Platelet-rich plasma for treatment of chronic proximal hamstring tendinopathy.

Aim: To determine whether platelet-rich plasma (PRP) can successfully treat symptoms associated with proximal hamstring tendinopathy. Materials & methods: Charts were retrospectively reviewed of patients with a diagnosis of chronic proximal hamstring tendinopathy who underwent an ultrasound-guided leukocyte-rich PRP injection to assess reported outcomes at baseline and final follow-up post-intervention. Results: In 22 patients with a mean age of 48.7 years and mean symptom duration of 26.5 months, mean Numeric Pain Rating Scale and Victorian Institute of Sport Assessment Scale for Proximal Hamstring Tendinopathy subscores demonstrated statistically significant improvements (p < 0.05) at a mean of 7.91 months follow-up. Sixty-eight percent of patients demonstrated ≥50% reduction of pain. Conclusion: Pain and functional outcomes improved following injection of PRP.

Factors Predictive of Outcomes in Vertebral Body Stapling for Idiopathic Scoliosis.

STUDY DESIGN: Retrospective review. OBJECTIVES: To identify factors associated with successful outcomes in patients treated with vertebral body stapling (VBS) for idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: The standard of care for moderate scoliosis (20°-45°) consists of observation and bracing with the goal of halting curve progression. Although several recent studies have confirmed the efficacy of bracing in altering the natural history of scoliosis, bracing is not universally effective. Recent studies have demonstrated that VBS is a safe and viable treatment for some young patients with scoliosis at risk for progression. The identification of factors associated with successful outcomes in VBS for idiopathic scoliosis would better define the population likely to benefit from VBS. METHODS: We retrospectively reviewed all patients from a single institution treated with VBS who met previously defined inclusion criteria. Successful treatment was defined as avoidance of a fusion and a final Cobb angle no more than 10° greater than the pretreatment Cobb angle. RESULTS: We identified 63 patients who met inclusion criteria. The patients underwent VBS at a mean age of 10.78 years and had a mean follow-up of 3.62 years (minimum 2 years). The mean pre-op Cobb angle for stapled thoracic curves was 29.5°. Seventy-four percent of the patients who had VBS of the thoracic curve have avoided progression and/or fusion, and the mean Cobb angle at most recent follow-up was 21.8°. The mean preoperative Cobb angle for lumbar curves was 31.1°. Eighty-two percent of the patients who had VBS of the lumbar curve have avoided progression and/or fusion, and their mean Cobb angle at follow-up was 21.6°. CONCLUSION: VBS is effective at preventing progression and fusion for moderate idiopathic scoliosis in immature patients. The complication rates are low.

How Prospective Physical Medicine and Rehabilitation Trainees Rank Residency Training Programs.

BACKGROUND: Since the inception of the National Resident Matching Program, multiple studies have investigated the factors applicants consider important to ranking prospective residency programs. However, only 2 previous studies focused on prospective physical medicine and rehabilitation (PM&R) trainees, and the most recent of these studies was published in 1993. It is unknown whether these previous studies are reflective of current prospective PM&R residents. OBJECTIVE: To assess various factors that contribute to prospective PM&R residents' decision making in choosing a residency program and compare these findings with previous studies. DESIGN: An anonymous, voluntary questionnaire. SETTING: A single PM&R residency program. PARTICIPANTS: All applicants to a single PM&R residency program. METHODS: All applicants to our PM&R residency program were invited to participate in a 44-item, 5-point Likert-based questionnaire. Applicants were asked to rate the importance of various factors as they related to constructing their residency rank list. MAIN OUTCOME MEASUREMENTS: Means and standard deviations were calculated for items included in the survey. RESULTS: A response rate of 26% was obtained, with the responses of 98 applicants (20%) ultimately analyzed. The highest rated factors included "perceived happiness of current residents," "opportunities for hands-on procedure training," "perceived camaraderie among current residents," "perceived camaraderie among faculty and current residents," "perceived quality of current residents," and "perceived work/life balance among current residents." Although male and female respondents demonstrated similar ranking preferences, an apparent difference was detected between how genders rated the importance of "whether the program projects a favorable environment for women" and "whether the program projects a favorable environment for minorities." As compared with previous PM&R applicants, current prospective trainees seem to place greater importance on skill acquisition over didactic teaching. CONCLUSION: Prospective PM&R residents highly value subjective perceptions of prospective PM&R training programs and the ability to obtain hands-on procedural experience. LEVEL OF EVIDENCE: Not applicable.