a-passive-ankle-dorsiflexion-testing-system-for-an-vivo-model-overuse

A Passive Ankle Dorsiflexion Testing System for an <em>In Vivo</em> Model of Overuse-induced Tendinopathy

Tendinopathy is a chronic tendon condition that results in pain and loss of function and is caused by repeated overload of the tendon and limited recovery ...

Beth Israel Deaconess Medical Center, Harvard Medical School

Medialization and anteromedialization of the tibial tubercle are used to correct patellar subluxation in adults.

The effects of medialization and anteromedialization of the tibial tubercle on patellofemoral mechanics and kinematics.

Computed tomography (CT) scans are often used to evaluate proximal humerus fractures. We conducted a study to determine if use of preoperative CT scans affects surgical decision-making with respect to proximal humerus fractures. Three board-certified orthopedic surgeons interpreted plain radiographs of 40 proximal humerus fractures and then CT scans with reformatted images. Results were assessed for interrater reliability. Use of CT significantly improved interobserver reliability in fracture characterization and assessment. Surgeons were more likely to identify a displaced fracture (P < .01), an impaction (P < .001), and involvement of the anatomical neck (P < .03). However, CT did not improve agreement with use of AO (Arbeitsgemeinschaft für Osteosynthesefragen) fracture classification and did not significantly alter treatment recommendations. CT scans provide more detail about the character of proximal humerus fractures (displacement, involved segments) but do not significantly influence surgical treatment recommendations when compared with plain radiographs alone.

Using computed tomography to assess proximal humerus fractures.

The purpose of this study was to compare gap formation, strength, and stiffness of repaired radial tears of the meniscus treated using a new all-inside technique versus a traditional inside-out suture technique.

Analysis of a new all-inside versus inside-out technique for repairing radial meniscal tears.

The rotator interval (RI) has been exploited as a potentially benign point of entry into the glenohumeral (GH) joint. Bounded by the supraspinatus, subscapularis and coracoid process of the scapula, the RI is believed to be important in the shoulder's soft tissue balancing and function. However, the role of the RI in shoulder kinematics is not fully understood. The purpose of this study is to describe the effect of the RI on GH motion during abduction of the arm.

The effect of the rotator interval on glenohumeral kinematics during abduction.

There remains controversy on the role of the deltoid on glenohumeral translations during basic and pitching motions. We thus studied the passive effect of the deltoid on the deltoid glenohumeral joint center (GHJC).

Bulk effect of the deltoid muscle on the glenohumeral joint.

Changes to the integrity of the acromioclavicular (AC) joint impact scapulothoracic and clavicular kinematics. AC ligaments provide anterior-posterior stability, while the coracoclavicular (CC) ligaments provide superior-inferior stability and a restraint to scapular internal rotation. The purpose of this cadaveric study was to describe the effect of sequential AC and CC sectioning on glenohumeral (GH) kinematics during abduction (ABD) of the arm. We hypothesized that complete AC ligament insult would result in altered GH translation in the anterior-posterior plane during abduction, while subsequent sectioning of both CC ligaments would result in an increasing inferior shift in GH translation.

Influence of disruption of the acromioclavicular and coracoclavicular ligaments on glenohumeral motion: a kinematic evaluation.

Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Treatment options for SIS include conservative modalities such as use of nonsteroidal anti-inflammatory drugs, physical therapy, and subacromial corticosteroid injections (CSIs). Although studies have found improvement in pain, function, and range of motion after CSI, the effect of injection route (anterior or posterior) on shoulder pain in patients with SIS has not been investigated. In the study reported here, patients were randomly assigned to 2 treatment groups: anterior CSI and posterior CSI. Pain was assessed with a visual analog scale (VAS) and function with the Single Assessment Numeric Evaluation (SANE). Patients were evaluated before injection (baseline) and 1, 3, and 6 months after injection. Of the 55 patients enrolled, 25 received anterior CSI and 30 received posterior CSI. The 2 groups showed no significant difference in VAS pain at baseline or 1, 3, or 6 months after injection. SANE scores were statistically different at 3 months. Each group had significantly less pain and better function 1, 3, and 6 months after injection than at baseline. Age, sex, and body mass index did not significantly affect the efficacy of anterior or posterior CSIs. In patients with SIS, subacromial CSI reduces pain and improves function for up to 6 months. These effects are no different for anterior and posterior injection routes. As a result, clinicians should rely on their clinical acumen when selecting injection routes, as anterior and posterior are both beneficial.

Comparison of Anterior and Posterior Cortico-steroid Injections for Pain Relief and Functional Improvement in Shoulder Impingement Syndrome.

Patients commonly present with shoulder complaints to the primary care and orthopaedic setting. The differential includes rotator cuff tears, subacromial impingement, osteoarthritis, and adhesive capsulitis, also known as frozen shoulder. Despite the prevalence of adhesive capsulitis, it is commonly misdiagnosed and management remains unclear. This article reviews the presentation of adhesive capsulitis, presents an overview of the pathophysiology of this poorly understood disease, and evaluates nonoperative treatment options for adhesive capsulitis. (Journal of Surgical Orthopaedic Advances 26(4):193-199, 2017).

Evaluating Nonoperative Treatments for Adhesive Capsulitis.

The recent federal ruling to against Affordable Care Act (ACA), specifically the mandate requiring people to buy insurance, has once again brought the healthcare reform debate to the spotlight. The ACA increased the number of insured Americans through the development of subsidized healthcare plans and health insurance exchanges. Insurance-based differences in the rate of upper extremity elective orthopaedic surgery have been described before and after healthcare reform in Massachusetts, where a similar mandate was put into place years before the ACA was passed. However, no comprehensive study has evaluated insurance-based differences of knee elective surgery before and after reform.

Article	Year
The effects of medialization and anteromedialization of the tibial tubercle on patellofemoral mechanics and kinematics. The American journal of sports medicine\| PubMed ID: 16436533	2006
Using computed tomography to assess proximal humerus fractures. American journal of orthopedics (Belle Mead, N.J.)\| PubMed ID: 24660183	2014
Analysis of a new all-inside versus inside-out technique for repairing radial meniscal tears. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association\| PubMed ID: 25312766	2015
The effect of the rotator interval on glenohumeral kinematics during abduction. BMC musculoskeletal disorders\| PubMed ID: 26818612	2016
Bulk effect of the deltoid muscle on the glenohumeral joint. Journal of experimental orthopaedics\| PubMed ID: 26914759	2014
Influence of disruption of the acromioclavicular and coracoclavicular ligaments on glenohumeral motion: a kinematic evaluation. BMC musculoskeletal disorders\| PubMed ID: 27855670	2016
Comparison of Anterior and Posterior Cortico-steroid Injections for Pain Relief and Functional Improvement in Shoulder Impingement Syndrome. American journal of orthopedics (Belle Mead, N.J.)\| PubMed ID: 28856359	2017
Evaluating Nonoperative Treatments for Adhesive Capsulitis. Journal of surgical orthopaedic advances\| PubMed ID: 29461189	2017
Mandated health insurance increases rates of elective knee surgery. World journal of orthopedics\| PubMed ID: 30788225	2019

Arun J. Ramappa

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