The American journal of sports medicine
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Randomized Controlled Trial
Optimal dose of intra-articular corticosteroids for adhesive capsulitis: a randomized, triple-blind, placebo-controlled trial.
Intra-articular corticosteroid injection is a commonly used therapy for adhesive capsulitis, but there are only few studies that compare the efficacy of corticosteroids according to different doses. ⋯ We assessed the efficacy of corticosteroid injections according to 2 different doses that are most widely used in intra-articular injections for adhesive capsulitis. This study shows that there were no significant differences between the high- and low-dose corticosteroid groups, indicating the preferred use of a low dose in the initial stage.
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Trochlear dysplasia is one of the most consistent anatomic factors that can lead to recurrent patellar dislocations. Various trochleoplasty procedures have been described to treat patellar dislocations in high-grade dysplasia by creating a new congruent trochlea. ⋯ Sulcus-deepening trochleoplasty is a valid option for the primary surgical treatment of carefully selected patients with recurrent patellar dislocations with high-grade trochlear dysplasia type B and D. Concomitant etiological factors must be cautiously corrected in an associated procedure. Midterm follow-up showed satisfactory restoration of patellar stability and improvement of knee scores with no complication of subsequent arthritis.
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Medial patellofemoral ligament (MPFL) reconstruction is a routine procedure for patellar instability. The majority of the techniques require hardware fixation or a bony procedure at the patella. However, most of the complications described in the literature can be attributed to patellar fixation. The "superficial quad technique" uses the superficial slip of the quadriceps tendon as the graft material, which provides a better anatomic match to the native MPFL. ⋯ The results were comparable with those of other studies in the literature that used hamstring grafts, but without associated patellar complications. The superficial quad technique uses graft material that is a better anatomic match to the native MPFL. It provides anatomic patellar fixation without a bony procedure.
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Symptomatic medial collateral ligament (MCL) instability is rare, and it is frequently associated with multiligament injuries. Most clinical investigations have failed to clearly define the specific objective outcome measures assessing the stability of the MCL quantitatively before and after the reconstruction procedure. ⋯ In a small set of patients with multiligament-injured knees, valgus laxity can be effectively restored through surgical management with superficial MCL reconstruction, when the other associated ligament injuries are reconstructed as well. The subjective functional results were significantly improved postoperatively at short-term follow-up.
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Achilles tendon ruptures represent more than 40% of all tendon ruptures requiring surgical management. About 20% of acute Achilles tendon tears are not diagnosed at the time of injury and become chronic, necessitating more complicated management than fresh injuries. Several techniques for the reconstruction of chronic tears of the Achilles tendon have been described, but the superiority of one technique over the others has not been demonstrated. ⋯ Mini-invasive reconstruction of the Achilles tendon, with a gap lesion larger than 6 cm, using the ipsilateral free semitendinosus tendon graft provides a significant improvement of symptoms and function, although calf circumference and ankle plantarflexion strength do not recover fully.