Range Of Motion In Patients Research Articles

Clinical outcomes of primary Latarjet technique in recurrent shoulder dislocation using BioLatarjet® LCS cannulated flat head screws

Background: The Latarjet technique is an effective procedure that reconstructs and augments the glenohumeral joint instability. It improves stability by increasing the glenoid width and using the sling effect. The aim of the study was to assess the functional outcomes of the primary Latarjet treatment with BioLatarjet® LCS cannulated flat head screws in cases of recurrent shoulder dislocation. Methods: In this retrospective study, 30 patients were treated with the primary Latarjet technique. Rowe score, visual analog scale (VAS), Quebec back pain disability scale (QDS), and, American shoulder and elbow surgeon score (ASES), and range of motion (ROM) were evaluated in the selected population at the time point of 6-week, 3-month, and 6-month after surgery for the determination of the functional outcomes in them. Results: The results showed that all patients had excellent or good functional outcomes with significant improvements in Rowe score, VAS score, QDS, and ASES scores (p<0.0001). The ROM in patients for forward elevation, cross body adduction, external rotation by side of body/neutral, and internal rotation by side of body/neutral were related to better clinical outcome and less movement of recurrent instability with optimal graft placement. Conclusions: These findings have clinical significance in that they demonstrate the effectiveness of the Latarjet technique in improving stability without significantly increasing the risk of complications. The BioLatarjet® LCS cannulated flat head screws were found to be safe and efficient for primary Latarjet surgeries, providing appropriate graft healing and a low recurrence of instability, with a good return-to-sports rate.

Effects of combined taping of quadriceps and hamstring muscles on pain and disability in patients with knee osteoarthritis: Randomized assessor-blinded controlled study

BackgroundThe ability of patients suffering from knee osteoarthritis to carry on routine daily activities is a significantly valuable target. ObjectivesThis study aimed to assess the effect of quadriceps and hamstring taping using kinesio tape on knee pain, function and range of motion (ROM) in patients suffering from knee osteoarthritis. MethodsTwenty-four patients, ages ranging between 50 and 70 years, diagnosed with chronic knee osteoarthritis were randomly allocated into two equal groups. Group (A) received kinesio tape on quadriceps and hamstring muscles in addition to conventional exercises while, group (B) received solely conventional exercises. Pain, knee flexion ROM and function were assessed using the visual analogue scale (VAS), the universal goniometer and Western Ontario and McMaster Universities Osteoarthritis Scale (WOMAC) respectively. Both groups were assessed before and after four weeks of treatment. ResultsMixed Design Multivariate Analysis of Variance (MANOVA) revealed non-significant differences between groups in pain, ROM and WOMAC (P > 0.05) post-treatment. Additionally, pairwise tests revealed significant reduction of VAS and WOMAC with significant increase in ROM (P < 0.05) for group (A) post-treatment. While group (B) showed significant reduction of VAS and WOMAC (P < 0.05) with non-significant change in ROM (P = 0.109) post-treatment. ConclusionQuadriceps and hamstring taping in addition to conventional exercises has no more effect than conventional exercises alone for decreasing pain and disability and increasing ROM in patients suffering from chronic knee osteoarthritis.

Balance alterations are associated with neck pain and neck muscle endurance in migraine

BackgroundMigraine patients may present with both cervical and balance dysfunctions. The neck plays an important role in balance by providing substantial proprioceptive input, which is integrated in the central nervous system and influences the balance control systems. Whether balance and neck dysfunctions are associated in patients with migraine is still to be explored. ObjectivesThis study aimed to assess the association between the sensory organization test of balance with neck pain features, cervical strength, endurance, and range of motion in patients with migraine. MethodsSixty-five patients with migraine underwent the sensory organization test assessed with the Equitest-Neurocom® device. Maximum voluntary isometric contraction, cervical flexion and extension range of motion, and cervical flexor and extensor endurance were assessed. In addition, the features of migraine and neck pain were collected. Patients were dichotomized according to cut-off scores of balance performance and the association between outcomes were explored. ResultsPatients with reduced balance performance presented a higher frequency of migraine (p = 0.035), a higher frequency of aura (p = 0.002), greater neck pain intensity (p = 0.013), and decreased endurance of cervical flexors (p = 0.010) and extensors (p < 0.0001). The total balance score was correlated with age (r = −0.33; p = 0.007), migraine frequency (r = −0.29; p = 0.021), neck pain intensity (r = −0.26; p = 0.038), and endurance of the cervical flexors (r = 0.39; p = 0.001) and extensors (r = 0.36; p = 0.001). Migraine frequency, neck pain intensity, and endurance of the cervical flexors can predict 21% of the sensory organization test variability. ConclusionNeck pain features and endurance of the cervical muscles are related to reduced balance performance in patients with migraine. These results shed light to a better understanding of balance alterations in migraine patients.

Comparison of Different Methods of Measuring Finger Range of Motion via Telehealth

This study examined the accuracy and reliability of measuring total motion of the fingers via telehealth using the following three different methods: (1) goniometry, (2) visual estimation, and (3) electronic protractor. Measurements were compared with in-person measurement, which was assumed to be the reference standard. Thirty clinicians measured finger range of motion from prerecorded videos of a mannequin hand with articulating fingers, which was posed in extension and flexion that simulated a telehealth visit, using a goniometer with results blinded to the clinician (blinded goniometry), visual estimation, and an electronic protractor, in random order. Total motion was calculated for each finger and for all four fingers in sum. The experience level, familiarity with measuring finger range of motion, and opinions of measurement difficulty were assessed. Measurement with the electronic protractor was the only method equivalent to the reference standard within 20°. Remote goniometer and visual estimation did not fall within the acceptable error margin of equivalence, and both underestimated total motion. Electronic protractor also had the highest interrater reliability (intraclass correlation [upper limit, lower limit], 0.95 [0.92, 0.95]); goniometry (intraclass correlation, 0.94 [0.91, 0.97]) was nearly identical, whereas visual estimation (intraclass correlation, 0.82 [0.74, 0.89]) was much lower. Clinicians' experience and familiarity with range of motion measurements had no relationship with the findings. Clinicians reported visual estimation as the most difficult (80%) and electronic protractor as the easiest method (73%). This study showed that traditional in-person forms of measurement underestimate finger range of motion via telehealth; a new computer-based method (ie, electronic protractor) was found to be more accurate. The use of an electronic protractor can be beneficial to clinicians measuring range of motion in patients virtually.

Comparison of Corticosteroids vs Conventional Physical Therapy for Management of Adhesive Capsulitis

Objective: To compare the role of corticosteroids and conventional physical therapy for management of adhesive capsulitis Methodology: This comparative study was conducted in Orthopedic Department, Combined Military Hospital Abbottabad. March 2022 to February 2023. Patient of active adhesive capsulitis of shoulder joint diagnosed by orthopedic surgeon were recruited. Patients in group A received single shot of methylprednisolone with local anesthesia with in the joint cavity while group B received conventional physical therapy at rehab department of our hospital. Pain scores via visual analogue scale and range of motion via goniometer was compared in both groups at baseline and at 8 weeks of treatment. Results: A total of 160 patients of adhesive capsulitis were recruited. Mean age was 42.55±10.96 years. 70 (43.7%) patients were female while 90 (56.3%) were male. Baseline pain scores and range of motion parameters were not statistically significant between the two comparison groups. At the end of 8 weeks mean pain scores were statistically significantly low in patients who took intra-articular corticosteroids as compared to those who underwent physiotherapy sessions (p-value&lt;0.001). Range of motion parameters were also statistically significantly better in patients who took corticosteroids as compared to those who underwent physiotherapy (p-value&lt;0.001). Conclusion: Use of corticosteroids emerged as a better option for treatment of pain and restricted range of motion in patients of adhesive capsulitis when compared to routine physiotherapy offered in our clinical settings. Keywords: Adhesive Capsulitis; Corticosteroids; Efficacy; Physiotherapy

Instability after reverse shoulder arthroplasty with tendon transfer: a case series

BackgroundReverse shoulder arthroplasty with tendon transfer (RSA-TT) was introduced by Boileau for patients with rotator cuff arthropathy and combined loss of active elevation and external rotation. TT at the time of RSA has been shown to increase external rotation compared to RSA alone. Postoperative instability following RSA-TT is thought to be an uncommon complication reported in around 5% of cases. We present a novel case series of RSA-TT and postoperative instability. MethodsA multicenter retrospective review was performed identifying patients who underwent RSA-TT between 2008 and 2021. Patients with rotator cuff arthropathy and combined loss of active elevation and external rotation undergoing RSA-TT and aged more than 18 years were included. Revision arthroplasty cases were excluded. Implants and TT technique were selected by the treating surgeon. Patient demographics, surgical data, and postoperative metrics were collected. Continuous variables were calculated as mean and standard deviation and then compared using Student’s t-test. Frequencies and proportions were calculated for categorical variables and compared using Chi-squared test. ResultsThirty-one patients underwent RSA-TT; 21 patients had sufficient follow-up for analysis. Seven patients (25%) had a postoperative dislocation event. Patients with instability were male with average age of 70 ± 6 years and body mass index 29 ± 4 kg/m2. The latissimus dorsi was transferred in all patients with teres major additionally transferred in 2 patients. Subscapularis was repaired in 4 patients, irreparable in 1 patient, and voluntarily not repaired in 2 patients. All dislocation events were anterior and spontaneous without inciting traumatic event. Three patients dislocated within 2 weeks of surgery. Three patients dislocated 1-2 months postoperatively. One patient dislocated nearly 6 months following surgery. At time of revision surgery, TT was intact in all patients. Two patients required multiple revision procedures to attain definitive stability, including one conversion to hemiarthroplasty. The TTs were taken down in 3 patients. At final follow-up, all patients remained stable. There were no documented nerve palsies. Final range of motion for patients with and without instability did not significantly differ. DiscussionThe series suggests that postoperative instability following RSA-TT is more common than previously reported. Despite instability requiring surgical revision, final range of motion did not significantly differ between those with stable and unstable RSA-TT patients. In those who suffered an instability event, dislocation occurred within 2 months of surgery in 86% of cases. It is important to be aware of this elevated risk of instability following this procedure and to tailor rehabilitation protocols accordingly.

Demographic and radiographic factors for knee symptoms and range of motion in patients with knee osteoarthritis: a cross-sectional study in Beijing, China

BackgroundKnee osteoarthritis (KOA) causes not only pain, stiffness, and dysfunction of the knee, but also the reduction of the joint range of motion (ROM). This study explored the demographic and radiographic factors for knee symptoms and ROM in patients with symptomatic KOA.MethodsThe demographic variables, Kellgren-Lawrence (KL) grade, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) of patients with symptomatic KOA recruited in Beijing were collected. The knee ROM of all patients were also measured. We analyzed the influencing factors for WOMAC and ROM using a generalize linear model, respectively.ResultsThis study included a total of 2034 patients with symptomatic KOA, including 530 males (26.1%) and 1504 females (73.0%), with a mean age of 59.17 (± 10.22) years. Patients with advanced age, overweight or obesity, a family history of KOA, a moderate-to-heavy manual labor job and use of nonsteroidal anti-inflammatory drugs (NSAIDs) had significantly higher WOMAC and lower ROM (all P < 0.05). The more the comorbidities, the higher the WOMAC (all P < 0.05). Patients with higher education had better ROM than those with only an elementary education(β = 4.905, P < 0.05). Compared with those KL = 0/1, the WOMAC of patients whose KL = 4 were higher (β = 0.069, P < 0.05), but the WOMAC of those KL = 2 were lower (β = -0.068, P < 0.05). ROM decreased with the increase of KL grade (all P < 0.05).ConclusionsKOA patients with advanced age, overweight or obesity, a family history of KOA in first-degree relatives, a moderate-to-heavy manual labor job tended to have more severe clinical symptoms and worse ROM. Patients with more severe imaging lesions tend to have poorer ROM. Symptom management measures and regular ROM screening should be taken early to these people.

Retrospective and Prospective Outcomes of Distal Radioulnar Joint Prosthesis Arthroplasty at a Single Center

Distal radioulnar joint (DRUJ) arthritis can cause painful and limited motion of the forearm leading to decreased function. When conservative treatment options are exhausted, surgical treatments are the next step. The purpose of this study was to retrospectively and prospectively evaluate outcomes of Scheker DRUJ total arthroplasty at a single center and add to the limited data on this procedure. In a retrospective and prospective cohort of 12 patients, 13 DRUJ prosthetics implanted from 2014 to 2021 were evaluated from a single center. The primary outcome was patient satisfaction with the procedure, including comparisons of preoperative and postoperative visual analog scale, Disabilities of the Arm, Shoulder, and Hand, and willingness to repeat the procedure. Secondary outcomes included range of motion, subjective grip strength, need for hardware revision, subsequent procedures, and postoperative complaints. Out of 12 patients that were at least 1-year after surgery from DRUJ arthroplasty, 1 was deceased at the time of final survey and 1 underwent bilateral DRUJ arthroplasty. Seven of 12 available patients were surveyed over the phone. On average, patient range of motion after surgery was 76° in each direction for pronation and supination. There was a clinically significant improvement in the Disabilities of the Arm, Shoulder, and Hand score and a statistically significant improvement in visual analog scale pain rating. Seventy-five percent of patients surveyed were satisfied with their outcomes and would undergo the surgery again. Only one patient required additional surgery, and there were no instances of hardware failure at an average follow-up of 40 months. Our study has shown positive outcomes with decrease in pain, improvement in function via Disabilities of the Arm, Shoulder, and Hand evaluation, and subjective patient satisfaction, with a 100% prosthesis survival rate. The DRUJ arthroplasty prosthesis is a viable alternative to other DRUJ salvage procedures. Therapeutic Level III.

Effects of 6 weeks of ankle stability exercises on pain, functional abilities, and flexibility in patients with chronic non-specific low back pain: a randomized controlled trial

BackgroundDue to delayed activation of the deep trunk muscles, patients with chronic non-specific low back pain use different adjustment strategies to maintain postural control. Patients with chronic non-specific low back pain maintain a quite standing posture during pain episode and challenging activities by using signals from other joints, mainly the ankle joint. Since proprioceptive signals from the ankle joint reduce postural control variability in patients with chronic non-specific low back pain, this study explored whether ankle stability exercises added to traditional physical therapy exercises would improve the intensity of pain, functional disabilities and lumbar flexion range of motion in patients with chronic non-specific low back pain.MethodsSixty patients with chronic non-specific low back pain participated in the current study. Patients were randomly assigned into two groups: group A and group B. Patients in group A received traditional physical therapy exercises for low back pain. Patients in group B received the same traditional physical therapy exercises as patients in group A, plus ankle stability exercises. The intensity of pain, functional disability, and lumbar flexion range of motion were assessed twice before and after a 6-week period during which each group received their interventions.ResultsMixed design MANOVA revealed a significant decrease in visual analog scale and Oswestry Disability Index in group B compared to group A post treatment (p < 0.05). Moreover, there was a significant increase in the lumbar flexion range of motion in group B compared with group A post treatment (p < 0.05).ConclusionThe findings of this study revealed that adding ankle stability exercises to the traditional physical therapy exercises significantly improved pain, Oswestry Disability Index, and lumbar flexion range of motion in patients with chronic non-specific low back pain. Thus, ankle strengthening and proprioceptive exercises may be beneficial in the management of chronic non-specific low back pain.

Quantification of joint space width with different grades of manual traction in patients with adhesive capsulitis-A fluoroscopic study

Adhesive capsulitis causes adaptive shortening of the non-contractile structures around the shoulder joint which may affect the distraction distance or joint space width (JSW) between the glenoid and humeral head. Joint traction is a commonly used manual therapy technique to reduce pain and gain range of motion in patients with adhesive capsulitis. However, changes in JSW with manual traction are not objectively assessed. This study aimed to find differences in shoulder JSW with different grades of traction and made comparisons between the affected and the unaffected side using 2D fluoroscopy. Forty-one subjects (24 males, 17 females; age 53.9±7.9 years) diagnosed with adhesive capsulitis with low to moderate joint irritability were included. Their mean duration of symptoms was 5.25±1.7 months. True anteroposterior view images of the shoulder were taken with the patient in a supine position with their arms held at 75° of abduction. Images of the affected and unaffected side were taken while no traction, grade 2 and grade 3 manual traction were applied. The JSW was determined as the linear distance between the articular surfaces. Repeated measures ANOVA with post hoc testing was used for analysing differences across the sides (affected and unaffected side) and conditions (No, grade 2 and grade 3 traction). There was no significant interaction between conditions and sides (P=0.99). Averaged across sides, the JSW with grade 2 or 3 traction was 0.18 and 0.23 mm more than the no traction condition (P=0.013 and P=0.001, respectively). There were no differences in the JSW with grade 2 or 3 traction. Averaged across the conditions, the JSW on the unaffected side was 0.21 mm more than the affected side (P=0.03). The study demonstrates that adhesive capsulitis causes a reduction in JSW at 75° abducted position and grade 2 or 3 manual traction can significantly increase this JSW. Clinical Trial Registry India: CTRI/2018/12/016657.

Efficacy of Dry Needling Versus Transcutaneous Electrical Nerve Stimulation in Patients With Neck Pain Due to Myofascial Trigger Points: A Randomized Controlled Trial.

Introduction Myofascial pain is defined as pain arising primarily in muscles and associated with multiple trigger points. Among the non-pharmacological methods, trigger point injection and electrotherapy are effective methods to treat myofascial pain syndrome. This study compares the effectiveness of dry needling (DN) and transcutaneous electrical nerve stimulation (TENS) in reducing cervical pain intensity and improving cervical range of motion in patients with neck pain due to myofascial trigger points. Methods Fifty patients were enrolled and randomized into two groups. Patients in group A received dry needling, and those in group B received TENS. Patients were evaluated using the Visual Analog Scale (VAS), Neck Disability Index (NDI), and Cervical Range of Motion (CROM) before the treatment and on days 14and 28 after the treatment. The unpaired t-test was used to evaluate quantitative data, except for VAS, where the Mann-Whitney U test was used. All quantitative variables had a normal distribution with a standard deviation except for pain intensity (VAS), which deviated from the normal distribution. The significance level was set at a P-value=0.05. Results Both DN and TENS groups showed significant improvement in VAS, NDI, and CROM between days 0 and 28 (p=<0.001). The DN group showed greater improvements in pain intensity from day 0 to day 28 (p=<0.001). Between days 0 and 28, there was no discernible difference in NDI changes between the groups (p = 0.157 and p = 0.799, respectively). Mixed results were obtained for CROM, with significant improvement of cervical flexion in the dry needling group (p=<0.008) and significant improvement of cervical rotation to the painful side in the TENS group (<0.001). Conclusion Both dry needling and TENS are effective in reducing pain and improving NDI and CROM in patients with neck pain due to myofascial trigger points. However, as dry needling is more effective in pain reduction, a single session of dry needling is more beneficial and cost-effective as compared to multiple sessions of TENS.

Functional range of motion of the cervical spine in cervical fusion patients during activities of daily living

Following cervical spine fusion there is a reduction in maximum range of motion (ROM) but how this impacts activity of daily living (ADLs) and quality of life is unknown. This study’s purpose is to quantify maximum and functional cervical spine ROM in patients with multi-level cervical fusion (>3 levels) compared to controls during ADLs and to correlate functional range of motion with scores from patient reported outcomes measures (PROs) including the Comparative Pain Scale (CPS), Fear Avoidance Belief Questionnaire (FABQ), and Neck Disability Index (NDI).An inertial measurement unit (IMU) system quantified ROM during ADLs in the extension/flexion, lateral bending, and axial rotation directions of motion. The reliability of this system was compared to standard optical motion tracking. Fourteen participants (8 females, age = 60.0 years (18.7) (median, (interquartile range)) with a history of multi-level cervical fusion (years post-op 0.9 (0.7)) were compared to 16 controls (13 females, age = 52.1 years (15.8)). PROs were collected for each participant.Fusion participants had significantly decreased maximum ROM in all directions of motion. Fusion participants had decreased ROM for some ADLs (backing up a car, using a phone, donning socks, negotiating stairs). CPS, FABQ, and NDI scores were significantly increased in fusion participants. Reductions in two activities (backing up a car, stair negotiation) correlated with a combination of increased PRO scores.Cervical fusion decreases maximum ROM and is correlated with increased PROs in some ADLs, however there is minimal impact on functional ROM. Investigation into velocity and acceleration may yield categorization of pathologic movement.

A Systematic Review on Low-Level Laser Therapy in the Management of Shoulder Impingement Syndrome

Background: Conservative therapy is currently the elective treatment for shoulder impingement syndrome according to the scientific literature. The success of conservative therapy is due to physiotherapy and the application of its methods. The aim of this systematic review was to evaluate low-level laser therapy, a physiotherapeutic method for pain reduction and increasing the range of motion. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The screening of the literature was carried out on the Cochrane, PEDro, PubMed/Medline, and Scopus databases up until December 2021. All studies were randomized controlled trials (RCTs), and five articles met the inclusion criteria and were included in this study. The risk of bias was evaluated with PEDro and Jadad scales. Results: In this study, we reviewed five RCTs that compared low-level laser therapy with other physiotherapy treatments to reduce pain and improve range of motion in patients with shoulder impingement syndrome. Conclusions: Low-level laser therapy for shoulder impingement syndrome requires further investigation in future studies.

Darrach vs. Sauve-Kapandji: A Comprehensive Meta-Analysis of Surgical Outcomes in Distal Radioulnar Joint (DRUJ) Dysfunction.

Optimal treatment of chronic distal radioulnar joint (DRUJ) arthritis and instability remains unresolved in the literature. Specifically, no systematic comparison of two common options, Sauve-Kapandji (SK) and Darrach's, is available. A meta-analysis was performed utilizing the PUBMED and EMBASE databases and yielded a total of 47 available studies. Objective outcomes, such as wrist range of motion (ROM), forearm ROM, grip strength, and subjective outcomes, including pain and rate of return to work, were recorded. Statistical analysis was done using t test and chi-square test. For both the SK and Darrach's procedures, forearm ROM was significantly better postoperatively in both pronation (p = 0.0001 for both groups) and supination (p = 0.0001 for both groups). Wrist flexion decreased in the SK group (p = 0.0007), but no difference was found for wrist extension (p = 0.09). The Darrach's group showed a significance improvement in wrist extension (p = 0.0001). Grip strength was improved in the SK group (p < 0.0001), but not in the Darrach's group (p = 0.7831). No difference existed between the SK and Darrach's groups in proportion of patients who were pain-free. The SK group had higher numbers of patients return to work (p = 0.0057). There was not enough data from the studies to make any meaningful analysis in term of treatment failure and complications. Overall, both the SK and Darrach's procedures helped improve pain, wrist ROM, and forearm ROM in patient with chronic DRUJ disorders. The SK procedure can have advantages over the Darrach's procedures in terms of grip strength and rate of return to work. The online version contains supplementary material available at 10.1007/s43465-023-00826-5.

Comparison of the Immediate Effect of Active Stretching Techniques and Self-myofascial Release on the Flexibility of the Iliotibial Band and Functional Activities in Semi-Elite Athletes: A Randomized Clinical Trial

Background: The iliotibial band (ITB) is prone to shortening in sports activities. Correcting the lack of flexibility can be a factor in improving the overall biomechanics of the body and preventing future injuries. Methods: A total of 51 semi-elite athletes (age range: 20 - 40 years) with ITB shortness confirmed by the modified Ober’s test participated in this study. The participants were randomly divided into three groups, including foam roller, proprioceptive neuromuscular facilitation (PNF) active stretching, and a combination of foam roller and PNF stretching. Results: The mean of the active hip adduction range of motion (ROM), single-leg hop test, lateral hop test, and vertical jump in all three groups increased significantly after the intervention compared to before (P &lt; 0.05). All three studied groups had similar changes over time, and no group was superior to the others. Conclusions: Using a foam roller, PNF active stretching technique, and a combination of both can improve hip ROM in patients with ITB shortness. As a result, the functional activities of athletes, including vertical jump, lateral hop, and single-leg hop, can be improved. Flexibility and ROM increased significantly in all three treatment groups. There is no priority between different interventions.

A Bibliometric and Visual Analysis of the Most Cited Articles on Disc Arthroplasty.

Bibliometric literature review. Total disc arthroplasty (TDA) is an evolving technique used by surgeons to preserve neural elements and range of motion in patients with degenerative disc disease, spondylosis and more. In comparison to discectomy, disc arthroplasty has been shown to decrease morbidity, reduce adjacent-level disease, and preserve pre-operative range of motion. The objective of this manuscript is to provide a bibliometric analysis of the use of disc arthroplasty in scientific literature and highlight the main contributing authors and their publication characteristics. The Scopus database was used to perform a title-specific, keyword-based search for all publications until June 2022. The keyword "total disc arthroplasty" was used. The most-cited 100 articles were selected for analysis. Parameters included the following: title, citation count, citations per year, authors, specialty first author, institution, country of origin, publishing journal, Source Normalized, Impact Per Paper (SNIP), and Hirsch index. Our search on disc arthroplasty yielded 580 articles that were published, with the first publication on the topic found in 1966. The most cited 100 articles received a total of 8694 citations, with an average of 86.94 citations per article. After assessing countries with the greatest contributions, United States, China, and Germany were top 3 with 54, 14, and 7 articles, respectively. The bibliometric analysis provides an overview of how medical research is analyzed in academic medicine. In the present study, we evaluated the global trends in disc arthroplasty for the treatment of degenerative disc disease.

Comparison of Manual Therapy Technique to Therapeutic Exercise in the Treatment of Patients With Subacromial Impingement Syndrome: A Randomized Clinical Trial

ObjectiveThe purpose of this study was to compare the effects of manual therapy to therapeutic exercise on shoulder pain, disability, and range of motion (ROM) in patients with subacromial impingement syndrome (SAIS). MethodsSixty patients with SAIS were randomly assigned into the manual therapy (MT) and therapeutic exercise (TE) groups. Patients in the MT group were treated with joint mobilization, which was applied to the glenohumeral, acromioclavicular, sternoclavicular and scapulothoracic joints, and trigger point (TrP) inactivation using ischemic compression. Patients in the TE group performed therapeutic exercises. Shoulder pain, disability and active ROM (elevation, external rotation, and internal rotation) were assessed by the visual analog scale, the Shoulder Pain and Disability Index, and a goniometer, respectively. The outcomes were measured at baseline, after the intervention, and 1 month after the intervention. ResultsAfter the treatment, both groups had significant improvements in shoulder pain, disability, and ROM (P < .05). The MT group experienced a greater reduction in shoulder pain than the TE group (P < .001). However, in disability and ROM, both groups exhibited similar improvements in post-treatment and follow-up periods. ConclusionBoth MT and TE were effective in improving shoulder pain, disability, and ROM in patients with SAIS. Greater improvement in shoulder pain was observed in the MT group.

Effect of Functional Scapular Stabilization Training on Function and Pain in Frozen Shoulder Syndrome: A Randomized Controlled Trial

ObjectiveThe purpose of this study was to determine the effect of functional scapular stabilization training compared with the standard physical therapy on function and pain in people with frozen shoulder syndrome (FSS). MethodsIn a single-blind randomized controlled trial, 86 people with FSS were randomly allocated into the intervention group (functional stabilization training [n = 43]) and control group (standard physical therapy [n = 43]) using block randomization for 12 weeks. The primary outcome measures were the Shoulder Pain and Disability Index and the numeric pain rating scale. The secondary outcome measures were range of motion (ROM), range of passive abduction, and coracoid pain test. All the outcome measures were carried out by an independent blind outcome assessor at baseline and at the end of 12 weeks. ResultsA significant group × time interaction effect was observed for the Shoulder Pain and Disability Index (95% CI, 2.95-16.74; P < .01) and the numeric pain rating scale (95% CI, 0.67-2.07; P < .01) at the end of 12 weeks. The external rotation ROM showed a statistical significance with a mean change of 7.8° and P value of <.01. ConclusionThe present findings show that scapular functional stabilization training resulted in improvement of function, reduction in pain, and greater improvement in external rotation ROM in patients with FSS. Also, our study findings suggest the involvement of rotator interval and inferior soft-tissue structures as indicated by the coracoid pain test and range of passive abduction.

OVER 50% OF PATIENTS AT RISK OF IMPINGEMENT AFTER THA SURGERY ARE NOT CAPTURED WITH NEUTRAL BONY ALIGNMENT

Dislocation is one of the most common complications in total hip arthroplasty (THA) and is primarily driven by bony or prosthetic impingement. The aim of this study was two-fold. First, to develop a simulation that incorporates the functional position of the femur and pelvis and instantaneously determines range of motion (ROM) limits. Second, to assess the number of patients for whom their functional bony alignment escalates impingement risk.468 patients underwent a preoperative THA planning protocol that included functional x-rays and a lower limb CT scan. The CT scan was segmented and landmarked, and the x-rays were measured for pelvic tilt, femoral rotation, and preoperative leg length discrepancy (LLD). All patients received 3D templating with the same implant combination (Depuy; Corail/Pinnacle). Implants were positioned according to standardised criteria.Each patient was simulated in a novel ROM simulation that instantaneously calculates bony and prosthetic impingement limits in functional movements. Simulated motions included flexion and standing-external rotation (ER). Each patient's ROM was simulated with their bones oriented in both functional and neutral positions.13% patients suffered a ROM impingement for functional but not neutral extension-ER. As a result, 48% patients who failed the functional-ER simulation would not be detected without consideration of the functional bony alignment. 16% patients suffered a ROM impingement for functional but not neutral flexion. As a result, 65% patients who failed the flexion simulation would not be detected without consideration of the functional bony alignment.We have developed a ROM simulation for use with preoperative planning for THA surgery that can solve bony and prosthetic impingement limits instantaneously. The advantage of our ROM simulation over previous simulations is instantaneous impingement detection, not requiring implant geometries to be analysed prior to use, and addressing the functional position of both the femur and pelvis.

Triamcinolone acetonide with arthroscopic capsular release for frozen shoulder promotes early recovery of shoulder abduction

Current treatment options for frozen shoulder are not established as the standard-of-care. The condition may resolve without intervention, but symptoms may persist despite treatment. Frozen shoulder is associated with inflammatory reactions that can reduce quality of life. Our aim was to determine whether triamcinolone acetonide, an immunosuppressive steroid, improved functional recovery when administered after arthroscopic capsular release (ACR) for frozen shoulder. We selected participants using inclusion and exclusion criteria designed to reduce the impact of potential confounding factors. Under general anesthesia, we performed ACR followed by manipulation to ensure adequate range of motion (ROM) and wound closure. In the steroid treatment group, we injected triamcinolone acetonide into the glenohumeral joint immediately prior to wound closure. The follow-up period was six months. To determine the efficacy of steroids in improving overall post procedure functional recovery we statistically analyzed data from various qualitative and quantitative variables. Our study consisted of 22 patients with frozen shoulder, 11 in each of the surgery-only and surgery with steroid injection groups. There were no significant differences between groups in the demographic data of the study participants. We observed significantly greater improvements in abduction ROM in the steroid treatment group than in the surgery-only group, at three and six months post treatment. Improvements in other movement parameters were similar in both groups. The steroid-treated group had a significantly higher numerical rating scale score for night pain at three months post treatment than the surgery-only group. Postoperative steroid treatment led to early recovery of the abduction ROM in patients with frozen shoulder. Hence, the current standard-of-care protocol for frozen shoulder and other similar conditions requiring surgical intervention should include this type of treatment. Therapeutic reduction in the inflammatory response following ACR can significantly improve prognosis and quality of life.