The Jumper’s Knee – a New Look at Non-surgical Treatment. Pilot Study

2020 ◽  
Vol 22 (5) ◽  
pp. 353-362
Author(s):  
Bartłomiej Kacprzak ◽  
Natalia Siuba ◽  
Marek A. Synder ◽  
Marek Synde
Keyword(s):  
Conservative Treatment ◽  
Treatment Protocol ◽  
Return To Sport ◽  
Patellar Ligament ◽  
Jumper’S Knee ◽  
Treatment Techniques ◽  
Pain At Rest ◽  
No Gold Standard ◽  
Methods Of Treatment ◽  
Joint Evaluation

Background. There are many opinions and views regarding the methods of treatment of patellar ligament enthesopathy. No gold standard of treatment exists. This paper presents our approach involving conservative treatment and an appropriate rehabilitation regime. Our aim was to assess the effectiveness of a combination of various conservative treatment techniques and the time needed to return to sport. Material and methods. The study enrolled 14 patients treated in 2019 and 2020. Knee joint evaluation was based on clinical and radiological examination (sonography and MR). All patients were treated conservatively according to a specially prepared treatment protocol. Patients were evaluated at two-week intervals until the symptoms subsided completely. The KOOS, Kujala and SF36 questionnaires were used to evaluate the results. Results. All of the patients returned to painless physical activity within 3-4 weeks from the start of treatment. In the group of professional athletes, 100% returned to sport. The return to sport took slightly longer for pa­tients with bilateral (5-6 weeks) in comparison to unilateral jumper’s knee (3-4 weeks). The longest period of return to sport, in a patient who had severe pain at rest before starting treatment, was 7 weeks. Statistically significant improvement was noted in all of the questionnaires used and in all subdomains at 6 months after the beginning of the treatment. Conclusions. 1. The conservative approach proposed by us generated promising results in the treatment of the jumper’s knee. 2. A 100% rate of return to sport was recorded among our patients.

The role of probiotics in correction of microbiocenosis and cytokine balance of the oral cavity of patient with chronic inflammatory disease of periodont

2020 ◽  
Vol 25 (4) ◽  
pp. 323-330
Author(s):  
E. S. Ovcharenko ◽  
V. V. Erichev ◽  
S. I. Risovannij ◽  
T. V. Aksenova ◽  
S. V. Melekhov ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Periodontal Diseases ◽  
Treatment Protocol ◽  
Chronic Inflammatory Disease ◽  
Oral Microbiome ◽  
Comprehensive Treatment ◽  
Local Immunity ◽  
Treatment Techniques ◽  
Before And After

Relevance. A long-term inflammation in the oral cavity, unreasonable treatment of periodontal patients with antibiotics cause imbalance between certain types of fungal-bacterial associations accompanied by oral dysbiosis and change of local immune status. So, development and application of new comprehensive diagnosis and treatment techniques in periodontal patients, use of products for correction of microbiota and local immunity are a current and a long-term task. Purpose is to optimize the comprehensive treatment protocol of inflammatory periodontal diseases by introducing probiotics and evaluation of oral microbiome and cytokine profile.Materials and methods. 140 patients were examined. Of these 60 patients had chronic generalized plaque-induced gingivitis and 60 patients suffered from moderate chronic generalized periodontitis. Bacterial and fungal microbiome was assessed and the host immune response was evaluated in all patients before and after the treatment. Half of the patients were treated conventionally and the other half were treated according to a modified scheme: probiotic “Bifidumbacterin Forte” was added.Results. A large number of yeast-like fungi Candida and commensal bacteria were detected in periodontal pockets of patients with chronic generalized plaque-induced gingivitis and moderate chronic generalized periodontitis. That correlates with a significant increase of pro-inflammatory cytokines (TNF-α, IL—8), decrease of concentration of INF-γ and increase of antiinflammatory cytokine IL-4.Conclusion. Changes in clinical, microbiological and immunological values during a modified combination therapy with a probiotic and during a conventional treatment demonstrated that effectiveness of treatment of chronic gingivitis and chronic periodontitis increased by 40% and 37% respectively.

scholarly journals Classification for Haglund’s Syndrome (Deformity)

2019 ◽  
Vol 25 (2) ◽  
pp. 83-98
Author(s):  
A. P. Sereda ◽  
A. M. Belyakova
Keyword(s):  
Systematic Review ◽  
Conservative Treatment ◽  
Minimally Invasive ◽  
Morphological Characteristics ◽  
Patient Treatment ◽  
Treatment Techniques ◽  
Minimally Invasive Surgical ◽  
The Status ◽  
Total Treatment ◽  
Haglund’S Deformity

The objective of the study — to propose a classification for Haglund’s syndrome based on the differentiated treatment outcomes and to conduct a systematic review of articles on this topic.Materials and Methods. The article based on the diagnosis and treatment of 77 patients with Haglund’s syndrome. 68 patients with Haglund’s syndrome underwent surgery (79 operations), 14 of which were endoscopic. In 9 patients conservative treatment techniques were undertaken.Results. As a result of analyzing a variety of cases of Haglund’s syndrome, we proposed clinical and morphological classifications for Haglund’s syndrome that help to choose the optimal treatment tactics. according to its clinical form, Haglund’s deformity may be common, atypical, and “hiding”. A special clinical variation is a cosmetic form. Depending on morphological characteristics, it was proposed to distinguish upper, upper-lateral, “arc type”, total types, and atypical variations. With the upper type of deformity and, rarely, with the upper-lateral one, an endoscopic technique or minimally invasive surgical correction is preferable. For more extensive variants, the only solution should be an open procedure. The outcomes at 11.5±1.2 months after surgery showed significant improvement in patient condition as compared to the preoperative status (p<0.001). On the AOFAS, the scores were 92.2±3.1 after open procedures (86.1±3.5 and 93.2±2.2 for the different types) and 94.7±1.8 after endoscopic operations. However, we cannot speak confidently of the advantage of endoscopic surgery, since adequate resection during the endoscopic operation is possible only in limited cases of the Haglund’s deformity types (upper and upper-lateral). For the same reason, it is impossible to compare the results of minimally invasive surgery with fluoroscopic control with the results of open surgical intervention. according to AOFAS (p<0.001), conservative treatment also improved the status of patients, more specifically from 75.1±4.7 to 80.1±5.7. However these improvements were significantly less compared to surgical treatment (p<0.001). Our results of patient treatment were included in an updated systematic review of twenty-eight studies related to the results of open (681 patients in total) and endoscopic (321 patients in total) treatment of patients with Haglund’s syndrome.Conclusion. Particular attention should be paid to the “hiding” clinical cases which do not manifest signs of tenopathy, but are detrimental to athletic performance. We consider treatment strategy based on clinical and morphological classifications as justified, when the type of operation (open, minimally invasive or endoscopic) was determined by the type of deformity and its localization.

scholarly journals Treatment of diffuse euthyroid goiter in children

2019 ◽  
Vol 45 (1) ◽  
pp. 23-26
Author(s):  
T. E. Taranushenko ◽  
A. Ya. Panfilov ◽  
S. A. Dogadin
Keyword(s):  
Conservative Treatment ◽  
Potassium Iodide ◽  
Thyroid Volume ◽  
Therapeutic Effects ◽  
Weekly Dose ◽  
High Prevalence ◽  
Daily Dose ◽  
Toxic Goiter ◽  
Methods Of Treatment ◽  
Positive Results

High prevalence of diffuse euthyroid goiter and inefficiency of conservative treatment aimed at normalization of thyroid volume necessitate search for optimal methods of treatment. Results of thyroxin and potassium iodide (antistrumin) therapy of 110 children with diffuse toxic goiter, living in a region with medium-grave iodine deficiency, are analyzed. The diagnosis was verified by clinical data, ultrasonic examinations, and hormone measurements. Changes in the volume of the thyroid under the effect of thyroxin and antistrumin therapy could be variously directed: the involved thyroid might enlarge, shrink, or not change at all. Therapeutic effects of thyroxin and antistrumin on the degree of thyroid decrease and incidence of positive results after 6-month therapy were virtually the same. Thyroxin in a daily dose of 2.0-2.5 \xg/kg promoted a decrease and normalization of the thyroid size. Efficacy of thyroxin significantly increased if it was used longer than for 6 months. Potassium iodide (antistrumin) in a weekly dose of 2000 pg (equivalent to daily 200 pg iodine) led to decrease of goiter size and normalization of the thyroid volume. The best results were observed after a no more than 6-month course of treatment. A longer course brought about a tendency to a higher incidence of untoward effects (enlargement of the thyroid).

Tenosynovitis of Hand and Wrist: A Literature Review

1986 ◽  
Vol 49 (9) ◽  
pp. 288-292 ◽  
Author(s):  
Ashok Chandani
Keyword(s):  
Conservative Treatment ◽  
Literature Review ◽  
Extensor Tendon ◽  
Dominant Hand ◽  
Age Group ◽  
Work Related ◽  
Causative Factors ◽  
Definition Of ◽  
The Right ◽  
Methods Of Treatment

This literature review of tenosynovitis of hand and wrist concentrates on the definition of tenosynovitis, aetiology and causative factors, site of occurrence, general methods of treatment and specific occupational therapy procedures. Despite extensive research into tenosynovitis, very little is yet known about causative factors. There also continues to be much controversy surrounding how to use splinting and the usefulness of rest in the treatment of tenosynovitis. On the basis of descriptive studies it can be said that tenosynovitis mostly affects the wrist and hand and more commonly the extensor tendon of the right/dominant hand. It is suggested that tenosynovitis occurs more commonly in females and the peak incidence is in the 35–40 years age group. Common opinions regarding causative factors are work related, infections and manifestations of diseases. Treatment of tenosynovitis mostly lies in rest and splinting and some suggest that electrotherapy and diathermy may help. If conservative treatment fails, many advocate surgery.

Protocol for a systematic review of paediatric meniscal repair

2020 ◽  
Author(s):  
Dean Malik ◽  
Aadhar Sharma ◽  
Chinmay Gupte
Keyword(s):  
Treatment Options ◽  
Treatment Protocol ◽  
Meniscal Repair ◽  
Paediatric Population ◽  
Long Term Effects ◽  
Qualitative Synthesis ◽  
Anterior Cruciate Ligaments ◽  
Treatment Techniques ◽  
Anterior Cruciate

Abstract Background Meniscal tears in the paediatric population represent a significant challenge. Improved sensitivity of diagnostic imaging and increased intensity of organised sport among children is in part responsible for an increased incidence of injuries identified. While rare, these injuries have a significant impact on a patient’s future and necessitate timely and meticulous repair. Methods Adhering to PRISMA guidelines, MEDLINE, Embase and Cochrane databases will be interrogated from inception to November 2019. All primary clinical studies in which paediatric meniscal injuries are treated will be identified and included. Treatment techniques will be grouped according to surgical technique and a further analysis of any papers concomitantly repair anterior cruciate ligaments will also be analysed to identify any superiority. A qualitative synthesis will at first be attempted with further quantitative analysis should heterogeneity of studies allow it. Discussion Paediatric meniscal injuries provide a dilemma for even the most experience surgeon, with no consensus on a preferred treatment option. Outcomes are often poor and can have long-term effects with early onset of osteoarthritis and limitation of future function. As such, this review will be pivotal in identifying the different treatment options being employed for meniscal repair in a paediatric population, if there is any superiority in a given treatment choice and moving towards identified a standard treatment protocol.

Randomized clinical trial of conservative treatment for patients with whiplash-associated disorders: considerations for the design and dynamic treatment protocol

2003 ◽  
Vol 26 (7) ◽  
pp. 412-420 ◽  
Author(s):  
Gwendolijne G.M Scholten-Peeters ◽  
Arianne P Verhagen ◽  
Catharina W.M Neeleman-van der Steen ◽  
John C.A.M Hurkmans ◽  
Ria W.A Wams ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Conservative Treatment ◽  
Randomized Clinical Trial ◽  
Treatment Protocol ◽  
Dynamic Treatment ◽  
Whiplash Associated Disorders

scholarly journals Successful Treatment of Osgood–Schlatter Disease with Autologous-Conditioned Plasma in Two Patients

Joints ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 191-194 ◽  
Author(s):  
Dirk-Jonas Danneberg
Keyword(s):  
Successful Treatment ◽  
Skeletal Maturity ◽  
Treatment Protocol ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Treatment Resistant ◽  
Plasma Therapy ◽  
Athletic Population ◽  
Autologous Platelet Concentrate ◽  
Autologous Platelet

AbstractOsgood–Schlatter Disease (OSD) is a painful, growth-related overuse condition of the tibial tuberosity, leading to inflammation of the patellar ligament at the tibial tuberosity. It primarily affects young adolescents, athletic population, and usually, resolves with age or skeletal maturity. Therapy is usually conservative, with surgery indicated in a minority of cases. For patients with treatment-resistant or refractory OSD, an alternative is the application of autologous platelet concentrate. Here, we describe two cases in which autologous-conditioned plasma therapy was used to treat OSD, and present the treatment protocol developed in our clinic.

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