Repair of the rotator cuff tear is a joint-tightening procedure that can worsen joint stiffness. This paradoxical phenomenon complicates treatment of rotator cuff tear with joint stiffness. As a result, there is controversy about how and when to treat joint stiffness. As many treatments have been published, this review discusses the latest findings on treatment of rotator cuff tear with joint stiffness.
ObjectiveLateral and medial epicondylitis are relatively common diseases, but they do not improve quickly and are known to reduce patients' quality of life. Much research has been done on Platelet‐Rich Plasma (PRP) as a treatment for lateral epicondylitis, but research on medial epicondylitis is lacking. The purpose of this study is to compare: (i) the pain intensity; and (ii) the functional outcome between the simultaneous treatment of medial and lateral epicondylitis and the treatment of only lateral or medial epicondylitis using PRP.MethodsIn this retrospective study, 209 patients treated with PRP on epicondylitis between March 2018 and December 2021 were enrolled. Simultaneous treatment was underwent 68 patients (group I). Seventy patients were treated for lateral epicondylitis (group II). The remaining 71 patients were treated for medial epicondylitis (group III). The visual analogue scale for pain (VAS) and the Mayo elbow performance score (MEPS) were evaluated for clinical outcomes at the initial visit and 6 months after injection.ResultsVAS for pain and MEPS showed significant improvement in all three groups compared to before treatment. There was no significant difference between three groups on –ΔVAS (P > 0.05). However, in case of ΔMEPS, group III showed significantly lower compared to groups II and III (P < 0.05). No patients showed worsening of symptoms or complications during the treatment.ConclusionPRP injection for the patient with elbow medial and lateral epicondylitis can be treated effectively simultaneously in terms of pain. From a functional point of view, the effect of simultaneous treatment may be lessened than in the case of only lateral and medial treatment.
This study compared the results of proximal and distal chevron osteotomy in patients with severe hallux valgus. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include severe hallux valgus.
Materials and Methods:This study analyzed 127 severe hallux valgus surgeries. Of these, 76 patients (76 feet) were excluded for lack of adequate follow-up and additional procedures (Akin procedure), leaving 51 patients (51 feet) in the study. The mean age of the patients was 58 years (21~83 years), and the mean follow-up duration was 18 months (12~32 months). The patients were divided into two groups. Group 1 underwent distal chevron osteotomy, and group 2 underwent proximal chevron osteotomy performed sequentially by a single surgeon. The patients were interviewed for the American Orthopaedic Foot and Ankle Society (AOFAS) score before and one year after surgery. The anteroposterior weight-bearing radiography of the foot was taken before and one year after surgery.Results: There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and an increase in the AOFAS score. Significant improvement of the hallux valgus and intermetatarsal angle corrections was observed in both groups, and the sesamoid position was similar in each group. More improvement in radiographic correction of intermetatarsal angle was noted in group 2. Both procedures gave similar good clinical and radiological outcomes.
Conclusion:This study suggests that a distal chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting severe hallux valgus as a proximal chevron osteotomy with a distal soft-tissue procedure.
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