American Journal of Orthopedic Research and Reviews


Review Article of American Journal of Orthopedic Research and Reviews EFFECTIVENESS OF CONDROPROTECTORS IN TREATING OSTEOARTHRITIS: A BIBLIOGRAPHIC REVIEW Alana Gomes de Souza1*, Malu Avila Sobrinho de Vasconcelos2, Nathalia Moura Fernandes2, Cintia Justino Rabelo3, Bruno Souza dos Santos4, Marta Maria de França Fonteles1 1Universidade Federal do Ceará;2Centro Universitário Farias de Brito;3Centro Universitário Católica de Quixadá;4 Universidade Federal de Pernambuco; Introduction: Osteoarthritis (OA) is the most common rheumatologic disease in the world and the elderly are the most affected, although there is no defined age for its onset. Obesity is a risk factor, with healthy eating habits and physical exercise practices being recommended for treatment and prevention. The pharmacological treatment for OA is oral chondroprotective agents and viscosupplements, although anti-inflammatory drugs are widely prescribed, they do not cause clinical improvement, they only treat the symptoms of the disease. Objective: This study gathered articles from clinical trials in Brazil with the purpose of investigating whether the pharmacological treatments used are effective. Methods: The electronic platforms used for data collection were: Scielo, CAPES Journal Portal and Google Academic. Articles published in the last six years with clinical trials in Brazil were considered. Articles involving surgeries, those that used physiotherapy as an adjunct therapy and those that used animal or non-human research in their research were excluded. The search was through the descriptors: hyaluronic acid, glucosamine and chondroitin. Results: The search resulted in six articles, in which three were used chondroprotectors and the other three viscosupplements. Chondroprotectors were effective in 66.66% of clinical trials and viscosupplements in 100%. Conclusion: Pharmacological treatments for OA showed high efficacy, however the sample of the present work was small, thus, further studies are needed to confirm the results obtained. Keywords: Osteoarthritis. Chondroprotectors. Viscosupplement ...


Research Article of American Journal of Orthopedic Research and Reviews EFFECTIVENESS OF KINESIOTHERAPEUTIC EXERCISES IN LOMBALGY SECONDARY TO BONE DEMINERALIZATION AND LUMBAR HYPOLORDOSIS: AN EXPERIENCE REPORT João Adriano Correia Santos¹* ¹UniAGES. Objective: To report the experience of the effects of kinesiotherapy exercises applied to a patient with low back pain associated with bone demineralization and lumbar hypolordosis. Methods: Physiotherapeutic monitoring of a 55-year-old female patient from Bahia is presented, presenting a condition compatible with low back pain, secondary to bone demineralization in the lumbosacral spine, dorsal and lumbar hypolordosis. In the assessment, the Owestry questionnaires (14 points), Visual Analogue Scale (grade 6), FABQ-Brazil subscale (43 points), absence of lateral shift, hip movement (internal rotation D = 27º, E = 31º) were applied , segmental mobility test of the thoracolumbar spine (hypermobile vertebrae = L1 to S1), Pronation Instability test (positive), symptoms longer than 16 days, aberrant movements with finger climbing, centralization of symptoms in the flexion and lateral inclination movements, and periphery to knee E. in extension. Thus, it was classified in the Mobilization / Manipulation and Stabilization groups, which was subjected to physical therapy intervention during 12 visits. Therapeutic approaches were based on segmental stabilization exercises associated with co-contraction of the abdominal and pelvic muscles, passive stretching, myofascial release with digit pressure and pelvic, sacroiliac and thoracic mobilization exercises. Results: After treatment, there were positive effects on low back pain and when performing movements, gaining flexibility, mobility and muscle strength, as well as feeling of well-being and improved sleep. Conclusion: It is inferred, therefore, that the conduct based on clinical reasoning is of paramount importance for the physiotherapeutic performance in the kinetic-functional problems arising from low back pain, which contributed to the improvement of the pathological condition and promotion of quality of life. Keywords: Backache. Physiotherapy. Quality of life ...


Research Article of American Journal of Orthopedic Research and Reviews Expired Air Carbon Monoxide Testing Is Effective for Preoperative Screening of Cigarette Use in Orthopaedic Patients: A Prospective Pilot Study of 70 Veterans Sean R. Sterrenberg, MD1; David M. Gallacher, BS1; John P. Tabb, BS1; Melissa S. Schmidt, RN2; Lucas Anissian, MD2; Kenneth R. Gundle, MD1,2; Ryan B. Wallenberg, MD2 1Oregon Health and Science University, Department of Orthopaedics and Rehabilitation, Portland, OR, USA; 2 Portland VA Medical Center, Operative Care Division, Portland, OR, USA Introduction: Screening for cigarette use is standard in the orthopedic pre-operative clinic, however traditional biochemical testing methods, including serum and urine cotinine assays, do not differentiate active smoking from nicotine replacement therapy (NRT). In this prospective pilot study, we hypothesize that exhaled carbon monoxide (eCO) testing will be non-inferior to the gold standard serum cotinine (SC) test in screening for pre-operative cigarette use, will differentiate active smoking from NRT, and will allow for substantial cost savings in a clinic setting. Methods: Adult orthopaedic veterans indicated for elective surgery at our institution were offered inclusion. Self-reported smoking status (SRS), eCO and SC levels were obtained preoperatively. An eCO level of >6 parts per million and a SC level >3 ng/ml were considered positive for recent cigarette use. Agreement between SRS, eCO levels and SC levels, and eCO level test-retest reliability were evaluated. Results: Of the 55 patients enrolled into the study, 4 were self-reported Current Smokers and 51 were self-reported Ex-Smokers or Non-Smokers. Combining SRS with eCO levels as a screening tool for recent cigarette use yielded a sensitivity of 100%, a specificity of 98%, a positive predictive value of 95% and a negative predictive value of 100%. eCO testing differentiated NRT from cigarette use in all non-smoking patients. Test-retest reliability for eCO levels showed perfect agreement ...


Research Article of American Journal of Orthopedic Research and Reviews Motion and its Effects on the Cement Mantle - A Biomechanical Analysis of Femoral Stem Displacement during Implant Cementation Michael P. Ast, MD1; Adam Gitlin, MD2; Nadeen O. Chahine, PhD3; Daniel Grande, PhD4; Peter Lementowski, MD5 1Hospital of Special Surgery, New York, NY; 2University of Florida College of Medicine, Jacksonville, FL; 3Department of Biomechanics, Columbia Uni-versity, New York, NY; 4Feinstein Institute for Medical Research, Manhasset, NY; 5Westchester Medical Center, Valhalla, NY Background: It is a common notion that motion of a femoral component during cementation should be avoided as it may weaken the cement mantle. We created an in vitro model of cemented femoral components and subjected them to varying  rotational motion during the cement curing process, to measure the effect on the pullout strength of the stem. Methods:  21 sawbones femurs were separated into four groups.  The first group served as control and was cemented in a standard fashion. The remainder of the stems were divided into groups and subjected to angular rotational displacement within the cement mantle during curing .  Anteroposterior and lateral radiographs were obtained of each model to evaluate for cement defects. Pullout strength testing was performed. Results: Despite rotational displacement, no cement defects were noted on imaging.  The control stems showed an average pullout strength of 3735.79N. The experimental groups showed a trend for lower failure loads but it was not statistically significant (P=0.063). Of the 21 stems tested, three encountered cement mantle failure and associated stem pullout and the remainder failed by peripros-thetic fracture. Conclusion: Despite conventional thinking that rotational displacement during the cementing process leading to disruption of the cement mantle integrity, this was not borne out in our study.  This should give surgeons confidence that in the set-ting of unintended rotational displacement ...

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American Journal of Orthopedic Research and Reviews