Hitting the Mark: Optimizing the Use of Calcium Phosphate Injections for the Treatment of Bone Marrow Lesions of the Proximal Tibia and Distal Femur

Publication date: Available online 10 September 2018Source: Arthroscopy TechniquesAuthor(s): Brian J. Rebolledo, Kevin M. Smith, Jason L. DragooAbstractIncreased contact pressures of the osteoarthritic joint can lead to underlying osseous injury, with resultant marrow edema changes of the subchondral bone. These osteoarthritis-related bone marrow lesions can subsequently lead to persistent pain and further disability. Limited joint preservation treatment options exist to alleviate symptoms or potentially alter the natural history of the affected joint; however, recent success with injectable calcium phosphate has provided early pain relief and may provide a scaffold for endogenous repair mechanisms. In this Technical Note, a comprehensive surgical approach using injectable calcium phosphate to target bone marrow lesions of the proximal tibia and distal femur is presented. Critical technique considerations include the use of magnetic resonance and fluoroscopic imaging to target the area of the subchondral bone while refraining from overfilling and/or forced pressurization during delivery and the use of postinjection arthroscopy to prevent potential injurious sequelae.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research

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Authors: Chen Y, Jiang W, Yong H, He M, Yang Y, Deng Z, Li Y Abstract Osteoarthritis (OA) is the most common cause of disability in worldwide population, which is characterized by cartilage breakdown, synovial fibrosis, osteophyte formation and pain. Synovial inflammation is usually found in both early and late stages in most of the OA patients. Macrophages, the major component of the mononuclear phagocyte system, play a critical role in OA pathogenesis through the induction of inflammatory mediators, growth factors and proteinases. So, drugs that can target macrophages and macrophage-associated inflammatory pathwa...
Source: American Journal of Translational Research - Category: Research Tags: Am J Transl Res Source Type: research
CONCLUSIONS To our best knowledge, this study is the first regarding the effects of an injection method in the treatment of osteoarthritis secondary to DDH. According to our study, PrT is superior to exercises. PrT could provide significant improvement for clinical outcomes in DDH and might delay surgery. PMID: 32045406 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
ConclusionAssessing large amounts of post-TKA and post-THA step data using mobile technology is feasible. Completion rates were good, making the technology very useful for collecting frequent PROMs. Being unable to ensure that patients always carried their phones limited our analysis of the step counts.
Source: HSS Journal - Category: Orthopaedics Source Type: research
Publication date: Available online 7 February 2020Source: Journal of OrthopaedicsAuthor(s): Meredith L.Grogan Moore, Joost T.P. Kortlever, Mark H.F. Keulen, David P. Brigati, Kevin Bozic, Karl M. KoenigAbstractBackgroundPatient-reported outcome measures (PROMs) are increasingly integrated into reporting requirements tied to reimbursement. There may be advantages to computer adaptive tests that apply to many different anatomical regions and diseases, provided that important information is not lost.Questions1) Does the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) computer adaptive te...
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research
Pain, the main symptom of osteoarthritis (OA), can lead to functional disability in patients with knee OA. Understanding the association factors related to knee pain is important since preventing OA-induced disabilities can be achieved by modifying these pain-associated issues. Therefore, this study was aimed to investigate the association factors for OA-induced knee pain in Taiwanese patients who received total knee replacements (TKR). In this retrospective study, 357 subjects who had undergone TKR at the Taipei Municipal Wan-Fang Hospital were recruited. The distribution of pain severity among patients with knee OA was ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research
Abstract INTRODUCTION: We investigated the effects of lower back pain (LBP) on measures of pain, disability, and function in highly symptomatic hip OA patients receiving intra-articular steroid injection (IASI) therapy. We also investigated the effect of radiographic severity of hip OA for comparison to LBP. METHODS: 97 consenting subjects with symptomatic hip OA presenting for IASI were evaluated at baseline, assessed over an 8-week period, and followed at least 1 year later for new arthroplasty. At baseline and 8 weeks follow-up patient demographics, presence/absence of back pain, physical fun...
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
Abstract Purpose: The current study aimed to evaluate the internal consistency, test-retest reliability, and construct validity of the translated and adapted Arabic version of the Oxford shoulder score in patients with shoulder disorders.Methods: One hundred four patients (average age 45.9 ± 15.2 years; female 78.8%) with shoulder disorders, including impingement syndrome, rotator cuff disorder, osteoarthritis, and adhesive capsulitis, participated. The participants were asked to complete the adapted Arabic version of the Oxford shoulder score, shoulder pain and disability index, and th...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Authors: Eftekharsadat B, Aghamohammadi D, Dolatkhah N, Hashemian M, Salami H Abstract Background: We aimed to determine dietary intake and serum concentration of α-tocopherol and lycopene in subjects with knee osteoarthritis (KOA) in relation to pain intensity and functional status and comparing them with healthy controls. Methods: This case-control study was conducted among 35 patients with primary KOA and 35 matched healthy subjects selected using convenience sampling method. Dietary intakes of alpha-tocopherol and lycopene were estimated from 24-hour dietary records. Visual Analogue Scale (VAS) and Weste...
Source: International Journal for Vitamin and Nutrition Research - Category: Nutrition Tags: Int J Vitam Nutr Res Source Type: research
DiscussionTrapeziectomy with LRTI for thumb carpometacarpal osteoarthritis provided early subjective improvements in outcomes as early as 3 months post-procedure. However, more than 6 months are required to determine objective improvements in outcomes. To obtain early patient-reported satisfactory outcomes, we should focus not on improving hand and finger strength, but on treating postoperative surgical site pain and preventing thumb stiffness.Level of evidenceIV, retrospective therapeutic study.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Symptoms of osteoarthritis (OA) evolve over years with variable rate and course. While studies have focused on understanding long-term trajectories of OA [e.g., 1], how these relate to shorter-term fluctuations in symptoms is not well-understood. Yet for many people, the lived experience of OA is recurrent fluctuations in episodic pain of varying frequency, intensity and duration; it is these episodes of increased pain and associated disability that often drive primary healthcare consultation. Historically, the term ‘exacerbation’ and ‘flare-up’ have been used interchangeably to describe sudden-onse...
Source: Osteoarthritis and Cartilage - Category: Rheumatology Authors: Tags: Editorial Source Type: research
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