Clinical Outcomes of Patients With Anterior Shoulder Instability and Glenolabral Articular Disruption Lesions: A Retrospective Comparative Study

2020 ◽  
Vol 48 (14) ◽  
pp. 3472-3477
Author(s):  
Martin S. Davey ◽  
Eoghan T. Hurley ◽  
Christopher A. Colasanti ◽  
John P. Scanlon ◽  
Mohamed Gaafar ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Instability ◽  
Return To Sport ◽  
Return To Play ◽  
Anterior Shoulder Instability ◽  
Control Group ◽  
Control Groups ◽  
Level Of Evidence ◽  
Significant Difference ◽  
And Control

Background: Anterior shoulder instability is a common clinical condition that often requires surgical stabilization. Glenoid labral tears are often associated with instability, with glenolabral articular disruption (GLAD) lesions occasionally being identified arthroscopically during repair, particularly in collision athletes. Purpose: To evaluate the clinical outcomes and recurrence rates in patients who had GLAD lesions and underwent arthroscopic Bankart repair (ABR) and compare them with a control group without GLAD lesions. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of patients who underwent ABR with GLAD lesions, by a single surgeon between July 2012 and March 2017, was performed. Additionally, these were pair matched in a 2:1 ratio for age, sex, sport, and level of play with a control group who underwent ABR without GLAD lesions. Return to sport, the level of return, and the timing of return were assessed. The visual analog scale (VAS) for pain score, Rowe score, Shoulder Instability–Return to Sport after Injury (SIRSI) score, and Subjective Shoulder Value (SSV) were evaluated. Results: The study included a total of 66 patients (22 and 44 patients for the GLAD and control groups, respectively), with a mean age of 25.8 years and a mean follow-up of 66 months. Overall, there was no significant difference in any of the clinical outcome scores (VAS, Rowe, SIRSI, and SSV) utilized for the GLAD and control groups ( P > .05 for all). Similarly, there was no significant difference in the total rate of return to play (90.9% vs 88.6%; P > .99) or return at the same/higher level (68.2% vs 72.7%; P = .78). There was no significant difference in timing of return to play (6.3 ± 6.6 months vs 6.4 ± 2.5 months; P = .98). There were 3 cases (13.6%) requiring further surgery (1 revision stabilization, 1 arthroscopic release, and 1 rotator cuff repair) in the GLAD group and 2 cases (4.5%) requiring further surgery (both revision stabilization) in the control group; the difference was not statistically significant ( P = .32). Conclusion: After arthroscopic repair, patients with GLAD lesions had similar midterm outcomes when compared with a control group without GLAD lesions.

Return to Professional Australian Rules Football After Surgery for Traumatic Anterior Shoulder Instability

2021 ◽  
pp. 036354652110290
Author(s):  
Michael Perret ◽  
Sarah Warby ◽  
Godefroy Brais ◽  
Stephanie Hinse ◽  
Sophie Hoy ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Field Performance ◽  
Return To Play ◽  
Anterior Shoulder Instability ◽  
Level Of Evidence ◽  
Australian Football League ◽  
Early Return ◽  
Significant Difference ◽  
Australian Football

Background: The treatment of traumatic anterior shoulder instability in professional Australian Football League (AFL) players is challenging, with an emphasis on early return to play and avoidance of instability recurrence. Purpose: To investigate return-to-sport (RTS) outcomes and complications after 2 different procedures for traumatic anterior shoulder instability in professional AFL players. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed our surgical database for professional AFL players who underwent capsulolabral stabilization or open Latarjet procedure by a single surgeon between 2006 and 2017. Outcomes included RTS, on-field performance, and complications. Between-group analyses for RTS and complications were estimated using Kaplan-Meier survival analyses. Within-group analyses for on-field performance data were performed using paired t tests with significance set at .05. Results: A total of 58 capsulolabral stabilization procedures in 54 players and 32 Latarjet procedures in 29 players were included in the analysis; 93.1% of capsulolabral patients and 96.9% of Latarjet patients returned to professional AFL. The median RTS time was 6.8 months for the capsulolabral group and 7.3 months for the Latarjet group. There was no significant difference in RTS rates between the 2 groups ( P = .270). Of those undergoing surgery early in the season, 75% of the capsulolabral and 71% of Latarjet group were able to RTS within the same season, at a mean time of 16.9 weeks and 18.8 weeks, respectively. There was a significant difference in instability recurrence, with 19% for the capsulolabral group and no recurrence in the Latarjet group ( P = .017). There was no significant reduction in player on-field performance in either group ( P < .05). Conclusion: In this study, the median RTS in AFL players was approximately 7 months after capsulolabral and Latarjet surgery with no compromise to on-field performance. Instability-related complications occurred only in the capsulolabral group, and the incidence increased with time.

scholarly journals Clinical Outcomes of Revision Arthroscopic Capsulolabral Repair for Recurrent Anterior Shoulder Instability With Moderate Glenoid Bone Defects: A Comparison With Primary Surgery

2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110598
Author(s):  
Young Dae Jeon ◽  
Hyong Suk Kim ◽  
Sung-Min Rhee ◽  
Myeong Gon Jeong ◽  
Joo Han Oh
Keyword(s):  
Clinical Outcomes ◽  
Bone Defect ◽  
Shoulder Instability ◽  
External Rotation ◽  
Anterior Shoulder Instability ◽  
Level Of Evidence ◽  
Primary Surgery ◽  
Significant Difference ◽  
Primary Groups

Background: The optimal revision surgery for failed primary arthroscopic capsulolabral repair (ACR) has yet to be determined. Revision ACR has shown promising results. Purpose: To compare the functional, strength, and radiological outcomes of revision ACR and primary ACR for anterior shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: Between March 2007 and April 2017, a total of 85 patients underwent ACR (revision: n = 23; primary: n = 62). Functional outcome scores and positive apprehension signs were evaluated preoperatively, at 1 year, and then annually. Isokinetic internal and external rotation strengths were evaluated preoperatively and at 1 year after surgery. Results: The mean follow-up was 36.5 ± 10.2 months (range, 24-105 months). There was no significant difference between the revision and primary groups in the glenoid bone defect size at the time of surgery (17.3% ± 4.8% vs 15.4% ± 5.1%, respectively; P = .197). At the final follow-up, no significant differences were found in the American Shoulder and Elbow Surgeons score (97.6 ± 3.1 vs 98.0 ± 6.2, respectively; P = .573), Western Ontario Shoulder Instability Index score (636.7 ± 278.1 vs 551.1 ± 305.4, respectively; P = .584), or patients with a positive apprehension sign (17.4% [4/23] vs 11.3% [7/62], respectively; P = .479) between the revision and primary groups. There was no significant difference between the revision and primary groups for returning to sports at the same preoperative level (65.2% vs 80.6%, respectively; P = .136) and anatomic healing failure at 1 year after surgery (13.0% vs 3.2%, respectively; P = .120). Both groups recovered external rotation strength at 1 year after surgery (vs before surgery), although the strength was weaker than in the uninvolved shoulder. In the revision group, a larger glenoid bone defect was significantly related to a positive apprehension sign (22.0% ± 3.8%) vs a negative apprehension sign (16.0% ± 3.2%; cutoff = 20.5%; P = .003). Conclusion: In patients with moderate glenoid bone defect sizes (10%-25%), clinical outcomes after revision ACR were comparable to those after primary ACR. However, significant glenoid bone loss was related to a positive remaining apprehension sign in the revision group. Surgeons should consider these findings when selecting their revision strategy for patients with failed anterior shoulder stabilization.

scholarly journals PHYSICAL ACTIVITY IN THE TREATMENT OF DEPRESSION IN COLLEGE STUDENTS

2022 ◽  
Vol 28 (1) ◽  
pp. 68-71
Author(s):  
Xiaowei He
Keyword(s):  
Mental Health ◽  
College Students ◽  
Physical Exercise ◽  
Control Group ◽  
Observation Group ◽  
Control Groups ◽  
Level Of Evidence ◽  
Treatment Of Depression ◽  
Significant Difference ◽  
And Control

ABSTRACT Introduction: The mental health of college students is getting more and more attention from society. Physical exercise as a means of psychotherapy and mental health has become common at home and abroad. Objective: We explore the effect of prescribing physical exercise in the treatment of depression in college students. Methods: College students who had been diagnosed with depression were randomly divided into an observation group and a control group, each with 18 patients. The control group received drug treatment. The observation group received sports therapy in addition to drug therapy. Results: There was a statistically significant difference in HAMD scores between the observation and control groups in the first week (P<0.01). Conclusions: Exercise can play a role in treating depression patients rapidly, safely, and efficiently. Level of evidence II; Therapeutic studies - investigation of treatment results.

scholarly journals Latarjet procedure enables 73% to return to play within 8 months depending on preoperative SIRSI and Rowe scores

2021 ◽  
Author(s):  
Yoann Bohu ◽  
◽  
Pierre Abadie ◽  
Floris van Rooij ◽  
Luca Nover ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Multivariable Analysis ◽  
Return To Sport ◽  
Patient Characteristics ◽  
Return To Play ◽  
Anterior Shoulder Instability ◽  
Latarjet Procedure ◽  
Level Of Evidence ◽  
Injury Index ◽  
Sport Type

Abstract Purpose Systematic reviews report return to play (RTP) within 5.8 months (range, 3–8) following the Latarjet procedure, but the factors that influence RTP remain unknown. The present study aimed to report the rate and time of return to play (RTP) during the first 8 months following the Latarjet procedure, and to determine the influence of sport type or patient characteristics. Methods The authors retrospectively collected the records of patients that underwent Latarjet procedures for anterior shoulder instability between 2015 and 2017. Patients were excluded if they had any concomitant rotator cuff tendon lesions, or previous ipsilateral shoulder surgery. The authors retrieved patient demographics, time from injury to surgery, type of sport practiced (overhead/non-overhead, contact/non-contact), as well as pre- and postoperative Western Ontario Shoulder Instability index (WOSI), Shoulder Instability-Return to Sport After Injury index (SIRSI), and Rowe score. Results A total of 217 patients (217 shoulders) were eligible for inclusion, comprising 184 males and 33 females, aged 26.8 ± 7.3 years at index surgery. The main sport practiced prior to surgery involved overhead (n = 173, 80%) and/or contact (n = 152, 70%) activities. By 8 month follow-up, 158 patients (73%) resumed their main sport, at a mean of 5.1 ± 1.5 months. Multivariable analysis revealed that RTP was more likely in patients with higher preoperative Rowe score (OR, 1.02; p = 0.024) and SIRSI score (OR, 1.02; p = 0.008). Conclusions By 8 months following the Latarjet procedure, 73% of patients had resumed their main sport. The likelihood of RTP was significantly associated with preoperative Rowe and SIRSI scores, but not with sport type. Level of evidence IV.

Effects of Virgin Coconut Oil as Adjunct Therapy in the Treatment of Allergic Rhinitis

2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Coconut Oil ◽  
Test Group ◽  
Nasal Symptom ◽  
Control Group ◽  
Virgin Coconut Oil ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.

Impact of intrawound vancomycin powder on prevention of surgical site infection after posterior spinal surgery

2021 ◽  
pp. 1-9
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Go Yoshida ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
Propensity Score ◽  
Spinal Surgery ◽  
Control Group ◽  
Control Groups ◽  
Propensity Score Model ◽  
Significant Difference ◽  
Surgical Data ◽  
Vancomycin Powder ◽  
Vancomycin Group ◽  
And Control

OBJECTIVESurgical site infection (SSI) after posterior spinal surgery is one of the severe complications that may occur despite administration of prophylactic antibiotics and the use of intraoperative aseptic precautions. The use of intrawound vancomycin powder for SSI prevention is still controversial, with a lack of high-quality and large-scale studies. The purpose of this retrospective study using a propensity score–matched analysis was to clarify whether intrawound vancomycin powder prevents SSI occurrence after spinal surgery.METHODSThe authors analyzed 1261 adult patients who underwent posterior spinal surgery between 2010 and 2018 (mean age 62.3 years; 506 men, 755 women; follow-up period at least 1 year). Baseline and surgical data were assessed. After a preliminary analysis, a propensity score model was established with adjustments for age, sex, type of disease, and previously reported risk factors for SSI. The SSI rates were compared between patients with intrawound vancomycin powder treatment (vancomycin group) and those without (control group).RESULTSIn a preliminary analysis of 1261 unmatched patients (623 patients in the vancomycin group and 638 patients in the control group), there were significant differences between the groups in age (p = 0.041), body mass index (p = 0.013), American Society of Anesthesiologists classification (p < 0.001), malnutrition (p = 0.001), revision status (p < 0.001), use of steroids (p = 0.019), use of anticoagulation (p = 0.033), length of surgery (p = 0.003), estimated blood loss (p < 0.001), and use of instrumentation (p < 0.001). There was no significant difference in SSI rates between the vancomycin and control groups (21 SSIs [3.4%] vs 33 SSIs [5.2%]; OR 0.640, 95% CI 0.368–1.111; p = 0.114). Using a one-to-one propensity score–matched analysis, 444 pairs of patients from the vancomycin and control groups were selected. There was no significant difference in the baseline and surgical data, except for height (p = 0.046), between both groups. The C-statistic for the propensity score model was 0.702. In the score-matched analysis, 12 (2.7%) and 24 (5.4%) patients in the vancomycin and control groups, respectively, developed SSIs (OR 0.486, 95% CI 0.243–0.972; p = 0.041). There were no systemic complications related to the use of vancomycin.CONCLUSIONSThe current study showed that intrawound vancomycin powder was useful in reducing the risk of SSI after posterior spinal surgery by half, without adverse events. Intrawound vancomycin powder use is a safe and effective procedure for SSI prevention.

Thyroid Functions in Children on Levetiracetam or Valproic Acid Therapy

2020 ◽  
Author(s):  
Elif Karatoprak ◽  
Samet Paksoy
Keyword(s):  
Valproic Acid ◽  
Subclinical Hypothyroidism ◽  
Control Group ◽  
Thyroid Function Tests ◽  
Healthy Children ◽  
Control Groups ◽  
Acid Therapy ◽  
Significant Difference ◽  
And Control ◽  
Tsh Levels

AbstractThe aim of this study was to investigate the thyroid functions in children receiving levetiracetam or valproate monotherapy. We retrospectively reviewed the records of children with controlled epilepsy receiving valproic acid (VPA group) or levetiracetam monotherapy (LEV group) for at least 6 months. Free thyroxine 4 levels (fT4) and thyroid stimulating hormone (TSH) levels were compared between VPA group, LEV group, and age- and gender-matched healthy children (control group). A total of 190 children were included in the study: 63 were in the VPA, 60 in the LEV, and 67 in the control group. Although there was no significant difference regarding average fT4 levels, higher TSH levels were found in the VPA group when compared with the LEV and control groups (p < 0.001 and p < 0.001, respectively). There was no significant difference in terms of fT4 and TSH values in the LEV group when compared with the control group (p = 0.56 and p = 0.61, respectively). Subclinical hypothyroidism (defined as a TSH level above 5 uIU/mL with a normal fT4 level was detected in 16% of patients in the VPA group, none in the LEV and control groups. Our study found that VPA therapy is associated with an increased risk of subclinical hypothyroidism while LEV had no effect on thyroid function tests.

scholarly journals Clinical and Immunological Efficacy of Mangosteen and Propolis Extracted Complex in Patients with Gingivitis: A Multi-Centered Randomized Controlled Clinical Trial

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2604
Author(s):  
Jin-Young Park ◽  
Kyung-A Ko ◽  
Ji-Yeong Lee ◽  
Jae-Woon Oh ◽  
Hyun-Chang Lim ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Daily Intake ◽  
Test Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Control Groups ◽  
Immunological Parameters ◽  
Significant Difference ◽  
Patient Reported ◽  
And Control

Background: Mangosteen and propolis extracts (MAEC) have been potential therapeutic agents known to exhibit powerful antioxidant and anti-inflammatory properties. The aim of the current study was to evaluate the clinical and immunological efficacy of MAEC as well as safety and patient-reported outcomes (PROMs) on gingivitis and incipient periodontitis. Methods: This study was performed on 104 patients diagnosed with gingivitis or incipient periodontitis. At baseline, the participants were randomly allocated to either the test group, with daily intake of a single capsule containing 194 mg of MAEC for eight weeks, or control group, with placebo. Clinical periodontal evaluation and immunological parameters from saliva and gingival sulcular fluid were assessed at baseline, four, and eight weeks. Individual PROMs were assessed by OHIP-14 questionnaires. Results: There was a significant difference of modified gingival index at four and eight weeks between the test and control groups. In the test group, crevicular interleukin (IL)-6 was reduced, and the salivary matrix metalloproteinase (MMP)-9 was increased after eight weeks. PROMs were improved up to four weeks compared to placebo. Conclusion: Oral administration of MAEC would have a potential to reduce gingival inflammation clinically and immunologically in the patients with gingivitis and incipient periodontitis.

The Baby Shark (Songs Heard Affecting Resuscitation Kinetics) study

2020 ◽  
pp. bmjstel-2020-000657
Author(s):  
Rebecca Singer ◽  
Grace Leo ◽  
Tessa Davis ◽  
Ben Lawton ◽  
Henry Goldstein ◽  
...  
Keyword(s):  
Control Group ◽  
Control Groups ◽  
Target Zone ◽  
Compression Depth ◽  
Significant Difference ◽  
Overall Performance ◽  
The Mean ◽  
Training Exercises ◽  
And Control ◽  
Musical Cues

Previous research has examined the utilisation of musical cues to improve the performance of cardiopulmonary resuscitation (CPR) delivered in training environments. We postulated a musical cue that is both contemporary and transcends cultures may improve CPR performance. Our aim was to establish whether chest compressions are performed with improved rate and depth if a song of a fixed beat (PinkFong’s ‘Baby Shark’ with a tempo of 115 beats per minute (bpm) and 15 beats in each verse) is played to a healthcare professional immediately before undertaking CPR compared to whale noises (a non-metronomic rhythm). 58 Participants of a paediatric conference (majority doctors) were randomly assigned to listen to a minute of Baby Shark (28) or whale song (30) and then undertake a minute of CPR. There was no significant difference in the mean compression rate between the Baby Shark and control groups, with the groups achieving 121 and 125 bpm, respectively (p=0.18). In relation to compression depth within the target zone, the Baby Shark group had more compressions completed within the target zone (55%) than the control group (39%) although this difference was not significant (p=0.08). Listening to Baby Shark prior to undertaking simulated CPR does not improve overall performance, but there is a potential tendency to improve adequate compression depth which may be beneficial in training exercises.

scholarly journals Mechanisms of Intravascular Linear Ablation Induced Restenosis in Rabbit Abdominal Aorta

2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Qiang Chen ◽  
Manman Wang ◽  
Shuai Shao ◽  
Hongze Liu ◽  
Xiaodong Xia ◽  
...  
Keyword(s):  
Intimal Hyperplasia ◽  
Coronary Intervention ◽  
Transluminal Angioplasty ◽  
Artery Dissection ◽  
Control Group ◽  
High Cholesterol Diet ◽  
Control Groups ◽  
Vsmc Proliferation ◽  
Significant Difference ◽  
And Control

Objectives. Percutaneous coronary intervention (PCI) is the mainstay treatment for coronary artery disease but complications such as in-stent restenosis and thrombosis remain problematic. Radiofrequency balloon angioplasty (RBA) can improve lumen dimension, fusing intimal tears, and artery dissection but is associated with higher restenosis rate. Methods. After establishing an atherosclerosis model based on endothelial abrasion and high cholesterol diet, forty-five rabbits were randomly divided into three groups: RBA (n=20), percutaneous transluminal angioplasty (PTA) (n=20), and control groups (n=5). The RBA and PTA groups were subdivided according to harvested time posttreatment, respectively (1 hour, 7 days, 14 days, and 28 days). Aorta segments were then isolated for hematoxylin and eosin staining, Masson trichrome staining, immunohistochemistry, and Western blot for TLR-4, NF-κB, MCP-1, and VCAM-1expression. Results. At 28 days, intimal area was significantly lower in the RBA group compared to the PTA and control groups, whilst luminal and medial area were comparable in the RBA and PTA group but higher and lower than the control group, respectively. Expression of TLR-4, NF-κB, MCP-1, and VCAM-1 showed no significant difference between RBA and PTA groups. Conclusions. RBA can depress the intimal hyperplasia and promote dilatation of the artery to greater extents than PTA at 28 days. However, this did not involve TLR-4 signaling pathway, which likely plays a negligible role in mediating restenosis. Reduction of intimal hyperplasia may be due to injury of ablation to the tunica media and inhibition of VSMC proliferation and migration.

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