Journal of orthopaedics and sports medicine最新文献

英文中文

Outcomes Following Capsular Distention for Stage II Adhesive Capsulitis II期粘连性囊炎囊扩张后的结果

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500087

Alyssa Pelak, A. Hassan, Arnav Barve, Antonio Madrazo-Ibarra, Jonathan M. Kirschner, Vijay B. Vad

Background: There has been many different treatments for adhesive capsulitis explored including physical therapy, manipulation under anesthesia, arthroscopic capsular release, corticosteroid injections, and capsular distention without consensus regarding the most effective treatment. Capsular distention has not been explored in a mid-term study. Therefore, this study aims to investigate the mid-term outcomes of the procedure and analyze the need for a second procedure following initial distention. Methods: This study included 27 patients with average age of 58 diagnosed with stage II adhesive capsulitis. The primary outcome was the rate of second procedures in patients following initial capsular distention, utilizing both electronic medical record and direct patient questions. The secondary outcomes included patient satisfaction rating, range of motion (ROM) limitations, limitations on Activities of Daily Living (ADLs) and time to follow up. Results: At an average follow up of 49 months, 78% of patients did not require a second procedure following capsular distention. The group that required second procedure had a significantly higher percentage of hypothyroid patients and a shorter time to follow up visits. Additionally, 81% of the total cohort reported their outcomes as “good,” 74% had no ROM limitations and 89% had no limitations on ADLs. Conclusion: Capsular distention shows promising results for mid-term follow up with patient reported outcomes and over three quarters of patients not requiring a second procedure. Further research on the use of this treatment is warranted including randomized controlled trials and longer term follow up.

背景:对于粘连性囊炎，有许多不同的治疗方法，包括物理治疗、麻醉下操作、关节镜下释放囊膜、皮质类固醇注射和囊膜扩张，但对最有效的治疗方法尚无共识。在中期研究中尚未探讨荚膜膨胀。因此，本研究旨在调查手术的中期结果，并分析首次扩张后第二次手术的必要性。方法:本研究纳入27例平均年龄58岁的II期粘连性囊炎患者。主要结果是利用电子医疗记录和患者直接询问的方式，观察患者在初次囊膜膨胀后进行第二次手术的比率。次要结果包括患者满意度评分、活动范围(ROM)限制、日常生活活动(adl)限制和随访时间。结果:在平均49个月的随访中，78%的患者在囊膜扩张后不需要第二次手术。需要第二次手术的那一组甲状腺功能减退患者的比例明显更高，随访时间也更短。此外，81%的患者报告他们的结果“良好”，74%的患者没有ROM限制，89%的患者没有adl限制。结论:胶囊膨胀显示了中期随访的良好结果，患者报告的结果超过四分之三的患者不需要第二次手术。有必要对这种治疗的使用进行进一步的研究，包括随机对照试验和长期随访。

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引用次数: 1

Peroneus Longus Tendon Autograft for Anterior Cruciate Ligament Reconstruction: A Safe and Effective Alternative in Nonathletic Patients 腓长肌腱自体移植物用于前交叉韧带重建:一种安全有效的非运动患者替代方法

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500091

Rahaman Sk, Halder Rc, Tayaba T, Mamun Mba, Islam Ms, K. Mmr, Rahman Mm, Hossain Gmj, Kamruzzaman M

Background: The Anterior Cruciate Ligament (ACL) is one of the most vital parts for sustaining knee joint stability. But, the frequency of ACL injuries is increasing alarmingly. The Peroneus Longus Tendon (PLT) is now considered to be a promising graft which is a safe and efficient alternative to other grafting methods. Methods: This was a prospective interventional study conducted at a tertiary care orthopaedic teaching hospital, during the period of March, 2019-August, 2022. The sample size for this study was 64. For statistical analysis, SPSS version 20 was used as a statistical tool. Result: There were 9(14.1%) respondents who were <18 years of age, followed by 22(34.4%) who were aged between 18-20 years, while the remaining 33(51.6%) were aged >20 years. The mean ± SD diameter (mm) was 8.3 ± 0.8, length (mm) was 8.5 ± 0.4, height (cm) was 174.1 ± 8.6, weight (kg) was 76.2 ± 13.2 and BMI was 25.0 ± 3.4. The majority of the patients (50%) were injured 1-3 months prior to the surgery. At the 6-month follow-up period, according to Lachman indicators after the surgery, 59(92.2%) of the respondents were graded 0, and the remaining 5(7.8%) were graded I. At the 12-month follow-up, the majority (93.8%) were graded 0, and 4(6.3%) graded I. At the 18-months follow-up, 59(92.2%) were graded 0 and 5(7.8%) were graded I. At the 6-month follow- up period by KT- 2000 indicators (mm) after the surgery, 57(89.1%) of the respondents were graded 0-2 mm, followed by 7(10.9%) graded 3-5 mm. At 12-months followed up the most 59(92.2%) were graded 0-2 mm and followed by 5(7.8%) graded 3-5 mm at the 18-month followed up, 57(89.1%) graded 0-2 mm, and followed by 7(10.9%) graded 3-5 mm. Conclusion: Peroneus longus tendon autograft in ACL reconstruction is a safe procedure that has a satisfactory result which was proved by the Lachman’s Test and the IKDC (KT-2000) score. PLT can prove to be an effective alternative autograft for ACL reconstruction.

背景:前交叉韧带(ACL)是维持膝关节稳定最重要的部分之一。但是，前交叉韧带损伤的频率正在惊人地增加。腓骨长肌腱(PLT)目前被认为是一种有前途的移植物，是一种安全有效的替代其他移植方法。方法:前瞻性介入研究于2019年3月- 2022年8月在某三级骨科教学医院进行。本研究的样本量为64人。统计分析采用SPSS version 20作为统计工具。结果:20岁以下年龄层9例(14.1%)。平均±SD直径(mm) 8.3±0.8，长度(mm) 8.5±0.4，身高(cm) 174.1±8.6，体重(kg) 76.2±13.2,BMI 25.0±3.4。大多数患者(50%)在手术前1-3个月受伤。在6个月随访期间,根据拉指标手术后,59例(92.2%)的受访者评分0,剩下的5(7.8%)评分在12个月的随访,绝大多数(93.8%)评分0和4(6.3%)评分在18个月的随访,59(92.2%)评分0和5(7.8%)分级i在6个月时间的随访,KT - 2000指标(mm)手术后,57例(89.1%)的受访者评分0 - 2毫米,紧随其后的是7(10.9%)级配3 - 5毫米。随访12个月时，0-2 mm的患者最多59例(92.2%)，3-5 mm的患者最多5例(7.8%)，0-2 mm的患者最多57例(89.1%)，3-5 mm的患者最多7例(10.9%)。结论:经Lachman试验和IKDC (KT-2000)评分证实，自体腓骨长肌腱移植重建前交叉韧带是一种安全、满意的手术方法。PLT是ACL重建的一种有效的自体移植物。

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引用次数: 1

Comparison of Musculoskeletal Manifestations Between Diabetes and Hypothyroidism Patients 糖尿病与甲状腺功能减退患者肌肉骨骼表现的比较

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500116

Shaila Sharmin Shahnewaz, Supriya Sarker, Tahmeed Kamal, Naima Akhter Dina

引用次数: 0

Outcomes of Coracoid Bone Graft Positioning During the Latarjet Procedure with Respect to Surgical Approach 在Latarjet手术中喙骨移植物定位与手术入路的关系

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500121

Gary Ulrich MD, Shariff Bishai DO, MS

The Latarjet procedure represents a successful treatment option for patients with recurrent shoulder instability with glenoid bone loss, and its indications are expanding. One of the most important steps of the Latarjet procedure with respect to outcome is the positioning of the coracoid graft in both the oblique axial and sagittal planes. In the axial plane, a graft placed too medial can result in recurrent instability, whereas a graft placed too lateral can result in development of osteoarthritis. In the sagittal plane, the coracoid graft is ideally positioned in a subequatorial position to best restore stability as a graft positioned too inferior or too superior could result in recurrent instability. In this review, we discuss the outcomes of coracoid graft positioning with respect to surgical approach, including the open, mini-open, arthroscopically assisted, and all-arthroscopic approaches to the Latarjet procedure.

Latarjet手术是复发性肩关节不稳伴肩关节骨丢失患者的成功治疗选择，其适应症正在扩大。Latarjet手术中最重要的步骤之一是将喙骨移植物定位在斜轴位和矢状面。在轴向面，过于内侧的移植物可导致复发性不稳定，而过于外侧的移植物可导致骨关节炎的发展。在矢状面，喙突移植物的理想位置是在髌下位置，以最好地恢复稳定性，因为移植物的位置过低或过高都会导致复发性不稳定。在这篇综述中，我们讨论了喙突移植物定位与手术入路的结果，包括开放、小开放、关节镜辅助和全关节镜入路。

引用次数: 0

Mitochondrial Biogenesis as a Therapeutic Target for Rotator Cuff Tendon Tears. 线粒体生物生成作为肩袖肌腱撕裂的治疗靶点。

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 Epub Date: 2023-12-04 DOI: 10.26502/josm.511500133

Armand N Yazdani, Arian Abdi, Parth Patel, Prathosh Velpuri, Vikrant Rai, Devendra K Agrawal

Rotator Cuff Injuries (RCI) are highly prevalent and characterized by shoulder pain, restricted shoulder movement, and difficulty with overhead activity, radiating pain in the deltoid muscle, and atrophy of the rotator cuff muscles. Increasing age, hand dominance, smoking, hypertension, hyperlipidemia, and obesity are common risk factors. Chronic inflammation plays a critical role in the underlying pathogenesis. RCI accounts for massive healthcare expenditure costing about $15,000 per repair, and over 4.5 million physician visits per year, however, there is still no therapeutic target to improve clinical outcomes. Mitochondrial biogenesis in response to inflammatory stimuli supports increased cellular energy requirements, cell proliferation, and differentiation. This suggests that mitochondrial biogenesis may play a role in healing RCI by serving as a protective factor against free oxygen species and promoting homeostasis within the rotator cuff. There is evidence highlighting the potential therapeutic benefits of mitochondrial biogenesis in various inflammatory diseases, but no study explored the role of mitochondrial biogenesis in rotator cuff tears. Since hypercholesterolemia is a risk factor for RCI, we investigated the effects of hypercholesterolemia on the expression of PGC-1α, a marker of mitochondrial biogenesis, in rotator cuff muscle. The findings revealed an increased gene and protein expression of inflammatory mediators and PGC-1α, suggesting enhanced inflammation and increased mitochondrial biogenesis due to hypercholesterolemia. Additional studies are warranted to further investigate the chronic effect of hyperlipidemia induced RCI to elucidate the cause of insufficient mitochondrial biogenesis unable to protect the rotator cuff and the therapeutic effect of promoting mitochondrial biogenesis.

肩袖损伤（RCI）的发病率很高，主要表现为肩部疼痛、肩部活动受限、高空作业困难、三角肌放射痛以及肩袖肌肉萎缩。年龄增长、手部优势、吸烟、高血压、高脂血症和肥胖是常见的风险因素。慢性炎症在潜在的发病机制中起着至关重要的作用。RCI 造成了巨大的医疗开支，每次修复费用约为 15,000 美元，每年有超过 450 万人次就诊，但目前仍没有改善临床结果的治疗目标。线粒体在炎症刺激下的生物生成支持细胞能量需求的增加、细胞增殖和分化。这表明，线粒体生物生成可能在 RCI 愈合过程中发挥作用，成为抵御游离氧的保护因子，并促进肩袖内的平衡。有证据表明线粒体生物生成对各种炎症性疾病具有潜在的治疗作用，但还没有研究探讨线粒体生物生成在肩袖撕裂中的作用。由于高胆固醇血症是 RCI 的风险因素之一，我们研究了高胆固醇血症对线粒体生物生成标志物 PGC-1α 在肩袖肌肉中表达的影响。研究结果显示，炎症介质和 PGC-1α 的基因和蛋白表达增加，表明高胆固醇血症导致炎症加剧和线粒体生物生成增加。有必要开展更多研究，进一步探讨高脂血症诱导的 RCI 的慢性效应，以阐明线粒体生物生成不足无法保护肩袖的原因，以及促进线粒体生物生成的治疗效果。

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引用次数: 0

Karyopherins in the Remodeling of Extracellular Matrix: Implications in Tendon Injury. Karyopherins在细胞外基质重塑中的作用：肌腱损伤的意义。

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 Epub Date: 2023-09-14 DOI: 10.26502/josm.511500122

Connor Diaz, Finosh G Thankam, Devendra K Agrawal

Rotator Cuff Tendinopathies (RCT) are debilitating conditions characterized by alterations in the extracellular matrix (ECM) of the shoulder tendon, resulting in pain, discomfort, and functional limitations. Specific mediators, including HIF-1α, TGF-β, MMP-9 and others have been implicated in the morphological changes observed in the tendon ECM. These mediators rely on karyopherins, a family of nuclear proteins involved in nucleo-cytoplasmic transport; however, the role of karyopherins in RCT remains understudied despite their potential role in nuclear transport mechanisms. Also, the understanding regarding the precise contributions of karyopherins in RCT holds great promise for deciphering the underlying pathophysiological mechanisms of the disease and potentially fostering the development of targeted therapeutic strategies. This article critically discusses the implications, possibilities, and perspectives of karyopherins in the pathophysiology of RCT.

肩袖肌腱病（RCT）是一种使人衰弱的疾病，其特征是肩肌腱的细胞外基质（ECM）发生改变，导致疼痛、不适和功能受限。特异性介质，包括HIF-1α、TGF-β、MMP-9和其他介质，与肌腱ECM中观察到的形态学变化有关。这些介质依赖于核外蛋白，一个参与核质转运的核蛋白家族；然而，尽管核球蛋白在核转运机制中具有潜在作用，但其在RCT中的作用仍有待研究。此外，对核糖核酸酶在随机对照试验中的确切贡献的理解，对于破译该疾病的潜在病理生理机制和潜在的促进靶向治疗策略的发展具有很大的前景。本文批判性地讨论了核外周蛋白在RCT病理生理学中的意义、可能性和前景。

引用次数: 0

Dry Needling as a Treatment for Hallux Valgus – A Case Report 干针治疗拇外翻1例

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500097

Omri Zilberberg, Dr. Sheehan N MISCP MMedSE PhD, Dr. Sanocka D MD PhD

，

引用次数: 0

Estimation of Ivermectin Treatment Demand for the Management of Strongyloidiasis Cases Worldwide: A Systematic Review 估计伊维菌素治疗需求管理的圆线虫病例世界:一个系统的回顾

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500103

Heron Gezahegn Gebretsadik

，

引用次数: 0

Spinal Manipulative Therapy for Atypical Cervicogenic Symptoms: A Review 脊柱推拿治疗不典型宫颈源性症状:综述

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500079

David E. Bellin, Damien MY Tam, Gordon Cheung, Emannual Wong

There is considerable evidence to support the importance of cervicogenic spinal dysfunction in musculoskeletal complaints, and the development of atypical symptoms including dizziness, dysphagia, angina, and visual disturbances. However, there are other possible causes for these symptoms, and secondary adaptive changes should also be considered in differential diagnosis. Understanding the pathophysiology of these symptoms and differential diagnosis of their potential origin is important for therapy. In addition to symptoms, the evaluation of potential impairments (altered cervical joint position and movement sense, static and dynamic balance, and ocular mobility and coordination) should become an essential part of the routine assessment of those with traumatic neck pain, including those with concomitant injuries such as concussion and vestibular or visual pathology or deficits. Once adequately assessed, appropriate tailored management should be implemented. Research to further assist differential diagnosis and to understand the most important contributing factors associated with abnormal cervical afferent input and a subsequent disturbance to the sensorimotor control system, as well as the most efficacious management of such symptoms and impairments, is important for the future.

有相当多的证据支持颈源性脊柱功能障碍在肌肉骨骼疾病中的重要性，以及不典型症状的发展，包括头晕、吞咽困难、心绞痛和视觉障碍。然而，这些症状还有其他可能的原因，在鉴别诊断中也应考虑继发性适应性改变。了解这些症状的病理生理学和鉴别诊断其潜在的起源是重要的治疗。除了症状外，评估潜在的损伤(颈椎关节位置和运动感觉改变、静态和动态平衡、眼球活动和协调)应成为外伤性颈部疼痛患者常规评估的重要组成部分，包括那些伴有脑震荡、前庭或视觉病理或缺陷的患者。一旦得到充分评估，就应实施适当的有针对性的管理。研究进一步协助鉴别诊断，了解与异常颈部传入输入和随后的感觉运动控制系统紊乱相关的最重要因素，以及对此类症状和损伤的最有效管理，对未来很重要。

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引用次数: 0

Results of Arthroscopic Repair of Bankart Lesion in Chronic Anterior Instability of the Shoulder 肩关节镜下治疗慢性前路不稳的Bankart损伤的结果

Journal of orthopaedics and sports medicine

Pub Date : 2023-01-01 DOI: 10.26502/josm.511500095

Halder Rc, Rahaman Sk, K. Mmr, Mamun Mba, Faruqe O, Islam Ms, Hoque M, Rashid Mmo, Hossain Gmj

Background: The shoulder is the most commonly dislocated major joint, affecting roughly 2% of the general population. Long-term studies have demonstrated a correlation between the number of instability episodes and the risk of degenerative arthritis. In an effort to treat the unstable shoulder, orthopedic surgeons have described several different operations that may help to prevent recurrent subluxation or dislocation in chronic instability cases. This study has been undertaken to assess the short-term functional outcome of Arthroscopic repair of Bankart’s Lesion in patients with Chronic Anterior Instability of the Shoulder using Constant Murley’s Score. Material and Method: This prospective observational study was carried out at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), from July 2017 to June 2019. Twenty cases of chronic anterior shoulder dislocation meeting the inclusion and exclusion criteria were taken in this study and underwent arthroscopic repair of bankart lesion. Here, 3 or 4 anchors were used. Cases were followed up for 6 months. The outcome was assessed with Constant Murley Scoring. Results: The mean age was 26.716.83 years with a male predominance (95%). Most cases were students (50%) and the main cause of injury was sports (50%). The mean recurrence number was 10.65 ± 4.75 times and was significantly associated with decreasing age. The mean interval between 1 injury and surgery was 3 ± 1.89 years. Bankart lesions were found in 20% of cases in pre-operative imaging. At the final follow-up, 2 (10%) cases of limited movement were found. In 18 (90%) cases, 3 anchors were used. Finally, there was significant improvement regarding pain status, activity of daily living, forward flexion, abduction, external rotation, internal rotation and power of shoulder muscle. In the last follow-up, 2 (10%) cases of limited movement were found. The mean CMS pre-operatively and post-operatively were 63.05 ± 5.23 and 88.25 6.29 respectively (p<0.05). In the final outcome, 16 (80%) scored excellent, 3 (15%) were found good and 1 (5%) was found poor. Conclusion: It may be concluded that arthroscopic Repair of Bankart Lesion with suture anchors in chronic anterior instability of the shoulder is a safe surgery regardless of shoulder function or range of motion.

背景:肩关节是最常见的主要关节脱位，约占总人口的2%。长期研究表明，不稳定发作的次数与退行性关节炎的风险之间存在相关性。为了治疗不稳定的肩部，骨科医生已经描述了几种不同的手术，这些手术可能有助于预防慢性不稳定病例中复发性半脱位或脱位。本研究采用Constant Murley 's评分评估肩关节镜下慢性前路不稳患者Bankart病变修复的短期功能结果。材料与方法:本前瞻性观察性研究于2017年7月至2019年6月在美国国立创伤与骨科康复研究所(NITOR)进行。本研究选取符合纳入和排除标准的慢性肩关节前脱位20例，行关节镜下bankart病变修复术。在这里，使用了3或4个锚。病例随访6个月。采用Constant Murley评分法评估结果。结果:平均年龄26.716.83岁，男性居多(95%)。以学生为主(50%)，运动损伤为主(50%)。平均复发次数为10.65±4.75次，与年龄的降低有显著相关性。1次损伤至手术的平均时间间隔为3±1.89年。术前影像学检查发现20%的病例存在Bankart病变。在最后随访时，发现2例(10%)活动受限。在18例(90%)病例中，使用了3个锚。最后，疼痛状态、日常生活活动、前屈、外展、外旋、内旋和肩部肌肉力量均有显著改善。在最后一次随访中，发现2例(10%)活动受限。术前、术后CMS平均值分别为63.05±5.23、88.25 6.29 (p<0.05)。在最终结果中，优16例(80%)，良3例(15%)，差1例(5%)。结论:无论肩关节功能或活动范围如何，关节镜下缝合锚钉修复Bankart病变是一种安全的手术。

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