Osteochondral lesions (OCL) of the talus occur in 38% of the patients with supination external rotation type IV ankle fractures and 6 % of ankle sprains. Osteoarthritis is reported subsequently in 8–48% of the ankles. Several marrow stimulation methods have been used to treat the symptomatic lesion, including arthroscopic debridement and micro fracture. Encouraging midterm results have been reported, but longterm outcome is unknown in relation to more invasive treatments such as transfer of autologous osteoarticular tissue from the knee or talus (OATS), autologous chondrocyte implantation (ACI), frozen and fresh allograft transplantation.AimThe aim of our study was to review our long term results of arthroscopic treatment of osteochondral lesions of the talus.Materials and methods65 patients underwent arthroscopic treatment of the OCL between 1993 and 2000. There were 46(71%) men and 19(29%) women. The mean age at surgery was 34.2 years. The right side was affected in 43 patients and the left side in 22 p...

Arthroscopic treatment of osteochondral lesions of the talus - a long term follow up study

Intraexaminer reliability of hand-held dynamometry in the upper extremity: a systematic review.

To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.

Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

OBJECTIVE To evaluate the effect of a moderate-to-high-intensity, aerobic and resistance exercise with person-centered guidance in older adults with rheumatoid arthritis (RA), through a randomized controlled multicenter trial. METHODS Older adults (ages 65-75 years) with RA (n = 74) were randomized to either a 20-week exercise intervention at a gym (n = 36) or to home-based exercise of light intensity (n = 38). Assessments were performed at baseline, at 20 weeks, and at 12 months. The primary outcome was the difference in the Health Assessment Questionnaire disability index (HAQ DI) score, and the secondary outcomes were the differences in physical fitness assessed by a cardiopulmonary exercise test, an endurance test, the timed up and go test, the sit to stand test, and an isometric elbow flexion force measurement. RESULTS No significant differences between the groups were found for the primary outcome, HAQ DI score. Within the intervention group there was a significant improvement in the HAQ DI score when compared to baseline (P = 0.022). Aerobic capacity (P < 0.001) and 3 of 4 additional performance-based tests of endurance and strength significantly improved (P < 0.05) in the intervention group when compared to the control group. In the intervention group, 71% of patients rated their health as much or very much improved compared to 24% of patients in the control group (P < 0.001). At the 12-month follow-up, there were no significant differences in change between the 2 groups on the HAQ DI score. A significant between-group difference was found for change in an endurance test (P = 0.022). CONCLUSION Aerobic and resistance exercise with person-centered guidance improved physical fitness in terms of aerobic capacity, endurance, and strength in older adults with RA.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/acr.23589

Effects of Aerobic and Resistance Exercise in Older Adults With Rheumatoid Arthritis: A Randomized Controlled Trial.

Validation of a machine learning-derived clinical metric to quantify outcomes after total shoulder arthroplasty.

Introduction
To the best of our knowledge there is no other report of an elderly patient who was surgically treated for a patellar fracture with tension band wiring and who subsequently suffered from an avulsion fracture of the tibial tuberosity. The combination of a patellar fracture and avulsion of the patellar ligament has only been described as complication after bone-patellar tendon-bone anterior cruciate ligament reconstructions. However, due to demographic changes and more elderly patients treated this injury may become more frequent in future.

/pdf/stress-avulsion-of-the-tibial-tuberosity-after-tension-band-1jqqcnxpwe.pdf

Stress avulsion of the tibial tuberosity after tension band wiring of a patellar fracture: a case report.

Reports using the Constant-Murley score often lack details regarding how strength measurement was performed, which may have an important impact on the results obtained. A description of the measurement is especially important when patients are unable to adopt the prescribed position of 90° shoulder abduction, leading to invalid or highly discrepant scores. We investigated the influence of shoulder abduction and torso position on strength measurement with special emphasis on intraobserver reliability. Thirty-three healthy volunteers were examined using a handheld dynamometer (Isobex®) in 30°, 60°, and 90° abduction with or without stabilization of the torso. A linear correlation between strength measurements in different degrees of abduction was observed, with values at 90° abduction on average 15% lower than at 60° and 45% lower than at 30°. In multivariate analysis, gender and weight had a substantial impact on the strength of individual measurement positions. Intraobserver reliability was related to arm and torso position (intraclass correlation coefficients, 0.71–0.93) and was highest for 90° abduction without torso stabilization. These findings emphasize the importance of standardized torso and arm positions ensuring high reliability when performing the strength measurement of the Constant-Murley score.

/pdf/reliability-of-shoulder-abduction-strength-measure-for-the-b3kj5qacul.pdf

Reliability of Shoulder Abduction Strength Measure for the Constant-Murley Score

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Stress avulsion of the tibial tuberosity after tension band wiring of a patellar fracture: a case report.

Reliability of Shoulder Abduction Strength Measure for the Constant-Murley Score