Intramuscular tendon involvement on MRI has limited value for predicting time to return to play following acute hamstring injury

2017 ◽  
Vol 52 (2) ◽  
pp. 83-88 ◽  
Author(s):  
Anne D van der Made ◽  
Emad Almusa ◽  
Rod Whiteley ◽  
Bruce Hamilton ◽  
Cristiano Eirale ◽  
...  
Keyword(s):  
Case Series ◽  
Return To Play ◽  
Hamstring Injury ◽  
Full Thickness ◽  
Retrospective Case ◽  
Cross Sectional ◽  
Male Athletes ◽  
Serious Injury ◽  
The Individual ◽  
Mean Time

BackgroundHamstring injury with intramuscular tendon involvement is regarded as a serious injury with a delay in return to play (RTP) of more than 50 days and reinjury rates up to 63%. However, this reputation is based on retrospective case series with high risk of bias.ObjectiveDetermine whether intramuscular tendon involvement is associated with delayed RTP and elevated rates of reinjury.MethodsMRI of male athletes with an acute hamstring injury was obtained within 5 days of injury. Evaluation included standardised MRI scoring and scoring of intramuscular tendon involvement. Time to RTP and reinjury rate were prospectively recorded.ResultsOut of 70 included participants, intramuscular tendon disruption was present in 29 (41.4%) injuries. Injuries without intramuscular tendon disruption had a mean time to RTP of 22.2±7.4 days. Injuries with <50%, 50%–99% and 100% disruption of tendon cross-sectional area had a mean time to RTP of 24.0±9.7, 25.3±8.6 and 31.6±10.9 days, respectively. Injuries with full-thickness disruption took longer to RTP compared with injuries without disruption (p=0.025). Longitudinal intramuscular tendon disruption was not significantly associated with time to RTP. Waviness was present in 17 (24.3%) injuries. Mean time to RTP for injuries without and with waviness was 22.6±7.5 and 30.2±10.8 days (p=0.014). There were 11 (15.7%) reinjuries within 12 months, five (17.2%) in the group with intramuscular tendon disruption and six (14.6%) in the group without intramuscular tendon disruption.ConclusionTime to RTP for injuries with full-thickness disruption of the intramuscular tendon and waviness is significantly longer (by slightly more than 1 week) compared with injuries without intramuscular tendon involvement. However, due to the considerable overlap in time to RTP between groups with and without intramuscular tendon involvement, its clinical significance for the individual athlete is limited.

scholarly journals Assessment and Trends in the Methodological Quality of the Top 50 Most Cited Articles in Shoulder Instability

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096708
Author(s):  
Avinesh Agarwalla ◽  
Kaisen Yao ◽  
Anirudh K. Gowd ◽  
Nirav H. Amin ◽  
J. Martin Leland ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Methodological Quality ◽  
Surgical Techniques ◽  
Case Series ◽  
Cross Sectional Study ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Number Of Citations

Background: Citation counts have often been used as a surrogate for the scholarly impact of a particular study, but they do not necessarily correlate with higher-quality investigations. In recent decades, much of the literature regarding shoulder instability is focused on surgical techniques to correct bone loss and prevent recurrence. Purpose: To determine (1) the top 50 most cited articles in shoulder instability and (2) if there is a correlation between the number of citations and level of evidence or methodological quality. Study Design: Cross-sectional study. Methods: A literature search was performed on both the Scopus and the Web of Science databases to determine the top 50 most cited articles in shoulder instability between 1985 and 2019. The search terms used included “shoulder instability,” “humeral defect,” and “glenoid bone loss.” Methodological scores were calculated using the Modified Coleman Methodology Score (MCMS), Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS) score. Results: The mean number of citations and mean citation density were 222.7 ± 123.5 (range, 124-881.5) and 16.0 ± 7.9 (range, 6.9-49.0), respectively. The most common type of study represented was the retrospective case series (evidence level, 4; n = 16; 32%) The overall mean MCMS, Jadad score, and MINORS score were 61.1 ± 10.1, 1.4 ± 0.9, and 16.0 ± 3.0, respectively. There were also no correlations found between mean citations or citation density versus each of the methodological quality scores. Conclusion: The list of top 50 most cited articles in shoulder instability comprised studies with low-level evidence and low methodological quality. Higher-quality study methodology does not appear to be a significant factor in whether studies are frequently cited in the literature.

Radiographs of 366 removed limb lengthening nails reveal differences in bone abnormalities between different nail types

2021 ◽  
pp. 1-5
Author(s):  
Christopher A. Iobst ◽  
Markus Winther Frost ◽  
Jan Duedal Rölfing ◽  
Ole Rahbek ◽  
Anirejuoritse Bafor ◽  
...  
Keyword(s):  
Case Series ◽  
Limb Lengthening ◽  
Retrospective Case ◽  
High Prevalence ◽  
Nail Insertion ◽  
Radiological Changes ◽  
Low Prevalence ◽  
Nail Removal ◽  
Mean Time ◽  
Bone Abnormalities

Aims Limb lengthening nails have largely replaced external fixation in limb lengthening and reconstructive surgery. However, the adverse events and high prevalence of radiological changes recently noted with the STRYDE lengthening nail have raised concerns about the use of internal lengthening nails. The aim of this study was to compare the prevalence of radiological bone abnormalities between STRYDE, PRECICE, and FITBONE nails prior to nail removal. Methods This was a retrospective case series from three centres. Patients were included if they had either of the three limb lengthening nails (STYDE, PRECICE, or FITBONE) removed. Standard orthogonal radiographs immediately prior to nail removal were examined for bone abnormalities at the junction of the telescoping nail parts. Results In total, 306 patients (168 male, 138 female) had 366 limb lengthening nails removed. The mean time from nail insertion to radiological evaluation was 434 days (36 to 3,015). Overall, 77% of STRYDE nails (20/26) had bone abnormalities at the interface compared with only 2% of FITBONE (4/242) and 1% of PRECICE nails (1/98; p < 0.001). Focal osteolysis in conjunction with periosteal reaction at the telescoping interface was only observed in STRYDE nails. Conclusion Bone abnormalities at the interface of telescoping nail parts were seen in the majority of STRYDE nails, but only very rarely with FITBONE or PRECICE nails. We conclude that the low prevalence of radiological changes at the junctional interface of 242 FITBONE and 98 PRECICE nails at the time of nail removal does not warrant clinical concerns.

scholarly journals Anatomical Variation of the Psoas Valley: A Scoping Review

2020 ◽  
Author(s):  
Yuichi Kuroda ◽  
Ankit Rai ◽  
Masayoshi Saito ◽  
Vikas Khanduja
Keyword(s):  
Scoping Review ◽  
Case Reports ◽  
Anatomical Variation ◽  
Case Series ◽  
Anatomical Variations ◽  
Anterior Wall ◽  
Computer Search ◽  
Retrospective Case ◽  
Cross Sectional ◽  
Acetabular Rim

Abstract Background: This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications. Methods: A systematic computer search of EMBASE, PubMed and Cochrane for literature related to the psoas valley was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series, case reports and review articles that described the psoas valley and its synonyms were included. Studies on animals as well as book chapters were excluded. Results: Of the 313 articles, the filtered literature search identified 14 papers describing the psoas valley and its synonyms such as iliopsoas notch, a notch between anterior inferior iliac spine and the iliopubic eminence, Psoas-U and anterior wall depression. Most of these were cross-sectional studies that mainly analyzed normal skeletal hips. In terms of anatomical variation, 4 different configurations of the anterior acetabular rim have been identified and it was found that the curved type was the most frequent while the straight type may be nonexistent. Additionally, the psoas valley tended to be deeper in males as compared with females. Several papers established the psoas valley, or Psoas-U in a consistent location at approximately 3 o'clock on the acetabular rim which may have implications with labral pathology. Conclusion: This review highlights the importance of the anatomy of the psoas valley which is a consistent bony landmark. The anatomy and the anatomical variations of the psoas valley need to be well-appreciated by surgeons involved in the management of young adults with hip pathology and also joint replacement surgeons to ensure appropriate seating of the acetabular component.

scholarly journals Is a cross-match necessary before a cat’s first blood transfusion?

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Ben Safrany ◽  
Sophie Adamantos
Keyword(s):  
Blood Transfusion ◽  
Research Question ◽  
Case Series ◽  
Individual Case ◽  
Randomised Control Trial ◽  
Clinical Expertise ◽  
Retrospective Case ◽  
Bottom Line ◽  
Cross Sectional ◽  
Transfusion Reactions

PICO question In transfusion-naïve cats receiving a type specific blood transfusion is cross-matched blood (major and minor) associated with an increased haematocrit development and reduction in acute transfusion reactions when compared with those receiving non-crossmatched blood?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Ten papers were critically reviewed. There were four retrospective case series, three prospective cross-sectional surveys, a retrospective cohort study, a prospective case series and a prospective randomised control trial. Strength of evidence Weak Outcomes reported It would appear that in the United Kingdom the incidence of non-AB transfusion reactions is low.  A single study suggests that cross-matching may result in a greater improvement in haematocrit, but this is unlikely to be clinically significant. There is evidence to support the hypothesis that non-AB antigens (for example the Mik antigen) differ with geographic distribution. Conclusion Based on the information available it is it is challenging to establish a meaningful clinical conclusion on which to base a recommendation.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals The incidence of uterine pathology in ovariectomised bitches

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Maria Norell Candetoft
Keyword(s):  
Research Question ◽  
Case Series ◽  
Individual Case ◽  
Clinical Expertise ◽  
Retrospective Case ◽  
Bottom Line ◽  
Gynaecological Examination ◽  
Long Term Follow Up ◽  
The Individual ◽  
Study Designs

PICO question What is the incidence of postoperative uterine pathology in ovariectomised bitches compared to ovariohysterectomised bitches?   Clinical bottom line Category of research question Incidence The number and type of study designs reviewed Three retrospective case series Strength of evidence Weak Outcomes reported None of the reviewed case series found any uterine pathology for ovariectomised bitches in the long-term follow-up of several years, although none of the studies performed a proper gynaecological examination to confirm a lack of pathology Conclusion With the limited evidence available, it appears that leaving the uterus when gonadectomising bitches does not seem to have a high risk for developing pathology as long as the ovaries are completely removed.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Current evidence supporting simultaneous prophylactic gastropexy in canine patients undergoing complete splenectomy

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Olivia Harris
Keyword(s):  
Research Question ◽  
Case Series ◽  
Conclusive Evidence ◽  
Current Evidence ◽  
Clinical Expertise ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Retrospective Case ◽  
Bottom Line ◽  
Cross Sectional

PICO question In dogs that have undergone a complete splenectomy, does performing a concurrent gastropexy decrease the risk of future gastric dilatation-volvulus (GDV) development when compared to not performing a concurrent gastropexy?   Clinical bottom line Category of research question Risk The number and type of study designs reviewed Five papers were critically reviewed which included one retrospective case series, one retrospective case-control study, and three combined retrospective cohort and cross-sectional survey studies Strength of evidence Weak Outcomes reported In dogs that have had a complete splenectomy, there is no conclusive evidence that prophylactic gastropexy decreases the risk of lifetime GDV development Conclusion Based on the limited information available, it is difficult to conclude if prophylactic gastropexy should be recommended routinely at the time of complete splenectomy   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Arthroscopic-assisted arthrodesis in the foot and ankle. Subtalar, tibiotalar, tibiocalcaneal, and metatarsophalangeal: 25 years of experience

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Luis Perez-Carro ◽  
Carlos Rodrigo-Arriaza ◽  
Lorena Trueba-Sanchez ◽  
Gustavo Gutierrez-Castanedo ◽  
Guillermo Menendez-Solana ◽  
...  
Keyword(s):  
Case Series ◽  
Invasive Procedure ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Non Union ◽  
End Stage ◽  
Mean Time ◽  
Radiographic Union

Objectives: Arthritis of the foot and ankle joints provoke pain and restricts function. The arthroscopic assisted arthrodesis (AAA) is a minimally invasive procedure for end stage arthritis to eliminate pain and achieve painless mobilization, with numerous benefits like faster time to union, less blood loss, less morbidity, less infection rate, and less soft tissue complications compared with open surgery. The objective of this paper is to retrospectively evaluate our case series (136 patients) of arthroscopic assisted foot and ankle fusion that includes the subtalar, tibiocalcaneal, tibiotalar and metatarsophalangeal joint in our last 25 years of practice. Level of Evidence: Level IV, retrospective case series. Materials and Methods: Patients who underwent arthroscopic assisted arthrodesis in the foot and ankle were identified by review of a registry. Minimum follow-up was 24 months. Patient demographics characteristics, time to radiographic union, and preoperative and postoperative American Orthopaedic Foot and Ankle Society score (AOFAS) were obtained. Results: Subtalar fusion: 43 patients. Radiographic union was seen in 40 patients at a mean time of 10 weeks (8-14) and non union was seen in three patients, of which 1 required open revision surgery. AOFAS score improved from 43 preoperatively (27-57) to 83 (67-93) postoperatively. Tibiotalar fusion: 55 patients. Radiographic union in a mean time of 12 weeks (7-15) in all 55 cases. AOFAS score improved from 50.5 preoperatively (25-60) to 82 (62-94) postoperatively. Tibiotalocalcaneal fusion: 3 patients. 2 patients with radiographic union at 14 and 16 weeks and 1 showed a fibrotic union of the subtalar joint without pain. AOFAS score improved from 43 preoperatively (34-58) to 78 (67-81) postoperatively. Metatarsophalangeal fusion: 35 patients. Radiographic union in 33 patients at a mean time of 8 weeks (6-11). Two patients presented asymptomatic non union. AOFAS score improved from 38 preoperatively (30-60) to 86 (75-93) postoperatively. Conclusion: Arthroscopic assisted arthrodesis in the foot and ankle is an excellent procedure for end stage degenerated joint.

scholarly journals Oral Human Papillomavirus Infection and Head and Neck Squamous Cell Carcinoma in Rural Northwest Cameroon

OTO Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 2473974X1881841
Author(s):  
Eleni M. Rettig ◽  
Zhen Gooi ◽  
Richard Bardin ◽  
Mesele Bogale ◽  
Lisa Rooper ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Squamous Cell ◽  
Case Series ◽  
Hpv Infection ◽  
Future Research ◽  
Retrospective Case ◽  
Cross Sectional ◽  
Study Population ◽  
Oral Hpv ◽  
Hpv Types

Objective Oral human papillomavirus (HPV) infection is the precursor for a growing subset of oropharyngeal squamous cell carcinomas (OPSCCs) in the developed world. This study was designed to characterize oral HPV infection and OPSCC in a region with high rates of HPV-driven cervical cancer. Study Design Cross-sectional cohort study, retrospective case series. Setting Northwest Cameroon referral hospital. Subjects and Methods Individuals infected with human immunodeficiency virus attending an outpatient clinic were evaluated for oral HPV infection with oral swabs or rinses that were tested for 51 HPV types. HNSCCs diagnosed and/or treated at the same hospital from 2011 to 2017 were retrospectively reviewed to ascertain demographic and tumor characteristics, and available OPSCCs were tested for HPV. Results The oral HPV infection study population comprised 101 participants. Most (69%) were female and never-smokers (84%). Participants had median 4 lifetime sexual partners (interquartile range, 3-7; range, 1-100). Five participants (5%) had oral HPV infection; one had 2 HPV types. HPV types detected were HPV68 (n = 2), HPV82 (n = 2), HPV32 (n = 1), and unknown (n = 1). No significant demographic or behavioral differences were detected among individuals with vs without oral HPV infection. OPSCCs comprised just 8% (n = 11) of 131 HNSCCs in the retrospective study population. Two of 7 OPSCCs were HPV positive. Conclusion The low prevalence of OPSCC observed in northwest Cameroon together with the rarity of oral HPV infection suggests low rates of HPV-driven oropharyngeal carcinogenesis in the region. Future research should examine how geographic differences in oral HPV infection are influenced by cultural norms and affect HPV-OPSCC epidemiology.

Sign in / Sign up

Export Citation Format

Share Document