Clinical Outcomes of Hip Arthroscopy for Hip Labrum Calcification in Young and Middle‐Aged Patients

Background: There is no consensus regarding the best treatment approach for middle-aged patients with anterior cruciate ligament (ACL) injuries. Chronic ACL-deficient knees are often associated with instability as well as secondary meniscal and cartilage lesions. ACL reconstruction (ACLR) has achieved satisfactory outcomes in younger patients; however, the effectiveness and safety of ACLR in middle-aged patients remain uncertain. Purpose: To compare the patient-reported functional scores, arthrometric outcomes, and complications of primary ACLR between older (≥50 years) and younger (<50 years) patients. Study Design: Systematic review; Level of evidence, 3. Methods: We conducted a systematic review of cohort studies that compared the clinical outcomes of ACLR between patients aged ≥50 years and those aged <50 years. The Cochrane Central Register of Controlled Trials, Embase, and MEDLINE databases were searched for relevant studies. The Methodological Index for Non-randomized Studies (MINORS) criteria was used to assess the risk of bias and conducted a random-effects meta-analysis to combine the data, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the overall quality of the body of retrieved evidence. The primary outcome was knee functional outcomes, and secondary outcomes were arthrometric outcomes of ACLR and complications. Results: This study included 4 retrospective cohort studies with a total of 287 participants (129 in the older group and 158 in the younger group). All included studies reported significant improvements in clinical outcomes in both groups after ACLR. No significant differences were noted in the improvement of International Knee Documentation Committee (IKDC) scores (mean difference [MD], 0.20 [95% CI, −2.65 to 3.05]; P = .89) and Lysholm scores (MD, −1.98 [95% CI, −6.93 to 2.98]; P = .43) between the 2 groups. No significant differences were observed in anteroposterior stability or risk of complications between the groups. Conclusion: ACLR may be performed in middle-aged patients (≥50 years) without concern for inferior clinical and arthrometric results compared with younger patients (<50 years).

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Association of MR-proANP with cardiovascular risk factors in middle aged patients with diabetes mellitus type 2 and non-diabetic controls

Endocrine Abstracts ◽

10.1530/endoabs.63.gp26 ◽

2019 ◽

Author(s):

Simona Chisaliita ◽

Magnus Wijkman ◽

Fredrik Nystrom ◽

Carl Johan Ostgren

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Diabetes Mellitus Type 2 ◽

Diabetes Mellitus Type ◽

Middle Aged ◽

Aged Patients ◽

Patients With Diabetes

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Dyslipidemia and hyperglycemia predict coronary heart disease events in middle-aged patients with NIDDM

Diabetes ◽

10.2337/diabetes.46.8.1354 ◽

1997 ◽

Vol 46 (8) ◽

pp. 1354-1359 ◽

Cited By ~ 76

Author(s):

S. Lehto ◽

T. Ronnemaa ◽

S. M. Haffner ◽

K. Pyorala ◽

V. Kallio ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Middle Aged ◽

Aged Patients

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Long Term Clinical and Echocardiographic Outcomes in Middle Aged Patients Undergoing the Ross Procedure

Structural Heart ◽

10.1080/24748706.2019.1587959 ◽

2019 ◽

Vol 3 (sup1) ◽

pp. 53-53

Author(s):

Jamie Romeo ◽

Grigorios Papageorgiou ◽

Francisco da Costa ◽

Hans Sievers ◽

Ad Bogers ◽

...

Keyword(s):

Ross Procedure ◽

Middle Aged ◽

Aged Patients

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Relevance of small right-to-left shunt in contrast-enhanced transcranial Doppler in young and middle-aged patients with cryptogenic stroke: a report of two cases and literature review

International Journal of Neuroscience ◽

10.1080/00207454.2020.1865345 ◽

2021 ◽

pp. 1-7

Author(s):

Liming Cao ◽

Xuming Huang ◽

Huilan Wang

Keyword(s):

Literature Review ◽

Transcranial Doppler ◽

Cryptogenic Stroke ◽

Middle Aged ◽

Aged Patients ◽

Contrast Enhanced

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Morphology of the Undersurface of the Anterolateral Acromion and Its Relationship to Surrounding Structures

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120977485 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097748

Author(s):

Yusuke Ueda ◽

Akimoto Nimura ◽

Keisuke Matsuki ◽

Kumiko Yamaguchi ◽

Hiroyuki Sugaya ◽

...

Keyword(s):

Deep Layer ◽

Micro Computed Tomography ◽

Middle Aged ◽

Aged Patients ◽

Coracoacromial Ligament ◽

3 Dimensional ◽

Bony Surface ◽

Inferior Aspect ◽

Histologic Evaluation ◽

Arthroscopic Subacromial Decompression

Background: A better understanding of the morphology underneath the acromion is needed to prevent complications after arthroscopic subacromial decompression. The precise correlations between the morphologic features underneath the acromion and the surrounding structures including the attachment of the coracoacromial ligament (CAL) and the origin of the deltoid middle head have not yet been determined in the absence of artifacts on the bony surface caused by dissection techniques. Moreover, anatomic findings in previous studies using only older-aged cadavers or dried bones may not reflect the morphologic features of younger and healthy specimens. Purpose: To characterize the anterolateral structures morphologically in the inferior aspect of the acromion, assess the relationships of these structures with surrounding structures without dissection artifacts on the bony surface, and verify the cadaveric data in the asymptomatic shoulders of living middle-aged patients. Study Design: Descriptive laboratory study. Methods: We initially analyzed the relationship between the morphology of the anterolateral structures and surrounding structures in 18 cadaveric shoulders (mean age, 81.8 years), 15 of which were subjected to macroscopic investigation of the CAL attachment and 3-dimensional micro—computed tomography investigation with radiopaque markers and 3 of which were subjected to histologic examination. We also analyzed the morphology underneath the anterolateral acromion in 24 asymptomatic shoulders of middle-aged patients (mean age, 54.8 years) to verify the cadaveric data. In both the cadaveric shoulders and the asymptomatic shoulders of live patients, the long axis, width, and height of the anterolateral prominence were measured by use of 3-dimensional CT imaging. Results: In cadavers, the anterolateral prominence underneath the acromion corresponded to the attachment of the CAL. Histologic evaluation revealed that the CAL was continuous to the deep layer of the deltoid middle head in the lateral acromion. The study in asymptomatic shoulders of middle-aged patients revealed bony prominences similar to those observed in cadavers. Conclusion: The anterolateral prominence, which corresponds to the attachment of the CAL below the acromion, may be a native structure below the acromion. Moreover, the CAL is continuous to the deep layer of the deltoid middle head in the lateral acromion.

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Relation between Vitamin D and COVID-19 in Aged People: A Systematic Review

Nutrients ◽

10.3390/nu13041339 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1339

Author(s):

Moustapha Dramé ◽

Cécilia Cofais ◽

Maxime Hentzien ◽

Emeline Proye ◽

Pécory Souleymane Coulibaly ◽

...

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Clinical Outcomes ◽

Oxygen Therapy ◽

Invasive Mechanical Ventilation ◽

Adverse Outcomes ◽

Aged Patients ◽

Aged People ◽

Severity Of The Disease

Background: Vitamin D has diverse and extensive effects on the immune system, including activating innate immunity and reducing the overactive adaptive immune response. A systematic review was performed to identify and synthesize the best available evidence on the association between vitamin D level and risk of COVID-19, adverse outcomes and possible benefits of supplementation in aged 60 years or over. Methods: A literature search was performed in PubMed© and Scopus© for all publications from inception published before 15 March 2021. Studies reporting data from aged patients on vitamin D use and COVID-19 were included. Basic science articles, editorials and correspondence were excluded. Publication year, study design and setting, characteristics of the study population were extracted. This study is registered with PROSPERO, under the number CRD42020223993. Results: In total, 707 studies were identified, of which 11 observational studies were included in the final review. Four studies compared vitamin D-supplemented COVID-19 patients to non-supplemented patients, and seven compared patients with vitamin D deficiency to patients without deficiency. In all four studies, patients with vitamin D supplementation had better rates of primary clinical outcomes (death, the severity of the disease, oxygen therapy requirement…). In studies comparing patients with vitamin D deficiency and patients without vitamin D deficiency, those without vitamin D deficiency had better primary clinical outcomes (death rate, the severity of the disease, oxygen therapy requirement, invasive mechanical ventilation need…). Conclusion: This systematic review seems to support an association between vitamin D deficiency and the risk of COVID-19 in aged people. In addition, vitamin D deficiency appears to expose these subjects to a greater risk of adverse outcomes. Because of its simplicity of administration, and the rarity of side effects, including vitamin D in preventive strategies for certain viral diseases, it appears to be an attractive option.

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Outcomes and Patient Satisfaction With Arthroscopic Partial Meniscectomy for Degenerative and Traumatic Tears in Middle-Aged Patients With No or Mild Osteoarthritis

The American Journal of Sports Medicine ◽

10.1177/0363546519857589 ◽

2019 ◽

Vol 47 (10) ◽

pp. 2412-2419

Author(s):

Alejandro Lizaur-Utrilla ◽

Francisco A. Miralles-Muñoz ◽

Santiago Gonzalez-Parreño ◽

Fernando A. Lopez-Prats

Keyword(s):

Patient Satisfaction ◽

Functional Outcomes ◽

Multivariate Regression ◽

Partial Meniscectomy ◽

Meniscal Tears ◽

Middle Aged ◽

Arthroscopic Partial Meniscectomy ◽

Aged Patients ◽

Female Sex

Background: There is controversy about the benefit of arthroscopic partial meniscectomy (APM) for degenerative lesions in middle-aged patients. Purpose: To compare satisfaction with APM between middle-aged patients with no or mild knee osteoarthritis (OA) and a degenerative meniscal tear and those with a traumatic tear. Study Design: Cohort study; Level of evidence, 2. Methods: A comparative prospective study at 5 years of middle-aged patients (45-60 years old) with no or mild OA undergoing APM for degenerative (n = 115) or traumatic (n = 143) tears was conducted. Patient satisfaction was measured by a 5-point Likert scale and functional outcomes by the Knee injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Univariate and multivariate regression analyses were used to identify factors correlating with patient-reported satisfaction at 5 years postoperatively. Results: Baseline patient characteristics were not different between groups. At the 5-year evaluation, the satisfaction rate in the traumatic and degenerative groups was 68.5% versus 71.3%, respectively ( P = .365). Patient satisfaction was significantly associated with functional outcomes ( r = 0.69; P = .024). In the degenerative group, 43 patients (37.4%) had OA progression to Kellgren-Lawrence (K-L) grade 2 or 3, but only 24 patients (20.8%) had a symptomatic knee at final follow-up. Multivariate regression analysis for patient dissatisfaction at 5-year follow-up showed the following significant independent factors: female sex (odds ratio [OR], 1.6 [95% CI, 1.1-2.3]; P = .018), body mass index >30 kg/m2 (OR, 2.6 [95% CI, 1.7-4.9]; P = .035), lateral meniscal tears (OR, 0.6 [95% CI, 0.1-0.9]; P = .039), and OA progression to K-L grade ≥2 at final follow-up (OR, 1.4 [95% CI, 1.2-2.6]; P = .014). At the final evaluation, there were no significant differences between groups in pain scores ( P = .648), WOMAC scores ( P = .083), or KOOS-4 scores ( P = .187). Likewise, there were no significant differences in the KOOS subscores for Pain ( P = .144), Symptoms ( P = .097), or Sports/Recreation ( P = .150). Although the degenerative group had significantly higher subscores for Activities of Daily Living ( P = .001) and Quality of Life ( P = .004), the differences were considered not clinically meaningful. Conclusion: There were no meaningful differences in patient satisfaction or clinical outcomes between patients with traumatic and degenerative tears and no or mild OA. Predictors of dissatisfaction with APM were female sex, obesity, and lateral meniscal tears. Our findings suggested that APM was an effective medium-term option to relieve pain and recover function in middle-aged patients with degenerative meniscal tears, without obvious OA, and with failed prior physical therapy.

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