Atlantoaxial Rotatory Subluxation in a 10-Year-Old Boy.
We describe the clinical challenges of managing a 10-year-old boy who presented with repetitive episodes of torticollis. Open-mouth odontoid radiograph and computed tomographic (CT) scan gave a diagnosis in ARRS, based on its characteristic imaging findings. The child was admitted multiple times for continuous halter traction in the first 6 months after symptom onset. He also experienced a temporary complication from an overcorrection with correcting neck bracing. Seven months after symptom onset, this case was discussed by a multidisciplinary spine team and referred to chiropractic clinic. Despite persistent radiographic ...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 15, 2020 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Shoulder Double Crush Syndrome: A Retrospective Study of Patients With Concomitant Suprascapular Neuropathy and Cervical Radiculopathy.
Conclusion: A significant percentage of patients with SSN have evidence of shoulder double crush syndrome. Patients with SSN and concomitant median neuropathy should have a detailed neck examination performed. PMID: 32612405 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 4, 2020 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Midfoot Arthritis in Children: Is There Any Relation With Malignancy?
Conclusion: According to the findings of the present study, it can be concluded that "midfoot arthritis" may be the first manifestation of leukemia in children even with a near-normal hematologic values. PMID: 32550767 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 21, 2020 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Cannabinoids in Chronic Non-Cancer Pain: A Systematic Review and Meta-Analysis.
Conclusions: There was moderate evidence to support cannabinoids in treating chronic, non-cancer pain at 2 weeks. Similar results were observed at later time points, but the confidence in effect is low. There is little evidence that cannabinoids increase the risk of experiencing serious AEs, although non-serious AEs may be common in the short-term period following use. PMID: 32127750 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - March 6, 2020 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Patients Prescribed Anakinra for Acute Gout Have Baseline Increased Burden of Hyperuricemia, Tophi, and Comorbidities, and Ultimate All-Cause Mortality.
Authors: Sharma E, Pedersen B, Terkeltaub R Abstract Objective: The interleukin-1 (IL-1) receptor antagonist anakinra is an effective, off-label option in acute gout flares, when conventional therapy options are narrowed. We performed a retrospective, randomized, case-controlled study to gain clinical insight on baseline factors for gout patients most likely to receive anakinra, and ultimate mortality of those who received anakinra. Methods: Of 1451 gout patients seen between January 2003 and January 2015 in a Veterans Affairs (VA) rheumatology group practice, under stringent managed care principles, 13 (100% m...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - December 17, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Lyme Arthritis in Children on the Uptick in Western New York Area.
Conclusions: A significant increase (P = .02) in Lyme arthritis cases was observed at Oishei Children's Hospital of Buffalo. Lyme arthritis may clinically present similarly to other forms of arthritis, such as oligoarticular juvenile idiopathic arthritis, so health care providers should be aware of distinguishing clinical features, which include rapid onset of swelling and patient age. Because the geographic area of endemic Lyme disease is expanding, all health care providers need to be aware of Lyme arthritis as a possible diagnosis. PMID: 31819695 [PubMed] (Source: Clinical Medicine Insights: Arthritis ...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - December 11, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Parkinson's Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly.
Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson's disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations. PMID: 31700249 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - November 10, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Safety of Intra-articular Methotrexate Injection With and Without Electroporation for Inflammatory Small Joints in Patients With Rheumatoid Arthritis.
Authors: Tada M, Inui K, Okano T, Mamoto K, Koike T, Nakamura H Abstract The general disease activity of patients with rheumatoid arthritis (RA) is well controlled by disease-modifying antirheumatic drugs, but local inflammation often remains in a few small joints. Electroporation, making small pores in cell membranes, has proven useful for drug delivery. The safety of a combination therapy of methotrexate (MTX) and electroporation for local joint inflammation in RA was investigated in a prospective, randomized, double-blind, placebo-controlled, exploratory study (UMIN000016606). The patients were randomly allocate...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - November 10, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Middle Cuneiform Stress Fracture in an Adolescent Athlete: A Case Report and Literature Review.
Authors: Krebs P, Borchers J Abstract A 13-year-old female soccer and basketball athlete presented with pain in the arch of her foot. Magnetic resonance imaging confirmed the diagnosis of a middle cuneiform stress fracture. The patient's stress fracture healed nonoperatively over a 10-week period complicated by nonadherence to a fracture boot, after which she was progressed back to full activity. Knowledge of these fractures and their treatment are important for sports medicine physicians, as they can often be overlooked, given their infrequent occurrence. There have been 8 previous case reports and 1 case series o...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 24, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Two-Year Results of the PHANTOM High Flex Trial: A Single-Arm Study on the Atlas Unicompartmental Knee System Load Absorber in Patients With Medial Compartment Osteoarthritis of the Knee.
This study confirmed that the benefit of a joint unloading device in the management of young patients with medial knee OA is maintained over 2 years. This trial was registered with ClinicalTrials.gov (NCT02711254). PMID: 31579106 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 5, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Reliability and Accuracy of MRI in Orthopedics: A Survey of Its Use and Perceived Limitations.
This study summarizes some of the concerns of MRI use in the orthopedic community and attempts to add a unique perspective on the attitudes, decision-making, and apparent economic problems that they face as well as uncover specific instances where MRIs were determined to be unreliable and incomplete in aiding the diagnosis and treatment algorithm. PMID: 31523134 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - September 18, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study.
Conclusions: Body mass index, LTS, and MTS angles were associated with ACL injury risk and BMI + MTS + LTS together revealed the greatest effect on ACL injury. PMID: 31427857 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 22, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Prevalence of Sarcopenia Obesity in Patients Treated at a Rural, Multidisciplinary Weight and Wellness Center.
Authors: Batsis JA, Gilbert-Diamond D, McClure AC, Weintraub A, Sette D, Mecchella JN, Rotenberg S, Cook SB, Rothstein RI Abstract Sarcopenic obesity portends poor outcomes, yet it is under-recognized in practice. We collected baseline clinical data including data on body composition (total and segmental muscle mass and total body fat), grip strength, and 5-times sit-to-stand. We defined sarcopenia using cut-points for appendicular lean mass (ALM) and obesity using body-fat cut-points. A total of 599 clinic patients (78.5% female; mean age was 51.3 ± 14.2 years) had bioelectrical impedan...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 8, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Xanthoma Combined With Gout Infiltration of the Achilles Tendon: A Case Report.
Authors: Fu Y, Huang QL Abstract Xanthoma is a rare condition mostly caused by hyperlipidemia. The pathogenesis of gout is hyperuricemia, which is caused by a disorder of purine metabolism and/or a decrease in uric acid excretion. Xanthoma combined with gout is very rare. This case report presents magnetic resonance images of a case of xanthoma combined with gout infiltration of the Achilles tendon. PMID: 31384134 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 8, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Colchicine-Induced Rhabdomyolysis: Clinical, Biochemical, and Neurophysiological Features and Review of the Literature.
We report the case of a 46-years-old man with long-term asymptomatic hyperuricemia who started taking colchicine (0.5 mg/day) and allopurinol (100 mg/d) for normalization of biochemical values. After the third week of starting treatment, acute weakness was present; and by the fifth week, profound weakness in lower extremities and tenderness and cramps on thighs and calves with inability to climb stairs were also observed. Biochemical evaluation showed elevated muscle enzymes (creatinine kinase [CK] raised to five-folds its normal value) and electromyographic features were consistent with myopathy (at rest, fi...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 29, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Comparison of Bone Mineral Densitometry at 2 Sites Versus 3 Sites in Patients Suspicious for Osteoporosis.
In this study, we aim to evaluate the bone mineral density (BMD) results of 2 standard sites with 3 sites including wrist in diagnosing osteoporosis. Methods: We evaluated the BMD results of 1272 individuals referred for suspected osteoporosis between 2012 and 2015. Those individuals were included with BMD at lumbar spine, femur neck, and wrist. Bone mineral density was measured using a dual-energy X-ray absorptiometry (DXA) device. Bone mineral density and T score were measured for all 3 sites. Results: There was significant correlation between wrist T score with hip T score (r = 0.606, P
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 19, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Does Neuromuscular Electrical Stimulation Improve Recovery Following Acute Ankle Sprain? A Pilot Randomised Controlled Trial.
Conclusions: In this pilot, randomised controlled trial, NMES was well tolerated by patients following ankle sprain and demonstrated statistically significant improvements in oedema reduction as measured by fluid displacement. No other changes were observed. Further work will need to confirm the clinical significance and effect on longer term recovery post-ankle sprain. PMID: 31205428 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 19, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Exploring Neuromuscular Electrical Stimulation Intensity Effects on Multifidus Muscle Activity in Adults With Chronic Low Back Pain: An Ultrasound Imaging-Informed Investigation.
Authors: Sions JM, Crippen DC, Hicks GE, Alroumi AM, Manal TJ, Pohlig RT Abstract Study design: Cross-sectional study. Background: Neuromuscular electrical stimulation (NMES) is an effective tool for stimulating multifidus muscle contractions. Ultrasound imaging (USI) is valid and reliable for quantifying multifidus activity represented by percent thickness change from a resting to contracted state. Thus, USI may be used to help determine optimal NMES intensity. Objectives: To explore NMES intensity effects on multifidus thickening in adults with chronic low back pain (CLBP). Methods: Sixty patients wit...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 19, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Pseudoaneurysm of the Second Dorsal Metatarsal Artery: Case Report and Literature Review.
Authors: Kinter CW, Hodgkins CW Abstract Pseudoaneurysms are a rare complication of foot and ankle surgeries that can potentially lead to serious sequelae, especially when there is delay in the diagnosis. Due to the rarity of this occurrence, guidelines for management are limited for orthopedic surgeons. Once diagnosed, the surgeon has to decide quickly on many options for how to best manage the patient. In this case report, we present the occurrence of a dorsal second metatarsal artery pseudoaneurysm that occurred after removal of hardware. We also discuss the most current literature on the subject to help guide o...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 19, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Progressive Akin Osteotomy.
We present a progressive Akin osteotomy that preserves the lateral cortex of the proximal phalanx and allows to remove the exact wedge size to achieve the preoperative planned correction. PMID: 31191066 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 15, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Supartz (Sodium Hyaluronate) for the Treatment of Knee Osteoarthritis: A Review of Efficacy and Safety.
Authors: Bronstone A, Neary JT, Lambert TH, Dasa V Abstract As concerns about the safety of systemic oral pharmacologic treatments for knee osteoarthritis (OA) mount, clinicians have increased the use of intra-articular hyaluronic acid (IA-HA) in managing mild-to-moderate knee OA. Supartz (sodium hyaluronate; Seikagaku Corporation, Tokyo, Japan) is the first IA-HA product to be approved in the world and has the longest history of global use. In this review, we summarize evidence supporting Supartz efficacy and safety, including data from pivotal clinical trials that resulted in approval of Supartz in the United Sta...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - April 27, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Closed Limb Fractures With Compromised Vascularization: A Narrative Review.
Authors: Vannabouathong C, Schemitsch E, Petrisor B, Bhandari M Abstract Vascular compromised fractures typically result in a high rate of healing complications, such as avascular necrosis, nonunion, delayed union, and arthritis, which severely affect a patient's function and quality of life. The purpose of this review was to identify and describe the epidemiology and available treatment options for the most well-known vascular compromised closed fractures. The injuries discussed in detail in this review were scaphoid, lunate, femoral neck, and talar fractures. Current evidence suggests that optimal treatment for v...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - March 28, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Bohler Angle and the Crucial Angle of Gissane in Paediatric Population.
In this study, Bohler angle and the crucial angle of Gissane in paediatric population were measured using lateral foot radiographs of 429 patients, from 0 to 16 years of age. The control group was composed of 70 adult patients. The sample had a mean Bohler angle of 35.4° ± 5.9° and a mean crucial angle of Gissane of 110.5° ± 7.4°. The greater mean difference was identified for Bohler angle (8°) in the age group of 5 to 8 years (39.6° ± 5.7°) and for the crucial angle of Gissane (5°-6°) in the age group of 0 to 4...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - March 21, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Bilateral Levofloxacin-Induced Achilles Tendon Rupture: An Uncommon Case Report and Review of the Literature.
Authors: Fernández-Cuadros ME, Casique-Bocanegra LO, Albaladejo-Florín MJ, Gómez-Dueñas S, Ramos-Gonzalez C, Pérez-Moro OS Abstract Since the introduction of Fluoroquinolones (FQ) in 1960s, these antibiotics have been used in airway and urinary tract infections, due to absorption, biodisponibility, posology and long half-life time properties. However, several reports state that FQ can cause tendinopathy and rupture. These adverse effects can occur within hours after initial treatment to up to 6 months after withdrawal. FQ-induced tendinopathy was first reported in 1983; since then...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - March 14, 2019 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs.
Authors: Vannabouathong C, Ayeni OR, Bhandari M Abstract Avulsion fractures compromise function and movement at the affected joint. If left untreated, it can lead to deformity, nonunion, malunion, pain, and disability. The purpose of this review was to identify and describe the epidemiology and available treatment options for common avulsion fractures of the upper and lower extremities. Current evidence suggests that optimal treatment is dependent on the severity of the fracture. Conservative efforts generally include casting or splinting with a period of immobilization. Surgery is typically indicated for more seve...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - November 20, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Patient Discomfort and Resident Confidence After Knee Intra-articular Injection Simulation Training: A Randomized Control Trial Study.
This study aims to evaluate whether targeted simulation model training in residency can increase residents' comfort level in performing intra-articular knee injections and decrease the pain of the procedure, as reported by patients injected. Residents were randomized into intervention and control groups. The comfort level of the residents as well as the pain levels from the procedures, as reported by patients, was recorded. The mean comfort level for the intervention group was 1.2, compared with that in the control group, which was 2.13; P value was .047. The mean pain level in the intervention group was 1.8, whereas in th...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 19, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Influence of HLA-B27 Subtypes on Ankylosing Spondylitis Phenotype: Comment on the Article by Akassou et al.
Authors: Fallahi S PMID: 30013411 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 19, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Short-Term Outcomes in Treatment of Knee Osteoarthritis With 4 Bone Marrow Concentrate Injections.
Conclusions: These results are promising, and additional research with a larger sample size and longer follow-up is needed to further examine the treatment effectiveness of multiple BMC injections for knee osteoarthritis. PMID: 29977117 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 8, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial).
Authors: Dauvissat J, Rizzo C, Lellouche H, Porterie J, Melac-Ducamp S, Locquet V, Travers V, Maillet B, Conrozier T Abstract Purpose: To assess safety and search predictive factors of efficacy of a single intra-articular injection of a mannitol-modified hyaluronic acid (HA) viscosupplement, in patients having trapeziometacarpal (TMC) osteoarthritis (OA). Methods: Patients with symptomatic TMC OA, not adequately relieved by analgesic therapy and/or by the use of a thumb splint, were included in a 3-month prospective multicentre open-label trial. All underwent plain radiographs with the Kapandji incidences allow...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 8, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Retrocalcaneal Bursitis Precedes or Accompanies Achilles Tendon Enthesitis in the Early Phase of Rheumatoid Arthritis.
Authors: Suzuki T, Hidaka Y, Seri Y Abstract The consecutive reports and stored images of ultrasound examinations for 100 symptomatic ankles of 74 patients with rheumatoid arthritis (RA) were reviewed for the presence or absence of retrocalcaneal bursitis (RCB) and Achilles tendon enthesitis (ATE). The ankles were classified into 4 categories based on the presence or absence of RCB or ATE. The number of RCB(-)/ATE(-), RCB(+)/ATE(-), RCB(+)/ATE(+), and RCB(-)/ATE(+) ankles was 62, 16, 12, and 10, respectively. When classifying patients into early RA and established RA, the percentage of RCB(-)/ATE(+) ankles with ear...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 15, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Pooled Analysis of Two Multicenter, Randomized Controlled Trials of a Single Intra-articular Injection of Gel-200 for Treatment of Osteoarthritis of the Knee.
Conclusion: This integrated analysis demonstrated the efficacy of a single intra-articular injection of Gel-200 compared with PBS for treatment of osteoarthritis of the knee over 26 weeks without major safety concerns. Trial Registration: NCT00449696 and NCT00450112. PMID: 29780263 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 23, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Late Presentation of Infected Silicone Granulomas in the Lower Limb.
Conclusions: Microorganisms can induce immune-mediated hypersensitivity and are believed to be the trigger for delayed activation of a quiescent foreign body to a granulomatous reaction. The substantial time delay between injection and reaction must be recognised and may be attributable to atypical microorganisms or biofilm formation. Previous antibiotic use can affect expedient microbiological diagnosis and treatment requires close collaboration with microbiologists. It is important that clinicians are aware of these important complications which are becoming more common with increased use of filler augmentation. PMID...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - March 9, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

An Observational 1-Month Trial on the Efficacy and Safety of Promerim for Improving Knee Joint.
This study was conducted to evaluate the efficacy and tolerability of the oral intake of promerim in the elimination of acute pain and discomfort associated with knee osteoarthritis (OA). Methods: Single-center, 1-month, prospective, observational clinical trial. A total of 92 patients not older than 70 years were included. Patients were offered to use 720-mg promerim for the first 15 days after admission after breakfast and then 360 mg for the second 15 days. All patients were analyzed with the visual analog scale (VAS) for pain, which ranges from 0 to 10, and the Western Ontario and McMast...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - February 27, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Osteoarthritis and the Complement Cascade.
Authors: Silawal S, Triebel J, Bertsch T, Schulze-Tanzil G Abstract Accumulating evidence demonstrates that complement activation is involved in the pathogenesis of osteoarthritis (OA). However, the intimate complement regulation and cross talk with other signaling pathways in joint-associated tissues remain incompletely understood. Recent insights are summarized and discussed here, to put together a more comprehensive picture of complement involvement in OA pathogenesis. Complement is regulated by several catabolic and inflammatory mediators playing a key role in OA. It seems to be involved in many processes obser...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - February 14, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Preliminary Evaluation of the Ability of Keratotic Tissue to Act as a Prognostic Indicator of Hip Fracture Risk.
The objective of this study was to investigate the potential of a prospective test for hip fracture based on spectroscopic analysis of nail tissue. Archived toenail samples from post-menopausal women aged 50 to 63 years in the Nurses' Health Study were obtained and analysed by Raman spectroscopy. Nails were matched case-controls sourced from 161 women; 82 who underwent a hip fracture up to 20 years after nail collection and 81 age-matched controls. A number of clinical risk factors (CRFs) from the Fracture Risk Assessment (FRAX) tool had been assessed at toenail collection. Using 80% of the spectra, models we...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 28, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Total Knee Arthroplasty: Does Day of Surgery Matter?
Authors: Malik AT, Khan S, Ali A, Mufarrih SH, Noordin S Abstract Introduction: There has been an influx of research studies aimed at identifying all factors that contribute to minimizing cost and maximizing postoperative care after total knee arthroplasty (TKA). Length of stay (LOS) has been defined as a significant factor that contributes to increased burden. We aimed at looking whether day of surgery has any significant effect on the LOS and postoperative complications following total knee arthroplasty (TKA). Materials and methods: Retrospective cohort study done at the Aga Khan University Hospital, Pakistan...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 28, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

The Protein Tyrosine Phosphatase Nonreceptor 22 (PTPN22) R620W Functional Polymorphism in Psoriasis.
Authors: Bin Huraib G, Al Harthi F, Arfin M, Rizvi S, Al-Asmari A Abstract Background: Psoriasis is a complex autoimmune disease caused by the interaction of genetic and environmental factors. PTPN22 gene polymorphism has been reported to affect psoriasis susceptibility; however, no data are available for Middle Eastern populations. Objective: The aim of this study was to investigate the association of PTPN22 (1858C/T) R620W polymorphism with psoriasis in a Saudi cohort. Methods: Saudi subjects (n = 306) including patients with psoriasis (n = 106) and matched controls (n =...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 21, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype?
Authors: Akassou A, Bakri Y Abstract The association of HLA-B27 with ankylosing spondylitis (AS) remains as one of the intriguing models that could exist between a molecule and human disease in medicine. Although it was reported in 1973, its contribution to AS and related spondyloarthritis continues to be a major challenge for scientific community. It is important to understand its etiopathogenic mechanism and its functions in these diseases. Although the diagnostic and prognostic roles of HLA-B27 in AS are still debated, there is an increasing interest for HLA-B27-based effects especially in HLA-B27(+) patients wi...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 19, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Medial Pivot in Total Knee Arthroplasty: Literature Review and Our First Experience.
Discussion and conclusions: Medial Congruent insert showed good to excellent clinical results at 1-year FU. Range of motion and subjective outcomes were satisfying and comparable with results obtained in literature using traditional TKA design. PMID: 29326531 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 13, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Rheological Properties of Commercially Available Hyaluronic Acid Products in the United States for the Treatment of Osteoarthritis Knee Pain.
Conclusions: Due to the differences in rheological properties between IA-HA products, the universal assessment of these products as a class may not be appropriate. Instead, it may be more appropriate to assess each product individually. Future research should aim to link these differences in rheological properties to the differences in clinical efficacy seen across these IA-HA products. PMID: 29326532 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 13, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Proliferative Synovitis of the Shoulder Bursae is a Key Feature for Discriminating Elderly Onset Rheumatoid Arthritis Mimicking Polymyalgia Rheumatica From Polymyalgia Rheumatica.
Authors: Suzuki T, Yoshida R, Hidaka Y, Seri Y Abstract Semiquantitative scoring for subacromial bursa (SAB), subdeltoid bursa (SDB), and subcoracoid bursa by both gray-scale (GS) and power Doppler (PD) ultrasonography was performed in 15 patients with polymyalgia rheumatica (PMR) (72.6 ± 7.7 years old) and 15 patients with elderly onset rheumatoid arthritis with PMR-like onset (pm-EORA) (70.7 ± 7.0 years old) before starting treatment. The GS grades of SAB were significantly higher in the shoulders with pm-EORA than in the shoulders with PMR. The GS and PD sc...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - December 17, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Efficacy of Intra-articular Injection of a Newly Developed Plasma Rich in Growth Factor (PRGF) Versus Hyaluronic Acid on Pain and Function of Patients with Knee Osteoarthritis: A Single-Blinded Randomized Clinical Trial.
CONCLUSIONS: In 6 months follow up, our newly developed PRGF and HA, both are effective options to decrease pain and improvement of function in patients with symptomatic mild to moderate knee osteoarthritis. PMID: 29051707 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 21, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Feasibility of the Atlas Unicompartmental Knee System Load Absorber in Improving Pain Relief and Function in Patients Needing Unloading of the Medial Compartment of the Knee: 1-Year Follow-Up of a Prospective, Multicenter, Single-Arm Pilot Study (PHANTOM High Flex Trial).
This study highlights the potential benefit of a joint unloading device in the management of young patients with medial knee OA. The trial is still ongoing and another analysis is planned at 24 months. PMID: 28989290 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 11, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Patient Preferences Regarding Surgical Interventions for Knee Osteoarthritis.
Authors: Moorman CT, Kirwan T, Share J, Vannabouathong C Abstract Surgical interventions for knee osteoarthritis (OA) have markedly different procedure attributes and may have dramatic differences in patient desirability. A total of 323 patients with knee OA were included in a dual response, choice-based conjoint analysis to identify the relative preference of 9 different procedure attributes. A model was also developed to simulate how patients might respond if presented with the real-world knee OA procedures, based on conservative assumptions regarding their attributes. The "amount of cutting and removal of t...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 5, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Magnetic Resonance Imaging of the Axial Skeleton in Patients With Spondyloarthritis: Distribution Pattern of Inflammatory and Structural Lesions.
Authors: Hoffstetter P, Al Suwaidi MH, Joist A, Benditz A, Fleck M, Stroszczynski C, Dornia C Abstract PURPOSE: Spondyloarthritis is a chronic inflammatory disorder of the musculoskeletal system driven by systemic enthesitis and typically involving the axial skeleton, ie, the spine and the sacroiliac joints. The purpose of this study was to assess the distribution pattern of inflammatory and structural magnetic resonance imaging (MRI) findings in spondyloarthritis. METHODS: Retrospective study of 193 patients with axial spondyloarthritis who received MRI of the spine and the sacroiliac joints. We quantitatively...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - September 13, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Hypokalemic Paralysis: A Hidden Card of Several Autoimmune Diseases.
We report a case of a lupic patient who presented rapidly progressive quadriparesis in the context of active renal disease. Research revealed severe refractory hypokalemia, metabolic acidosis, and alkaline urine suggestive of dRTA. We diagnosed Sjögren's syndrome based on sicca symptoms, an abnormal salivary glands' nuclear scan and the presence of anti-Ro/SSA and anti-La/SSB. In addition, the finding of thyroid peroxidase, thyroglobulin antibodies, and hypothyroidism led us to the diagnosis of Hashimoto thyroiditis. Due to the active renal involvement on the context of systemic lupus erythematosus and Sjögren's ...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 27, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

The Disease-Modifying Effects of Hyaluronan in the Osteoarthritic Disease State.
The objectives of this article are to (1) describe the etiology and pathophysiology of OA including both what is known about the genetics and biochemistry, (2) describe the role of HA on disease progression, (3) detail the antinociceptive and anti-inflammatory actions of HA in OA, and (4) present evidence of disease-modifying effects of HA in the preservation and restoration of the extracellular matrix. These data support that HA is not only just a simple device used for viscosupplementation but also a biologically active molecule that can affect the physiology of articular cartilage. PMID: 28839448 [PubMed] (Source: C...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 27, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Comparison of the 3 Different Injection Techniques Used in a Randomized Controlled Study Evaluating a Cross-Linked Sodium Hyaluronate Combined With Triamcinolone Hexacetonide (Cingal) for Osteoarthritis of the Knee: A Subgroup Analysis.
In this study, injections were administered by 1 of 3 approaches; however, there is currently no consensus on which, if any, of these techniques produce a more favorable outcome. To provide additional insight on this topic, the results of the previous trial were reanalyzed to determine whether (1) the effect of Cingal was significant within each injection technique and (2) pain reductions were similar between injection techniques across all treatment groups. Greater pain reductions with Cingal up to 3 weeks were only significant in the anteromedial subgroup. Across all therapies, both the anteromedial and anterolate...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 27, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Oral Anaerobic Bacteria in the Etiology of Ankylosing Spondylitis.
Authors: Ö─črendik M Abstract Ankylosing spondylitis (AS) is associated with periodontitis. Anti-Porphyromonas gingivalis and anti-Prevotella intermedia antibody titers were higher in patients with spondyloarthritis than in healthy people. Sulfasalazine is an effective antibiotic treatment for AS. Moxifloxacin and rifamycin were also found to be significantly effective. The etiology hypothesis suggests that oral anaerobic bacteria such as Porphyromonas spp and Prevotella spp contribute to the disease. These bacteria have been identified in AS, and we will discuss their pathogenic properties with respect to our...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 25, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Cost-Utility of a Single-Injection Combined Corticosteroid-Hyaluronic Acid Formulation vs a 2-Injection Regimen of Sequential Corticosteroid and Hyaluronic Acid Injections.
Authors: Belzile EL, Deakon RT, Vannabouathong C, Bhandari M, Lamontagne M, McCormack R Abstract Research has shown early and sustained relief with a combination therapy of a corticosteroid (CS) and hyaluronic acid (HA) in knee osteoarthritis (OA) patients. This can be administered via a single injection containing both products or as separate injections. The former may be more expensive when considering only product cost, but the latter incurs the additional costs and time of a second procedure. The purpose of this study was to compare the cost-utility of the single injection with the 2-injection regimen. The resu...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 25, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research