RESUMO
The role of the family physician in managing knee pain is expanding as recent literature supports nonsurgical management for many patients. Effective treatment depends on the etiology of knee pain. Oral analgesics-most commonly nonsteroidal anti-inflammatory drugs and acetaminophen-are used initially in combination with physical therapy to manage the most typical causes of chronic knee pain. The American Academy of Orthopaedic Surgeons recommends against glucosamine/chondroitin supplementation for osteoarthritis. In patients who are not candidates for surgery, opioid analgesics should be used only if conservative pharmacotherapy is ineffective. Exercise-based therapy is the foundation for treating knee osteoarthritis and patellofemoral pain syndrome. Weight loss should be encouraged for all patients with osteoarthritis and a body mass index greater than 25 kg per m2. Aside from stabilizing traumatic knee ligament and tendon tears, the effectiveness of knee braces for chronic knee pain is uncertain, and the use of braces should not replace physical therapy. Foot orthoses can be helpful for anterior knee pain. Corticosteroid injections are effective for short-term pain relief in patients with osteoarthritis. The benefit of hyaluronic acid injections is controversial, and recommendations vary; recent systematic reviews do not support a clinically significant benefit. Small studies suggest that regenerative injections can improve pain and function in patients with chronic knee tendinopathies and osteoarthritis.
Assuntos
Acetaminofen/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Medicina de Família e Comunidade/normas , Articulação do Joelho/fisiopatologia , Osteoartrite do Joelho/complicações , Dor/tratamento farmacológico , Dor/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos/uso terapêutico , Educação Médica Continuada , Terapia por Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Modalidades de Fisioterapia , Guias de Prática Clínica como Assunto , Estados UnidosRESUMO
PRP has become a popular form of regenerative medicine. This review looks at the evidence for its use in various musculoskeletal conditions.
Assuntos
Doenças Musculoesqueléticas , Plasma Rico em Plaquetas , Humanos , Doenças Musculoesqueléticas/terapiaRESUMO
Patients with rare chronic disorders and their caregivers increasingly form communities to support and exchange social experiences. Because up to 10% of the United States population is affected by one of 5000 to 6000 rare disorders, efforts to understand the individuals and affected communities are important. This study was conducted using community-based participatory research approaches within a community of patients and caregivers living with alpha-1 antitrypsin (AAT) deficiency. Patient populations at some risk for lung transplant include individuals who smoked cigarettes and patients who underwent liver transplant in infancy and later adulthood due to accumulation of misfolded AAT within hepatocytes.