https://www.sportsmed.theclinics.com/article/S0278-5919(03)00004-8/pdf

Types and epidemiology of tendinopathy.

Background
Pseudotumor-like periprosthetic tissue reactions around metal-on-metal (M-M) hip replacements can cause pain and lead to revision surgery. The cause of these reactions is not well understood but could be due to excessive wear, or metal hypersensitivity or an as-yet unknown cause. The tissue features may help distinguish reactions to high wear from those with suspected metal hypersensitivity.

/pdf/histological-features-of-pseudotumor-like-tissues-from-metal-3mga3jeug2.pdf

Histological Features of Pseudotumor-like Tissues From Metal-on-Metal Hips

https://www.sportsmed.theclinics.com/article/S0278-5919(12)00044-0/pdf

Epidemiology, Natural History, and Indications for Treatment of Rotator Cuff Tears

Primary disorders of tendons are common and constitute a high proportion of referrals to rheumatologists. Certain tendons are particularly vulnerable to degenerative pathology; these include the Achilles, patella, elements of the rotator cuff, forearm extensors, biceps brachi and tibialis posterior tendons. Disorders of these tendons are often chronic and can be difficult to manage successfully in the long term. Significant advances have been made in understanding the pathophysiology of these conditions. Histopathological evidence, together with advances in imaging techniques, has made us more appreciative of the degenerative (rather that inflammatory) nature of these conditions. Additionally the presence of neovascularization is now well-recognized in long-standing tendinopathy. We review the mechanical, vascular and developing neural theories that attempt to explain the aetiology of degenerative tendinopathy. We also explore theories of why specific tendons (such as the Achilles and supraspinatus tendons) are particularly prone to degenerative pathology. Traditionally, treatments have placed a heavy emphasis on anti-inflammatory strategies, which are often inappropriate. Recently, however, significant advances in the practical management of tendon disorders have been made. In particular the advent of 'eccentric loading' training programmes has revolutionized the treatment of Achilles tendinopathy in some patients. This concept is currently being extended to include other commonly injured tendons. Other current treatments are reviewed, as are potential future treatments.

/pdf/current-concepts-in-the-management-of-tendon-disorders-ml908vv40f.pdf

Current concepts in the management of tendon disorders

This chapter provides criteria for evaluating permanent impairment of the visual system as it affects an individual’s ability to perform activities of daily living. The visual system consists of the eyes and supporting structures, the neural pathways, and the visual cortex of the brain. The visual system is unique in that it combines the input from two separate eyes into a single visual perception.

Guides to the Evaluation of Permanent Impairment

From a retrospective, cohort study of 205 patients diagnosed with full-thickness tears of the rotator cuff, we determined, using ultrasound, the prevalence of such tears in their 129 siblings. Using 150 spouses as controls, the relative risk of full-thickness tears in siblings versus controls was 2.42 (95% CI 1.77 to 3.31). The relative risk of symptomatic full-thickness tears in siblings versus controls was 4.65 (95% CI 2.42 to 8.63). The significantly increased risk for tears in siblings implies that genetic factors play a major role in the development of full-thickness tears of the rotator cuff.

Genetic influences in the aetiology of tears of the rotator cuff SIBLING RISK OF A FULL-THICKNESS TEAR

Calcific tendinitis: natural history and association with endocrine disorders.

The pursuit of ‘best practice’, health economic planning, the increasing awareness and expectations of patients, pressure from politicians and the media, and the emergence of league tables for surgeons are some of the reasons why orthopaedic surgeons are encouraged to adopt evidence-based

The use of outcome scores in surgery of the shoulder

Seventy-one patients were randomly allocated to undergo either computer-navigated or conventional arthroplasty. A statistically significant improvement in alignment was seen in the computer-navigated cohort. Five-year functional outcome was assessed using the Knee Society, Short Form-36, Western Ontario and McMaster Universities Osteoarthritis Index, and a patient satisfaction score. At 5 years, 46 patients were available for assessment (24 navigated and 22 conventional knees). No patients had undergone revision. No statistically significant difference was seen in any component of any measure of outcome between navigated and conventional cohorts. Longitudinal data showed function to be well maintained with no difference in functional score between 2 and 5 years in either cohort. Despite achieving better alignment, 5 years postoperatively, the functional outcome with computer-navigated knee arthroplasty appears to be no different to that implanted using a conventional jig-based technique.

Computer Navigation vs Conventional Total Knee Arthroplasty: Five-Year Functional Results of a Prospective Randomized Trial

Introduction
Resurfacing metal-on-metal hip arthroplasty is increasing in popularity, especially in younger patients. To date, studies indicate that the procedure is associated with a good outcome in the medium-term. Formation of a peri-articuar mass is a rarely reported complication. In this study we analyse the imaging findings in patients with resurfacing implants presenting to our institution with peri-articular masses identified on cross sectional imaging.

P. Harvie

Papers

Genetic influences in the aetiology of tears of the rotator cuff SIBLING RISK OF A FULL-THICKNESS TEAR

Calcific tendinitis: natural history and association with endocrine disorders.

The use of outcome scores in surgery of the shoulder

Computer Navigation vs Conventional Total Knee Arthroplasty: Five-Year Functional Results of a Prospective Randomized Trial

The imaging spectrum of peri-articular inflammatory masses following metal-on-metal hip resurfacing