Bmc Musculoskel Dis
-
Bmc Musculoskel Dis · Jan 2010
Clinical TrialRotational alignment of the tibial component in total knee arthroplasty is better at the medial third of tibial tuberosity than at the medial border.
Correct rotational alignment of the femoral and tibial component is an important factor for successful TKA. The transepicondylar axis is widely accepted as a reference for the femoral component. There is not a standard reference for the tibial component. CT scans were used in this study to measure which of 2 tibial landmarks most reliably reproduces a correct femoro-tibial rotational alignment in TKA. ⋯ Using fixed bone landmarks for rotational alignment leads to a notable variance between femoral and tibial components. Referencing the tibial rotation on a line from the medial third of the tibial tubercle to the center of the tibial tray resulted in a better femoro-tibial rotational alignment than using the medial border of tibial tubercle as a landmark. Surgeons using fixed bearings with a high rotational constraint between the inlay and the femoral component should be aware of this effect to avoid premature polyethylene wear.
-
Bmc Musculoskel Dis · Jan 2010
An investigation of somatosensory profiles in work related upper limb disorders: a case-control observational study protocol.
Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP), remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain. ⋯ The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying neurophysiology in NSAP and may influence future classification and intervention studies relating to this condition.
-
Bmc Musculoskel Dis · Jan 2010
Work-related musculoskeletal disorders among nurses in Ibadan, South-west Nigeria: a cross-sectional survey.
Musculoskeletal disorders represent a significant occupational problem among nurses; however, data on musculoskeletal health of nurses in Sub-Sahara Africa are sparse. This study sought to determine the lifetime, 12-months period and point prevalence of work-related musculoskeletal disorders (WMSDs); the associated job risk factors and the coping strategies toward reducing the risk among nurses from selected hospitals in Ibadan, South-west Nigeria ⋯ A high proportion of Nigerian nurses reported WMSDs at some body site in their occupational lives with the low back being injured most often. Education programmes on prevention and coping strategies for musculoskeletal disorders are recommended for nurses in order to reduce the rate of occupational hazards and also promote efficiency in patient care.
-
Bmc Musculoskel Dis · Jan 2010
British pain clinic practitioners' recognition and use of the bio-psychosocial pain management model for patients when physical interventions are ineffective or inappropriate: results of a qualitative study.
To explore how chronic musculoskeletal pain is managed in multidisciplinary pain clinics for patients for whom physical interventions are inappropriate or ineffective. ⋯ Pain clinic practitioners readily embraced cognitive/behavioural based management strategies but relatively little consideration to the impact social factors played in managing chronic pain was reported. Consequently multidisciplinary pain clinics espousing a bio-psychosocial model of pain management may not be achieving their maximum potential.
-
Bmc Musculoskel Dis · Jan 2010
Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study.
Regional musculoskeletal pain such as back or shoulder pain are commonly reported symptoms in the community. The extent of consultation to primary care with such problems is unknown as a variety of labels may be used to record such consultations. The objective was to classify musculoskeletal morbidity codes used in routine primary care by body region, and to determine the annual consultation prevalence of regional musculoskeletal problems. ⋯ There is an extensive and varied regional musculoskeletal workload in primary care. Musculoskeletal problems are a major constituent of general practice. The output from this study can be used as a resource for planning future studies.