ABSTRACT
BACKGROUND: Vertebral augmentation including vertebroplasty and kyphoplasty may restore function without interfering with the therapeutic regimen of patients with multiple myeloma. We sought to evaluate the effects of adding multilevel vertebral augmentation to conventional therapy protocols for patients with multiple myeloma. MATERIALS AND METHODS: Forty-four patients recently diagnosed with multiple myeloma were randomly assigned to two groups. One group received multilevel vertebral augmentation (kyphoplasty or vertebroplasty) in addition to conventional therapy (MVA), and the other group received conventional therapy alone (CTA). Patients were evaluated before treatment and at 3 months, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years after treatment by using the Oswestry Disability Index (ODI), the Stanford Score (SS), and the Spinal Instability Neoplastic Score (SINS). RESULTS: The mean ODI, SS, and SINS were nearly equal before treatment, being 34.19 (68.38%), 4.58, and 12.30, respectively, for the MVA group and 32.29 (64.58%), 4.63, and 13.88, respectively, for the CTA group. There were significant differences in the ODI, SS, and SINS between the two groups at all follow-up intervals. The ODI and SINS were statistically significantly different between the two groups (P=.020 and P<.001, respectively). There was an insignificant difference in SS between the two groups. CONCLUSION: This study found that performing kyphoplasty and vertebroplasty in addition to conventional therapy for patients with multiple myeloma resulted in enhanced morbidity and functional outcomes. [Orthopedics. 202x;4x(x):xx-xx.].
ABSTRACT
Bilateral spontaneous quadriceps tendon rupture is a rare condition characterized by the simultaneous tear of the fibrous tissue connecting the quadriceps muscle to the patella bone. Prompt diagnosis is crucial for appropriate treatment and optimal outcomes. We present a case of a 70-year-old male with bilateral knee pain and an inability to walk, resulting from a trivial fall. Despite initial misdiagnosis, a thorough evaluation, including physical examination and imaging, revealed bilateral quadriceps tendon rupture. Surgical repair was performed, followed by a comprehensive rehabilitation program. At the four-month follow-up, the patient showed significant improvement in pain and function. This article provides a comprehensive review of the existing literature on bilateral quadriceps tendon rupture, emphasizing the challenges in the diagnosis and management of this rare condition. Early diagnosis, prompt surgical intervention, and a tailored rehabilitation program are crucial for successful outcomes.
ABSTRACT
Background: Osteoarthritis of the knee (OA) and osteoporosis are two conditions that have a significant impact on society, have a great impact on quality of life, and can lead to functional impairment. However, the relationship between knee OA and osteoporosis is unclear. Objective: The aim of this study was to examine if there is a link between symptomatic advanced knee osteoarthritis and low bone mineral density. Methods: A total of 430 patients with symptomatic and advanced radiographic knee OA served as participants in this study. Plain radiographs were used to screen participants for osteoarthritis, and a Dual Energy X-ray Absorptiometry (DEXA) scan was used to determine each participant's bone mineral density (BMD). Results: The lumbar spine, whole femur, and femoral neck BMD levels were statistically higher in the early OA (Kelldren-Lawrence (KL) I and II) group compared with the advanced (III and IV) OA group. Higher BMD at the whole femur and femoral neck but not at the lumbar spine was observed when comparing patients with grades I, II, and III with patients with grade IV after adjustment for body mass index. Conclusion: The findings of this study indicate that the degree of knee OA is correlated with a decline in BMD. These findings lend credence to the theory that the two conditions may be linked to one another. Our study concluded that patients with advanced knee osteoarthritis are at risk of developing osteoporosis. As a result, orthopedic doctors are required to screen for osteoporosis in patients with advanced knee osteoarthritis to both prevent and treat osteoporosis at an earlier stage.
