Rehab Centers: Can Knee Arthroplasty Play a Role in Weight Management in Knee Osteoarthritis?

Can knee arthroplasty play a role in weight management in knee osteoarthritis?

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Arthritis Care Res (Hoboken). 2012 Nov 8;
Franklin PD, Rosal MC

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Genetic and environmental influences on non-specific neck pain in early adolescence: A classical twin study.

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Eur J Pain. 2012 Nov 9;
Ståhl MK, El-Metwally AA, Mikkelsson MK, Salminen JJ, Pulkkinen LR, Rose RJ, Kaprio JA

BACKGROUND: Prevalence of neck pain has increased among adolescents. The origins of adult chronic neck pain may lie in late childhood, but for early prevention, more information is needed about its aetiology. We investigated the relative roles of genetic and environmental factors in early adolescent neck pain with a classic twin study. METHODS: Frequency of neck pain was assessed with a validated pain questionnaire in a population-based sample of nearly 1800 pairs of 11-12-year-old Finnish twins. Twin pair similarity for neck pain was quantified by polychoric correlations, and variance components were estimated with biometric structural equation modelling. RESULTS: Prevalence of neck pain reported at least once monthly was 38% and at least once weekly 16%, with no significant differences between gender and zygosity. A greater polychoric correlation in liability to neck pain was found in monozygotic (0.67) than for dizygotic pairs (0.38), suggesting strong genetic influences. Model fitting indicated that 68% (95% confidence interval 62-74) of the variation in liability to neck pain could be attributed to genetic effects, with the remainder attributed to unshared environmental effects. No evidence for sex-specific genetic effects or for sex differences in the magnitude of genetic effects was found. CONCLUSIONS: Genetic and unique environmental factors seem to play the most important roles in liability to neck pain in early adolescence. Future research should be directed to identifying pathways for genetic influences on neck pain and in exploring effectiveness of interventions that target already identified environmental risk factors.
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Guided Internet-delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: Randomized controlled trial.

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Eur J Pain. 2012 Nov 9;
Buhrman M, Fredriksson A, Edström G, Shafiei D, Tärnqvist C, Ljótsson B, Hursti T, Gordh T, Andersson G

BACKGROUND: Chronic pain can be treated with cognitive behavioural therapy delivered in multidisciplinary settings. However, relapse is likely, and there is a need for cost-effective secondary interventions for persons with residual problems after rehabilitation. The aim of the present study was to investigate the effects of a guided Internet-delivered cognitive behavioural intervention for patients who had completed multidisciplinary treatment at a pain management unit. METHODS: A total of 72 persons with residual pain problems were included in the study and were randomized to either treatment for 8 weeks or to a control group who were invited to participate in a moderated online discussion forum. The participants had different chronic pain conditions, and a majority were women (72%). Twenty-two percent of the participants dropped out of the study before the post-treatment assessment. RESULTS: Intent-to-treat analyses demonstrated differences on the catastrophizing subscale of the Coping Strategies Questionnaire (Cohen’s d?=?0.70), in favour of the treatment group but a small within-group effect. Differences were also found on other measures of pain-related distress, anxiety and depressive symptoms. A 6-month follow-up exhibited maintenance of improvements. CONCLUSIONS: We conclude that Internet-delivered treatment can be partly effective for persons with residual problems after completed pain rehabilitation.
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Shape of growth plate of proximal femur in children and its significance in the aetiology of slipped capital femoral epiphysis.

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Int Orthop. 2012 Nov 9;
Kandzierski G, Matuszewski L, Wójcik A

PURPOSE: The main objective of the study was to present the influence of the morphological shape of the proximal femoral growth plate in children as one of the risk factors for the incidence of slipped capital femoral epiphysis (SCFE) in adolescents. METHODS: This research is based on the X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) data obtained for 100 children three to 13 years old, all treated at the Children’s Orthopaedic Clinic and Rehabilitation Department and Department of Radiology Medical University of Lublin between 2005 and 2009. We took into account 83 children with healthy hip joints and 17 children with SCFE. We also performed morphological analysis of the shape of the proximal femoral growth plate together with X-ray, CT and MRI examinations of the proximal ends of cadaver femurs for two children aged six and 13. RESULTS: In the final findings we present an analysis of the shape of the proximal femoral growth plate in children between the third and 13th years of life and consider a correlation between the shape of the proximal femoral growth plate and its influence on the incidence of SCFE in adolescents. CONCLUSIONS: The change of shape of the proximal femoral growth plate from pleated to more spherical is one of the risk factors for the incidence of SCFE in children ten years old and older.
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Return to sport following anterior cruciate ligament reconstruction.

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Int Orthop. 2012 Nov 10;
Feller J, Webster KE

Rates of return to pre-injury sport following anterior cruciate ligament (ACL) reconstruction are less than might be expected from standard outcome measures and there appears to be a rapid decline in sporting participation after two to three years. There are many factors that influence whether an individual will return to sport following this type of surgery. They include not only surgical details and rehabilitation, but also social and psychological factors, as well as demographic characteristics. Age is of particular importance with older patients being less likely to resume their pre-injury sport. It is important that future research clearly identify the pre-injury characteristics of the study cohort when investigating return to sport, and also that there is consistent and precise terminology used to report rates of return to sporting activities. Little is known about how to determine when it is safe to return to sport following ACL reconstruction or how to predict whether an athlete will be able to successfully return to sport. Finally, it needs to be recognised that return to sport following ACL reconstruction is associated with a risk of further injury and the development of osteoarthritis.
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