Rotator cuff tears are prevalent in the population above the age of 60. The disease progression leads to muscle atrophy, fibrosis, and fatty infiltration, which is not improved upon with surgical repair, highlighting the need to better understand the underlying biology impairing more favorable outcomes. In this study, we collected supraspinatus muscle tissue from 6 month old female rabbits who had undergone unilateral tenotomy for 8 weeks at 1, 2, 4, or 8 weeks post-repair ( = 4/group).
View Article and Find Full Text PDFObligatory patella dislocation in flexion is an uncommon form of patellar instability, where the patella is located in extension and dislocates with every episode of knee flexion. This results in dramatically altered patellofemoral kinematics and can be extremely debilitating due to extensor strength deficits and lack of knee confidence in flexion. Concomitant pathology, which is often seen, includes a tight lateral retinaculum and a shortened extensor mechanism.
View Article and Find Full Text PDFThe rabbit supraspinatus is a useful translational model for rotator cuff (RC) repair because it recapitulates muscle atrophy and fat accumulation observed in humans after a chronic tear (the "first hit"). However, a timeline of RC tissue response after repair, especially with regard to recent evidence of muscle degeneration and lack of regeneration, is currently unavailable. Thus, the purpose of this study was to characterize the progression of muscle and fat changes over time after the repair of a chronic RC tear in the rabbit model.
View Article and Find Full Text PDFChronic rotator cuff tears can cause severe functional deficits. Addressing the chronic fatty and fibrotic muscle changes is of high clinical interest; however, the architectural and physiological consequences of chronic tear and repair are poorly characterized. We present a detailed architectural and physiological analysis of chronic tear and repair (both over 8 and 16 wk) compared with age-matched control rabbit supraspinatus (SSP) muscles.
View Article and Find Full Text PDFRotator cuff (RC) tears are prevalent in the population above the age of 60. The disease progression leads to muscle atrophy, fibrosis, and fatty infiltration in the chronic state, which is not improved with intervention or surgical repair. This highlights the need to better understand the underlying dysfunction in muscle after RC tendon tear.
View Article and Find Full Text PDFJ Am Acad Orthop Surg Glob Res Rev
October 2020
Orthopaedic practices have been markedly affected by the emergence of the COVID-19 pandemic. Despite the ban on elective procedures, it is impossible to define the medical urgency of a case solely on whether a case is on an elective surgery schedule. Orthopaedic surgical procedures should consider COVID-19-associated risks and an assimilation of all available disease dependent, disease independent, and logistical information that is tailored to each patient, institution, and region.
View Article and Find Full Text PDFBackground: Patellofemoral arthroplasty (PFA) is one option for the treatment of isolated patellofemoral osteoarthritis, but there are limited data regarding the procedure and results. Because isolated patellofemoral arthritis is relatively uncommon, available case series generally are small, and even within national registries, sample sizes are limited. Combining data from multiple registries may aid in assessing worldwide PFA usage and survivorship.
View Article and Find Full Text PDFObjective:: To present recommendations for athletic trainers and other health care providers regarding the identification of risk factors for and management of individuals with patellofemoral pain (PFP).
Background:: Patellofemoral pain is one of the most common knee diagnoses; however, this condition continues to be one of the most challenging to manage. Recent evidence has suggested that certain risk factors may contribute to the development of PFP.
Bipartite patella is an uncommon but potentially troublesome problem for young athletes. Numerous uncontrolled retrospective studies have reported good results after various treatments. What is needed are studies that will guide workup and support treatment decisions based on the condition of the cartilage surfaces of the fragment, presence of pseudoarthrosis, and size and location of the fragment.
View Article and Find Full Text PDFBackground: Conflicting findings exist on the effect of obesity on outcomes of lumbar spine surgery; results depend on the diagnosis studied, procedure evaluated, definition of obesity, and specific outcomes measured. The purpose of this retrospective cohort study is to examine the effect of increasing body mass index (BMI) on surgical-related, health-related, and long-term outcomes of lumbar spine surgery in a single representative patient sample.
Methods: Using a surgical registry from an integrated health care system, 8,049 instrumented lumbar spine cases were identified between 1/1/2009 and 09/30/2013.
Purpose: To estimate the association between hydroxymethylglutaryl-CoA inhibitor (statin) use and hip fracture.
Methods: We conducted a population-based case-control study. Cases were 6774 male enrollees in a large managed care organization, aged 45 or more years, with an incident hip fracture from 1997 to 2006.
Disorders of the patellofemoral joint are commonly seen in musculoskeletal clinics. In recent years, the expansion of imaging techniques, improvements in correlative injury anatomy, and more focused physical examinations have resulted in new knowledge about patellofemoral disorders. To achieve optimal patient outcomes, it is helpful for orthopaedic surgeons who treat knee problems to review the management of patellar dislocations and isolated patellofemoral arthritis, including treatment algorithms.
View Article and Find Full Text PDFContext: Although prevalence of obesity and incidence of total joint arthroplasty (TJA) have dramatically increased over the last two decades in the U.S., little is known of the preoperative and postoperative weight patterns of patients undergoing TJA.
View Article and Find Full Text PDFObjective: To evaluate the association of preoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) and structural injuries reported at the time of anterior cruciate ligament reconstruction (ACLR).
Design: Cross-sectional study.
Setting: Three medical centers in California.
Patellofemoral instability can be a disabling problem. Numerous techniques are employed for its treatment. Medial patellofemoral ligament (MPFL) reconstruction in combination with other procedures has been explored by many orthopedic surgeons.
View Article and Find Full Text PDFThis study characterized a cohort of obese total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients (1/1/2008-12/31/2010) and evaluated whether a clinically significant amount of pre-operative weight loss (5% decrease in body weight) is associated with a decreased risk of surgical site infections (SSI) and readmissions post-surgery. 10,718 TKAs and 4066 THAs were identified. During the one year pre-TKA 7.
View Article and Find Full Text PDFBackground: Plain films and computed tomography (CT)-based imaging were the first to establish measurements that evaluated patellar instability. Limited research has shown the efficacy of magnetic resonance imaging (MRI) in evaluating these established measurements.
Purpose: To identify morphological differences between normal knees and those with patellofemoral instability on MRI to determine what measurements are significant and how MRI-based means differ from historical means based on radiograph and CT imaging.
Clin Orthop Relat Res
January 2013
Background: The ability of patients with a total joint arthroplasty (TJA) to lose weight after surgery has been investigated in a few studies with inconsistent results.
Questions/purposes: We asked: (1) What is the quality of evidence of current published literature on postoperative weight trends for patients who have had a TJA? (2) Do patients lose any weight after TJA? (3) Do patients lose a clinically meaningful amount of weight after TJA?
Methods: We conducted a systematic review of PubMed and the Cochrane Library. Studies were summarized according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement.
Background: It has been suggested that a surgeon's experience and training are the most important factors associated with graft selection, but no studies have qualified this association. Graft usage prevalence has not been described for large anterior cruciate ligament reconstruction (ACLR) populations in the United States.
Purpose: To describe the prevalence of graft usage in a large community-based practice and evaluate the association of patient, surgeon, and site characteristics with choice of primary ACLR graft.
Context: Primary patellar dislocation continues to be a common problem facing clinicians today. These injuries are associated with significant morbidity and a substantial recurrence rate. Myriad operative and nonoperative options have been described to treat these injuries, although the evidence-based literature is sparse.
View Article and Find Full Text PDFThe principles of rehabilitation after medial patellofemoral ligament reconstruction are similar to those guiding rehabilitation after other ligamentous reconstructions of the knee, such as anterior cruciate ligament (ACL). The key features are to address pain control, range of motion (ROM), quadriceps strengthening, and proximal lower limb control. Return of full ROM, pain control, and protected weight bearing are stressed in the early phases of recovery.
View Article and Find Full Text PDFThe routine use of antibiotic-loaded bone cement (ALBC) in primary total knee arthroplasty (TKA) is controversial. Outcomes were recorded in patients who underwent primary TKA from May 2003 to March 2007 using a community-based total joint registry. Infection rates were compared in patients undergoing TKA with ALBC and regular cement.
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