Practical guidelines for the treatment of patellar fractures in adults.

Practical guidelines for the treatment of patellar fractures in adults. Swiss Med Wkly. 2020 Jan 15;150:w20165 Authors: Steinmetz S, Brügger A, Chauveau J, Chevalley F, Borens O, Thein E Abstract The role of the patella is paramount in the transmission of the quadriceps muscle forces, the increase of the lever arm, the distribution of the forces on the trochlea and the centring of the extensor apparatus. Despite the low incidence of patellar factures in comparison with other lower limb fractures, the painful and functional complications, such as knee stiffness, loss of extension and patellofemoral osteoarthritis, can be very disabling and will often compromise the return to a professional or recreational activity and induce falls in the elderly population. Treatment can be conservative or surgical, provided that it is adapted to the type of fracture. Undisplaced fractures with an intact extensor mechanism can be treated nonoperatively. Surgical treatment is recommended for fractures that either disrupt the extensor mechanism or have more than 2 to 3 mm of step-off and more than 1 to 4 mm of displacement. Tension band fixation is the most commonly employed surgical technique. In most cases, hardware has to be removed after fracture healing because of implant-related pain. Operative treatment of comminuted patellar fractures presents a significant challenge to surgeons. Failure to restore the articular surface contour results in posttraumatic arthriti...
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research

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AbstractPain is a health issue affecting all populations, regardless of age, gender, economic status, race, or geography. Acute pain is the most common type of pain, with a complex aetiology. Inadequately managed acute pain adversely affects quality of life and imposes significant economic burden. The majority of the available pain-relieving drugs have monomodal mechanisms of analgesia, which necessitates combining drugs with non-redundant mechanisms of action in order to provide adequate pain relief and reduce the side effects from higher doses of individual drugs. In this regard, combining an oral opioid (such as codeine...
Source: Pain and Therapy - Category: Anesthesiology Source Type: research
Conditions:   Rheumatoid Arthritis - Hand Joint;   Osteoarthritis Hand;   Pain;   Mobility Limitation;   Stiffness of Hand, Not Elsewhere Classified Interventions:   Other: Smartphone Application;   Other: Conventional treatment Sponsors:   University of Seville;   Fundación Pública Andaluza Progreso y Salud Not yet recruiting
Source: - Category: Research Source Type: clinical trials
ConclusionVisceral fat was associated with an increased risk of musculoskeletal and widespread pain.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: FULL LENGTH Source Type: research
Source: Arthritis Research and Therapy - Category: Rheumatology Authors: Tags: Letter Source Type: research
Source: Arthritis Research and Therapy - Category: Rheumatology Authors: Tags: Letter Source Type: research
Source: Arthritis Research and Therapy - Category: Rheumatology Authors: Tags: Letter Source Type: research
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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Abstract Background: Arthritis can have profound debilitating effects on the hand secondary to finger deformities and pain. Arthroplasty of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) can be performed to reduce pain while maintaining joint range of motion. Methods: We used outpatient surgery registries from the states of California and Florida to assess the trends of arthroplasty across several recent years and to determine if the outcomes differ based on disease etiology. Results: We found that there has been a steady decline in number of MCP arthroplasty procedures performed annually between...
Source: Hand Surgery - Category: Surgery Authors: Tags: J Hand Surg Asian Pac Vol Source Type: research
Weight loss has beneficial effects on clinical outcomes in knee osteoarthritis (OA), but the mechanism is still unclear. Since meniscus extrusion is associated with knee pain, this study assessed whether weight loss by diet and/or exercise is associated with less progression in meniscus extrusion measures over time.
Source: Osteoarthritis and Cartilage - Category: Rheumatology Authors: Source Type: research
Researchers here report that upregulation of α-Klotho and TGFβR2 together, via gene therapy, can modestly reverse osteoarthritis in a rat model in which untreated animals progress to a more severe stage of the condition. Inhibiting TGF-β receptors such as TGFβR2 is known to suppress chronic inflammation, and likely functions by interfering in the inflammatory TGF-β signaling produced by senescent cells. The evidence for cellular senescence to drive the progression of osteoarthritis is quite compelling at this point. Meanwhile, α-Klotho declines with age and upregulation of this protein is kn...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
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