RESUMEN
In addition to tears of the rotator cuff, isolated impingement syndrome of the shoulder is the most common diagnosis in shoulder disorders. This is of high relevance in orthopedic sports medicine. In fact, impingement of the shoulder is not the diagnosis but rather a symptom of a functional or even a structural pathology. Detailed knowledge about the different types of impingement and the underlying causes is essential to provide adequate treatment. Primarily, impingement of the shoulder should be treated nonoperatively. However, if there is no clinical improve despite adequate conservative treatment, there is usually a structural pathology which cannot be adequately compensated for and surgical treatment may be necessary. In the case of severe structural pathologies, such as a full-thickness tear of the rotator cuff, a subsequent surgical treatment may be indicated.
Asunto(s)
Descompresión Quirúrgica/métodos , Terapia por Ejercicio/métodos , Manipulaciones Musculoesqueléticas/métodos , Síndrome de Abducción Dolorosa del Hombro/diagnóstico , Síndrome de Abducción Dolorosa del Hombro/terapia , Articulación del Hombro/diagnóstico por imagen , Terapia Combinada/métodos , Medicina Basada en la Evidencia , Humanos , Resultado del TratamientoRESUMEN
Ligamentous instability of the elbow is a common pathology affecting athletes in different types of sports. It may lead to a permanent impairment of an athlete's ability to train and compete. The advancements made in arthroscopic, biomechanical and clinical diagnostic procedures allow for a better understanding of the etiology of elbow discomfort. As a result, ligamentous instability has been increasingly identified as a reason for acute and chronic pain in athletes. This article provides an overview of the etiology as well as diagnostic and rehabilitative procedures for ligamentous instability of the elbow in athletes and presents principles of rehabilitation in patients with symptomatic elbow instability.
Asunto(s)
Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/rehabilitación , Lesiones de Codo , Inestabilidad de la Articulación/diagnóstico , Inestabilidad de la Articulación/rehabilitación , Ligamentos Articulares/lesiones , Medicina Basada en la Evidencia , Humanos , Manipulaciones Musculoesqueléticas , Modalidades de Fisioterapia , Volver al Deporte , Resultado del TratamientoRESUMEN
The effect of oral supplementation with glycosaminoglycans (GAG) and radical scavengers (vitamin E/selenium) on the regeneration of osteochondral defects was investigated in rabbits. After introduction of defined osteochondral defects in the knee joint, groups of ten animals were given a GAG/vitamin E/selenium mixture or a placebo (milk sugar) for 6 weeks. Following sacrifice, histological and histochemical analysis was performed. The amount of synovial fluid was increased in the placebo group, while the viscosity of the synovial fluid was significantly enhanced in the GAG group. The amount of sulfated GAG in the osteochondral regenerates (8.8 +/- 3.6 % vs. 6.0 +/- 5.6 %; p <0.03) was significantly higher in the GAG group. In both groups, the GAG amount in the cartilage of the operated knee was significantly higher than in the non-involved knee (p <0.05). Histological analysis of the regenerates in the GAG group was superior in comparison with the placebo group. For the first time, a biological effect following oral supplementation with GAG was demonstrated in healing of osteochondral defects in vivo. These findings support the known positive clinical results.