Chappellswanson1487
ctions in patients with suspected IPT.
III, retrospective comparative trial limited by lack of a reference standard for iliopsoas tendonitis diagnosis.
III, retrospective comparative trial limited by lack of a reference standard for iliopsoas tendonitis diagnosis.
To perform an updated systematic review of the anatomy, biomechanics, function of the anterolateral ligament (ALL), and the clinical outcomes of anterolateral ligament reconstruction (ALLR) when performed in conjunction with anterior cruciate ligament reconstruction (ACLR).
A systematic search of the literature was performed by searching PubMed, the Cochrane Library, and Embase with the search phrase anterolateral ligament for articles published from February 2017 to May 2020. Inclusion criteria included studies that evaluated the anatomy, function, or biomechanics of the ALL; surgical technique articles on ALLR; clinical articles reporting outcomes of ALLR; studies published in English; and full-text articles. Exclusion criteria included studies published before February 2017. A subjective synthesis was performed, in which ranges were reported, and individual study data were presented in forest plots.
Overall, 40 articles were included in this systematic review, with 11 articles describing ALL anatomy, several studies have shown equivalent outcomes between these 2 cohorts.
The contents of this review provide great insight for orthopaedic surgeons who are performing ACLR and considering additional procedures to increase overall knee stability and decreaselikeliness for re-rupture. The postoperative functional and clinical outcomes shown in patients undergoing ACLR+ compared with I-ACLR should be given proper consideration when evaluating available treatment courses.
The contents of this review provide great insight for orthopaedic surgeons who are performing ACLR and considering additional procedures to increase overall knee stability and decrease likeliness for re-rupture. The postoperative functional and clinical outcomes shown in patients undergoing ACLR+ compared with I-ACLR should be given proper consideration when evaluating available treatment courses.
To evaluate factors associated with prolonged opioid use after arthroscopic knee surgery and to identify associations between preoperative usage and postoperative complications.
The MarketScan commercial database was searched to identify patients who underwent arthroscopic knee surgery from 2005 to 2014 (based on Current Procedure Terminology code). Preoperative comorbidities including Diagnostic and Statistical Manual of Mental Disorders mental health disorders, chronic pain, chronic regional pain syndrome, obesity, tobacco use, non-narcotic medications and diabetes were queried and documented. Patients who filled opioid prescriptions 1 to 3 months before surgery were identified. Patients who filled opioid prescriptions after surgery were identified. Adjusted odds ratios and 95% confidence intervals were calculated using multivariable logistic regression analysis to determine factors associated with prolonged postoperative opioid use.
In total, 1,012,486 patients who underwent arthroscopic knee surgery were identified, and we determined which of these patients were on preoperative opioids. Preoperative opioid usage was associated with a statistically significant increased risk of usage out to 1 year. There was a statistically significant association between postoperative usage and preoperative variables (mental health diagnosis, smokers, chronic pain, chronic regional pain syndrome, and use of non-narcotic medications). There was a statistically significant association between preoperative opioid use and 90-day readmission and postoperative complications.
In this study, we found that patients taking opioids 1 to 3 months before arthroscopic knee surgery have increased risk of postoperative use. Additionally, chronic opioid use, chronic pain, or use of non-narcotic medications has the highest risk of postoperative opioid use. Finally, preoperative use was associated with an increased risk of 90-day readmission.
Prognostic Level IV Evidence.
Prognostic Level IV Evidence.
To review the existing variables and their ability to predict recurrence of shoulder instability as it relates to the Instability Severity Index Score (ISIS), as well as evaluate any other pertinent imaging and patient history variables that may impact risk of recurrent anterior instability after arthroscopic Bankart repair.
All consecutive patients with recurrent anterior shoulder instability and who had arthroscopic instability repair were identified. Exclusion criteria were prior surgery on the shoulder, posterior or multidirectional instability, instability caused by seizure disorder, or a rotator cuff tear. All ISIS variables were recorded (age <20 years, sport type and level, hyperlaxity, Hill-Sachs on anteroposterior external rotation radiograph, loss of glenoid contour on anteroposterior radiograph), as well as additional variables (1) number of instability events; (2) total time of instability; (3) glenoid bone loss (GBL) percent; and (4) Hill-Sachs measures (H/L/W/D/Volume). Postoperative outg, GBL greater than 14.5%, Hill-Sachs volume greater than 1.3 cm
, and duration of instability symptoms (>3 months). The ISIS may need to be redesigned to incorporate variables that more accurately portray the actual risk of failure after arthroscopic stabilization, including quantification of both glenoid and humeral head bone loss.
III (Retrospective Case Series).
III (Retrospective Case Series).
To compare the clinical and radiologic outcomes of arthroscopically assisted coracoclavicular (CC) fixation using multiple soft anchor knots versus hook plate fixation in patients with acute high-grade Rockwood type III and V acromioclavicular (AC) joint dislocations.
This retrospective study included 22 patients with acute Rockwood type III and V AC joint dislocations who underwent arthroscopic fixation or hook plate fixation surgery between February 2016 and March 2018. Patients were categorized into 2 groups arthroscopically assisted CC fixation using multiple soft anchor knots group (AR, n= 12) and hook plate fixation group (HO, n= 10). We measured the CC distances (CCDs) and CCD ratio at 6 months, 1 year, and last follow-up postoperatively to compare the radiologic results between the groups. Clinical outcomes were assessed at 1 year postoperatively and at the last follow-up using the Visual Analog Scale, American Shoulder and Elbow Surgeons (ASES) scores, and Shoulder Pain and Disability Index (SPADI) scores, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Magnetic resonance imaging after hook plate removal was used to evaluate the healing ligaments and tendon-bone interface.
The patients in the AR group had better ASES, SPADI, and Quick DASH scores than the patients in the HO group at 1 year postoperatively and at last follow-up. The CCD and CCD ratio were significantly better in the AR group than in the HO group at the last follow-up period (P= .007/0.029). Magnetic resonance imaging findings showed grade I in 60% of patients in the AR group and grade III in 60% of patients in the HO group. AC joint arthritic change was observed in 40% of the HO group.
The CC fixation method using multiple soft anchor knots showed satisfactory results and had superior CC ligament healing ability and maintenance of CCD than hook fixation.
Level III, retrospective therapeutic comparative investigation.
Level III, retrospective therapeutic comparative investigation.
In this randomized placebo-controlled clinical trial, effect of oral inorganic nitrate (NO
) on metabolic parameters was assessed in patients with type 2 diabetes mellitus (T2DM).
Seventy-four eligible patients with T2DM were randomly assigned to NO
-rich beetroot powder (5g/d contains ~250mg NO
) and placebo groups to complete intervention over a 24-week period. this website Blood HbA1c, fasting serum glucose, insulin, C-peptide, as well as lipid profile were assessed at baseline and again at weeks 4, 12, and 24; indices of insulin resistance were also calculated. To assess safety of long-term oral NO
, liver and renal function tests were measured. An intention-to-treat approach was used for data analysis. To compare effect of intervention over time between the groups (time×group), repeated measures generalized estimating equation (GEE) linear regression models were used.
Mean age of the participants was 54.0±8.5 (47.9% were male) and mean duration of diabetes was 8.5±6.1 years. A total of 64 patients (n=35 in beetroot group and n=29 in placebo group) completed at least two visits and were included in the analyses. No significant difference was observed between the groups for glycemic and lipid parameters over time. Liver and renal function tests, as safety outcome measures, showed no undesirable changes during the study follow-up.
Supplementation with inorganic NO
had no effect on metabolic parameters in patients with T2DM.
Supplementation with inorganic NO3- had no effect on metabolic parameters in patients with T2DM.The inhalation of carbon monoxide (CO) gas and the administration of CO-releasing molecules were shown to inhibit the development of intestinal inflammation in a murine colitis model. However, it remains unclear whether CO promotes intestinal wound healing. Herein, we aimed to evaluate the therapeutic effects of the topical application of CO-saturated saline enemas on intestinal inflammation and elucidate the underlying mechanism. Acute colitis was induced with trinitrobenzene sulfonic acid (TNBS) in male Wistar rats. A CO-saturated solution was prepared via bubbling 50% CO gas into saline and was rectally administrated twice a day after colitis induction; rats were sacrificed 3 or 7 days after induction for the study of the acute or healing phases, respectively. The distal colon was isolated, and ulcerated lesions were measured. In vitro wound healing assays were also employed to determine the mechanism underlying rat intestinal epithelial cell restitution after CO treatment. CO solution rectal administration ameliorated acute TNBS-induced colonic ulceration and accelerated ulcer healing without elevating serum CO levels. The increase in thiobarbituric acid-reactive substances and myeloperoxidase activity after induction of acute TNBS colitis was also significantly inhibited after CO treatment. Moreover, the wound healing assays revealed that the CO-saturated medium enhanced rat intestinal epithelial cell migration via the activation of Rho-kinase. In addition, the activation of Rho-kinase in response to CO treatment was confirmed in the inflamed colonic tissue. Therefore, the rectal administration of a CO-saturated solution protects the intestinal mucosa from inflammation and accelerates colonic ulcer healing through enhanced epithelial cell restitution. CO may thus represent a novel therapeutic agent for the treatment of inflammatory bowel disease.Although many aspects of our lives have been transformed by digital innovation, widespread adoption of digital health advancements within the health care sector in general, and for hypertension care specifically, has been limited. However, it is likely that, over the next decade, material increases in the uptake of digital health innovations for hypertension care delivery will be seen. In this narrative review, we summarise those innovations thought to have the greatest chance for impact in the next decade. These include provision of virtual care combined with home blood pressure (BP) telemonitoring, use of digital registries and protocolised care, leveraging continuous BP measurement to collect vast amounts of individual and population-based BP data, and adoption of digital therapeutics to provide low-cost scalable interventions for patients with or at risk for hypertension. Of these, home BP telemonitoring is likely the most ready for implementation, but it needs to be done in a way that enables efficient guideline-concordant care in a cost-effective manner.
