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https://www.readbyqxmd.com/read/28812032/nonoperative-management-of-osteochondritis-dissecans-of-the-knee-progression-to-osteoarthritis-and-arthroplasty-at-mean-13-year-follow-up
#1
Thomas L Sanders, Ayoosh Pareek, Nick R Johnson, James L Carey, Travis G Maak, Michael J Stuart, Aaron J Krych
BACKGROUND: Osteochondritis dissecans (OCD) is a disorder of subchondral bone that commonly affects the knee. PURPOSE: To (1) evaluate the rate of arthritis and knee arthroplasty in a population-based cohort of patients with OCD lesions treated nonoperatively and (2) evaluate factors that may predispose patients to knee osteoarthritis and arthroplasty. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Eighty-six patients (mean age, 21...
July 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28811991/systematic-review-of-the-outcomes-of-surgical-treatment-of-prostate-metastases-to-the-spine
#2
REVIEW
Michelle J Clarke, Camilo A Molina, Daryl R Fourney, Charles G Fisher, Ziya L Gokaslan, Meic H Schmidt, Laurence D Rhines, Michael G Fehlings, Ilya Laufer, Shreyaskumar R Patel, Y Raja Rampersaud, Jeremy Reynolds, Dean Chou, Chetan Bettegowda, Ehud Mendel, Michael H Weber, Daniel M Sciubba
STUDY DESIGN: Systematic review. OBJECTIVE: Surgical decompression and reconstruction of symptomatic spinal metastases has improved the quality of life in cancer patients. However, most data has been collected on cohorts of patients with mixed tumor histopathology. We systematically reviewed the literature for prognostic factors specific to the surgical treatment of prostate metastases to the spine. METHODS: A systemic review of the literature was conducted to answer the following questions: Question 1...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28805960/factors-associated-with-high-pain-intensity-during-wound-care-procedures-a-model
#3
Sue E Gardner, Linda I Abbott, Catherine A Fiala, Barbara A Rakel
The most common wound care procedures (WPCs) performed on open wounds are dressing changes and wound cleansing. Dressing changes cause moderate to severe pain in 74% of patients, nearly half (36%) of whom experience severe pain (rated as 8-10 on a 10-point numeric rating scale). The purpose of this paper is to propose a model of clinically accessible factors that can be tested in order to develop a clinical tool to identify which patients are likely to experience high intensity pain during nonoperative WCPs, such as dressing changes...
June 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28803718/total-neoadjuvant-therapy-a-shifting-paradigm-in-locally-advanced-rectal-cancer-management
#4
REVIEW
Aaron J Franke, Hiral Parekh, Jason S Starr, Sanda A Tan, Atif Iqbal, Thomas J George
Colorectal carcinoma is the second leading cause of cancer-related deaths in the United States, with rectal cancer accounting for approximately one-third of newly diagnosed cases, thus representing a major socioeconomic health burden. Although minimally invasive procedures (ie, transanal excision) may be appropriate for a subset of patients with small, superficially invasive tumors, a more comprehensive trimodality approach with neoadjuvant chemoradiotherapy, total mesorectal excision, and systemic chemotherapy is recommended for medically operable patients with nonmetastatic, locally advanced rectal cancer (LARC)...
June 27, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28801826/brain-activity-changes-in-somatosensory-and-emotion-related-areas-with-medial-patellofemoral-ligament-deficiency
#5
Masaru Kadowaki, Taku Tadenuma, Nobuyuki Kumahashi, Yuji Uchio
BACKGROUND: Patellar instability with medial patellofemoral ligament (MPFL) deficiency is a common sports injury among young people. Although nonoperative and surgical treatment can provide stability of the patella, patients often have anxiety related to the knee. We speculate that neural dysfunction may be related to anxiety in these patients; however, the mechanism in the brain that generates this anxiety remains unknown. QUESTIONS/PURPOSES: (1) How does brain activity in patients with MPFL deficiency change in the areas related to somatic sensation against lateral shift of the patella? (2) How does patella instability, which can lead to continuous fear or apprehension for dislocation, influence brain activity in the areas related to emotion? METHODS: Nineteen patients with MPFL deficiency underwent surgical reconstruction in our hospital from April 2012 to March 2014...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28800707/radiographic-results-and-return-to-activity-after-sesamoidectomy-for-fracture
#6
Justin M Kane, James W Brodsky, Yahya Daoud
BACKGROUND: Limited data are available comparing the results of lateral sesamoidectomy and medial sesamoidectomy for the treatment of fractures recalcitrant to nonoperative treatment interventions. The hypothesis of this study was that sesamoidectomy for either lateral or medial sesamoid fractures would not change radiographic alignment of the first ray given the use of identical reconstruction of the plantar plate, intersesamoid ligament, and plantar ligament complex at the time of surgery...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28800569/surgery-for-refractory-coccygodynia-operative-versus-nonoperative-treatment
#7
John P Kleimeyer, Kirkham B Wood, Greger L√łnne, Tyler Herzog, Kevin Ju, Lisa Beyer, Christine Park
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes for patients with refractory coccygodynia treated with coccygectomy compared to a nonsurgical regimen of sitting aids, physical therapy, medications, and injections. SUMMARY OF BACKGROUND DATA: The surgical treatment of coccygodynia remains controversial. To date, there has only been one small comparative study of surgical versus nonsurgical treatment...
August 15, 2017: Spine
https://www.readbyqxmd.com/read/28798548/newborn-ear-deformities-early-recognition-and-novel-nonoperative-techniques
#8
REVIEW
Kelly Schultz, Diana Guillen, Renata S Maricevich
Congenital auricular anomalies are common sources of aesthetic concern and psychosocial distress for both children and their parents. Only one-third of these anomalies self-correct, leaving a large need for acceptable corrective methods. Otoplasty is often the standard treatment; however, newer nonsurgical methods, including splinting and molding in the neonatal period, have shown favorable results without the complications of surgical intervention and with the advantage of early intervention. These treatment options have not yet been widely adopted in Western countries due to delayed diagnosis of auricular deformities and confusion regarding treatment indications and technique...
August 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/28783475/prevalence-and-management-of-coracoid-fracture-sustained-during-sporting-activities-and-time-to-return-to-sport-a-systematic-review
#9
Derrick M Knapik, Sunny H Patel, Robert J Wetzel, James E Voos
BACKGROUND: Coracoid fractures sustained during sporting activities are rare. Previous reports are limited to individual case reports, small case series, and retrospective analyses. PURPOSE: To systematically review the literature and identify coracoid fractures sustained during sporting activities to determine fracture prevalence, sporting activities/mechanisms, management, and time to return to sport. STUDY DESIGN: Systematic review. METHODS: A systematic review was conducted investigating all studies in the literature published between January 1970 and April 2017 that reported on athletes sustaining coracoid fractures during sporting activity...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28781212/tendon-transfer-to-restore-the-extension-of-the-thumb-using-the-extensor-carpi-radialis-brevis-a-long-term-follow-up
#10
Shusen Cui, Guang Yang, Qiang Li, Guangzhi Wu, Zhenxing Wang, Ju Zhang, Wei Yu
PURPOSE: The present study aimed to investigate the long-term functional and clinical outcomes of a tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis. METHODS AND MATERIALS: From June 2005 to September 2012, eight patients (six males; two females) with a mean age of 30 years (range, 16-52 years) who suffered rupture or division of extensor pollicis longus underwent a tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis...
July 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28777214/recurrent-shoulder-instability-after-primary-bankart-repair
#11
Michael A Donohue, Timothy C Mauntel, Jonathan F Dickens
The glenohumeral joint is one of the most frequently dislocated joints and occurs with increasing frequency in collision and contact athletes, especially those in sports that repeatedly place the glenohumeral joint in a position of vulnerability. Nonoperative management of shoulder instability especially in young contact athletes results in unacceptably high recurrence rates; thus, early surgical stabilization has become commonplace. Surgical stabilization typically yields acceptable outcomes. However, recurrent anterior instability may occur following a previous stabilization procedure at rates of 7% to 12%...
September 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28777212/rehabilitation-following-surgery-for-glenohumeral-instability
#12
Michael Johnson
Shoulder dislocation and subsequent instability is a common problem in young athletes. Though it is not uncommon to attempt nonoperative rehabilitation in the early going, reinjury rates are high, particularly with contact sport athletes. As a result, many athletes will undergo a primary repair of one, or multiple, glenohumeral ligaments that make up the anterior shoulder capsule. This paper presents phases of rehabilitation from the preoperative stage up to returning to play. Criteria for phase progression are included, along with examples of common exercises and themes for each phase that allow the physical therapist to consider when working with patients who have had this type of shoulder surgery, allowing them to return to full function with low risk of reinjury...
September 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28776634/performance-and-return-to-sport-after-nonoperative-treatment-of-clavicle-fractures-in-national-football-league-players
#13
Robert A Jack, Kyle R Sochacki, Sergio M Navarro, Patrick C McCulloch, David M Lintner, Joshua D Harris
Clavicle fractures are often seen in contact sports. The purpose of this study was to determine (1) return-to-sport (RTS) rate of National Football League (NFL) players following nonoperative treatment of clavicle fractures, (2) posttreatment career length and games per season, (3) pre- and posttreatment performance, and (4) posttreatment performance compared with control players matched by position, age, years of experience, and performance. Public records were used to identify NFL players who underwent nonoperative treatment of clavicle fractures...
August 3, 2017: Orthopedics
https://www.readbyqxmd.com/read/28774219/nonoperative-management-and-rehabilitation-of-osteitis-pubis-pubic-bone-stress-in-professional-soccer-players-a-report-of-5-cases
#14
Stephen S McAleer, Ed Lippie, Darcy Norman, Helge Riepenhof
Study Design Case series. Background Pubic bone stress (PBS) is a common acute or chronic response of the pelvis in sports where sprinting, kicking, twisting and cutting are the dominant movements. Little literature exists regarding non-operative rehabilitation strategies for the condition and the outcome of conservative treatment has not been documented. Case Description Five professional and aspiring professional soccer players complaining of pubic symphysis pain, confirmed as PBS on magnetic resonance imaging and objective assessment...
August 3, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28768329/national-readmission-patterns-of-isolated-splenic-injuries-based-on-initial-management-strategy
#15
Graeme M Rosenberg, Lisa Knowlton, Charlotte Rajasingh, Yingie Weng, Paul M Maggio, David A Spain, Kristan L Staudenmayer
Importance: Options for managing splenic injuries have evolved with a focus on nonoperative management. Long-term outcomes, such as readmissions and delayed splenectomy rate, are not well understood. Objective: To describe the natural history of isolated splenic injuries in the United States and determine whether patterns of readmission were influenced by management strategy. Design, Setting, and Participants: The Healthcare Cost and Utilization Project's Nationwide Readmission Database is an all-payer, all-ages, longitudinal administrative database that provides data on more than 35 million weighted US discharges yearly...
August 2, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28766204/nonoperative-management-for-invasive-breast-cancer-after-neoadjuvant-systemic-therapy-conceptual-basis-and-fundamental-international-feasibility-clinical-trials
#16
Henry M Kuerer, Marie-Jeanne T F D Vrancken Peeters, Daniel W Rea, Mark Basik, Jennifer De Los Santos, Joerg Heil
With current advances in neoadjuvant systemic therapy (NST) and improved breast imaging, the potential of nonoperative therapy for invasive breast cancer has emerged as a viable option when utilizing meticulous image-guided percutaneous biopsy to document pathologic complete response. Feasibility clinical trials utilizing this approach are being performed by teams of investigators from single and multicenter/cooperative groups around the world. Imaging alone after NST lacks sufficient sensitivity and specificity in predicting pCR and therefore cannot be utilized for clinical selection of patients for omission of surgery...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28763414/capitellar-fractures-in-children-and-adolescents-classification-and-early-results-of-treatment
#17
Praveen G Murthy, Carley Vuillermin, Manahil N Naqvi, Peter M Waters, Donald S Bae
BACKGROUND: There has been limited published information regarding capitellar fractures in the pediatric population. The purpose of this investigation was to characterize capitellar fracture patterns in children and adolescents and to assess early clinical and radiographic treatment outcomes. METHODS: A retrospective analysis of 37 children and adolescents with capitellar fractures presenting to a tertiary pediatric hospital from 2004 to 2014 was performed. The mean patient age at the time of injury was 11...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28759405/outcomes-of-nonoperative-management-of-uncomplicated-appendicitis
#18
Richard G Bachur, Susan C Lipsett, Michael C Monuteaux
BACKGROUND AND OBJECTIVES: Nonoperative management (NOM) of uncomplicated pediatric appendicitis has promise but remains poorly studied. NOM may lead to an increase in resource utilization. Our objective was to investigate the trends in NOM for uncomplicated appendicitis and study the relevant clinical outcomes including subsequent appendectomy, complications, and resource utilization. METHODS: Retrospective analysis of administrative data from 45 US pediatric hospitals...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28758137/sciatic-nerve-injury-after-proximal-hamstring-avulsion-and-repair
#19
Thomas J Wilson, Robert J Spinner, Rohith Mohan, Christopher M Gibbs, Aaron J Krych
BACKGROUND: Muscle bellies of the hamstring muscles are intimately associated with the sciatic nerve, putting the sciatic nerve at risk of injury associated with proximal hamstring avulsion. There are few data informing the magnitude of this risk, identifying risk factors for neurologic injury, or determining neurologic outcomes in patients with distal sciatic symptoms after surgery. PURPOSE: To characterize the frequency and nature of sciatic nerve injury and distal sciatic nerve-related symptoms after proximal hamstring avulsion and to characterize the influence of surgery on these symptoms...
July 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28754159/the-role-of-electrical-stimulation-in-the-management-of-avascular-necrosis-of-the-femoral-head-in-adults-a-systematic-review
#20
Talal Al-Jabri, Jessica Yan Qi Tan, Gabriel Yihan Tong, Ravikiran Shenoy, Babar Kayani, Timothy Parratt, Tahir Khan
BACKGROUND: Avascular necrosis of the femoral head causes significant morbidity and occurs in up to 20,000 people per year. A variety of nonoperative and operative measures have been trialled however a definitive treatment algorithm is yet to be established. Young adults in many cases have undergone multiple surgical procedures in their lifetime with increasing risks of complications. Less invasive techniques may help reduce the number of operations required and positively influence the natural history of the disease process...
July 28, 2017: BMC Musculoskeletal Disorders
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