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Objective: To evaluate the efficacy of a specific rehabilitation program for patients in whom ultrasound-guided percutaneous treatment (UGPT) was performed for rotator cuff calcific tendinopathy (RCCT). Subjects and Methods: In this prospective observational study, 86 patients (22 males and 64 females) with shoulder calcific tendinopathy treated with UGPT were enrolled. At the end of the procedure, a corticosteroid injection into the subacromial-subdeltoid bursa was performed. The patients were then asked to follow a specific rehabilitation protocol (2 times/week for 5 weeks) that focused on mobility, strength and function. At baseline and after 6 weeks, clinical parameters, visual analog scale (VAS) and Constant-Murley scale (CMS) scores and ultrasound (US) features were collected. Results: The mean age of the patients was 48.9 ± 8.4 years and their mean BMI was 22.7 ± 2.1. Considering the whole cohort, the treatment was effective, with a significant decrease in the VAS score and an improvement in the CMS score. Thereafter, on the basis of the compliance to the rehabilitation program (by self-report), 53 and 33 patients were included in the rehabilitation group (Rehab group; performed exercises ≥2 times/week) and the No Rehab group (performed exercises <2 times/week), respectively. The comparison between the groups showed that the subjects who performed the exercises regularly had better results in terms of pain and functional recovery, and less associated diseases (e.g. adhesive bursitis and tenosynovitis of the long head of the biceps) than those who were less compliant with the program. Conclusions: UGPT, followed by a specific postprocedure rehabilitation program, was an effective treatment for RCCT. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article presents information on a study which evaluated the morphologic characteristics of the Achilles tendon in patients with diabetes in contrast with healthy patients. Topics discussed include the methods used, the recording of degenerative features like signs of enthesopathy, the evidence of significant increased of asymptomatic sonographic abnormalities in diabetic patients and the possible predisposition of diabetes to Achilles tendinopathy.

CoViD-19 epidemic started in China in late December 2019, and soon spread, turning into a pandemic. All medical specialties have soon been involved in the management of CoViD-19 patients; the daily Orthopaedic activity has been affected profoundly by this dramatic health emergency. The present paper aims to summarize all the measures and changes that had to be made in order to avoid the healthcare system collapse in the most affected areas, and provides an operative flowchart. [ABSTRACT FROM AUTHOR]

Several rheumatologic manifestations are more pronounced in subjects with diabetes, ie, frozen shoulder, rotator cuff tears, Dupuytren's contracture, trigger finger, cheiroarthropathy in the upper limb, and Achilles tendinopathy and plantar fasciitis in the lower limb. These conditions can limit the range of motion of the affected joint, thereby impairing function and ability to perform activities of daily living. This review provides a short description of diabetes-related joint diseases, the specific pathogenetic mechanisms involved, and the role of inflammation, overuse, and genetics, each of which activates a complex sequence of biochemical alterations. Diabetes is a causative factor in tendon diseases and amplifies the damage induced by other agents as well. According to an accepted hypothesis, damaged joint tissue in diabetes is caused by an excess of advanced glycation end products, which forms covalent cross-links within collagen fibers and alters their structure and function. Moreover, they interact with a variety of cell surface receptors, activating a number of effects, including pro-oxidant and proinflammatory events. Adiposity and advanced age, commonly associated with type 2 diabetes mellitus, are further pathogenetic factors. Prevention and strict control of this metabolic disorder is essential, because it has been demonstrated that limited joint motion is related to duration of the disease and hyperglycemia. Several treatments are used in clinical practice, but their mechanisms of action are not completely understood, and their efficacy is also debated. [ABSTRACT FROM AUTHOR]

The ideal strategy for tendon healing has not been identified to date. Recently, the use of stem cells based therapy has been proposed, due to their ability to proliferate and to differentiate towards specific connective tissues lineages. Embryonic stem cells should be considered the ideal cell source for regenerative therapies, but ethical factors limit their use in humans. Mesenchymal stem cells are more easily available and can be obtained by different sources. Amnion derived stem cells can differentiate towards all three germ layers, and can be used for allogeneic transplantation and stored thanks to cryopreservation. In veterinary medicine, stem cells have been used with encouraging results for the treatment of the Superficial Digital Flexor tendinopathy in the horses. Considering that Superficial Digital Flexor tendinopathy is similar for pathogenesis and histopathology to Achilles tendinopathy in man, this experience can provide supportive data to encourage the use of regenerative therapy in humans. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of osteoporotic vertebral fractures (OVF) increased in the last years. Compression fractures promote a progressive spine kyphosis increase, resulting in a weight shift and anterior column overload, with OVF additional risk (domino effect). The aim of this study is to evaluate the OVF treatment outcome using Spine Jack®, a titanium device for third generation percutaneous vertebral augmentation procedures (PVAPs). Materials and Methods: From February 2010, a prospective randomized study was performed examining 300 patients who underwent PVAP due to OVF type A1 according to Magerl/AO spine classification. Patients enrolled in the study were divided in two homogenous groups with regards to age (65-85 years), sex, and general clinical findings. Group A included 150 patients who underwent PVAP using Spine Jack® system; the second, group B (control group), included 150 patients treated by conventional balloon kyphoplasty. Patients underwent a clinical (visual analogue scale and Oswestry disability index) and radiographic follow-up, with post-operative standing plain radiogram of the spine at 1, 6, and 12 months. The radiographic parameters that were taken into account were: Post-operative anterior vertebral body height, pre-operative anterior vertebral body height, cephalic anterior vertebral body height, and caudal anterior vertebral body height. Results: Compared to the Spine Jack® group, the kyphoplasty group required a little longer operation time (an average of 40 min--group A vs. 45 min--group B, P < 0.05) and a greater amount of polymethylmethacrylate (4.0 mL--group A vs. 5.0 mL--group B, P < 0.05;). The post-operative increase in vertebral body height was greater in the Spine Jack® group than in the kyphoplasty group (P < 0.05). Discussion: PVAP are based on the cement injection into the vertebral body. Vertebroplasty does not allow the vertebral body height recovery. Balloon kyphoplasty allows a temporary height restoration. Spine Jack® has some new features compared to other systems: It is equipped with a mechanical and not a hydraulic opening control; this ensures a gradual and controlled vertebral fracture reduction. Conclusions: In our study, we demonstrated that the third generation PVAP with Spine Jack® is able to determine a safe vertebral body height restoration compared to the conventional balloon kyphoplasty. [ABSTRACT FROM AUTHOR]

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