Rehab Centers: Treatment of PCL, ACL, and Lateral-Side Knee Injuries: Acute and Chronic.

Treatment of PCL, ACL, and Lateral-Side Knee Injuries: Acute and Chronic.

Filed under: Rehab Centers

J Knee Surg. 2012 Dec; 25(4): 295-306
Levy BA, Stuart MJ

Combined posterior cruciate ligament, anterior cruciate ligament, and lateral-side disruption is one of the more common patterns of multiligament knee injury. This is a devastating injury with significant long-term functional sequelae, making accurate diagnosis and management extremely important. While surgical intervention is necessary to restore function, the specific management strategies remain controversial. This article will review the current literature and the authors’ preferred approach including physical examination, imaging, timing of surgery, surgical technique, and postoperative rehabilitation.
HubMed – rehab


Current Concepts in Knee Dislocations: PCL, ACL, and Medial Sided Injuries.

Filed under: Rehab Centers

J Knee Surg. 2012 Dec; 25(4): 287-294
Stannard JP, Bauer KL

Dislocations resulting in multiligament knee injuries are challenging to treat and diagnose. With proper diagnosis and anatomic reconstruction techniques, patients can have successful outcomes. This article describes the senior author’s (J.P.S.’s) preferred reconstruction techniques, timing for surgery, and rehabilitation techniques for injuries involving the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and posteromedial corner (PMC). We prefer to address these injuries in a staged fashion. The PCL, PMC, and any additional meniscal pathology are addressed in the index procedure. The ACL is reconstructed approximately 6 weeks later to ensure that acceptable range of motion has been regained. Staging procedures also allow time to maximize rehabilitation protocols for both the PCL and the ACL.
HubMed – rehab


The reporting of blinding in physical medicine and rehabilitation randomized controlled trials: A systematic review.

Filed under: Rehab Centers

J Rehabil Med. 2012 Nov 13;
Villamar MF, Contreras VS, Kuntz RE, Fregni F

Objective: To conduct a systematic review evaluating the reporting of blinding in randomized controlled trials published in the field of Physical Medicine and Rehabilitation over two time periods. Data sources: We searched MEDLINE via PubMed for all randomized controlled trials published in American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Clinical Rehabilitation, Disability and Rehabilitation and (Scandinavian) Journal of Rehabilitation Medicine in the years 2000 and 2010. Study selection: We initially identified 222 articles, and 139 (62.6%) met our selection criteria. Data extraction: Two independent investigators collected data regarding study characteristics and blinding from each article. Consistency of data extraction was evaluated. Data synthesis: When comparing articles from 2010 and 2000, the former showed significantly higher rates for reporting of blinding, explicitly describing key persons’ blinding status, and discussing the absence of blinding as a study limitation. There was a trend for lower reporting among trials with positive outcomes. No improvement was observed in other CONSORT-enforced parameters. Conclusions: Although the reporting of blinding in Physical Medicine and Rehabilitation randomized controlled trials shows some improvement over the past decade, it still does not fulfill current recommendations. Given its critical role in determining internal validity, stricter enforcement of CONSORT guidelines is needed.
HubMed – rehab


Cochlear Implantation Via the Middle Fossa Approach: Surgical and Programming Considerations.

Filed under: Rehab Centers

Otol Neurotol. 2012 Dec; 33(9): 1516-1524
Bento RF, Bittencourt AG, Goffi-Gomez MV, Samuel P, Tsuji RK, de Brito R

OBJECTIVES: To report the results of cochlear implantation via the middle fossa approach in 4 patients, discuss the complications, and present a detailed description of the programming specifications in these cases. STUDY DESIGN: Retrospective case review. SETTING: Tertiary-care referral center with a well-established cochlear implant program. PATIENTS: Four patients with bilateral canal wall down mastoid cavities who underwent the middle fossa approach for cochlear implantation. INTERVENTIONS: Cochlear implantation and subsequent rehabilitation. A middle fossa approach with cochleostomy was successfully performed on the most superficial part of the apical turn in 4 patients. A Nucleus 24 cochlear implant system was used in 3 patients and a MED-EL Sonata Medium device in 1 patient. The single electrode array was inserted through a cochleostomy from the cochlear apex and occupied the apical, middle, and basal turns. Telemetry and intraoperative impedance recordings were performed at the end of surgery. A CT scan of the temporal bones was performed to document electrode insertion for all of the patients. MAIN OUTCOME MEASURES: Complications, hearing thresholds, and speech perception outcomes were evaluated. RESULTS: Neural response telemetry showed present responses in all but 1 patient, who demonstrated facial nerve stimulation during the test. Open-set speech perception varied from 30% to 100%, despite the frequency allocation order of the MAP. CONCLUSION: Cochlear implantation via the middle cranial fossa is a safe approach, although it is a challenging procedure, even for experienced surgeons.
HubMed – rehab



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