Surgeons Consider Initial Nonoperative Treatment with Potential for Future Conversion to Reverse Arthroplasty a Reasonable Option for Older, Relatively Infirm, and Less Active Patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ryan Shu ◽  
Tom Crijns ◽  
David Ring ◽  
Amirreza Fatehi
Keyword(s):  
Nonoperative Treatment ◽  
Active Patients ◽  
Reverse Arthroplasty

scholarly journals Incidence and Risk Factors for a Partial Anterior Cruciate Ligament Tear Progressing to a Complete Tear After Nonoperative Treatment in Patients Younger Than 30 Years

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985662 ◽  
Author(s):  
Jean-Marie Fayard ◽  
Bertrand Sonnery-Cottet ◽  
Goran Vrgoc ◽  
Padhraig O’Loughlin ◽  
Geoffroy Dubois de Mont Marin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Nonoperative Treatment ◽  
Acl Tear ◽  
Complete Tear ◽  
The Mean ◽  
Anterior Cruciate ◽  
Active Patients

Background: Partial anterior cruciate ligament (ACL) tears are observed in 10% to 27% of isolated ACL tears. There is currently no consensus on diagnosis and treatment protocols, and the outcomes of nonoperative treatment remain undefined. Purpose: To assess the incidence and risk factors for the progression of partial ACL tears to complete ruptures after nonoperative treatment in active patients younger than 30 years. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 41 patients, all younger than 30 years and active in sports, were diagnosed with a partial ACL tear, with no associated meniscal or chondral lesions on magnetic resonance imaging (MRI). All were assigned to a nonoperative treatment program. The Lachman test, ≤4-mm side-to-side difference in laxity by Rolimeter, and MRI were utilized for the diagnosis. Tegner and International Knee Documentation Committee (IKDC) scores were assessed before and after the first lesion, and the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) score was assessed at last follow-up. Postinjury Tegner and IKDC scores were assessed before the second injury for patients progressing to a complete ACL tear and at last follow-up for patients without progression. Results: At a mean of 43 months (range, 24-96 months), the partial ACL injury progressed to a complete ACL tear in 16 (39%) patients. In the remaining 25 patients without progression, the mean Tegner and IKDC scores were 7.0 and 96.0 before the injury and 5.9 and 85.7, respectively, at last follow-up. The mean ACL-RSI score was 69.3. The Tegner and IKDC scores were significantly lower at final follow-up ( P = .0002 and P < .0001, respectively). Only 18 (44%) patients returned to their preinjury level of sports activities. A significantly increased risk of progression to a complete ACL tear was seen in patients ≤20 years (odds ratio, 5.19; P = .037) or patients practicing pivoting contact sports (odds ratio, 6.29; P = .026). Meniscal lesions were found in 50% of patients with a partial tear that progressed to a complete ACL tear. Conclusion: A partial ACL injury progressed to a complete ACL tear in 39% of young active patients treated conservatively, with half of the complete tears presenting with a concomitant meniscal lesion at the time of reconstruction. Age ≤20 years and participation in pivoting contact sports were identified as significant risk factors for progression to a complete tear.

Treatment of Early-Onset Hip Osteoarthritis in Young Patients

2018 ◽  
Vol 02 (03) ◽  
pp. 117-125
Author(s):  
Timothy Brown ◽  
Anthony Miniaci ◽  
Robert Westermann ◽  
Molly Day
Keyword(s):  
Early Onset ◽  
Treatment Options ◽  
Young Patients ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Hip Osteoarthritis ◽  
Nonoperative Treatment ◽  
Active Patients ◽  
Review Current

AbstractPain and debilitating symptoms due to hip osteoarthritis (OA) can significantly compromise quality of life in young, active patients. The management of the young adult with hip OA presents a unique set of challenges, with symptoms that originate from a variety of underlying hip pathologies, and patient age spanning from youth through middle age. Early options for hip OA include nonoperative treatment with anti-inflammatory medications, physical therapy, and injections. For patients with structural hip abnormalities (femoroacetabular impingement or dysplasia), arthroscopy or reconstructive osteotomy are acceptable treatment options. In advanced disease, joint-preserving techniques are often ineffective, and patients may require joint resurfacing or replacement. The treatment strategies for early hip OA continues to evolve with the development of new and refined surgical techniques, especially in the setting of underlying hip pathology, and a growing popularity of utilizing biologic agents. The purpose of this manuscript is to review current conservative and surgical management and to describe an algorithm for treatment of early-onset hip OA.

Dental anomalies of form and number in primary dentition in a Mexican population

2018 ◽  
Vol 14 (2) ◽  
Author(s):  
M.C. Ibarra
Keyword(s):  
Informed Consent ◽  
Treatment Plan ◽  
Primary Dentition ◽  
Mexican Population ◽  
X Rays ◽  
Dental Anomalies ◽  
Total Prevalence ◽  
Active Patients

Abstract: To determine the frequency and distributionof dental anomalies of shape and numberin primary dentition. Methods: The study is retro-prolective, crosssectionaland descriptive. The sample was probabilistic,stratified for convenience by gender. Theclinical record of 1,568 patients was reviewed.These patients attended the Clinic of PediatricDentistry of FEBUAP during the period of 2012-2014, only 720 records of patients were includedin the study (321 girls and 399 boys) between theages of 1-10 years old, who provided complete,crisp radiographic studies with the presence ofdental anomalies of shape or number, the studywas divided into active and inactive patients.For inactive patients, photographs of x-rays withdental anomalies of shape and/or number weretaken. For cases with active patients, an interviewwith one of the parents was conducted andauthorization with informed consent was requested,also the child agreed to do a clinical examinationand take intraoral photographs. Results:A total of 63 children had anomalies (17girls and 46 boys). The total prevalence of dentalanomalies was 9%, of which 3.1% were (fusedand geminated teeth), 1.1% (agenesis) and 1.9%(supernumerary), 1.3% (supernumerary roots),0.27% (macrodontia), 0.11% (microdontia), andfinally 0.27% corresponded to (talon cusp). Conclusions: Although the prevalence of theseanomalies is not high, it is important to do a routineradiographic examination for early diagnosisand accordingly apply the correct preventivemeasures to establish the best treatment plan.

scholarly journals Prevalence of Prescription Opioids for Nonoperative Treatment of Rotator Cuff Disease Is High

2021 ◽  
Vol 3 (2) ◽  
pp. e373-e379
Author(s):  
Jacob Gorbaty ◽  
Susan M. Odum ◽  
Meghan K. Wally ◽  
Rachel B. Seymour ◽  
Nady Hamid ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Nonoperative Treatment ◽  
Prescription Opioids ◽  
Rotator Cuff Disease
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