Long-term functional and structural outcome of rotator cuff repair in patients 60 years old or less.

Background: The long-term outcomes of rotator cuff repair (RCR) have not been well studied. The purpose of this study was to evaluate long-term functional and structural outcomes after RCR in younger patients.

Methods: A total of 49 patients (34 [69%] male) with a mean age of 51 ± 6 years were evaluated preoperatively, and at short- and long-term follow-ups (minimum 15 years).

Calcium requests in a primary care; An observational audit of biochemical requests and frequency of abnormal results.

Background/aims: This aim of this audit was to assess the extent of serum calcium testing and the frequency of hypercalcaemia in the primary care setting. We also assessed the appropriateness of subsequent investigations with repeat serum calcium and PTH testing if hypercalcaemia was identified.

Methods: All laboratory requests for adjusted calcium and PTH samples sent from primary care in Glasgow were analysed over a 12 month period.

Clinical and health economic evaluation of a post-stroke arrhythmia monitoring service.

Atrial fibrillation (AF) is a major cause of recurrent stroke and transient ischaemic attack (TIA) in the UK. As many patients can have asymptomatic paroxysmal AF, prolonged arrhythmia monitoring is advised in selected patients following a stroke or TIA. This service evaluation assessed the clinical and potential health economic impact of prolonged arrhythmia monitoring post-stroke using R-TEST monitoring devices.

C.acnes in the joint, is it all just a false positive?

Background: Cutibacterium Acnes (C.acnes) has been linked to several shoulder pathologies. An alternative hypothesis suggests it only occurs in the joint secondary to previous instrumentation.

Meningococcal meningitis and COVID-19 co-infection.

Bacterial co-infection in the ongoing pandemic of COVID-19 is associated with poor outcomes but remains little understood. A 22-year-old woman presented with a 3-week history of fever, headache, neck stiffness, rigours and confusion. She was noted to have a purpuric rash over her hands and feet.

Reasonable adjustments to provide equitable and inclusive assessment, screening and treatment of osteoporosis for adults with intellectual disabilities: A feasibility study.

Background: People with intellectual disabilities are a high risk population for developing osteoporosis and fragility fractures, yet they experience barriers to accessing dual-energy x-ray absorptiometry (DXA) bone mineral density (BMD) screening and fracture assessment. Reasonable adjustments are a statutory requirement in the UK, but there is a paucity of evidence-based examples to assist their identification, implementation and evaluation.

Method: Thirty adults with intellectual disabilities underwent DXA BMD screening and fracture risk assessment.

Vibration therapy versus standard treatment for tennis elbow: A randomized controlled study.

Aim: To determine whether a mechanical, high-frequency vibration device (Tenease) can improve pain and function for the treatment of tennis elbow (TE), compared with standard treatment.

Methods: Adults presenting to an elbow clinic with a clinical diagnosis of TE were randomized to standard treatment with physiotherapy, activity modification and analgesia or standard treatment plus Tenease therapy. Tenease therapy consisted of a 6-week period of treatment using the Tenease device with three 10-min episodes each day.

Clinical and radiologic outcomes following total shoulder arthroplasty using Arthrex Eclipse stemless humeral component with minimum 2 years' follow-up.

Background: Stemless humeral components benefit from less morbidity, better reproduction of the humeral anatomy, ease of revision, and fewer stem-related complications. Encouraging results are available up to 9 years after surgery from the designer's series. This is an independent study of 100 consecutive Eclipse stemless prostheses for osteoarthritis with a minimum 2-year follow-up (range, 2-6 years).

A randomized controlled trial of arthroscopic capsular release versus hydrodilatation in the treatment of primary frozen shoulder.

Background: Arthroscopic capsular release (ACR) and hydrodilatation (HD) have been developed for the management of frozen shoulder refractory to conservative treatment. To date no randomized trial has directly compared the efficacy of both interventions. The aim of this trial was to determine whether the Oxford Shoulder Score (OSS) differs between patients with frozen shoulder randomized to treatment with ACR or HD.

An experimental model to measure the ability of headphones with active noise control to reduce patient's exposure to noise in an intensive care unit.

Background: Defining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce patient's exposure to noise. Active noise control devices may prove to be useful adjuncts but there is currently little to quantify their ability to reduce noise in this complex environment.

Methods: Sound meters were embedded in the auditory meatus of three polystyrene model heads with no headphones (control), with headphones alone and with headphones using active noise control and placed in patient bays in a cardiac ICU.

The colonisation of the glenohumeral joint by is not associated with frozen shoulder but is more likely to occur after an injection into the joint.

Aims: Our aim was to investigate the prevalence of in the subcutaneous fat and capsule of patients undergoing shoulder surgery for frozen shoulder or instability.

Patients And Methods: A total of 46 patients undergoing either an arthroscopic capsular release or stabilisation had biopsies taken from the subcutaneous fat and capsule of the shoulder at the time of surgery. These samples were sent for culture in enrichment, and also for Nucleic Acid Amplification testing.

The Three-Portal Technique in Arthroscopic Lateral Epicondylitis Release.

Lateral epicondylitis, commonly referred to as tennis elbow, is a syndrome characterized by pain over the origin of the common extensor muscles of the fingers, hand and wrist at the lateral epicondyle. Reports of 70-90% response to conservative treatment at one year have been documented in the literature though refractory cases often require surgical management. Arthroscopic treatment of lateral epicondylitis allows for intra-articular visualization for concomitant pathology and localization of the Extensor Carpi Radialis Brevis tendon.

Liquorice-induced apparent mineralocorticoid excess presenting in the emergency department.

A 65-year-old woman with a background of myalgic encephalitis, who was taking alternative medicines and dietary supplements, presented with hypokalaemia and hypertension. After a thorough history it became apparent that this was most likely secondary to regular consumption of liquorice tea. The patient was advised to discontinue drinking this tea and was discharged.

Orthopaedic Injuries in Equestrian Sports: A Current Concepts Review.

Background: Despite the common nature of orthopaedic injuries in equestrian sports, there is no published review to specifically characterize orthopaedic injuries in equestrian athletes.

Purpose: To characterize orthopaedic injury patterns in equine sports-related injuries and their treatment.

Study Design: Systematic review; Level of evidence, 4.

Factors Expressed in an Animal Model of Anteroinferior Glenohumeral Instability.

Background: There is little information on the molecular factors important in healing and changes that occur in the glenoid labrum in response to injury. Using a novel animal model of acute anterior shoulder dislocation, this study characterizes the factors expressed in the glenoid labrum in response to injury and correlates their expression to glenohumeral stability.

Purpose: To study the response of the glenoid labrum to injury both biomechanically and with immunohistochemical testing.

Risk Factors for Infection After Rotator Cuff Repair.

Purpose: To identify risk factors for infection after rotator cuff repair. We hypothesized that patient characteristics and surgical technique would affect the rate of infection.

Methods: The records of 1,824 rotator cuff repairs performed by a single surgeon from 1995 to 2010 were reviewed retrospectively.

Assessing Osteoporosis in the Young Adult.

Osteoporosis in the young adult is a relatively rare phenomenon, and its diagnosis needs careful assessment of the affected person. The emphasis in the assessment of bone health is gradually shifting from a simple quantitative assessment of bone mineral density to one that includes bone quality. This may be particularly important in the young adult, where the aetiological cause of osteoporosis may be a primary genetic condition or secondary to another chronic condition.

Association between Propionibacterium acnes and frozen shoulder: a pilot study.

Background: Frozen shoulder has not previously been shown to be associated with infection. The present study set out to confirm the null hypothesis that there is no relationship between infection and frozen shoulder using two modern scientific methods, extended culture and polymerase chain reaction (PCR) for bacterial nucleic acids.

Methods: A prospective cohort of 10 patients undergoing arthroscopic release for stage II idiopathic frozen shoulder had two biopsies of tissue taken from the affected shoulder joint capsule at the time of surgery, along with control biopsies of subdermal fat.

Using WHO-FRAX to describe fracture risk: experience in primary care.

Ideally those at highest risk of fracture should be identified prior to fracture occurrence to reduce mortality, morbidity and costs. Case-finding strategies for those at high risk of first fracture or systematic case-finding strategies following fracture are recommended in the UK, rather than population-based screening to identify individuals at high fracture risk. General practices in the UK hold relevant data on individuals beyond fracture history that could allow identification of a wider group of patients at highest risk of fracture.

Tranexamic acid is associated with less blood transfusion in off-pump coronary artery bypass graft surgery: a systematic review and meta-analysis.

Objective: Tranexamic acid reduces blood loss and transfusion in on-pump coronary artery bypass graft (CABG) surgery. Compared with on-pump, off-pump surgery is associated with less blood loss and transfusion. Therefore, tranexamic acid may be less effective for off-pump surgery, and its safety profile may be different in this setting.

Impact of treatments for postmenopausal osteoporosis (bisphosphonates, parathyroid hormone, strontium ranelate, and denosumab) on bone quality: a systematic review.

The objective of this systematic review was to examine the influence of treatments for postmenopausal osteoporosis (parathyroid hormone [PTH], bisphosphonates, strontium ranelate, and denosumab) on bone quality and discuss the clinical implications. Most bone-quality data for PTH is from teriparatide. Teriparatide results in a rapid increase in bone-formation markers, followed by increases in bone-resorption markers, opening an "anabolic window," a period of time when PTH is maximally anabolic.

Medical training and the hospital at night: an oxymoron?

Context: Attempts to reduce doctors' working hours and streamline postgraduate medical training may mean junior doctors' out-of-hours experience is reduced. It is also proposed that, in the UK, compulsory clinical (Foundation Programme) competencies are to be accomplished in 1 year rather than 2 years as they are at present. This observational study was performed to examine the scope of opportunity available to junior doctors to achieve such competencies while working on a 'Hospital at Night' (H@N) team.