With much enthusiasm, we have read the article by Gómez et al. titled, ‘Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results.’ This research article regarding the difference between home-based and in-person rehabilitation models after Laterjet or arthroscopic Bankary surgery proved to pique the interest of this letter’s authors. Thus, we would like to comment on this work and guide future research on this topic. Gómez et al. compared the functional results in patients that underwent surgery for recurrent anterior shoulder instability (RAGHI) during the COVID-19 pandemic with in-person and home-based rehabilitation methods. The researchers concluded that the follow-up and different rehabilitation methods did not significantly differ in the patients return to function or athletics. While this shows hope for the home-based rehabilitation method, further research and consideration should be given to these methods. This letter will comment on the use of objective shoulder evaluation and uniform rehabilitation scheduling. To begin, the Western Ontario Shoulder Instability Index (WOSI) and subjective shoulder value (SSV) assessment methods have shown to be reliable indicators of postoperative quality of life and mobility. However, these measurements are self-reported by the patient and, hence, subjective based on patient outlook. Even for the at home protocol, we would recommend using more objective measures for evaluating anterior shoulder instability. In addition, these scores were only determined after the procedure, whereas we would recommend this information to be collected preand post-operatively to determine a significant difference. We believe that a more objective test for anterior shoulder instability is needed to assess recovery success. Tests such as the apprehension test, anterior release, or surprise test demonstrate the best sensitivity and specificity for clinically diagnosing anterior shoulder instability. The combination of history and performing apprehension, relocation, release or surprise, anterior load, and anterior drawer exam maneuvers optimize sensitivity and specificity for accurately diagnosing anterior shoulder instability in clinical practice. While these tests cannot be performed by the patient alone, it can still be used to assess the efficacy of in-person versus at-home rehabilitation with brief and necessary appointments with an Orthopaedic surgeon. Another point about the subjectivity of WOSI and SSV tests regards the timing of test application. The homebased rehabilitation group self-reported these results during the COVID-19 lockdowns. During this time the prevalence of mental health issues increased significantly, which may deem these self-reports sub-reliable. Although this may be a stretch in reasoning, reports of stress, anxiety, depression, and poor sleep quality rose dramatically during the time the patients were reporting, especially among those in the age range of this study. These reporting conditions may have led to differences in disclosure. While an unavoidable reality of subjective patient measures during this time, we think it is necessary for this to be made evident to readers. Lastly, we would recommend a more uniform rehabilitation schedule between the home-based and inperson groups. Standardizing the duration and phases of rehabilitation is an important aspect for post-operative health and returning to sports, however, we believe scheduling of rehab is just as important to consider. Although obtaining complete uniformity is nearly impossible between in-person and home-based rehabilitation, we would recommend the groups receive uniform

https://journals.sagepub.com/doi/pdf/10.1177/10225536231178576

Letter to the Editor: Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results

Rehabilitation has a fundamental role in the management of rotator cuff pathology whether the final choice is conservative or surgical treatment. Conservative treatment can give excellent results in cases of rotator cuff tendinopathies without rupture, partial tears less than 50% of the thickness of the tendon, chronic full-thickness tears in elderly patients and irreparable tears. It is an option prior to reconstructive surgery in non-pseudo paralytic cases. When surgery is indicated, adequate postoperative rehabilitation is the best complement to obtain a successful result. No consensus has still been established on the optimal postoperative protocol to follow. No differences were found between delayed, early passive and early active protocols after rotator cuff repair. However, early motion improved the range of motion in the short and mid-term, allowing faster recovery. A 5-phase postoperative rehabilitation protocol is described. Rehabilitation is also an option in specific failed surgical procedures. To choose a therapeutic strategy in these cases, it is reasonable to differentiate between Sugaya type 2 or 3 (tendinopathy of the tendon) and type 4 or 5 (discontinuity/retear). The rehabilitation program should always be tailored to the individual patient.

/pdf/current-trends-in-rehabilitation-of-rotator-cuff-injuries-3itfzvb6.pdf

Current trends in rehabilitation of rotator cuff injuries

Arthroscopic shoulder stabilisation surgery (ASSS) is a common procedure for treating anterior shoulder instability. Postoperative rehabilitation remains a crucial, but under-researched, aspect of patient recovery. Despite its importance, no comprehensive rehabilitation guideline based on robust clinical trials has emerged, leaving a gap in evidence-based practice. To address this, the British Elbow &amp; Shoulder Society appointed the Allied Health Professional Clinical Guideline Group to review current practices and establish clinical guidance on rehabilitation. This evidence synthesis aims to provide a critical synthesis and discussion on rehabilitation following ASSS. The intended outcome is to highlight areas of uncertainty and make recommendations for clinical practice and further research. The development of this evidence synthesis followed a rigorous five-stage process: (1) systematic literature review, (2) UK national practice survey, (3) expert consensus (Delphi) study, (4) updated literature search and review and (5) synthesis of the previous four stages. Stages 1–3 have been published previously. This evidence synthesis comprised stages 4 and 5. 10 key domains for postoperative rehabilitation from immediate postsurgery to return to normal function, including sports, were identified. This paper synthesises current knowledge and provides a platform for recommendations in clinical practice and future research. In particular, early shoulder movement was recommended during the ‘immobilisation period’, but confined to shoulder elevation up to 90°, anterior to the scapular plane, with neutral external rotation. Further high-quality primary research is needed to address uncertainties and expand the evidence base, thereby informing and challenging clinical practice. 

Critical evidence synthesis on rehabilitation following arthroscopic shoulder stabilisation surgery for traumatic anterior instability: consensus recommendations for clinical practice and research – commissioned by the British Elbow &amp; Shoulder Society

Does the distal nail position impact the rates of misalignment and bone union in distal tibial fractures?

Phosphaturic mesenchymal tumor (PMT) is an infrequent clinicopathological entity. It presents insidious bone pain and polymy-algia, accompanied by alterations in calcium and phosphorus metabolism that are difficult to resolve clinically. A multidisciplinary approach is a key to success in this pathology. We present the case of a 52-year-old female patient with a 10-year history of PMT in the right hemipelvis with ipsilateral hip extension. From the clinical point of view, she presented oncogenic osteomalacia (hy-pophosphatemia and hyperphosphaturia) that did not correct despite being administered the latest generation medication, burosumab, an FGF-23 inhibitor that increases renal tubular phosphate reabsorption. Resection with oncological margins was decided by a multidisciplinary committee resolving her clinical condition. Due to the rarity of this pathology, we decided to report the case.

Phosphaturic Mesenchymal Tumor of the Pelvis: A Multidisciplinary Approach

Aims Our objective is to compare the functional results in patients that underwent surgery for recurrent anterior shoulder instability (RAGHI) during the COVID-19 pandemic with remotely-based rehabilitation, to those who had surgery before the pandemic and had in-person rehabilitation therapy. Methods A retrospective case series of 68 patients were included and divided into two groups: In person-group and Home-based group. Western Ontario Shoulder Instability Index (WOSI) and Subjective Shoulder Value (SSV) scores were used to evaluate objective and subjective clinical parameters. Time and level of return to sports was studied by the Subjective Patient Outcome for Return to Sports (SPORTS) score. Results The mean SSV score was 82% (40–100) on the In-Person group compared with 87% (65–100) for the Home-Based group. Results for WOSI score were similar, with an average of 210.42 (90%) for In-Person and 261.45 (88%) for the Home-Based group (p 0.12). Return to sports was carried out in an average of 6.6 (4–16) months for In-Person group, compared to 6.5 (5–8) months for Home-Based. Conclusion Follow-up and rehabilitation methods for patients who underwent surgery for RAGHI, during COVID-19 lockdown, were not significantly (p 0.12) affected on functional and athletic return in comparison to traditional methods according to WOSI scale. Level of evidence IV Retrospective series of cases

Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

J. P. Taleb

Author Tools

Chat about Author

Papers

Does the distal nail position impact the rates of misalignment and bone union in distal tibial fractures?

Phosphaturic Mesenchymal Tumor of the Pelvis: A Multidisciplinary Approach

Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results