American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Nov 2006
ReviewVitamin D deficiency: implications in the rehabilitation setting.
Vitamin D deficiency, which can result from inadequate sun exposure, dietary intake, or problems with absorption, is rarely documented in the rehabilitation literature. Most likely, it is rarely thought of by the rehabilitation profession. This is problematic because vitamin D deficiency can present as musculoskeletal pain, which is commonly seen in both outpatient clinics and inpatient rehabilitation units. The populations with the greatest risk include the homebound elderly, people with pigmented skin, people with cultural and social avoidance of the sun, people who live in wintertime in climates above and below latitudes of 35 degrees, and people with gastrointestinal malabsorption. ⋯ Vitamin D deficiency should be included in the differential diagnosis in the evaluation of musculoskeletal pain complaints in the rehabilitation setting, and treatment of any identified deficiency should be considered a potentially important component of the treatment regimen.
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Am J Phys Med Rehabil · Nov 2006
Case ReportsAcute arterial occlusion after total knee arthroplasty.
There are a number of complications associated with total knee-joint arthroplasty. These include deep venous thromboses, peroneal palsy, infection, anemia, and Ogilvie's syndrome. An uncommon but potentially limb-threatening complication is acute arterial occlusion. ⋯ Careful management of patients after total knee arthroplasty requires an understanding that arterial occlusion is a rare limb-threatening complication of surgery, but that it is treatable with prompt, deliberate management. Physiatrists should be aware that this condition exists in postoperative knee-joint arthroplasty patients. They should pay careful attention to any patient with a history of peripheral vascular disease or postoperative peroneal palsy.