The American journal of sports medicine
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Increase in expression of substance P (SP) and calcitonin gene-related peptide (CGRP) has been reported in clinical samples of tendinopathy. ⋯ There was increased expression of SP and CGRP after collagenase-induced tendon injury, and their expression was positively associated with double-stance duration. Clinical Relevance Substance P and CGRP might be involved in the pathogenesis and origin of pain of tendinopathy and could be the targets for future intervention.
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Anatomical reconstruction techniques that can restore normal joint kinematics without increasing surgical complications could potentially improve clinical outcomes and help manage anterior cruciate ligament injuries more efficiently. ⋯ Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft could provide improved clinical outcomes over a conventional single-bundle reconstruction.
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High tibial osteotomy is technically demanding. Risks include injury to the popliteal neurovascular bundle. The present goal was to further define this risk. ⋯ To perform a safe osteotomy, the knee should be positioned in 90 degrees of flexion with the saw angled less than 30 degrees from the coronal plane. A protective device deep to the popliteus may protect against popliteal injury.
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As participation in weight training in the United States increases, the number of persons at injury risk increases. ⋯ Further research is needed to drive development of targeted, age- and gender-specific, evidence-based injury prevention strategies to decrease injury rates among weight training participants.
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Recent studies have reported that massive rotator cuff tears do not heal as predictably as, and may have diminished clinical outcomes compared with, smaller rotator cuff tears. An improved understanding of the biologic degeneration and the biomechanical alterations of massive rotator cuff tears should provide better strategies to optimize outcomes. The approach to patients with massive rotator cuff tears requires careful assessment of the patient and the extent of rotator cuff degeneration to determine the appropriate treatment. ⋯ Even though the biomechanical constructs for rotator cuff repairs have been improved, the integrity of the repair still depends on biologic healing at the tendon-to-bone junction. There has been much interest in the development of a scaffold to bridge massive rotator cuff tears and adjuvant biologic modalities including growth factors and tenocyte-seeded scaffolds to augment tendon-to-bone healing. The treatment of rotator cuff disease has improved considerably, but massive rotator cuff tears continue to pose a challenging problem for orthopaedic surgeons.