Journal of Back and Musculoskeletal Rehabilitation - Volume 4, issue 3
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: The human hip is the largest ball and socket joint in the body. It differs in design from the more common hinge joint in order to meet the requirements of ambulation. The hip is an inherently stable joint because of its bony structure and its extensive ligamentous and muscular support. Regardless of this stability, the hip joint maintains a wide functional range of movement. This dichotomy of function has resulted in a complex organization of joint structure. A thorough understanding of the biomechanic forces exerted across the joint surfaces is essential to the understanding of both normal and pathologic function.…The authors of this article will explore the complex structural anatomy of this joint system in light of the biomechanic principles that effect movement and weight bearing through the joint.
Keywords: Hip joint, biomechanics, anatomy, function, vector forces
Abstract: This review discusses the many etiologies of hip pain and how to clinically evaluate. Both primary hip disorders and conditions that refer pain to the hip are included in the differential diagnosis. The key components to a history are reviewed with clinically relevant examples. A comprehensive physical exam is described that includes disease and injury-specific tests. Imaging studies and diagnostic tests available are outlined. Conditions of bursitis, snapping hip syndromes, myofascial pain, fibromyalgia, arthropathies, fractures, neurogenic pain, metabolic diseases, and neoplastic disorders will be discussed.
Keywords: Hip, pain, physical examination, diagnosis, differential, medical history taking
Abstract: Osteoporosis is a common entity, especially among elderly Caucasian women. Osteoporosis leads to hip fracture in many persons, putting them at risk for death and marked handicap. Hip fracture shows a steady increase in incidence after age 60 years, and most of the victims are over age 75 years. Screening studies predict hip fracture up to 8 years before fracture. Estrogen therapy, to be effective, should be initiated between the ages of 50 and 60 years, 25 to 15 years before the most likely age of fracture. Guidelines describing for whom the physician targets estrogen therapy, which is not without…risks, are sketchy or nonexistent. The patient should also be educated as a young adult about risk factor modification for osteoporosis, including increasing exercise, ceasing smoking, and minimizing coffee and alcohol use.
Keywords: Hip fracture, osteoporosis, risk factors osteoporosis, prevention osteoporosis
Abstract: Rehabilitation professionals play an important role in the comprehensive postoperative management of the patient who has undergone a total hip replacement. Understanding the general surgical considerations that eventually impact the rehabilitation process is essential. Coordination of physicians, physical and occupational therapists, social services, and family members results in better quality of care. The technology and design of hip prostheses and fixation methods impact the functional outcome of total hip arthroplasty. Professionals involved in total hip arthroplasty rehabilitation should also understand the potential complications following total hip arthroplasty that oftentimes cause delays or revisions in the rehabilitation program. When these are…combined with appropriate preoperative patient selection and education, as well as postoperative physical and occupational therapy programs, most patients are able to achieve a satisfactory functional outcome, including independence in basic activities of daily living and independent ambulation with an assistive device.
Keywords: Rehabilitation, total hip replacement, physical therapy
Abstract: Venous thromboembolism is the most common and potentially lethal problem following elective or emergency hip surgery. Appropriate DVT prophylaxis is absolutely essential, as the incidence of both calf and proximal vein thrombosis is significant. Two to three percent of postoperative hip patients die secondary to pulmonary embolism. Prophylactic measures include a variety of pharmacological and non pharmacological tools. Early mobilization, leg exercises, and gradient compression stockings constitute a minimum protocol. Low-dose Coumadin or low molecular weight heparin should be employed as a pharmacological prophylaxis. If deep venous thrombosis is suspected, clinical judgment alone should not be a basis…for treatment decisions. Venography or, if necessary, other modem diagnostic agents must be employed. If appropriate studies are positive, aggressive treatment with heparin followed by Coumadin is suggested.
Abstract: Heterotopic ossification (HO) is a common finding after total hip arthroplasty (THA), and may cause diminished hip range of motion and an antalgic gait. Although the etiology remains unclear, two theories currently prevail. In this article, the incidence, etiology, risk factors, and classifications of HO are discussed. Effective prophylactic treatments including radiation and anti-inflammatory medications are detailed. Once HO is present, the value of these treatments are doubtful and surgical excision may be required after bony maturity. With increasing THA projected as the population ages, the need for safe, effective, and inexpensive prophylaxis may be required.
Keywords: Heterotopic ossification, total hip arthroplasty