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https://www.readbyqxmd.com/read/28929265/-fractures-of-the-lower-extremities-in-childhood-part-1-fractures-of-the-thigh-and-in-the-proximity-of-the-knee
#1
L Kremer, M Voth, I Marzi
Fractures in children are a major challenge in everyday clinical practice. The decision about the correct treatment of fractures follows the consideration of individual factors. The age of the child and the resulting residual growth play an essential role. This article aims to facilitate a structured approach with respect to examination, diagnostics and treatment in clinical practice. This first part of this series deals with fractures of the thigh and in the proximity of the knee joint in children. The peculiarity of pediatric bone lies in its growth, which results not only in a much faster healing tendency than in adults but also possesses a greater correction potential...
September 19, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28928818/the-value-of-computer-assisted-navigation-for-bone-reconstruction-after-tumor-resection
#2
Xuejun Peng, Fengping Wang, Jing Su
This study was designed to evaluate the use of computer-assisted navigation with computed tomography (CT) images for bone reconstruction after resection in malignant bone tumor treatment. Forty-five patients with malignant bone tumors were recruited for this study. CT scan images in a computer-assisted navigation system were used to assist during the osteotomy, the pairing with allografts, and the monitoring of the allograft and joint lines to perform joint reconstruction. Our results show that osteotomy and allograft pairing were successful in all patients...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28928664/yougui-pills-attenuate-cartilage-degeneration-via-activation-of-tgf-%C3%AE-smad-signaling-in-chondrocyte-of-osteoarthritic-mouse-model
#3
Lei Zhang, Ping-Er Wang, Jun Ying, Xing Jin, Cheng Luo, Taotao Xu, Shibing Xu, Rui Dong, Luwei Xiao, Peijian Tong, Hongting Jin
Yougui pills (YGPs) have been used for centuries in the treatment of Chinese patients with Kidney-Yang Deficiency Syndrome. Despite the fact that the efficiency of YGPs on treating osteoarthritis has been verified in clinic, the underlying mechanisms are not totally understood. The present study observes the therapeutic role of YGPs and mechanisms underlying its chondroprotective action in osteoarthritic cartilage. To evaluate the chondroprotective effects of YGPs, we examined the impact of orally administered YGPs in a model of destabilization of the medial meniscus (DMM)...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28928498/innovative-application-of-cox-flexion-distraction-decompression-to-the-knee-a-retrospective-case-series
#4
Luigi Albano
OBJECTIVE: The purpose of this study is to introduce the application of Cox flexion distraction decompression as an innovative approach to treating knee pain and osteoarthritis. METHODS: Six months of clinical files from one chiropractic practice were retrospectively screened for patients who had been treated for knee pain. Twenty-five patients met the criteria for inclusion. The treatment provided was Cox flexion distraction decompression. Pre-treatment and post-treatment visual analog pain scales (VAS) were used to measure the results...
August 2017: Journal of the Canadian Chiropractic Association
https://www.readbyqxmd.com/read/28927387/development-of-the-treatment-beliefs-in-knee-and-hip-osteoarthritis-toa-questionnaire
#5
Ellen M H Selten, Johanna E Vriezekolk, Henk J Schers, Marc W Nijhof, Willemijn H van der Laan, Roelien G van der Meulen-Dilling, Rinie Geenen, Cornelia H M van den Ende
BACKGROUND: Use of conservative treatment modalities in osteoarthritis (OA) is suboptimal, which appears to be partly due to patients' beliefs about treatments. The aim of this study was to develop a research instrument assessing patients' beliefs about various treatment modalities of hip and knee OA: the 'Treatment beliefs in OA (TOA) questionnaire'. METHODS: The item pool that was retrieved from interviews with patients and healthcare providers comprised beliefs regarding five treatment modalities: physical activity, pain medication, physiotherapy, injections and arthroplasty...
September 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28926466/barriers-impeding-the-use-of-non-pharmacological-non-surgical-care-in-hip-and-knee-osteoarthritis-the-views-of-general-practitioners-physical-therapists-and-medical-specialists
#6
Ellen M H Selten, Johanna E Vriezekolk, Marc W Nijhof, Henk J Schers, Roelien G van der Meulen-Dilling, Willemijn H van der Laan, Rinie Geenen, Cornelia H M van den Ende
BACKGROUND: Non-pharmacological, non-surgical treatment modalities are underused in the management of knee and hip osteoarthritis (OA). One possible explanation for this could be healthcare providers' opinions about these treatment modalities. The objective of this qualitative study was to identify healthcare providers' views on non-pharmacological, non-surgical care for OA. METHODS: Semi-structured in-depth interviews with 24 healthcare providers (rheumatologists, orthopedic surgeons, physical therapists and general practitioners) were held...
September 19, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28926095/model-based-assessment-using-conventional-bioequivalence-limits-to-ensure-safety-and-efficacy-of-rivaroxaban-in-patients-undergoing-hip-or-knee-replacement
#7
Mario González-Sales, Lanyan Fang, Myong-Jin Kim, Liang Zhao
We evaluated whether the current bioequivalence limit is adequate to ensure safety and efficacy of rivaroxaban in patients under total hip arthroplasty and total knee arthroplasty based on its model informed benefit/risk profile. Clinical data from a total of 7145 patients from 3 phase 2 and 4 phase 3 clinical trials were included in the current model-based exposure-response analysis. The relationships between rivaroxaban exposure measurements (ie, minimum or trough, maximum, average concentration, and area under the concentration-time curve [AUC] at steady state) and clinical outcomes (ie, the probabilities of major bleeding [MB] and venous thromboembolism [VTE]) were modeled using NONMEM 7...
September 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28924379/the-overexpression-of-carm1-promotes-human-osteosarcoma-cell-proliferation-through-the-pgsk3%C3%AE-%C3%AE-catenin-cyclind1-signaling-pathway
#8
Shijie Li, Dongdong Cheng, Bin Zhu, Qingcheng Yang
Osteosarcoma (OS) is a kind of malignant bone tumor that occurs frequently in the region surrounding the knee joint and poses a threat to the health of teenagers. Since the application of chemotherapy to treat OS, 5-year survival rate in patients has improved from 10% to 70%, but patient survival has not changed over the past four decades. Coactivator-associated arginine methyltransferase 1 (CARM1) is a member of the PRMT protein family; it acts as an oncogene in many cancers, but its function in OS is still unknown...
2017: International Journal of Biological Sciences
https://www.readbyqxmd.com/read/28921415/comparing-the-safety-and-efficacy-of-celecoxib-for-the-treatment-of-osteoarthritis-in-asian-and-non-asian-populations-an-analysis-of-data-from-two-randomized-double-blind-placebo-controlled-active-comparator-trials
#9
Andri Lubis, Wei Wang, Graça Lima, Rana Fayyad, Chris Walker
INTRODUCTION: Celecoxib is an effective treatment for pain associated with osteoarthritis. There are differences in patient demographics among ethnic groups, with Asian populations typically smaller in body size. As a consequence, there may be a perception that celecoxib is less effective, or has poorer tolerability in Asian patients. METHODS: This analysis compares data from two multicenter, randomized, double-blind, placebo-controlled, active-comparator trials of celecoxib for the treatment of osteoarthritis of the knee: one study in Asian patients and the other in a mixed population comprised mostly of non-Asian patients (from which Asian patients were excluded for this analysis)...
September 18, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28921017/the-german-arthroscopy-registry-dart
#10
Ralf Mueller-Rath, Oliver Miltner, Alfred Hochrein, Philipp Niemeyer
In Germany, more than 400,000 arthroscopic procedures are performed each year. The DART registry is designed to study the outcome of arthroscopic procedures of the shoulder, hip, knee and ankle joint under everyday clinical circumstances using patient-reported outcome measures (PROMs). DART aims at identifying patient-specific factors correlated with therapy-associated complications and treatment failure and will help study the influence of concurrent joint diseases and procedures. To achieve these tasks, a Web-based remote data entry system will be applied and adapted to the needs of DART...
September 18, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28920710/use-of-strong-opioids-for-chronic-pain-in-osteoarthritis-an-insight-into-the-latin-american-reality
#11
Miguel Angel Ruiz Iban, Javier Benavides, Juan Pablo Forero, Sacha Bittelman, Rafael Martinez, Miguel Angel Mite, Jorge Diaz Heredia, Sergio Ulloa, Mauro Marcelo Lizárraga Ferrand
Osteoarthritis is the most common cause of arthritis and one of the principle causes of chronic pain. Although opioids are frequently employed for chronic pain treatment, their usage for osteoarthritis pain remains controversial due to the associated adverse effects. Most guidelines reserve their use for refractory pain in patients with hip and knee osteoarthritis. The situation is even more complex in Latin America, where the prevalence of insufficient pain treatment is high because of the limited availability and use of strong opioids...
September 18, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28919746/in-vitro-and-in-vivo-studies-of-a-novel-bacterial-cellulose-based-acellular-bilayer-nanocomposite-scaffold-for-the-repair-of-osteochondral-defects
#12
Jyoti V Kumbhar, Sachin H Jadhav, Dhananjay S Bodas, Amruta Barhanpurkar-Naik, Mohan R Wani, Kishore M Paknikar, Jyutika M Rajwade
Bacterial cellulose (BC) is a naturally occurring nanofibrous biomaterial which exhibits unique physical properties and is amenable to chemical modifications. To explore whether this versatile material can be used in the treatment of osteochondral defects (OCD), we developed and characterized novel BC-based nanocomposite scaffolds, for example, BC-hydroxyapatite (BC-HA) and BC-glycosaminoglycans (BC-GAG) that mimic bone and cartilage, respectively. In vitro biocompatibility of BC-HA and BC-GAG scaffolds was established using osteosarcoma cells, human articular chondrocytes, and human adipose-derived mesenchymal stem cells...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28918790/-bandages-for-knee-problems
#13
Marius Henriksen, Søren Thorgaard Skou
The use of knee braces is common, and there is an abundance of different brace types available both "over the counter" and as "prescription devices". The braces are used for a range of knee problems ranging from minor knee discomfort to post-surgical rehabilitation. The available evidence is generally in favour of brace applications although the amount and quality of evidence is moderate to low with a positive benefit-harm balance. However, braces should generally not be used as a stand-alone or primary treatment strategy, but can be used as a potentially beneficial supplement to patients with knee disorders if needed...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918789/-treatment-of-anterior-cruciate-ligament-ruptures
#14
Uffe Jørgensen, Michal Rindom Krogsgaard
Anterior cruciate ligament (ACL) injuries are typically seen in cutting sports. Rehabilitation can be tried in athletes in non-cutting sports and in recreational athletes. If knee instability is experienced, the cessation of risk activities or reduction in activity level are recommended. With recurrent episodes of instability ACL-reconstruction is recommended. 65% return to sports at preinjury level after ACL-reconstruction, 18% after non-operated partial rupture and 7% after non-operated total rupture.
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918788/-fast-track-total-knee-arthroplasty
#15
Kirill Gromov, Billy B Kristensen, Christoffer Calov Jørgensen, Torben Bæk Hansen, Henrik Kehlet, Henrik Husted
Fast-track total knee arthroplasty (TKA) is a well-established concept including optimized logistics and evidence-based treatment, focusing on minimizing surgical stress and improved post-operative recovery, thus leading to lower mortality and morbidity as well as high patient satisfaction. All patients are eligible for fast-track TKA, and hence the fast-track concept should be standard at all joint replacement facilities. Future challenges of fast-track TKA include safe introduction of outpatient protocols, acute and chronic pain after surgery and optimal utilization of post-operative physiotherapy...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918787/-running-and-causes-of-running-related-injuries
#16
Camilla Kjær Cullum, Peter Hung Thanh Tran, Simon Døssing
Running is one of the most popular sports among the adult Danish population. Overuse injuries of the knee, such as runners knee, jumpers knee, patello-femoral pain syndrome and patello-femoral pre-arthrosis, are common and cause reduction of the health beneficial physical activity. Treatment should primarily focus on adjustment of training habits and physiotherapeutic guided rehabilitation. Other treatment options include changing landing pattern during running, corticosteroid injections, non-steroid anti-inflammatory drugs and ultimately surgery...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918786/-treatment-of-meniscal-pathology
#17
Martin Wyman Rathcke, Martin Lind, Morten Ilum Boesen, Nis Nissen, Anders Ploug Boesen, Bjarne Mygind-Klavsen, Per Hölmich
The menisci play a major role in knee function regarding joint movement, stability, load distribution and load transmission. Injuries to the menisci cause pain, and meniscal tears are a common reason for patient referral. In Denmark, partial meniscectomy increased significantly until 2010, and several studies have questioned the long-term effect of meniscectomy as an overall procedure. A Danish national clinical guideline on knee meniscal pathology was published in May 2016, and this article is a short summary of updated knowledge on meniscal pathology and relevant conclusions from the guideline...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918785/-algorithm-for-workup-of-acute-swollen-knee-without-previous-trauma
#18
Jens Olesen, Finn Elkjær Johannsen
Acute non-traumatic swelling of the knee is a common clinical challenge. The reason for the swelling has to be explored in order to give the correct treatment. This article gives an overview of possible diagnoses and suggests an algorithm for an approach to non-traumatic knee arthritis. Fundamental in the examination is a thorough patient anamnesis, which will help to differentiate between inflammatory and non-inflammatory arthritis. If there is not an obvious degenerative reason for the knee effusion, a joint aspiration followed by synovial fluid white cell count (WCC), microscopy and/or culture will add valuable information...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918784/-treatment-of-patellar-instability
#19
Martin Lind, Peter Faunø, Ole Gade Sørensen, Bjarne Mygind-Klavsen
First-time patellar luxation appears typically in teenagers and young adults below the age of 16 years, with a prevalence of 45/100,000/year. This luxation is treated with brief limited mobility in a bandage, and with a complementary physiotherapy if the mobility is influenced afterwards. Risk factors for patellar instability are patellofemoral dysplasia, hyperlaxity, patella alta and valgus malalignment in the knee joint. In case of repeated luxation the treatment is surgical, i.e. reconstruction of the medial patellofemoral ligament recreating the medial patella-stabilizing structures...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918783/-treatment-of-patellofemoral-pain-includes-more-than-knee-rehabiliation
#20
Michael Skovdal Rathleff, Negar Pourbordbari, Martin Bach Jensen, Jens Lykkegaard Olesen
Patellofemoral pain is a debilitating condition which affects one in 14 adolescents and a similar number of adults. It is characterized by peri- or retropatellar pain during loaded bending of the knee. The purpose of this review is to provide a short, up-to-date review of the diagnostics, differential diagnostics and evidence-based treatment for both adolescents and adults with patellofemoral pain. The key message is that treatments of patellofemoral pain should include a combination of patient education to support self-management and exercises to strengthen the hip and knee muscles...
September 18, 2017: Ugeskrift for Laeger
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