Orthopedics Research Today is a free monthly online journal that collates and summarizes the latest research about Orthopedics, including details on chronic injuries, muscoskeletal disorders, surgery, reconstruction.

New therapeutic approaches for management of sport-induced muscle strains.

De Carli A, Volpi P, Pelosini I, Ferretti A, Melegati G, Mossa L, Tornese D, de Girolamo L, Scarpignato C

Kirk Kilgour Sport Injury Center, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.

Muscle strains are one of the most common sports-induced injuries. Depending on the severity and location of the muscle strain, different treatment approaches can be taken. This review highlights recent trends in conservative, pharmacologic, and surgical approaches to the management of sports-induced muscle injuries as presented at a symposium held during the 93rd Annual Congress of the Italian Society of Orthopedics and Traumatology (SIOT) in Rome, Italy in November 2008. Conservative approaches now include growth factor therapy and administration of autologous platelet-rich plasma during the early postinjury period; however, its use is currently considered a doping violation under the World Anti-Doping Agency code, therefore restricting its use to nonelite sports people only. Topical anti-inflammatory therapy is a promising therapeutic strategy, since it allows local analgesic and anti-inflammatory effects while minimizing systemic adverse events. As the drug delivery system is critical to clinical effectiveness, the advent of a new delivery system for ketoprofen via a new-generation plaster with a marked increase in tissue penetration and a clinical efficacy comparable with that of oral administration, provides a viable option in the treatment of single sport lesions. Surgical treatment of muscle lesions is less common than conservative and topical therapies and indications are limited to more serious injuries. Presentations from SIOT 2008 show that advances in our understanding of the healing process and in conservative, pharmacologic, and surgical treatment approaches to the management of sports-induced muscle strains contribute to better clinical outcomes, faster healing, and a swifter return to normal training and activity levels.

Published 5 February 2010 in Adv Ther.
Full-text of this article is available online (may require subscription).

Articles on Orthopedics published 5 February 2010:

Outcomes of a Standardized Surgical and Rehabilitation Program in Transtibial Amputation for Peripheral Vascular Disease: A Prospective Cohort Study.   Am J Phys Med Rehabil.

Johannesson A, Larsson G-U, Ramstrand N, Lauge-Pedersen H, Wagner P, Atroshi I: Outcomes of a standardized surgical and rehabilitation program in transtibial amputation for peripheral vascular disease: A prospective cohort study. OBJECTIVE:: To study the outcomes of a new surgical and rehabilitation program for initial unilateral transtibial amputation in patients with peripheral vascular disease. The program consists of sagittal incision, rigid dressing, compression therapy using silicone ... [Abstract] [Full-text]

Articles on Orthopedics published 4 February 2010:

Skin necrosis after self-administered intramuscular diclofenac.   J Plast Reconstr Aesthet Surg, 63(1): e4-e5.

Intramuscular diclofenac is used extensively for pain relief in medical practice. Tissue necrosis is a rare but serious complication of intramuscular injections. The pathogenetic mechanism is still not completely understood. A case of tissue necrosis following self-administration of diclofenac inadvertently injected into an arterial perforator branch of the superficial femoral artery is reported, supporting a vascular pathogenesis. [Abstract] [Full-text]

A comparison of the effects of prosthetic and commercially pure metals on retrieved human fibroblasts: The role of surface elemental composition.   Acta Biomater, 6(2): 702-707.

The most common clinical cause of long-term failure in total joint replacement surgery is inflammatory aseptic osteolysis; a condition in which bone surrounding the prosthetic implant, and to which the implant is attached, is resorbed, rendering the artificial device loose and painful. Historically, the severity of this bone resorptive process has been thought to be predominately attributed to the size and shape of wear-debris particles, particularly the metallic particulates that interact ... [Abstract] [Full-text]

Decreased in the number and function of circulation endothelial progenitor cells in patients with avascular necrosis of the femoral head.   Bone, 46(1): 32-40.

INTRODUCTION: Once non-traumatic avascular necrosis of the femoral head (ANFH) happened, vascular impairment and feeble collateral circulation are followed by poor outcomes. Circulating endothelial progenitor cells (EPCs) may substantially contribute to vascular homeostasis such as vascular repair and new blood vessel growth. We investigated whether abnormalities in EPCs levels and functions are present in ANFH patients. METHODS: 54 ANFH patients were enrolled, including steroid-induced (n=21), ... [Abstract] [Full-text]

Soluble complement receptor type 1 inhibits complement system activation and improves motor function in acute spinal cord injury.   Spinal Cord, 48(2): 105-11.

Study design:Spinal cord injured rat model, treated with soluble complement receptor type 1 (sCR1).Setting:Experimental Animal Department of China Medical University, Shenyang, China.Objectives:Soluble CR1 is a powerful inhibitor of complement activation. In this study, we investigate the effectiveness of sCR1 on spinal cord injury (SCI) in rats.Methods:Spinal cord injury was induced in Sprague-Dawley rats. Three experimental groups were examined; the sCR1 group was administered sCR1 at 1 h ... [Abstract] [Full-text]

Minimally invasive technique of triple anterior screw fixation for an acute combination atlas-axis fracture: case report and literature review.   Spinal Cord, 48(2): 174-7.

Study design:A case report to describe the minimally invasive technique of treating C1-type II odontoid combination fractures.Objective:To introduce a new, minimally invasive technique of triple anterior screw fixation for acute combination atlas-axis fractures.Summary of background data:Management for C1-type II odontoid combination fractures includes traction, immobilization and posterior fusion with and without instrumentation and anterior odontoid screw fixation. The combination of odontoid ... [Abstract] [Full-text]

Rationale for use of polyetheretherketone polymer interbody cage device in cervical spine surgery.   Spine J, 10(1): 66-69.

COMMENTARY ON: Song K-J, Choi B-W, Kim G-H, Song J-H. Usefulness of polyetheretherketone (PEEK) cage with plate augmentation for anterior arthrodesis in traumatic cervical spine injury. Spine J 2010;10:50-57 (in this issue). [Abstract] [Full-text]

SirT1 enhances survival of human osteoarthritic chondrocytes by repressing PTP1B and activating the IGF receptor pathway.   Arthritis Rheum.

OBJECTIVE.: The protein deacetylase SirT1 inhibits apoptosis in a variety of cell systems by distinct mechanisms, yet its role in chondrocyte death has not been explored. Here we assess the role of SirT1 in the survival of osteoarthritic human chondrocytes. METHODS.: SirT1, PTP1B, PTP1Bmutant expression plasmids and SirT1siRNA and PTP1BsiRNA were transfected into primary human chondrocytes. Levels of apoptosis were determined by flow cytometry and activation of components of the IGFR/Akt ... [Abstract] [Full-text]

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