ABSTRACT
Background: Latest studies have shown effective clinical outcomes after arthroscopic Bankart repair [ABR] but have shown some risk factors for re-dislocation after surgery. We assessed whether patients are at a risk for re-dislocation during the first year after ABR, examined the recurrence rate after ABR, and sought to recognize new risk factors
Materials and Methods: We performed ABR utilizing bioabsorbable suture anchors in 51 consecutive shoulders [50 patients] with traumatic anterior shoulder instability. Average patient age was 26.5 [range, 15-40] years. We assessed re-dislocation after ABR using patient telephone interviews [follow-up rate, 100%] and correlated re-dislocation with several risk factors
Results: Re-dislocation after ABR occurred in five shoulders [9.8%], of which 4 sustained re-injuries within the first year with the arm elevated at 90° and externally rotated at 90°. Of the remaining 46 shoulders without re-dislocation, 4 had re-injury under the same conditions within the first year. Consequently, re-injury within the first year was a risk for re-dislocation after ABR [P < 0.001, chi-squared test]. Using multivariate analysis, large Hill-Sachs lesions [odds ratio, 6.75; 95% CI, 1.35-64.5] and <4 suture anchors [odds ratio, 9.45; 95% CI, 1.88-72.5] were significant risk factors for re-dislocation after ABR
Conclusion: The recurrence rate after ABR was not associated with the time elapsed and that repair strategies should augment the large humeral bone defect and use >3 anchors during ABR
ABSTRACT
Background: Gastroesophageal reflux disease [GERD] is a chronic motility disorder resulting in reflux of stomach contents in to the esophagus. It has a prevalence rate of 10-20% in the western world. In the Gulf region, the prevalence of GERD is not yet well characterized. Annually, millions of Muslims gather from across the world embark on a religious pilgrimage to Mecca in Saudi Arabia. They represent a population with various socio-demographic characteristics, life styles, dietary habits and social life stresses that might affect the prevalence of this chronic disorder
Objective: the aim of this study was to determine the prevalence and impact of GERD on the pilgrims in Mecca region during the Hajj period in the year 1438 Hegira
Methods: participants were asked to fill a self-administered questionnaire, GERD questionnaire [GERDQ] and GERD-HRQL were used for making the diagnosis of GERD and to assess its impact on the patient's quality of life
Results: the prevalence of GERD among the study population was 29.0%, with a statistically significant association with age and nationality. Neither smoking nor the presence of other diseases showed statistically significant relationship with the presence of GERD [p>0.05]. GERD-HRQL scale showed a statistically higher median in GERD patients compared to healthy subjects. Moreover, 58 participants [52.73%] showed poor quality of life compared to 52 participants [47.27%] who expressed good quality
Conclusion: this study showed a prevalence rate of GERD among pilgrims in Mecca region to be 29.0%, which has an impact on their daily life activities. These data indicate a need for a comprehensive approach to GERD management in the health-care system
ABSTRACT
Background: Anterior Cruciate Ligament [ACL] reconstruction is a well-known surgical knee procedure performed by orthopaedic surgeons. There is a general consensus for the effectiveness of a postoperative ACL reconstruction rehabilitation program, however there is little consensus regarding the optimal components of a program
Objective of the Study: to assess the merits and demerits of current ACL reconstruction rehabilitation programs and interventions based on the evidence supported by previously conducted systematic reviews
Methods: a Systematic search in the scientific database [Medline, Scopus, EMBASE , and Google Scholer] between 1970 and 2017 was conducted for all relevant Systematic reviews discussing the primary endpoint [ ACL reconstruction rehabilitation ] studies were analyzed and included based on the preset inclusion and exclusion criteria. Study screening and quality was assessed against PRISMA guidelines and a best evidence synthesis was performed
Results: the search results yielded five studies which evaluated eight rehabilitation components [bracing, Continuous passive motion [CPM], neuromuscular electrical stimulation [NMES], open kinetic chain [OKC] versus closed kinetic chain [CKC] exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation]. A strong evidence suggested no added benefit of short term bracing [0-6 weeks post-surgery] compared to standard treatment. Whilst a moderate evidence reinforced no added advantage of continuous passive motion to standard treatment for boosting motion range. Furthermore, a moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions including: the use of NMES and exercise, accelerated and non-accelerated rehabilitation, early and delayed rehabilitation, and eccentric resistance programs after ACL reconstruction
Conclusion: short term post-operative bracing and continuous passive motion [CPM] introduce no benefit over standard treatment and thus not recommended. A moderate evidence suggested equal efficiency for 1] CKC and OKC are equally effective for knee laxity, pain and function, at least in the short term [6-14 weeks] after ACL reconstruction and 2] home based and clinic based rehabilitation. Nevertheless, the degree of physiotherapy input remains unclear