Glenohumeral osteoarthritis: overview, therapy, and rehabilitation.

PURPOSE: Glenohumeral osteoarthritis (GHOA) is a common cause of pain and functional disability of the shoulder. Despite the limited evidence, there are several options for the treatment of this pathology. The aim of this article is to provide current information on the characteristics of the disease and the pathophysiology, evidence based on medical and surgical treatments with emphasis on the rehabilitation process. METHODS: It was performed with an extensive literature review, mainly clinical practice guidelines, randomized controlled trials, reviews, focusing on the rehabilitation management. RESULTS: There are few clinical practice guidelines that address GHOA as a pathology with unique characteristics. Evidence based treatment recommendations are mostly supported by low-quality evidence and experts' opinions, with few high levels of evidence studies guiding treatment decisions. CONCLUSIONS: Despite the lack of good quality evidence, rehabilitation programs have proven to be efficient and reliable, and this revision provides information and recommendations in this field. Implication of Rehabilitation Glenohumeral osteoarthritis is a common cause of pain and functional disability of the shoulder There are few clinical practice guidelines that address Glenohumeral Osteoarthritis as a pathology with unique characteristics, and recommendations for rehabilitation and therapeutic exercise are poor The paper provides current information on the characteristics of the disease, its rehabilitation process, and could be of interest for rehabilitation professionals to direct their practices in this field.

Proposal and Evaluation of a Telerehabilitation Platform Designed for Patients With Partial Rotator Cuff Tears: A Preliminary Study.

OBJECTIVE: To propose and evaluate the effectiveness of a telerehabilitation platform designed for patients with rotator cuff (RC) tears. METHODS: During the first study phase, a virtual service platform that included information on RC tear pathology, joint care, and a series of instructions regarding therapeutic exercise was designed and created. Subsequently, in the clinical phase, a quasi-experimental study was performed. The platform was tested on patients and evaluated at baseline and at 1, 2, 3, and 6 months with respect to their pain levels and functionality on the Constant-Murley (CM) scale. RESULTS: Eleven patients were included, 5 women and 6 men, with a median age of 55 years (range, 42-68 years). Pain diminished from a baseline value of 64 mm (range, 40-80 mm) to 16 mm (range, 0-30 mm) at 6 months (p<0.001). Points on the CM scale rose from a baseline value of 54 points (range, 51-66 points) to 85 points (range, 70-100 points) at 6 months (p=0.001). Functionality in daily living and work activities, movement, and strength exhibited significant changes at 6 months (p<0.05). CONCLUSION: Significant changes were observed in pain and functionality in this group of participants who used a telerehabilitation platform. To the best of our knowledge, this is the first study that included a specific program for RC tears.

Knee muscle strength correlates with joint cartilage T2 relaxation time in young participants with risk factors for osteoarthritis.

The objective of this study is to correlate T2 relaxation time (T2RT), measured by magnetic resonance imaging (MRI) with quadriceps and hamstring strength in young participants with risk factors for knee osteoarthritis (OA). A descriptive cross-sectional study was conducted with participants between 20 and 40 years of age, without diagnosis of knee OA. Their T2 relaxation time was measured through MRI, and their muscle strength (MS) was measured with an isokinetic dynamometer. Seventy-one participants were recruited, with an average age of 28.3 ± 5.5 years; 39 (55 %) were females. Negative correlations were found between T2RT and quadriceps peak torque (QPT) in males in the femur r = -0.46 (p = 0.01), tibia r = -0.49 (p = 0.02), and patella r = -0.44 (p = 0.01). In women, correlations were found among the femur r = -0.43 (p = 0.01), tibia r = -0.61 (p = 0.01), and patella r = -0.32 (p = 0.05) and among hamstring peak torque (HPT), in the femur r = -0.46 (p = 0.01), hamstring total work (HTW) r = -0.42 (p = 0.03), and tibia r = -0.33 (p = 0.04). Linear regression models showed good capacity to predict T2RT through QPT in both genders. The present study shows that early changes in femoral, tibial, and patellar cartilage are significantly correlated with MS, mainly QPT, and that these early changes might be explained by MS, which could play an important role in pre-clinical phases of the disease.

[Total hip arthroplasty in patients with cerebral vascular event. Case report]. / Artroplastia total de cadera primaria en paciente con evento vascular cerebral. Reporte de un caso.

INTRODUCTION: Associated neurological disorders pose a challenge hip joint reconstruction. The imbalance and poor muscle tone predispose to dislocation and loosening of the prosthesis. CLINICAL CASE: The following is the case of a 67 years old patient with a hemorrhagic cerebral vascular event with a secondary left hemiparesis. Ten years later had a femoral neck fracture on the affected side. Initially she was treated with conservative management resulting in pain and discapacity, valued with WOMAC scale as 12 points. Two years later was treated with total hip arthroplasty with large diameter femoral head. We present the follow up of 41 months, asymptomatic, walking using a cane and a WOMAC score of 41, with no signs of radiological loosening or dislocation. CONCLUSIONS: There is no experience documented in neurological disorders associated with hip diseases that requires a total hip arthroplasty. Loosening of the implants, dislocation and heterotopic ossification has been described as complications of the procedure. Large heads in total hip arthroplasty and a correct surgical technique associated with a multidisciplinary management in patients with neurological disorders offers an opportunity as a treatment in patient with hip disorders.