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Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Orthopedic tests: Patella apprehension test: The patient lies supine with 30 degrees of knee flexion, and the quadriceps muscle relaxes.A medial force is applied to the patella with the examiner's thumb, and the examiner observes the patient’s facial expression.The test is positive if the patient exhibits an apprehensive facial expression or contracts the quadriceps muscle.81Patella tracking assessment: Positive when the patella moves sideways.Patellar hypermobility.82
Orthopaedics
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
There are several metabolic disorders which affect bone, e.g. hyperparathyroidism and osteomalacia. Again, these are treated by doctors, the orthopaedic surgeon is only used to treat the problems that arise in the bones and joints. Much is written about osteoporosis, the morbidity it produces, and its management. This is particularly appropriate today as many young girls exercise little and eat poorly; they are not laying down an adequate bone mass in childhood and will have poor reserves when they start to lose their bone mass around the menopause. Future generations of orthopaedic surgeons are likely to be very busy repairing the pathological fractures arising in these women.
The Musculoskeletal System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Systemic lupus erythematosus is diagnosed by presentation of a number of clinical symptoms, most commonly arthralgia (arth = joint, algia = pain) and arthritis. Laboratory tests show abnormal ANA titer, positive LE cell test. Several different drugs are utilized in the treatment of systemic lupus erythematosus. Aspirin and the NSAIDs are used to manage arthralgias or synovitis (inflammation of the synovium), pleurisy, headache, and low-grade fever. The antimalarial agent hydroxychloroquine is effective in treating arthralgias, arthritis, and skin disease. Corticosteroids are used to control the inflammatory response. Connective tissue disorders are treated by rest and exercise, physical and occupational therapy, heat, supportive or rehabilitative devices, education, nutrition, and orthopedic surgery.
Early perioperative versus postoperative meloxicam for pain control in patients undergoing orthopedic surgery: a systematic review and Meta-analysis of randomized controlled trials
Published in Current Medical Research and Opinion, 2023
Abdelrahman Mahmoud, Mohamed Abuelazm, Ali Ashraf Salah Ahmed, Mahmoud Elshinawy, Toka Ashour, Mohamed Abugdida, Basel Abdelazeem
The main role of orthopaedic surgery is to prevent and manage musculoskeletal diseases which are associated with a high incidence of disability1. Orthopaedic operations vary from arthroscopic to open major operations; however, they are associated with severe postoperative pain compared with other surgical procedures1,2, with 58% of total knee replacement patients and 47% of total hip replacement patients reporting moderate to severe pain in the first day after surgery3. Postoperative pain is a serious concern to physicians who use a variety of options, including systemic and intra-articular analgesics, to control it. Furthermore, non-steroidal anti-inflammatory drugs (NSAIDs) are widely used as a potent analgesic, antipyretic, and anti-inflammatory, with subtle evidence confirming their superiority for postoperative pain management4. Despite the usage of analgesics, some patients experience worse episodes of postoperative pain than others, which affect early ambulation, delay restoring of function, and prolong the recovery period5.
Bipedal hopping as a new measure to detect subtle sensorimotor impairment in people with multiple sclerosis
Published in Disability and Rehabilitation, 2022
Megan C. Kirkland, Katie P. Wadden, Michelle Ploughman
First, PubMed/Medline was searched for keywords “hop” or “jump*” AND “children” or “elderly” or “nervous system diseases”[MESH] or “validity” or “reliability”, restricted to human studies that assessed hopping/jumping as an outcome measure, and excluding jumping interventions. The initial articles (elderly (157 results), nervous system diseases (1120 results), validity (299 results), and reliability (417 results)) were reviewed for eligibility. Hop/jumping in children was the largest field, and thus articles published in the previous 5 years (2015–2019; 495 results) were considered. Additional searches were conducted for hopping/jumping in specific neurological disorders using search terms “autism” (24), “coordination disorder” (20), “fibromyalgia” (2), “stroke” (74), “concussion” (26), “Down syndrome” (21), “Charcot-Marie Tooth” (7), “Cerebral Palsy” (72), “intellectual disability” (40), “encephalopathy” (9), “neurofibromatosis” (5), and “multiple sclerosis” (11). We checked the keywords in Cochrane, Embase, and Google Scholar and scanned article reference lists to complete the search. We consolidated content from the final 311 relevant studies asking; (1) How was the test performed, (2) What aspect of performance was being measured, (3) How was performance measured, and (4) In which health conditions did the tests detect impairment? To supplement descriptions, relevant supporting literature from the fields of athletics and orthopedic injury were incorporated. We then applied this information in the development and testing of a novel bipedal hop test (BHT) to detect subtle lower limb impairment in people with MS.
Rest-activity daily rhythm and physical activity levels after hip and knee joint replacement: the role of actigraphy in orthopedic clinical practice
Published in Chronobiology International, 2021
Jacopo Antonino Vitale, Giuseppe Banfi, Valentina Tivolesi, Catia Pelosi, Stefano Borghi, Francesco Negrini
Every patient, independently from the type of joint arthroplasty performed, spent the first two days after surgery in the orthopedic surgery ward, where they began rehabilitation since the first day after surgery, when patients were verticalized for the first time. The third day post-surgery, they were moved in the rehabilitation ward, where rehabilitation process was intensified. Every day from PRE to POST10, patients followed a rehabilitation protocol, leaded by physical therapists 6 days per week: 30 minutes/day in the orthopedic surgery ward in POST1, and 70 minutes/day from POST3 to POST10. For both hip and knee joint replacement, the rehabilitative protocol involved also education and instruction about how to behave after joint replacement. Specific physical exercises were performed under the supervision of expert physiotherapists: passive mobilization of the involved joint in order to restore as early as possible range of motion, and active mobilization, strengthening and proprioceptive training of the lower limbs, gait training using two crutches, in order to regain full autonomy as soon as possible.