Christopher L Camp, Andrew R Jensen, Devin P Leland, Nancy Flynn, Jeff Lahti, Stan Conte
BACKGROUND: As the incidence of ulnar collateral ligament reconstruction (UCLR) surgery continues to rise, an improved understanding of baseball pitchers' perspectives on the postoperative recovery process and return to pitching is needed. The purpose of this study was to analyze pitchers' perspectives on recovery following UCLR. METHODS: During the 2018 baseball season, an online questionnaire was distributed to the certified athletic trainers of all 30 Major League Baseball (MLB) organizations...
September 17, 2020: Journal of Shoulder and Elbow Surgery
Hiroki Miyamoto, Kota Watanabe, Atsushi Teramoto, Naoya Iida, Tatsuya Taniguchi, Kento Hirota, Keisuke Negishi, Mineko Fujimiya
BACKGROUND: The shoulder is a uniquely complex large joint. Effective and safe physical therapy efforts towards rehabilitating injured and repaired shoulders requires a thorough understanding of shoulder mechanics from both generalized and very specific perspectives. Numerous biomechanical studies have been published on the shoulder. None of the studies, to our knowledge, considered the strain of the deep layers of the supraspinatus tendon for scapular plane elevation. METHODS: Ten unilateral fresh-frozen human cadaveric specimens were used for the study...
September 3, 2020: Clinical Biomechanics
Muhammad Saaiq
BACKGROUND: Established Volkmann's ischemic contractures (VICs) represent the eventuality of neglected acute compartment syndrome (ACS) of the forearm. This study assessed the clinical and demographic presentation of VICs. METHODS: This study was conducted at Department of Plastic Surgery, National Institute of Rehabilitation Medicine, Islamabad, Pakistan over a period of three years and included all patients of either gender who presented with VICs and analyzed various corrective procedures instituted as surgical remedies...
May 2020: World Journal of Plastic Surgery
Xiuhong Tang, Xiangpeng Kong, Zheng Cao, Qunqun Chen, Wei Chai
Objective: To explore the safety and effectiveness of quadriceps snip in complex total knee arthroplasty (TKA). Methods: A clinical data of 19 cases (29 knees) with complex TKA assisted with quadriceps snip between January 2016 and May 2017 were retrospectively analyzed. There were 9 males (13 knees) and 10 females (16 knees). The age of patients ranged from 34 to 66 years (mean, 50.2 years). Four patients (8 knees) were ankylosing spondylitis, 5 patients (7 knees) were rheumatoid arthritis, and 10 patients (14 knees) were knee osteoarthritis...
September 15, 2020: Chinese Journal of Reparative and Reconstructive Surgery
Yu-Ju Chang, Feng-Hang Chang, Peng-Hsuan Hou, Kai-Hsiang Tseng, Yen-Nung Lin
OBJECTIVE: To determine whether dextrose prolotherapy offers clinical benefits in patients with shoulder pain and bursitis. DESIGN: Double-blinded, randomized controlled trial. SETTING: Outpatient rehabilitation department of a single medical center. PARTICIPANTS: Fifty patients who had received a diagnosis of shoulder pain and bursitis through clinical tests and ultrasound examination. INTERVENTIONS: Participants were randomly assigned to the D15W group or the placebo group to receive either 15% dextrose injection or normal saline injection, respectively...
September 11, 2020: Archives of Physical Medicine and Rehabilitation
Kyle Casadei, John Kiel, Michael Freidl
Triceps tendon injuries are an uncommon clinical entity poorly described in the literature. This review discusses the spectrum of pathology, effective diagnosis, nonsurgical treatment, surgical treatment, rehabilitation, and surgical complications of triceps tendon injuries. Management of triceps tendinopathies depends on the mechanism of injury and the patient's motor examination. Triceps tendinopathies and partial tendon tears with intact strength can be managed conservatively with rest, ice, immobilization, nonsteroidal anti-inflammatory drugs, and physical therapy...
September 2020: Current Sports Medicine Reports
J J Pilkington, R Obeidallah, M Baltatzis, C Fullwood, S Jamdar, A J Sheen
BACKGROUND: Surgery has a recognised role in the treatment of 'sportsman's groin'. This study hypothesises that elite athletes have a superior advantage in both pre- and post-op rehabilitation and therefore will present and resume sporting activities quicker. METHODS: A retrospective analysis on a secure database of athletes presenting with groin pain that underwent surgery for 'inguinal disruption'. All data were explored via appropriate descriptive statistics and comparisons made between elite and amateur athletes...
September 9, 2020: Surgical Endoscopy
Diogo Thomaz Kawachi, Francisco Simões Deienno, Denis Varanda, Andrea Christina Cortopassi, Trajano Sardenberg
Objective  To evaluate the biomechanical properties of the "figure-of-eight" and Kessler suture techniques for tendons. Methods  Flexor tendons of porcine fingers were divided into two groups with triple central "figure of eight" sutures (six passages) and Kessler sutures (two passages) associated with simple and continuous peripheral sutures, and submitted to continuous longitudinal mechanical tests, to obtain the mechanical properties of maximum load and energy at maximum load. Results  The mean maximum load and energy at maximum load in the "figure-of-8" suture were of 63...
August 2020: Revista Brasileira de Ortopedia
Claudio Pizzolato, Vickie B Shim, David G Lloyd, Daniel Devaprakash, Steven J Obst, Richard Newsham-West, David F Graham, Thor F Besier, Ming Hao Zheng, Rod S Barrett
Musculoskeletal tissues, including tendons, are sensitive to their mechanical environment, with both excessive and insufficient loading resulting in reduced tissue strength. Tendons appear to be particularly sensitive to mechanical strain magnitude, and there appears to be an optimal range of tendon strain that results in the greatest positive tendon adaptation. At present, there are no tools that allow localized tendon strain to be measured or estimated in training or a clinical environment. In this paper, we first review the current literature regarding Achilles tendon adaptation, providing an overview of the individual technologies that so far have been used in isolation to understand in vivo Achilles tendon mechanics, including 3D tendon imaging, motion capture, personalized neuromusculoskeletal rigid body models, and finite element models...
2020: Frontiers in Bioengineering and Biotechnology
Lyndal Solomons, Jenny J Y Lee, Margaret Bruce, Lynita D White, Alex Scott
BACKGROUND: The insertion of filiform needles intramuscularly (a.k.a. intramuscular stimulation/dry needling) has been suggested as a possible treatment for various painful musculoskeletal conditions. Our aim was to answer the question, is intramuscular stimulation more effective than sham intramuscular stimulation/dry needling for the treatment of Achilles tendinopathy? METHODS: 52 participants with persistent midportion Achilles tendinopathy began and 46 completed one of three treatment protocols which were randomly assigned: (G3) a 12-week rehabilitation program of progressive tendon loading plus intramuscular stimulation (n = 25), (G2) the same rehabilitation program but with sham intramuscular stimulation (n = 19), or (G1) a reference group of rehabilitation program alone (as an additional control) (n = 8)...
2020: PloS One
Edoardo Cipolletta, Riccardo Mashadi Mirza, Andrea Di Matteo, Marco Di Carlo, Walter Grassi, Emilio Filippucci
OBJECTIVES: To evaluate the clinical efficacy of ultrasound (US)-guided soft tissue adapted biocompatible hyaluronic acid (STABHA) injections in the subacromial-subdeltoid bursa of patients with supraspinatus tendon tear. METHODS: In this prospective study, patients with a symptomatic partial-thickness or small full-thickness supraspinatus tendon tear, diagnosed by US, were consecutively enrolled. Patients received one injection at baseline visit and one after 2 weeks and performed rehabilitation therapy...
September 4, 2020: Clinical and Experimental Rheumatology
John T Campbell, Clifford L Jeng
Painful accessory navicular and spring ligament injuries in athletes are different entities from more common posterior tibialis tendon problems seen in older individuals. These injuries typically affect running and jumping athletes, causing medial arch pain and in severe cases a pes planus deformity. Diagnosis requires a detailed physical examination, standing radiographs, and MRI. Initial treatment focuses on rest, immobilization, and restriction from sports. Orthotic insoles may alleviate minor pain, but many patients need surgery to expedite recovery and return to sports...
October 2020: Clinics in Sports Medicine
W Hu, D Le Nen, N Kerfant, A S Henry, A Trimaille, M Rouanet, H Letissier, A Perruisseau-Carrier, P Ta
Complex forearm defects with significant damage to, or loss of skin, tendon, muscle, bone and neurovascular structures represent a great challenge for surgeons. The management of such injuries, whether a result of trauma or tumor resection, is focused on preservation of the damaged limb and restoration of hand function. A multidisciplinary approach combining plastic and orthopedic surgical expertise in a coordinated team is proposed to address these challenging cases. The authors have laid emphasis on adequate debridement for wound bed preparation, bone stabilization and reconstruction for a stable bony framework, vascular repair for early revascularization, musculotendinous and nerve reconstruction as well as vascularized tissue coverage on a case-to-case basis to facilitate optimal functional recovery...
September 2, 2020: Annales de Chirurgie Plastique et Esthétique
Jason Gardenier, Rohit Garg, Chaitanya Mudgal
Background  Tendon transfer in the upper extremity represents a powerful tool in the armamentarium of a reconstructive surgeon in the setting of irreparable nerve injury or the anatomic loss of key portions of the muscle-tendon unit. The concept uses the redundancy/expendability of tendons by utilizing a nonessential tendon to restore the function of a lost or nonfunctional muscle-tendon unit of the upper extremity. This article does not aim to perform a comprehensive review of tendon transfers. Instead it is meant to familiarize the reader with salient historical features, common applications in the upper limb, and provide the reader with some technical tips, which may facilitate a successful tendon transfer...
August 2020: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Sara E Harper, Rebecca A Roembke, John D Zunker, Darryl G Thelen, Peter G Adamczyk
This study introduces a noninvasive wearable system for investigating tendon loading patterns during outdoor locomotion on variable terrain. The system leverages shear wave tensiometry, which is a new approach for assessing tendon load by tracking wave speed within the tissue. Our wearable tensiometry system uses a battery-operated piezoelectric actuator to induce micron-scale shear waves in a tendon. A data logger monitors wave propagation by recording from two miniature accelerometers mounted on the skin above the tendon...
August 26, 2020: Sensors
Flávio Santos da Silva, Bento João Abreu, Bengt I Eriksson, Paul W Ackermann
PURPOSE: To examine healing adaptations over 17 weeks post Achilles tendon (AT) rupture in the injured region (IR) compared to an uninjured region (UIR) of the AT. METHODS: Twenty-four rats were subjected to a complete right-sided AT rupture, while the left side served as a control. ATs were harvested at 1, 2, 8 and 17 weeks post-rupture and stained with antibodies specific to Collagen type I (Col I) and II (Col II) as well as Alcian Blue and Picrosirius Red staining techniques...
August 27, 2020: Knee Surgery, Sports Traumatology, Arthroscopy
Pratik Phansopkar, Vrushali Athawale, Aachal Birelliwar, Waqar Naqvi, Swapna Kamble
Radial nerve is a frequently injured nerve. Radial nerve palsy result from direct trauma, neuropathies, and fracture over the humerus, malignant tumor and neuritis. A case of 26-year male is presented in this report who had a road traffic accident resulting in injury over the right shoulder, wrist joint and diagnosed of radial nerve palsy, consequently was operated with soft tissue reconstruction with tendon transfers which resulted into pain over wrist joint and loss of extensors muscle function of the wrist joint, which led to difficulty in performing activities of daily living...
2020: Pan African Medical Journal
Haowei Zhang, Miko Lin Lv, Yin Liu, Wanju Sun, Wenxin Niu, Duo Wai-Chi Wong, Ming Ni, Ming Zhang
BACKGROUND: Minimally invasive fixation using crossing screws was believed to produce satisfactory clinical outcome whereas its stability in early weight-bearing remained controversial. This study aimed to analyze the biomechanical stability of minimally invasive fixation during balanced standing and walking stance, and provide evidence for early rehabilitation. METHODS: A finite element model of foot-ankle-shank complex was reconstructed based on computed tomography and magnetic resonance images, and validated by plantar pressure of the model participant...
August 15, 2020: Clinical Biomechanics
Rami G Alrabaa, Mario H Lobao, William N Levine
PURPOSE OF REVIEW: This review presents epidemiology, etiology, management, and surgical outcomes of rotator cuff injuries in tennis players. RECENT FINDINGS: Rotator cuff injuries in tennis players are usually progressive overuse injuries ranging from partial-thickness articular- or bursal-sided tears to full-thickness tears. Most injuries are partial-thickness articular-sided tears, while full-thickness tears tend to occur in older-aged players. The serve is the most energy-demanding motion in the sport, and it accounts for 45 to 60% of all strokes performed in a tennis match, putting the shoulder at increased risk of overuse injury and rotator cuff tears...
August 22, 2020: Current Reviews in Musculoskeletal Medicine
Trevor Vander Doelen, Alex Scott
BACKGROUND: The aim of this observational study was to document changes in pain, dysfunction, and fear of movement in basketball players using a multimodal rehabilitation approach for managing patellar tendinopathy. METHODS: A multimodal treatment approach was utilized with basketball athletes during a competitive season. Numeric pain rating scale (NPRS), Victorian Institute of Sport Assessment Patellar (VISA-P) questionnaire, and a Tampa Scale of Kinesiophobia were used as outcome measures to assess for patellar tendon pain and knee function...
July 2020: Journal of Bodywork and Movement Therapies
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