A SLAP lesion associated with calcific tendinitis of the long head of the biceps brachii at its origin

Calcific tendinitis is a common condition with characteristic clinical and radiological findings. Although we do not know which condition initiated the pathologic cascade, we present a rare case of calcific tendinitis of the long head of the biceps brachii at its origin, associated with a SLAP lesion. The calcium deposit was removed and the SLAP lesion was repaired with a suture anchor arthroscopically.     

WARFARIN EMBRYOPATHY

A 34 year-old gravida 2 para 1 (1001) mother was on prophylactic anticoagulation therapy because of pulmonary emboli postabdominal surgery. The pregnancy was terminated at 25 weeks' gestation after ultrasound examination showed a mild hydrocephalus and a cardiac structural defect. Congenital abnormalities of the delivered fetus included nasal hypoplasia, earfold atresia, bilobled lungs, coarctation of the aorta, ventriculuar septal defect, gastroschisis, and radiographic skeletal stippling. The radiological and physical findings were consistent with warfarin embryopathy.     

Electroacupuncture for the treatment of supraspinatus calcific tendonitis

BackgroundConservative treatment of calcific tendonitis includes rest, medications, and physical therapy. Several physiotherapy interventions such as shockwave therapy are commonly used. The aim of this study was to investigate the efficacy of an electrotherapy method called electroacupuncture, in the treatment of calcific tendonitis.Methods40 patients with calcific tendonitis were randomly divided to receive either a combination of medications and electroacupuncture, or just a course of medications. Evaluated outcomes included pain using the visual analog scale, shoulder range of motion with the use of goniometer, and quality of life along with functional status using the Instrumental Activities of Daily Living Scale (IAOLDS) and the Beck Depression Inventory (BDI). Radiological evaluation for the progression of the calcific deposits was also performed. All these evaluations were performed before and at the end of treatment. A final interview with the patients regarding any recurrent episodes was performed 18–24 months after the end of treatment.ResultsThe intervention group showed greater improvement in pain intensity (2.8 points), range of motion (forward flexion, +30; abduction +29) when compared with the control group (for all, P < .05) while there was no statistically significant difference regarding the quality of life (IOLDS +0.2; BDI 0). Radiological evaluation demonstrated total or nearly total absorption of calcific deposits in 15 patients of the intervention group and in 8 patients of the control group.ConclusionThe successful clinical results of electroacupuncture and the regression of calcific depositions after treatment showed that electroacupuncture may have a role as a treatment modality in calcific tendonitis.     

基于MRI针刀治疗冈上肌肌腱炎的临床随机对照研究

目的:观察基于MRI针刀治疗冈上肌肌腱炎的临床疗效。方法:将72例冈上肌肌腱炎患者随机分为治疗组和对照组,每组36例。治疗组采用针刀治疗,对照组采用电针治疗,观察周期为2周。评价两组患者的临床疗效,比较两组患者的疼痛视觉模拟量表(VAS)评分及疼痛弧试验阳性率的变化。结果:治疗后,治疗组的总有效率为91.2%,对照组为84.8%,治疗组的疗效优于对照组(P0.05)。治疗后,两组患者的VAS评分均显著降低(P0.01),且治疗组患者的评分低于对照组(P0.01);两组患者的疼痛弧试验阳性率均显著降低(P0.01),治疗组患者的疼痛弧试验阳性率为17.65%,对照组为27.27%,但两组比较差异无统计学意义(P0.05)。结论:基于MRI针刀治疗冈上肌肌腱炎具有较好的疗效,可明显缓解患者的疼痛症状,改善患者的体征。     

Lipoprotein(a) and aortic valve stenosis: A casual or causal association?

AimsThis review aims to provide an update of available methods for imaging calcification activity and potential therapeutic options.Data SynthesisAortic valve calcification represents the most common heart valve condition requiring treatment among adults in Western societies. No medical therapies are proven to be effective in treating symptoms or reducing disease progression. Therefore, surgical or transcatheter aortic valve replacement remains the only available treatment option. Elevated circulating concentrations of lipoprotein(a) is strongly associated with degenerative aortic stenosis. This relationship was first observed in prospective observational studies, and the causal relationship was confirmed in genetic studies.ConclusionsNew therapeutic targets have been identified and new imaging techniques could be used to test the effectiveness of new agents and further clarify the pathophysiology of AVS. No therapy that specifically lowers Lp (a) levels has been approved for clinical use.     

Complications of calcific tendinitis of the shoulder: a concise review

Calcific tendinitis (CT) of the rotator cuff (RC) muscles in the shoulder is a disorder which remains asymptomatic in a majority of patients. Once manifested, it can present in different ways which can have negative effects both socially and professionally for the patient. The treatment modalities can be either conservative or surgical. There is poor literature evidence on the complications of this condition with little consensus on the treatment of choice. In this review, the literature was extensively searched in order to study and compile together the complications of CT of the shoulder and present it in a clear form to ease the understanding for all the professionals involved in the management of this disorder. Essentially there are five major complications of CT: pain, adhesive capsulitis, RC tears, greater tuberosity osteolysis and ossifying tendinitis. All the above complications have been explained right from their origin to the control measures required for the relief of the patient.Level of evidence 5.     

A multidisciplinary approach including the use of platelet-rich plasma to treat an elite athlete with patellar tendinopathy – a case report

Objective:

Patellar tendinopathy affects a substantial proportion of athletes involved in jumping or kicking activities. Platelet rich plasma (PRP) injections may be a promising treatment used in conjunction with common traditional therapies.

Clinical Features:

Patellar tendinopathy is often the result of repetitive or excessive overload on the patellar tendon. Activity modification, cryotherapy, eccentric exercises, shockwave therapy, and PRP have been indicated as treatment options during various stages of this condition.

Intervention and Outcome:

A 23 year old female, elite track and field athlete was managed for patellar tendinopathy with a combination of traditional therapeutic interventions as well as a PRP injection. This athlete returned to pre-injury level of competition six months post-injection.

Conclusion:

Emerging literature on PRP appears to be promising for patellar tendinopathy, however, it remains unclear which patients may benefit most and whether the stage of the disorder has an impact on the clinical outcome.     

Tripled semitendinosus anterior cruciate ligament reconstruction with Endobutton fixation: A 2-3-year follow-up study of 35 patients

We evaluated the clinical outcome of tripled semitendinosus tendon ACL reconstruction with femoral Endobutton (Acufex, Smith&Nephew, Andover, MA) and tibial Suture Washer (Acufex, Smith&Nephew, Andover, MA) (n 29) or post screw fixation (n 6) in 35 patients on an average of 28 (20-37) months after surgery. On the basis of IKDC criteria, 22 patients showed a normal or nearly normal knee function and 25 patients had a KT 1000 maximal manual side-to-side difference of &#104 5 mm at follow-up. Subjectively, 28 patients graded their knee function as normal or nearly normal. The average Lysholm score was 88 points, average OAK score 90 points and average modified HSS score 93 points. 19 patients reached their preinjury level of activity at follow-up. The postoperative Lachman test was &#104 1+ in 24 patients and 24 patients also showed an absent pivot shift. Significant bone tunnel enlargement occurred in 26 patients on the femoral side and in 23 patients on the tibial side. We found no correlation between bone tunnel enlargement and clinical outcome. The clinical outcome of tripled semitendinosus tendon ACL reconstruction with Endobutton fixation on the femoral side was not entirely satisfactory. The procedure was associated with a high incidence of bone tunnel enlargement in this series.