS) was assessed with an isokinetic dynamometer (IsoMed 2000), myometer, and free oscillation technique, respectively. Measurements were taken at three time points: pre-intervention, post-intervention/pre-fatigue, and post-fatigue.</p></div><div><h3>Results</h3><p>MAS (P = 0.006) and PT (P = 0.007) in the intervention group increased more from pre-to post-intervention compared with the control group. Post-fatigue MAS (P = 0.016) and PT (P = 0.031) increased more in the intervention group than in the control group.</p></div><div><h3>Conclusion</h3><p>Moxibustion enhanced PT and knee MAS, suggesting that this intervention could be used in injury prevention and benefit fatigue resistance in young recreational athletes.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"34 ","pages":"Pages 20-27"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/ce/main.PMC10550517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147682","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}
Pub Date : 2023-10-01DOI: 10.1016/j.asmart.2023.09.002
Muhindra Rao Gsangaya , Ohnmar Htwe , Amaramalar Selvi Naicker , Badrul Akmal Hisham Md Yusoff , Norlelawati Mohammad , Elaine Zi Fan Soh , Murugeaswaran Silvaraju
Purpose
Anterior cruciate ligament injury (ACL) commonly occurs during sporting events. It causes pain, instability and reduction in range of movement of the knee which results in altered balance, reduced strength as well as loading to the involved knee. The challenge to get the patient back to competitive sports level much depends on the rehabilitation process. Post ACLR rehabilitation is challenging due to the long rehabilitation time as well as boring repetitive exercises. The aim of this study is to compare between the effectiveness of using immersive virtual reality (PlayStation VR) in addition to the conventional rehabilitation as an aid in rehabilitation of patients after ACLR in terms of objective functional assessment and pain and subjective knee function scoring.
Methods
This randomised controlled trial was undertaken in a tertiary hospital in Malaysia from July 2019 until July 2020. Thirty patients were randomised into a group undergoing purely conventional rehabilitation (Group 1) and a group undergoing both conventional rehabilitation and immersive virtual reality assisted rehabilitation (Group 2). The immersive virtual reality assisted rehabilitation was started at 3 months post operatively for 3 months duration. Limb loading, balance, range of motion, functional hop tests of the knee, pain and subjective scoring of the knee with the International Knee Documentation Committee (IKDC) Scores were measured preoperatively and at 6 months.
Results
There were significant differences in terms of improvement of pain scores (p = 0.012) as well as IKDC Scores (p = 0.024) in Group 2 as compared to Group 1. However, there were no significant differences with regards to limb loading, balance, range of motion and functional hop tests of the knee (p > 0.05). No adverse events were observed during the study period.
Conclusion
Immersive virtual reality can be used as an adjunct in rehabilitation of patients after ACL reconstruction in terms of improving their pain as well as their subjective knee evaluation. Large randomised control trial is recommended to further investigate the efficacy.
{"title":"Comparison between the effect of immersive virtual reality training versus conventional rehabilitation on limb loading and functional outcomes in patients after anterior cruciate ligament reconstruction: A prospective randomized controlled trial","authors":"Muhindra Rao Gsangaya , Ohnmar Htwe , Amaramalar Selvi Naicker , Badrul Akmal Hisham Md Yusoff , Norlelawati Mohammad , Elaine Zi Fan Soh , Murugeaswaran Silvaraju","doi":"10.1016/j.asmart.2023.09.002","DOIUrl":"10.1016/j.asmart.2023.09.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Anterior cruciate ligament injury (ACL) commonly occurs during sporting events. It causes pain, instability and reduction in range of movement of the knee which results in altered balance, reduced strength as well as loading to the involved knee. The challenge to get the patient back to competitive sports level much depends on the rehabilitation process. Post ACLR rehabilitation is challenging due to the long rehabilitation time as well as boring repetitive exercises. The aim of this study is to compare between the effectiveness of using immersive virtual reality (PlayStation VR) in addition to the conventional rehabilitation as an aid in rehabilitation of patients after ACLR in terms of objective functional assessment and pain and subjective knee function scoring.</p></div><div><h3>Methods</h3><p>This randomised controlled trial was undertaken in a tertiary hospital in Malaysia from July 2019 until July 2020. Thirty patients were randomised into a group undergoing purely conventional rehabilitation (Group 1) and a group undergoing both conventional rehabilitation and immersive virtual reality assisted rehabilitation (Group 2). The immersive virtual reality assisted rehabilitation was started at 3 months post operatively for 3 months duration. Limb loading, balance, range of motion, functional hop tests of the knee, pain and subjective scoring of the knee with the International Knee Documentation Committee (IKDC) Scores were measured preoperatively and at 6 months.</p></div><div><h3>Results</h3><p>There were significant differences in terms of improvement of pain scores (p = 0.012) as well as IKDC Scores (p = 0.024) in Group 2 as compared to Group 1. However, there were no significant differences with regards to limb loading, balance, range of motion and functional hop tests of the knee (p > 0.05). No adverse events were observed during the study period.</p></div><div><h3>Conclusion</h3><p>Immersive virtual reality can be used as an adjunct in rehabilitation of patients after ACL reconstruction in terms of improving their pain as well as their subjective knee evaluation. Large randomised control trial is recommended to further investigate the efficacy.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"34 ","pages":"Pages 28-37"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/bf/main.PMC10570631.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239698","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}
For radial tears, all-inside suture (AIS) repair was clearly biomechanically superior, compared to conventional trans-capsular suture (TCS) repairs. However, clinical comparative studies of these two repairs techniques have not to be performed. Therefore, the aim of this study was to compare the clinical outcomes after AIS repair and TCS repairs for isolated radial tear at middle segment of lateral meniscus (RTMLM) in stable knees of young athletes.
Methods
Twenty-six athletes (mean age, 19.1 years) underwent AIS repair with the double horizontal suture technique, using SutureLasso™ (Arthrex, Naples, FL) for isolated RTMLM (AIS group), and 20 athletes (mean age, 19.0 years) underwent inside-out repair, one of TCS repairs, with tie-grip suture technique (TCS group). All athletes were assessed for preoperative and two-year postoperative Knee injury and Osteoarthritis Outcome Score (KOOS). At six-month after repair, the lateral meniscal extrusion on mid-coronal plane on MRI and healing status on second-look arthroscopy were also evaluated in all patients.
Results
In both groups, KOOS improved to either good or excellent postoperatively, while complete healing was found in only 23 and 25% at second-look arthroscopy. We identified no group-dependent differences in KOOS or healing status on arthroscopy. However, a close examination of failure rates revealed significant lower rates in AIS group relative to that of TCS group (p = 0.048). Moreover, the change from preoperative to postoperative lateral meniscal extrusion in AIS group was significantly smaller than that in TCS group (p = 0.038).
Conclusions
AIS and TCS repairs for RTMLM were comparable in providing satisfactory clinical results with low rates of complete healing on arthroscopy. However, AIS repair could have lower failure rate of healing on arthroscopy and minimize postoperative lateral meniscal extrusion more effectively than TCS repair on MRI.
{"title":"Clinical outcomes after repair of an isolated radial tear in the middle segment of the lateral meniscus - All-inside suture repair vs trans-capsular suture repair –","authors":"Ryohei Uchida , Shuji Horibe , Yoshinari Tanaka , Akira Tsujii , Yuta Tachibana , Kazutaka Kinugasa , Konsei Shino","doi":"10.1016/j.asmart.2023.08.002","DOIUrl":"10.1016/j.asmart.2023.08.002","url":null,"abstract":"<div><h3><strong>Background/objective</strong></h3><p>For radial tears, all-inside suture (AIS) repair was clearly biomechanically superior, compared to conventional trans-capsular suture (TCS) repairs. However, clinical comparative studies of these two repairs techniques have not to be performed. Therefore, the aim of this study was to compare the clinical outcomes after AIS repair and TCS repairs for isolated radial tear at middle segment of lateral meniscus (RTMLM) in stable knees of young athletes.</p></div><div><h3><strong>Methods</strong></h3><p>Twenty-six athletes (mean age, 19.1 years) underwent AIS repair with the double horizontal suture technique, using SutureLasso™ (Arthrex, Naples, FL) for isolated RTMLM (AIS group), and 20 athletes (mean age, 19.0 years) underwent inside-out repair, one of TCS repairs, with tie-grip suture technique (TCS group). All athletes were assessed for preoperative and two-year postoperative Knee injury and Osteoarthritis Outcome Score (KOOS). At six-month after repair, the lateral meniscal extrusion on mid-coronal plane on MRI and healing status on second-look arthroscopy were also evaluated in all patients.</p></div><div><h3><strong>Results</strong></h3><p>In both groups, KOOS improved to either good or excellent postoperatively, while complete healing was found in only 23 and 25% at second-look arthroscopy. We identified no group-dependent differences in KOOS or healing status on arthroscopy. However, a close examination of failure rates revealed significant lower rates in AIS group relative to that of TCS group (p = 0.048). Moreover, the change from preoperative to postoperative lateral meniscal extrusion in AIS group was significantly smaller than that in TCS group (p = 0.038).</p></div><div><h3><strong>Conclusions</strong></h3><p>AIS and TCS repairs for RTMLM were comparable in providing satisfactory clinical results with low rates of complete healing on arthroscopy. However, AIS repair could have lower failure rate of healing on arthroscopy and minimize postoperative lateral meniscal extrusion more effectively than TCS repair on MRI.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"33 ","pages":"Pages 25-31"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/bf/main.PMC10480070.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180017","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}
The posterior circumflex humeral artery, a branch of the axillary artery, is compressed by the humeral head during repeated abduction and external rotation of the shoulder joint owing to its anatomical structure. This damages the vascular endothelium, resulting in thrombi, arterial dissection, and aneurysms, a condition known as posterior, circumflex humeral artery pathological lesions. A thrombus may form at the site and becomes a peripheral embolus, resulting in peripheral arterial occlusion.A 21-year-old right-handed elite man college volleyball player noticed coldness and pain in his right hand during a game. Cyanosis was present except in the middle finger, and the beating radial artery was palpable; however, the ulnar artery was not. Doppler ultrasound examination revealed thrombus occlusion of the ulnar artery and common palmar artery of the index finger. Peripheral arterial occlusion was diagnosed due to embolization of a thrombus from this site. The patient stopped practicing volleyball immediately after the onset of symptoms and was started on cilostazol 200 mg and rivaroxaban 15 mg. Subjective coldness of the fingers improved one week after the start of treatment. The patient resumed practice four weeks after the start of treatment and participated in a game by the seventh week.Posterior circumflex humeral artery pathological lesions are caused by overhead motions such as pitching. They are most commonly reported in athletes playing volleyball, although rare, and many cases of aneurysm formation have been reported.Observing a cold sensation in the periphery after practice is necessary for screening.
{"title":"Posterior circumflex humeral artery pathological lesions with digital ischemia in an elite volleyball player: A case report and literature review","authors":"Tomofumi Nishino , Daigo Hiraya , Yuki Yamamoto , Tomomi Suzu , Yusuke Nishida , Masashi Yamazaki","doi":"10.1016/j.asmart.2023.08.005","DOIUrl":"10.1016/j.asmart.2023.08.005","url":null,"abstract":"<div><p>The posterior circumflex humeral artery, a branch of the axillary artery, is compressed by the humeral head during repeated abduction and external rotation of the shoulder joint owing to its anatomical structure. This damages the vascular endothelium, resulting in thrombi, arterial dissection, and aneurysms, a condition known as posterior, circumflex humeral artery pathological lesions. A thrombus may form at the site and becomes a peripheral embolus, resulting in peripheral arterial occlusion.A 21-year-old right-handed elite man college volleyball player noticed coldness and pain in his right hand during a game. Cyanosis was present except in the middle finger, and the beating radial artery was palpable; however, the ulnar artery was not. Doppler ultrasound examination revealed thrombus occlusion of the ulnar artery and common palmar artery of the index finger. Peripheral arterial occlusion was diagnosed due to embolization of a thrombus from this site. The patient stopped practicing volleyball immediately after the onset of symptoms and was started on cilostazol 200 mg and rivaroxaban 15 mg. Subjective coldness of the fingers improved one week after the start of treatment. The patient resumed practice four weeks after the start of treatment and participated in a game by the seventh week.Posterior circumflex humeral artery pathological lesions are caused by overhead motions such as pitching. They are most commonly reported in athletes playing volleyball, although rare, and many cases of aneurysm formation have been reported.Observing a cold sensation in the periphery after practice is necessary for screening.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"33 ","pages":"Pages 1-5"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/8c/main.PMC10458282.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10107394","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}
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