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AimsWe evaluated clinical and radiographic outcomes of total shoulder arthroplasty (TSA) using the second-generation Trabecular Metal (TM) Glenoid component. The first generation component was withdrawn in 2005 after a series of failures were reported. Between 2009 and 2012, 40 consecutive patients with unilateral TSA using the second-generation component were enrolled in this clinical study. The mean age of the patients was 63.8 years (40 to 75) and the mean follow-up was 38 months (24 to 42).MethodsPatients were evaluated using the Constant score (CS), the American Shoulder and Elbow Surgeons (ASES) score and routine radiographs.ResultsSignificant differences were found between the pre- and post-operative CS (p = 0.003), ASES (p = 0.009) scores and CS subscores of pain (p < 0.001), strength (p < 0.001) and mobility items (p < 0.05). No glenoid or humeral components migrated. Posterior thinning of the keel and slight wear at the polyethylene-TM interface was observed in one patient but was asymptomatic. Radiolucent lines were found around three humeral (< 1.5 mm) and two glenoid components (< 1 mm) and all were asymptomatic.DiscussionTSA with the second-generation TM Glenoid component results in satisfactory to excellent clinical performance, function, and subjective satisfaction at a mean follow-up of about three years. Radiographic changes were few and did not affect the outcome. Take home message: This paper highlights that the second generation Trabecular Metal Glenoid has better outcomes than those reported with the first-generation component. Cite this article: Bone Joint J 2016;98-B:75–80.

Our objectives were to determine the reporting of symptoms, the medical outcome and the work status of meat plant workers diagnosed with clinical carpal tunnel syndrome (CTS). Forty-seven cases of CTS were identified from a previously reported study, and were matched by age, gender and hand use. Cases and controls were followed up for 24 months. The Provincial Workers' Compensation Board and company health records were used to determine the reporting of symptoms, interventions and work status. Thirty-one study cases and all control cases were followed for the full 24 months (16 study cases were lost to follow-up). In total, 12 cases reported symptoms of CTS during the 24 months (eight study cases and four controls). Of the eight study cases, one required surgical release of the carpal tunnel. After a period of work modification, five of the eight study cases returned to regular duty and the remainder were placed on permanent job restrictions. Of the four controls, one subject had a surgical release and returned to regular work, two subjects' jobs were permanently modified, and the fourth returned to regular duty. Occupation-related CTS in meat packers appears to be transient and responsive to conservative measures, with a surgical rate comparable to other occupations.

OBJECTIVES: To determine prevalence and incidence of carpal tunnel syndrome (CTS) in a modern meat packing plant. The secondary objective was to explore the relation between ethnicity and CTS. METHODS: Six hundred and sixty five workers were interviewed and examined to find the prevalence of CTS. Subsequently, 421 workers without CTS were followed up and examined at a median interval of 253 days; of those, 333 remained without CTS and were again examined at a median interval of 148 days. RESULTS: The prevalence and incidence of CTS was 21% and 11/100 person-years, respectively. The incidence for Asian mixed, white, and other ethnicities was 12.0, 12.2, and 7.2 cases/100 person- years, respectively. The observed incidence for men and women was 9.7 and 18.4 cases/100 person-years, respectively. This difference was not quite significant (p = 0.068) with an estimated relative risk (women v men) of 1.9 (95% confidence interval (95% CI) 0.9 to 3.8). The interaction between sex and use of tools was significant (p = 0.04), however, although the relative risk for CTS in women who used tools was 4.2 the numbers were small and not significant. The relative risk for men who used tools was 0.64 and not significant. The percentage of incident cases with comorbid disease was only 6.3% (3/47). CONCLUSIONS: The prevalence and incidence of CTS in this workforce were higher than in the general population. However, the prevalence of CTS in this modern, mechanised plant was not significantly different from that reported in older plants. No relation was found between ethnicity, age, body mass index, and CTS for either prevalence or incidence. Comorbid disease among the cases of CTS is significantly less than that found in other industry.

The purpose of this study was to determine the prevalence and incidence of trigger finger (TF) in a meat-packing plant and explore the relationship between hand-tool use and the development of TF. A cross-sectional study was competed wherein 665 workers were interviewed and examined to determine the point prevalence. Subsequently, 454 TF-negative workers were followed up and examined twice at a median interval of 225 days. The point prevalence of TF was 14%. The person-year incidence rate was 12.4% and 2.6% for tool use and non-tool use workers, respectively. Forty-three cases of TF (75.2%) in the incidence arm of the study used a hand tool, for a relative risk of 4.7 (P < 0.002; 95% confidence interval, 1.5-23.9). Although a significant relationship was found between ethnicity and the presence of TF in the prevalence data, this was not confirmed in the incidence study. There is an increased prevalence of TF in this meat-packing plant and high worker turnover may underestimate the true prevalence rates. Hand-tool use increases the risk of developing TF.

Background The medical care programme during Paralympic Winter Games should reflect the particular needs and necessities of Paralympic athletes and their support staff. Objective To characterise in detail the medical encounters at the 2010 Vancouver Paralympic Winter Games in order to improve knowledge or injury and illness patterns for medical providers at future adaptive sports events. Design Prospective (sports) injury epidemiological study. Setting The data collection took place during the Vancouver 2010 Paralympic Winter Games. Participants Data are reported on all persons involved in the Vancouver 2010 Paralympic Winter Games that consulted VANOC Medical Services, with particular emphasis on athlete records (n=502 participating athletes). Interventions Systematic records were held on all medical and physical therapy consultations throughout the duration of the Games. Main outcome measurements Number of patients treated during the 2010 Vancouver Paralympic Winter Games, stratified by accreditation status, injury or illness type and services consulted. Results At the Vancouver 2010 Paralympic Winter Games, more than 2717 medical interventions occurred for injury or illness, of whom 25% were athlete encounters (n=657). Consultations were mainly for minor injury/illness, majority of musculoskeletal nature; with only seven hospitalisations (five athletes) for a total of 24 inpatient days stay (16 days for athletes). 977 pharmacy prescriptions were issued, which in seven cases were followed up with a Therapeutic Use Exemption application. Alpine Ski was responsible for over 50% of the athlete imaging visits and approximately 20% of total imaging visits (n=332). Physical therapy interventions (n=897) primarily addressed back and shoulder structures. Conclusion A critical analysis of the actual findings and an efficient transfer of knowledge indicate the need for a multidisciplinary approach with other functional areas related to the organisation of Paralympic (Winter) Games, as well as for the initiating of longitudinal study to gain further and in-depth knowledge on sport injuries and exercise-induced physiological reactions in Paralympic Athletes.

Background Epidemiological data and logistical details are crucial pieces of information for organisers of medical care at mass sporting events. Objective To outline the medical facilities at the 2010 Winter Olympic Games and to report the epidemiology of medical encounters. Design Prospective descriptive study. Setting Nine competition venues, six non-competition venues and two Polyclinics (Vancouver and Whistler). Medical services were available at all venues. The Polyclinics housed an inter-disciplinary team of health-care professionals. Imaging modalities (including CT and MRI) were on-site at the Polyclinics. Participants 2567 athletes, 82 National Olympic Committees, an estimated 4000 Officials, 25 000 Workforce/Volunteers, 10 000 Performers and 10 000 Media. Medical Services included 1560 volunteers and 19 full-time staff. Assessment Medical encounters were entered into a Medical Encounter Database (ATOS Origin). Games-Time reporting period was February 4th to 28th, inclusive. Computers were located at each Venue. Main outcome measure Medical encounters. Results There were 9038 medical encounters (8198 accredited; 840 spectator). The busiest venues were the Whistler Polyclinic (n=3124) and Vancouver Polyclinic (n=2930). Of the competition venues, the busiest were Whistler Sliding Centre (bobsleigh/luge/skeleton), Canada Hockey Place and Pacific Coliseum (figure skating and short track speed skating). Venues with the greatest number of spectator medical encounters were Canada Hockey Place (n=186), B.C. Place Stadium (Opening/Closing Ceremonies) (n=128) and UBC Sports Centre (hockey) (n=90). Sports with the highest and lowest athlete medical encounters were Alpine Skiing and Nordic Combined, respectively. The majority of encounters were musculoskeletal (MSK) (n=29%). There were 131 ground ambulance transfers and seven air ambulance extractions/transfers resulting in 14 hospital admissions and 43 outpatient visits. Conclusion The majority of medical encounters were seen at the Polyclinics. Although most were MSK, there was a high demand for other disciplines such as Dental and Imaging. Multi-disciplinary Polyclinics equipped with primary and ancillary services are essential at future Games.