Physician Sportsmed
-
Physician Sportsmed · May 2014
ReviewThe effects of platelet-rich plasma in the treatment of large-joint osteoarthritis: a systematic review.
Osteoarthritis (OA) is a common and costly condition with both operative and nonoperative treatments available. Platelet-rich plasma (PRP) is emerging as a treatment option for a variety of musculoskeletal pathologies, including OA. ⋯ Platelet-rich plasma may be an effective treatment for knee OA. However, because of the low level of evidence, small sample sizes, and wide variability in treatment, no definitive recommendations can be made at this time.
-
Physical activity is a potent therapy for both the prevention and treatment of cardiovascular disease. Exercise appears to most benefit people who are the least active. There is some evidence to suggest that a curvilinear relationship exists between exercise and survival, whereby beyond an optimal level of fitness, the principle of diminishing returns applies. ⋯ The incidence of sudden cardiac death in athletes is greater than in matched, nonathletic counterparts, and this finding is driven by the provocation of an underlying cardiac abnormality by strenuous exertion. The task of detecting pathological myocardial substrate in athletes is made difficult by physiological adaptations to exercise that can mimic the appearance of cardiomyopathies and ion channelopathies in some individuals. This article details the clinical evaluation of the athlete with reference limits for cardiac physiological remodeling and discusses the diagnostic dilemmas that arise.
-
Physician Sportsmed · May 2014
Pregabalin reduces opioid consumption and improves outcome in chronic pain patients undergoing total knee arthroplasty.
Recently, multimodal pain control has been used to manage postoperative pain in patients undergoing total knee arthroplasty (TKA). This approach combines numerous modalities, such as opioids, nonsteroidal anti-inflammatory drugs, local anesthetics, and acetaminophen, in an effort to reduce overall opioid consumption and also to provide better pain control. Gabapentinoids are a class of drugs that have been used as part of multimodal approach, and may be effective in patients who are previous users of chronic pain medication. The hypothesis of this study was that the addition of pregabalin reduces opioid consumption and/or improves pain after TKA, even in patients who are previous users of chronic pain medications. ⋯ Pregabalin in the context of multimodal pain management may be associated with reduced opioid consumption and other medical complications in patients undergoing TKA, including previous users of chronic pain medications.
-
Physician Sportsmed · May 2014
Functional results following surgical repair of simultaneous bilateral quadriceps tendon ruptures.
Unilateral quadriceps tendon ruptures are common conditions treated by orthopedic surgeons. There is a paucity of information concerning functional outcomes in bilateral tendon ruptures. The aim of this study is to assess a series of 5 cases with simultaneous quadriceps tendon ruptures that underwent acute surgical repair with the purpose of identifying the functional outcomes as compared with unilateral injuries. We hypothesize that patients with bilateral quadriceps tendon ruptures have worse functional outcomes than patients with unilateral ruptures. ⋯ Patients with early surgical repair of bilateral, simultaneous extensor mechanism ruptures exhibit adequate recovery and return to a high level of function. Our patients were younger than those reported in the literature and had minimal comorbidities. The IKDC scores reflected good outcomes in the bilateral rupture group, albeit lower than in the unilateral group.
-
Physician Sportsmed · May 2014
Case ReportsCase report: upper extremity deep venous thrombosis in a 19-year-old baseball player.
This report describes a case of a collegiate baseball player who presented with 3 weeks of worsening right shoulder pain and mild swelling and faint discoloration of the right arm and hand. He was found to have a nonocclusive clot on his brachial vein and was treated with anticoagulants. ⋯ Upper extremity deep vein thromboses are extremely uncommon. However, because they can have potentially life-threatening consequences, deep vein thromboses must be on the differential for any athlete who presents with increased pain, swelling, or discoloration of an extremity.