tag:blogger.com,1999:blog-52895764874685278552024-03-18T22:48:45.744-07:00Knee Medicine and ScienceThe blog has three main objectives. First, to be center of information and knowledge for patients suffering from various knee joint conditions. Secondly, to provide clinicians with recent evidence related to anatomy, biomechanics, diagnosis and treatment of knee joint injuries. Finally, to fill the gap between research and clinical practice.Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.comBlogger98125tag:blogger.com,1999:blog-5289576487468527855.post-28641391847924192022014-02-12T10:42:00.001-08:002014-02-12T10:45:00.138-08:00Acute knee MRI and x-ray pictures.<iframe allowfullscreen="" frameborder="0" height="270" src="//www.youtube.com/embed/uSu02FvA8pc" width="480"></iframe><!--[if gte mso 9]><xml><br />
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<![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;">Great video presenting x-ray and MRI examination of an acute knee injury.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;">All rights reserved to the Radiology Channel. </span></span>Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com3tag:blogger.com,1999:blog-5289576487468527855.post-36648467407135736782014-01-31T12:27:00.003-08:002014-01-31T12:29:05.828-08:00BJSM Podcast: Tuning up rehabilitation after ACL reconstruction.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSqFs0JnK6MeD7TWD7zz2YvfHimF5zf34we0TuWXMpwJuPYfLMZ-MZb8vsurmhn3W62uqqf_Q7VR_iuVMHtyiSfI7t9Dsd8vyh5w00uAkHbUkzgXzP2u4MVNnQC9aW3_zvb5xuJn0lBnI/s1600/acl-injury-1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSqFs0JnK6MeD7TWD7zz2YvfHimF5zf34we0TuWXMpwJuPYfLMZ-MZb8vsurmhn3W62uqqf_Q7VR_iuVMHtyiSfI7t9Dsd8vyh5w00uAkHbUkzgXzP2u4MVNnQC9aW3_zvb5xuJn0lBnI/s1600/acl-injury-1.jpg" height="200" width="160" /></a></div>
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his approach to management of ACL in athletes. Definitely a must to listen for
both, clinicians and ACL patients.</span></span><br />
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Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com2tag:blogger.com,1999:blog-5289576487468527855.post-26607651923853434202014-01-31T11:24:00.002-08:002014-01-31T11:25:18.293-08:00Best practice for primary isolated ACL reconstruction.<!--[if gte mso 9]><xml>
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<![endif]--><br />Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com1tag:blogger.com,1999:blog-5289576487468527855.post-65161611427007652672014-01-28T09:24:00.001-08:002014-01-31T12:29:49.592-08:00ACL injury.<div class="separator" style="clear: both; text-align: center;">
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</xml><![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">The picture presents Jakub Błaszczykowski, a polish midfielder playing
for Borussia Dortmund football club. He has recently ruptured his ACL which
means that we will not see this talented player for the rest of current season.
The anterior cruciate ligament (ACL) is one of the most commonly injured
ligaments of the knee. The post will cover current concepts in regards to the
causes, history, risk factors, diagnosis and treatment of the ACL tear.</span></span><br />
<a name='more'></a><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">ACL injury occurs as a result of a lack of stability provided by the
dynamic and passive stability mechanisms of the knee. ACL injuries occur most
frequently in non-contact situations with the athlete in single foot stance,
forceful valgus knee collapse with knee close to full extension accompanied
with external or internal rotation of the tibia (in situation involving
landing, deceleration or rapid change of direction).<span style="mso-spacerun: yes;"> </span>Athletes participating in football (soccer),
basketball, handball and skiing are most commonly affected. </span></span><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Commonly cited in the literature risk factors may include female sex,
decreased intercondylar femoral notch size, decreased depth of concavity of the
medial tibial plateau, increased slope of the tibial plateaus, increased
anterior-posterior knee laxity, prior reconstruction of the ACL, familial
predisposition, muscle imbalances (quad dominant), increased knee adduction
moment, hormonal and genetic factors as well as extrinsic factors such as weather,
type and condition of playing surface, and footwear. These risk factors most
likely act in combination to influence the risk of suffering ACL injury.</span></span><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">With an acute injury, the patient often describes that they heard a loud
pop and then developed intense pain in the knee. The knee joint will begin to
swell within a few hours because of bleeding within the joint. Later, patient
may complain of recurrent pain and swelling and giving way episodes.</span></span><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Physical examination includes the Lachman test, the pivot-shift test,
and the anterior drawer test.</span></span><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> Plain X-rays of the knee may be done looking for broken bones
(especially in children). MRI has become the test of choice to image the ACL
rupture.</span></span><span style="font-family: Arial,Helvetica,sans-serif;"></span>
<span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Existing treatment options are directed to avoid subsequent lesions to the
meniscus and/or cartilage and prevent from early knee osteoarthritis development.
ACL tear may be treated by non – surgical methods or by operative procedure. Nonsurgical
treatment may be appropriate for patients who are less active, do not
participate in activities that require running, jumping, or pivoting. In this
case, conservative treatment usually incorporates physical therapy and exercise
rehabilitation to return strength, range of motion and neuromuscular control. <span style="mso-spacerun: yes;"> </span>The other option is usually reserved for
active patients and pro athletes who require full knee stability during their
sports activity. ACL reconstruction is performed and most commonly, an
autograft (hamstring or patellar tendon) is used to reconstruct the ACL. Also,
allograft is an option although it has been recently shown to be a significant predictive
factor for subsequent ACL injury. </span></span>
Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com1tag:blogger.com,1999:blog-5289576487468527855.post-5972237164085510602013-12-31T13:34:00.001-08:002013-12-31T13:35:28.800-08:00Knee neurovascular evaluation.<iframe allowfullscreen="" frameborder="0" height="344" src="//www.youtube.com/embed/xeW7dwcBZCI" width="459"></iframe><!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><br />
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<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Pain in the knee joint may be caused by several factors. One of them, is refereed pain form the lumbar spine, thus differentiation is crucial. In this video, Dr Mark Hutchinson presents neurovascular examination of the knee joint when there is suspicion of lumbar spine involvement. </span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;"> </span><br />
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Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com2tag:blogger.com,1999:blog-5289576487468527855.post-52589120796957412722013-12-31T13:12:00.002-08:002013-12-31T13:13:18.957-08:00Risk Factors for Meniscectomy After Meniscal Repair.<!--[if gte mso 9]><xml>
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</xml><![endif]--><b><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Risk Factors for Meniscectomy After Meniscal Repair.</span></span></b><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Lyman, S., Hidaka, C., Valdez, A., Hetsroni, I., Jung Pan, T., Do, H.,
Dunn, W., and Marx, R. American Journal of Sports Medicine; 41: 2772 – 2778. </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><a href="http://ajs.sagepub.com/content/41/12/2772.abstract">http://ajs.sagepub.com/content/41/12/2772.abstract</a></span></span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">There is lack of clear evidence indicating rate of and risk factors for
meniscectomy in patients following meniscal repair. This study was conducted to
investigate these factors. Data including information on nearly 10 000 patients
were retrospectively analyzed. </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Authors found that overall frequency of subsequent meniscectomies was
8.9%. Patients who underwent concomitant ACL surgery were less susceptible to
undergo meniscectomy. In patients who had isolated meniscal repair, older age,
lateral meniscus injury and being operated by surgeon with a higher annual
meniscal repair volume were factors decreasing risk of subsequent meniscectomy
procedure.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">All rights reserved to the American Journal of Sports Medicine.</span></span><br />
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Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-64486965569275927602013-12-31T12:30:00.003-08:002013-12-31T12:31:40.518-08:0020% of ACL reconstructed patients may need further surgeries.<!--[if gte mso 9]><xml>
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subsequent surgery and predictors after anterior cruciate ligament
reconstruction.</span></b></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Hettrich, C., Dunn, W., Reinke, E., MOON group, and Spindler, K.
Americna Journal of Sports Medicine, 2013; 41: 1534 – 1540.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><a href="http://ajs.sagepub.com/content/41/7/1534.abstract">http://ajs.sagepub.com/content/41/7/1534.abstract</a></span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
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<br /></div>
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Authors followed almost 1000 patients for few years after they underwent
ACL reconstruction. The main aim of the study was to determine the rate at
which following surgeries were required and to identify risk factors that
predisposed for re – surgery among this sample.</span></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">At six year follow – up nearly 20% of participants required subsequent surgery
on the ipsilateral knee while 10% underwent surgery on the contralateral knee.
On the ipsilateral knee, cartilage procedures were most commonly performed
(13%), followed by ACL revision surgery (7.7%). Young age at the time of initial
surgery and the use of allografts were predictors for subsequent procedure. Revision
ACLR, female sex, body mass index, and surgical exposure were not significant
risk factors.</span></span><br />
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Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-24987586016298739132013-11-30T13:12:00.001-08:002013-12-31T12:37:38.241-08:00BJSM Podcast: Running injuries.<!--[if gte mso 9]><xml>
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</span>- Miller gives his opinion on common running injuries.</span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><div class="MsoNormal">
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<span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"></span><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">All rights reserved to the BJSM.</span></span>
</div>
Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com2tag:blogger.com,1999:blog-5289576487468527855.post-84114364793208040192013-11-30T13:10:00.001-08:002014-02-01T03:32:11.857-08:00ACL case examination.<iframe allowfullscreen="" frameborder="0" height="344" src="//www.youtube.com/embed/44-Of-664DU" width="459"></iframe>Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-85804434446169939382013-11-11T13:26:00.002-08:002013-11-11T13:27:14.136-08:00New ligament found in the human knee.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjklxrFQwAbDlfadDup3NFhd9HhasX-jnI4arH5CTzGwpR8w4ov7uzBjdbYAH_6jizpXGP4_K31_yAW62icgqtiARyXtuBgv67YaZJIcT2gtGEdveHfETSmAFtuLwqMWhiA9GUGaUMxTl0/s1600/131105081352-large.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjklxrFQwAbDlfadDup3NFhd9HhasX-jnI4arH5CTzGwpR8w4ov7uzBjdbYAH_6jizpXGP4_K31_yAW62icgqtiARyXtuBgv67YaZJIcT2gtGEdveHfETSmAFtuLwqMWhiA9GUGaUMxTl0/s1600/131105081352-large.jpg" height="245" width="320" /></a></div>
<span style="font-family: Arial,Helvetica,sans-serif;"><b><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Anatomy of the
anterolateral ligament of the knee.</span></b></span><br />
<div class="MsoNormal">
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Claes, S., Vereecke,
E., Maes, M., Victor, J., Verdonk, P. and Bellemans, J. Journal of Anatomy, 2013; 223 (4): 321 –
328. </span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><a href="http://onlinelibrary.wiley.com/doi/10.1111/joa.12087/abstract;jsessionid=3DFF5DD716C515796F363EA0BE1E37BC.f04t04" target="_blank">Abstract.</a></span></span><br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibzAiRefCQcwmPOd2lsH4OUUBAP6VjO2fL3SuDVkFVdhZ5iGcyAWpr3wz8dL3aDO11QLm-SqjBYEvuFDN3T-hkC_C64kcew0OHEJXbv097pdORB5_jQ3Y4iIM-__xzUfrx1Lnn_vtr_mE/s1600/131105081352-large.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><br /></a></div>
<br />
Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-46778953572047328402013-10-24T12:47:00.002-07:002013-12-26T03:11:41.046-08:00Lower extremity function in ACL - deficient vs. ACL - reconstructed patients.<!--[if gte mso 9]><xml>
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</xml><![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Lower extremity performance following ACL
rehabilitation in the KANON-trial: impact of reconstruction and predictive
value at 2 and 5 years.</span></b></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Ericsson, Y.,
Roos, E. and Frobell, R. British Journal of Sports Medicine, 2013; 47: 980 –
985. </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><a href="http://bjsm.bmj.com/content/47/15/980.full" target="_blank">Full text available.</a> </span></span><br />
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Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-17286968411793573212013-10-07T07:56:00.000-07:002013-10-07T07:56:00.665-07:00Factors predicting meniscal repair success.<!--[if gte mso 9]><xml>
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</xml><![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Pathologic
Characteristics of the Torn Human Meniscus.</span></b></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Mesiha, M., Zurakowski, D., Soriano,
J., Nielson, J., Zarins, B. and Murray, M. American Journal of Sports Medicine,
2007; 35: 103 – 112. </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/17092929">http://www.ncbi.nlm.nih.gov/pubmed/17092929</a></span></span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Due to its avascularity, meniscus has
poor healing characteristics. Currently, surgeons opt to preserve as much
meniscus tissue as possible to prevent early OA changes in the knee joint
therefore one of the surgical methods to deal with this type of lesion, is
meniscal repair. However, lack of information exists on patient related factors
that could help identify tears at higher risk for repair failure. Cellularity
of the meniscus is one of the factors that determine repair failure or success.
The study was conducted to investigate whether specific patients related
factors including patient age, time since injury, and tear type are related to
the cellularity of torn meniscus tissue. </span></span><br />
<a name='more'></a><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Forty-four torn menisci were collected
from patient’s ages 18 to 76 years at the time of arthroscopic meniscectomy. Authors
found that age, time since injury and tear type all had significant effects on
the histologic characteristics of the torn meniscus. Specifically, those older than
40 years, with degenerative or radial tear type and longer injury history had decreased
intrinsic and perimeniscal cellularity in their torn menisci.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Although patients >40 years old
have good short term clinical success after meniscal repair, it is reported
that long –term effectiveness is low which, according to authors might be
associated with the decreased intrinsic and perimeniscal cellularity in their
meniscus in these group.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">In regards to time since injury, authors
suggest that although meniscus cells are capable of surviving some period after
injury there might be a critical point when cell death occur. </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Finally, authors observed that radial
and degenerative tear types were associated with a significantly higher rate of
articular cartilage change. Also, they reported formation of a synovialized,
cell-dense, perimeniscal layer (associated with successful meniscus healing in animal
models) in longitudinal tears, but not in the degenerative tear type.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">All rights reserved to the American
Journal of Sports Medicine.</span></span><br />
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<![endif]--><br />Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-22387288578024159982013-10-03T06:40:00.000-07:002013-10-03T06:40:00.722-07:00Knee Examination: Inspection in walking.<br />
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<div class="MsoNormal">
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Professor Mark Hutchinson presents
basic principles and discusses what you need to look at during knee inspection
in walking.</span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
<div class="MsoNormal">
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">All rights reserved to the BJSM
videos.</span></span></div>
Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-14119254973909570002013-09-30T02:52:00.002-07:002013-09-30T02:53:47.200-07:00BJSM Podcast: Dealing with shin pain.<div class="MsoNormal">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"><span style="font-family: Arial, Helvetica, sans-serif;">In this BJSM podcast, Professor Phillip N<span style="display: none; mso-hide: all;"> Professor philip Newmann</span>ewman from University of Canberra, addresses some of the key
issues related to diagnosis, risk factors and treatment of Medial Tibia Stress
Syndrome among running population. He also shares his views on barefoot
running.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"><span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://soundcloud.com/bmjpodcasts/professor-phillip-newman-on?in=bmjpodcasts/sets/bjsm-1" target="_blank">Listen here.</a></span></span></div>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">All rights reserved to the BJSM.</span>Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-27810902287899122282013-09-28T07:30:00.001-07:002013-09-28T07:39:38.845-07:00Knee osteoarthritis.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfWw3pE3GvvOzeguVqdpiLJm28LF1Nq4xJfStey9h0RYDfPW_FKMCm84mQzIXcQYN5Pa-ESRM_T9zN7IWKQWuIjdMXBFup1C3Y8jdOKNjc7az8GPeFln-EFwIquB3hRkn33RSa-kKvDLU/s1600/knoa1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfWw3pE3GvvOzeguVqdpiLJm28LF1Nq4xJfStey9h0RYDfPW_FKMCm84mQzIXcQYN5Pa-ESRM_T9zN7IWKQWuIjdMXBFup1C3Y8jdOKNjc7az8GPeFln-EFwIquB3hRkn33RSa-kKvDLU/s1600/knoa1.jpg" height="240" width="320" /></a></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">Osteoarthritis
(OA) is the most common form of arthritis and is a chronic condition
characterized by the breakdown of the joint’s cartilage , subchondral bone, synovial
tissue and soft tissue structures around the joint. OA may occur in any joint, but
the knee is one of the most commonly affected. The post will cover current
concepts in regards to the causes, history, risk factors, diagnosis and
treatment of the knee OA.</span></span></div>
<a name='more'></a><span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">The pathogenesis
of OA is not well understood but it likely involves local mechanical, systemic,
genetic and environmental factors. Of the three joint compartments that combine
to form the knee joint, the medial tibiofemoral compartment is the most common
site of knee OA, presumably as a result of the majority of load being placed on
this compartment.</span><br />
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">The most
important risk factors for incident OA include ageing, congenital and developmental abnormalities,
joint injury, (occupational) physical activity,
and obesity. Important risk factors for OA progression include
malalignment, muscle weakness, and
obesity.</span></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">Clinically OA is
characterised by joint pain, stiffness, limitation of movement, crepitus and </span><span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">occasionally
effusion and other signs of inflammation. Joint pain is usually less in the
morning and worse in the evening after a day’s activity. Joint stiffness occur after
periods of rest and goes away quickly when activity resumes. Joint soreness may
be present after periods of overuse or inactivity. Effusion usually occurs due
to joint overload.</span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">Diagnosis is
based on patient’s history, medical examination and X-ray pictures that may
show joint space narrowing, marginal osteophytes, subchondral bone sclerosis
and cysts.</span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">Existing
treatment options are directed to prevent progression and reduce symptoms.
These include non-surgical (non - pharmacological and pharmacological) and
surgical interventions.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">Non-pharmacological
approaches include combination of education, lifestyle advices including
regular physical activity, advices aiming for weight reduction in case of obesity
and exercises directed to improvement of
muscle strength and range of motion. Pharmacological treatment options are paracetamol, NSAIDs, weak opioids
and injection therapy. Surgical options include total joint replacement and
other surgical approaches, </span><span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">like osteotomy
and unicompartmental knee replacement.</span></div>
Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-51662933584012321252013-09-24T12:14:00.002-07:002013-09-24T12:21:09.725-07:00Exercises are effective in knee OA.<!--[if gte mso 9]><xml>
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</xml><![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Exercise
for lower limb osteoarthritis: systematic review incorporating trial sequential
analysis and network meta-analysis.</span></b></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Uthman, O., Van Der Vindt, D., Jordan,
J., Dziedzic, K., Healey, E., Peat, G. and Foster, N. British Medical Journal,
2013; 347:f5555 doi: 10.1136/bmj.f5555.</span></span><br />
<div class="MsoNormal">
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><a href="http://www.bmj.com/highwire/filestream/662980/field_highwire_article_pdf/0/bmj.f5555.full.pdf" target="_blank">Full text available.</a> </span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
<div class="MsoNormal">
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">“60 trials (44 knee, two hip, 14 mixed)
covering 12 exercise interventions and with 8218 patients met inclusion
criteria.”</span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">“The study showed that there is firm
evidence for a beneficial effect of exercise interventions over no exercise, for
both pain and functional improvement, in people with lower limb osteoarthritis.”</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">“In terms of the cumulative probability
of being the overall best exercise intervention for pain in lower limb
osteoarthritis, aquatic strengthening plus aerobic flexibility exercise (81%)
was closely followed by strengthening exercise only (76%), and aquatic
strengthening plus aerobic exercise (73%).”</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">“The combination of strengthening,
flexibility, and aerobic exercise (71%) and aquatic strengthening plus aerobic
(71%) exercises had the highest probability of being the best overall treatment
for function.”</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">All rights reserved to the British
Medical Journal.</span></span>Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com1tag:blogger.com,1999:blog-5289576487468527855.post-84318812662412117342013-09-11T03:12:00.000-07:002013-12-26T03:11:54.847-08:00ACL rehab - pool exercises.<iframe allowfullscreen="" frameborder="0" height="270" src="//www.youtube.com/embed/Uqp7G_S8XfE" width="480"></iframe><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Excellent video presenting various exercises you can perform in water with your patients following ACL reconstruction.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">All rights reserved to the HydroWorx Pools.</span></span>Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-54069949521235883792013-09-10T08:24:00.000-07:002013-09-10T08:24:45.443-07:00The knee most commonly affected in Ironman triathletes.<div class="MsoNormal">
<b><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"><span style="font-family: Arial, Helvetica, sans-serif;">High prevalence of overuse
injury among iron-distance triathletes.<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"><span style="font-family: Arial, Helvetica, sans-serif;">Andersen C., Clarsen, B., Johansen, T. and Engebresten, L. British
Journal of Sports Medicine, 2013; 47: 857 – 861. <o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12.0pt;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/23902775"><span lang="EN-US">http://www.ncbi.nlm.nih.gov/pubmed/23902775</span></a></span><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"><o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">Ironman distance triathlon has recently gained a lot of popularity in
both professional and amateur athletes. Due to its endurance character, overuse
injuries should occur. Nevertheless, lack of studies is present investigating
injuries among Iron distance triathletes.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"><span style="font-family: Arial, Helvetica, sans-serif;">This was a 26-week prospective cohort study including 174 participants.
Study found that the majority of injury cases in this group were overuse
conditions. The most common sites of the injury were the knee, lower leg, lower
back and shoulder. The average prevalence of overuse problems was 56%. <o:p></o:p></span></span></div>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 12pt;">Study findings seem important for developing strategies to prevent and treat
overuse injuries in triathletes. The knee and lower leg were most commonly
affected body sites and this seems to be in agreement to what running athletes
experience. Patellofemoral pain syndrome, “shin splints”, Iliotibial band
syndrome , Achilles tendinopathy appears to be one of the most prevalent overuse
conditions seen in runners and triathletes. Study results indicate that it
would be advisable for Ironman triathletes to incorporate specific strategies
into ther normal traing routine to prevent knee and lower leg overuse problems.</span><br />
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"></span></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US;"><span style="font-family: Arial, Helvetica, sans-serif;">All rights reserved to the British Journal of Sports Medicine.</span><o:p></o:p></span></div>
Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-27301460215031940492013-09-08T09:23:00.003-07:002013-09-08T09:25:47.900-07:00Proprioceptive exercises in knee OA patients - systematic review.<!--[if gte mso 9]><xml>
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</xml><![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">The effectiveness of proprioceptive-based
exercise for osteoarthritis of the knee: a systematic review and meta-analysis.</span></b></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Smith, T., King,
J. and Hing, C. Rheumatology International, 2012; 32: 3339 – 3351.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/22821333">http://www.ncbi.nlm.nih.gov/pubmed/22821333</a></span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
<div class="MsoNormal">
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Proprioception
is essential for our daily life activities. It is suggested that proprioceptive
deficits might occur in people suffering from knee OA. There seems to be some
evidence that exercises may improve clinical outcomes in patients with knee OA.
Nevertheless, there is lack of clear evidence suggesting that proprioceptive
type exercises might be effective in knee OA patients. The purpose of this
study was to determine the effectiveness of proprioceptive exercises for knee
OA using meta-analysis.</span></span></div>
<a name='more'></a><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Seven RCTs
including 560 participants (203 males and 357 females) with a mean age of 63
years were included in this systematic review. The methodological quality of
the evidence base was moderate. Primary outcome measure was functional outcome
at 1 year follow up using WOMAC and KOOS scales. Secondary outcome measures
included pain, general or quality of life health measures, JPS capability, knee
range of motion, exercise compliance and acceptability, and quadriceps and
hamstring muscle strength.</span></span><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Meta-analysis
demonstrated that those who received the proprioceptive intervention presented
with statistically significantly better secondary outcome scores compared to the
non-treatment group. In regards to differences between proprioceptive group vs
strengthening exercise control only one secondary outcome measure - walk over
spongy ground - was demonstrated to be statistically faster by the
proprioceptive group.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">In
conclusion, study findings indicate that compared to a non – treatment control,
proprioceptive exercises improve functional outcomes in people with knee OA. In
comparison to general exercise programme, proprioceptive exercises demonstrated
similar outcomes, only providing superior results with respect to JPS-related
measurements.</span></span><br />
<div class="MsoNormal">
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">However, the
current evidence base is small, with limited literature over longer-term
outcomes.</span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">All rights
reserved to the Rheumatology International.</span></span><span style="font-family: Arial,Helvetica,sans-serif;">
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Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-47263535213297098782013-08-25T08:56:00.000-07:002013-12-26T03:12:06.688-08:00MSc Thesis: Biomechanical and neuromuscular adaptations in those with ACL reconstruction during functional movements.<!--[if gte mso 9]><xml>
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gait patterns of those with ACL reconstruction (>1yr) and in healthy controls
with specific focus to determine if factors associated with the development
and/or progression of knee OA were observed in ACL reconstructed individuals
when compared to healthy counterparts.</span></span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
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reserved to Michelle Hall.</span></span></div>
Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-68494321208280434812013-08-23T10:39:00.001-07:002013-12-26T03:14:57.261-08:00Cartilage repair rehabilitation guidelines.<iframe allowfullscreen="" frameborder="0" height="270" src="//www.youtube.com/embed/B7LDw_rLd2k" width="480"></iframe><br />
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Hambly from the University of Kent shares her opinion on rehabilitation
guidelines following knee cartilage repair in soccer players. The presentation
was given at the 2012 Football Medicine Strategies for Knee Injuries Conference
in London.</span></span></div>
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<![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US">.</span></span>Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-88530293394776568572013-08-22T05:48:00.002-07:002013-08-22T05:50:36.098-07:00BJSM Podcast: Return to exercise after ACL injury.<!--[if gte mso 9]><xml>
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</xml><![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt;">In this short BJSM
Podcast, Professor Lars Engebretsen had a discussion with Professor Richard
Frobell from the Lund University about his recent study on ACL injury and regarding
what is the evidence on back to exercise after ACL injury.</span></span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt;"><a href="https://soundcloud.com/bmjpodcasts/return-to-exercise-after-acl?in=bmjpodcasts/sets/bjsm-1" target="_blank">Listen here.</a> </span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
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<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt;">All rights
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<![endif]--><br />Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-48890749360871972502013-08-21T08:51:00.004-07:002013-08-21T09:04:18.168-07:00Do Minimalist Shoes Really Simulate Barefoot Running?<!--[if gte mso 9]><xml>
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</xml><![endif]--><span style="font-family: Arial,Helvetica,sans-serif;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Running in a minimalist and lightweight
shoe is not the same as running barefoot: a biomechanical study.</span></b><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"> </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Bonacci,
J., Saunders, P., Hicks, A., Rantalainen, T., Vicenzino, B. and Spratford, W.
British Journal of Sports Medicine, 2013; 47: 387 – 392. </span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/23314887">http://www.ncbi.nlm.nih.gov/pubmed/23314887</a></span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQqPIiQ5nSc1KBglO0mS1O-_IDsXUPFALEWD49pLKidDKs9n8ADZKF40bR88jxygiENzXWkcHTlE7HgRRz0uGJo8V4tFgbaK4aW0WmLHHwz9c4UajTVFOXcjTNGhopUOtYV-3zedrq9CE/s1600/barefootracer.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQqPIiQ5nSc1KBglO0mS1O-_IDsXUPFALEWD49pLKidDKs9n8ADZKF40bR88jxygiENzXWkcHTlE7HgRRz0uGJo8V4tFgbaK4aW0WmLHHwz9c4UajTVFOXcjTNGhopUOtYV-3zedrq9CE/s1600/barefootracer.jpg" height="169" width="200" /></a><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Minimalist
shoes have been designed to mimic barefoot running due to its supposed efficacy
in prevention of running related overuse injuries. Nevertheless, there is
little evidence that running mechanics in minimalist shoes are similar to those
observed during barefoot running. The study was conducted to compare running
mechanics between barefoot running and running in a “minimalist” shoe (Nike
Free 3.0), racing flat (Nike Lunaracer 2), and “regular” running shoes. Ground
reaction force data and kinematics were collected from 22 highly trained
runners.</span></span><br />
<a name='more'></a><span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Authors
found that in comparison with shod, running barefoot demonstrated a less
dorsiflexed ankle at initial contact, a less flexed knee during midstance,
lesser joint moments and work done at the knee and greater joint moments and
work done at the ankle. No significant differences were observed between shod
conditions.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">Author’s
conclusions were that the minimalist shoe cannot entirely replicate the mechanics
of running barefoot and that prescription of minimalist shoes as a mechanism to
change running mechanics may not be justified. Also, from a therapeutic
standpoint, barefoot running may have benefits to those with knee issues, but
may put the foot, ankle, Achilles, and calf at greater risk.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">There are
few limitations to point out. First, the cohort was composed solely from highly
– trained runners and their running mechanic is supposed to be fairly consistent
across different shod conditions. It would rather be easier to find difference
in running mechanics, depending on shoes condition, in recreationally trained
runners. Also, Nike Free 3.0 cannot be regarded as a true minimalist shoe due
to its relatively high cushioning volume and 4mm heel drop thus the results
could have been different when using, Vibram FiveFingers for instance. Based on
that, caution is advised when interpreting the results.</span></span><br />
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opinion (and I do run a lot), minimalist shoes do change the running mechanics.
I was once invited to participate in a similar study and I had a chance to run
in a minimalist shoes. I can tell you that it felt different; I run smoother
and landed more on a forefoot and on the next day I could feel my calves pretty
sore which could indicate increased calf muscles recruitment during running in
these shoes.</span></span>
<br />
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<![endif]--><br />Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0tag:blogger.com,1999:blog-5289576487468527855.post-14032620820927823232013-08-17T08:33:00.002-07:002013-08-18T03:11:17.262-07:00Manual therapy and exercises for knee and hip OA patients.<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">Manual therapy, exercise therapy, or both, in
addition to usual care, for osteoarthritis of the hip or knee: a randomized
controlled trial. 1: clinical effectiveness.<o:p></o:p></span></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">Abbott, J., Robertson,
M., Chapple, C., et al.. Osteoarthritis and Cartilage, 2013; 8: 525 – 534.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/23313532"><span lang="EN-US">http://www.ncbi.nlm.nih.gov/pubmed/23313532</span></a><o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">Physiotherapy, in the
form of exercise therapy and/or manual therapy is considered to be first line
treatment, excluding pharmacological interventions, for knee and hip
osteoarthritis. Nevertheless, there is lack of evidence supporting its long –
term effectiveness. Therefore, authors
conducted this study to evaluate the clinical effectiveness of manual
physiotherapy and/or exercise physiotherapy in addition to usual care for
patients with osteoarthritis (OA) of the hip or knee.</span></span></div>
<a name='more'></a><span style="font-family: Arial, Helvetica, sans-serif;">206 adults participated
in the study. The primary outcome was change in the Western Ontario and
McMaster osteoarthritis index (WOMAC) at 1-year follow – up. Secondary outcome
measures were physical performance tests reults at 1-year follow – up.</span><br />
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">Results showed that, in
regards to primary outcome, all intervention groups improved but only usual
care plus manual therapy and usual care plus exercise therapy achieved
clinically significant reductions of >28 WOMAC points from baseline. Outcomes
of the physical performance tests (timed up and go, 30 s sit to stand, 40 m self-paced
walk) favoured exercise therapy in addition to usual care. Interestingly, the
combination of exercise and manual therapy did not produce additional benefit. In conclusion, study showed that that both
manual physiotherapy and exercise physiotherapy in addition to usual care produce
significant improvements in symptoms and physical function, respectively, in
patients with moderate to severe OA of the hips or knees at one year follow -
up.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">This study proves that
both manual therapy and exercises seem to be an effective tool against knee and
hip OA, and this is also in agreement with my clinical experience. Usually, I
combine manual therapy and specific exercises and as long as the patient is
willing to continue the treatment for several sessions, the results appear. Nevertheless,
I find that patients with severe OA (osteophytes, joint space narrowing and
subchondral bone sclerotisation) require longer treatment and more time to
respond well. I found it interesting that that combined MT
and exercises were less effective that any of them alone.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span lang="EN-US" style="font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="font-family: Arial, Helvetica, sans-serif;">What are your
experiences with knee and hip OA patients? Do you have any gold standard for
treating them?<o:p></o:p></span></span></div>
<span style="font-family: Arial, Helvetica, sans-serif;">All rights reserved to
the Osteoarthritis and Cartilage. </span>Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com3tag:blogger.com,1999:blog-5289576487468527855.post-82893775743180201952013-07-30T11:44:00.001-07:002013-07-30T11:45:28.962-07:00Prevention and treatment of MTSS.<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/dE9ycipVlDI?feature=player_embedded' frameborder='0'></iframe></div>
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video presenting various stretches and exercises for those suffering from ‘Shin
splints’ and for those wishing to avoid this common lower extremity overload
condition. I would definitely recommend including this exercises to your normal
workout routine.</span></span><br />
<span style="font-family: Arial,Helvetica,sans-serif;"><span lang="EN-US" style="font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">All rights
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<![endif]--><br />Tomasz Cudejkohttp://www.blogger.com/profile/17987113262103772072noreply@blogger.com0