Degenerative arthritis of the craniovertebral junction

Atul Goel

doi:10.4103/jcvjs.jcvjs_142_21

Sleep Impairment

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2009.mayjun04 ◽

2009 ◽

Vol 14 (3) ◽

pp. 7-10

Author(s):

Craig Uejo ◽

Stephen Demeter

Keyword(s):

Rotator Cuff ◽

Distal Clavicle ◽

Rotator Cuff Disease ◽

Degenerative Arthritis ◽

Sixth Edition ◽

Cuff Tear ◽

Shoulder Region ◽

Illness Causation ◽

Traumatic Rotator Cuff Tear ◽

Distal Clavicle Resection

Abstract In the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, distal clavicle resection (resection arthroplasty of the acromioclavicular joint [ACJ]) results in ratable impairment, but only a single diagnosis within a region may be rated. Therefore, if another impairing condition is present in the shoulder region (eg, impingement syndrome or rotator cuff disease) only that resulting in the greatest causally related impairment is rated. In the setting of an occupational or other compensable injury or illness, causation of the impairment often is a key issue because, typically, only impairment that is causally related to the injury can be rated. For example, assume that a lifting injury at work caused a tear in a rotator cuff tendon that was already attenuated by repetitive impingement on inferiorly projecting spurs from longstanding degenerative arthritis of the ACJ. If surgery was performed for a traumatic rotator cuff tear and the distal clavicle also was resected due to preexisting ACJ arthritis, the latter surgery is not considered to be related to the injury. In other words, because the ACJ arthritis was neither caused nor worsened by the injury, this condition is not rated. The distal clavicular resection may have been warranted to diminish pain due to ACJ arthritis and/or eliminate the distal clavicle as a source of impingement.

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Apportionment of Impairment from Meniscal Tears and Knee Arthritis

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2013.sepoct01 ◽

2013 ◽

Vol 18 (5) ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Charles N. Brooks ◽

James B. Talmage

Keyword(s):

Medial Meniscus ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Detailed Knowledge ◽

Meniscal Tears ◽

Knee Arthritis ◽

Degenerative Arthritis ◽

Study Results ◽

Physical Findings ◽

Causation Analysis

Abstract Meniscal tears and osteoarthritis (osteoarthrosis, degenerative arthritis, or degenerative joint disease) are two of the most common conditions involving the knee. This article includes definitions of apportionment and causes; presents a case report of initial and recurrent tears of the medial meniscus plus osteoarthritis (OA) in the medial compartment of the knee; and addresses questions regarding apportionment. The authors, experienced impairment raters who are knowledgeable regarding the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), show that, when instructions on impairment rating are incomplete, unclear, or inconsistent, interrater reliability diminishes (different physicians may derive different impairment estimates). Accurate apportionment of impairment is a demanding task that requires detailed knowledge of causation for the conditions in question; the mechanisms of injury or extent of exposures; prior and current symptoms, functional status, physical findings, and clinical study results; and use of the appropriate edition of the AMA Guides. Sometimes the available data are incomplete, requiring the rating physician to make assumptions. However, if those assumptions are reasonable and consistent with the medical literature and facts of the case, if the causation analysis is plausible, and if the examiner follows impairment rating instructions in the AMA Guides (or at least uses a rational and hence defensible method when instructions are suboptimal), the resulting apportionment should be credible.

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Locked Dorsal Compression Plate Arthrodesis for Degenerative Arthritis of the Midfoot

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2019.09.044 ◽

2020 ◽

Vol 59 (6) ◽

pp. 1171-1176

Author(s):

Debbie Y. Dang ◽

Wesley W. Flint ◽

Craig T. Haytmanek ◽

Katherine J. Ackerman ◽

Michael J. Coughlin ◽

...

Keyword(s):

Degenerative Arthritis ◽

Compression Plate

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Surgical Strategies in Craniovertebral Junction Lesions

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0032-1314106 ◽

2012 ◽

Vol 73 (S 02) ◽

Author(s):

Y. Shulev ◽

V. Stepanenko ◽

A. Trashin

Keyword(s):

Craniovertebral Junction ◽

Surgical Strategies

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Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

Journal of Wrist Surgery ◽

10.1055/s-0040-1721435 ◽

2021 ◽

Author(s):

J. Terrence Jose Jerome

Keyword(s):

Retrospective Study ◽

Natural History ◽

Functional Outcome ◽

Grip Strength ◽

Scaphoid Nonunion ◽

Proximal Pole ◽

Degenerative Arthritis ◽

Level Of Evidence ◽

History Of ◽

The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

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