Notes

Well-designed interplay in between extended non-coding RNAs as well as the Wnt signaling procede in osteosarcoma.
isualization while restoring the native biomechanics of the hip as best as possible are important.
To determine whether early patient-reported outcome improvements in the 6 months after surgery are predictive of achieving a patient acceptable symptomatic state (PASS) at 2 years.

A prospectively collected database was retrospectively reviewed. Inclusion criteria included patients ≥18 years of age, Tönnis grade 0 or 1 changes, radiographic imaging consistent with femoroacetabular impingement or labral pathology, a primary diagnosis of symptomatic femoroacetabular impingement for which they underwent primary hip arthroscopy, and baseline, 6-month, and 2-year modified Harris Hip Score (mHHS) scores. Revision cases were excluded. Receiver operating characteristic curve analysis was conducted to determine whether 6-month change in mHHS was a predictor for achieving PASS at 2 years.

There were 173 patients (mean age 39.8, 61.8% female) included within the study. Patients who do not achieve the minimal clinically important difference (MCID), defined as a change of 8 points in mHHS, by 6 months (n= 21) tended to have significantly lower mHHS scores at 1 year and 2 years compared with those who did (n= 152). Only 52% of patients who did not achieve MCID by 6 months achieved MCID by 2 years (vs 98% for those that did) and only 24% achieved PASS by 2 years (vs 88% that did). see more Using the MCID as a cutoff for improvement in mHHS at 6 months results in a 96% sensitivity but 47% specificity for predicting PASS achievement at 2 years. Using 24 points of improvement in mHHS as a cutoff at 6 months improves sensitivity and specificity to 81% and 80%, respectively.

Early improvement in mHHS scores is associated with 2-year outcomes. Patients who do not achieve MCID within 6 months of surgery have a high rate of not achieving PASS at 2 years.

IV, case series study.
IV, case series study.
To report outcomes of endoscopic iliopsoas tenotomy (EIT) in patients with iliopsoas tendinopathy following total hip arthroplasty (THA) and determine whether improvements in clinical scores are associated with acetabular cup anteversion measured on plain radiographs or overhang measured using established and alternative computed tomography (CT)-based methods.

We evaluated patients who underwent EIT for iliopsoas tendinopathy after THA (2014-2017), performed between the lesser trochanter and psoas valley. Indications were groin pain during active hip flexion, exclusion of other complications, and no pain relief after 6 months of conservative treatment. Pretenotomy inclination and anteversion were measured on radiographs; sagittal and axial overhang were measured on CT scans on slices passing through (Method 1) prosthetic head center and (Method 2) anterior margin of acetabular cup. Modified Harris hip score (mHHS), Oxford Hip Score (OHS), and level of groin pain were recorded at 12 or more months. Wilcoxod in 17%, and moderate in 11%. Regression analyses revealed no associations between clinical scores and overhang/anteversion.

For patients with iliopsoas tendinopathy following THA, endoscopic iliopsoas tenotomy granted clinically important improvements of mHHS in 76% and OHS in 89%, despite moderate residual groin pain in 11%. Improvements in clinical scores did not seem to be associated with the extent of cup overhang or anteversion in the cases for which adequate preoperative imaging was available.

Level IV, retrospective cohort study.
Level IV, retrospective cohort study.
To report a prospective study of patients who underwent blood flow restriction training (BFRT) for marked quadriceps or hamstring muscle deficits after failure to respond to traditional rehabilitation after knee surgery.

The BFRT protocol consisted of 4 low resistance exercises (30% of 1 repetition maximum) leg press, knee extension, mini-squats, and hamstring curls with 60% to 80% limb arterial occlusion pressure. Knee peak isometric muscle torque (60° flexion) was measured on an isokinetic dynamometer.

Twenty-seven patients (18 females, 9 males; mean age, 40.1 years) with severe quadriceps and/or hamstrings deficits were enrolled from April 2017 to January 2020. They had undergone a mean of 5.3 ± 3.5 months of outpatient therapy and 22 ± 10 supervised therapy visits and did not respond to traditional rehabilitation. Prior surgery included anterior cruciate ligament reconstruction, partial or total knee replacements, meniscus repairs, and others. All patients completed 9 BFRT sessions, and 14 patients es.
To compare postoperative pain and early recovery after hip arthroscopy with and without a perineal post for joint distraction.

We retrospectively reviewed a consecutive series of patients who underwent hip arthroscopy before and after the adoption of a postless technique. Patients who underwent concurrent periacetabular or femoral osteotomy were excluded. Demographic information, procedure variables, and visual analog scale (VAS) pain scores were recorded. Analgesic medications given were converted to morphine milligram equivalents (MME) for comparison. Uni- and multivariate analyses were conducted to compare total MME, postoperative pain, and time to discharge between groups.

One hundred patients were in each group. The overall age (mean ± standard deviation) was 26.5 ± 9.9 years (Post [P] 57 females; No Post [NP] 68 females). Total operative time (P 100.4 ± 17.9 minutes vs NP 89.1 ± 25.5 minutes, P= .0004), traction time (P 45.8 ± 10.3 minutes vs NP 40.9 ± 11.1 minutes, P= .0017), and operating room time (P 148.8 ± 19.3 minutes vs NP 137.3 ± 25.8 minutes, P= .0005) were found to be shorter in the NP group. Total MME, and final VAS pain scores in the PACU were similar between both groups (MME, P= .1620; VAS, P= .2139). Time to discharge was significantly shorter in the NP group (P 207.2 ± 58.8 vs NP 167.5 ± 47.9, P < .0001). Patient age (≥25 years) (65.2 ± 18.1 vs 59.8 ± 15.7 [MME], P= .0269) and elevated body mass index (≥25) (65.1 ± 17.1 vs 59.3 ± 16.4 [MME], P= .0164) were factors associated with greater total MME consumption. Female sex was associated with higher postoperative VAS pain scores (FM 4.1 ± 1.6 vs M 3.4 ± 1.8 P= .0027).

Adoption of the postless technique did not result in prolonged operating room or operative time. Overall, both groups had similar postoperative pain, however, the time from surgery to hospital discharge was shorter in the postless group.

III, retrospective comparison study.
III, retrospective comparison study.
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