Calcific Tendinopathy of the Shoulder: A Retrospective Comparison of Traditional Barbotage Versus Percutaneous Ultrasonic Barbotage.

OBJECTIVE: The purpose of this study was to compare a traditional barbotage technique with percutaneous ultrasonic barbotage (PUB) for the treatment of rotator cuff (RC) calcific tendinopathy. DESIGN: Three-year retrospective review. SETTING: Participants aged 18 to 75 presenting at 2 highly specialized outpatient orthopedic referral centers with symptomatic RC calcific tendinopathy. PATIENTS: There were 75 patients included (23 patients in the traditional barbotage group; 52 patients in the PUB group) with an average age of 55.3(6.5) and 55.9(9.8), respectively. There was no significant difference in demographics between groups. INTERVENTIONS: Traditional barbotage or PUB. MAIN OUTCOME MEASURES: Primary outcome measure was pain rated on the Numeric Pain Rating Scale (NPRS) with secondary outcomes investigating patient satisfaction. RESULTS: The barbotage and PUB group demonstrated a significant improvement in pain (barbotage 2.4, P = 0.01; PUB = 2.6, P < 0.001) with no statistically significant difference between the 2 treatment modalities (95% CI: -1.8 to 2.2; P = 0.83, P = 0.83). Median follow-up for NPRS recordings was 17-weeks in the barbotage group and 8-weeks in the PUB group ( P = 0.004). Both groups demonstrated similar patient-reported satisfaction, without major complications. CONCLUSION: The traditional barbotage and PUB procedures improved pain with a high patient satisfaction rate. LEVEL OF EVIDENCE: Level III.

Amniotic dehydrated cell and protein concentrate versus corticosteroid in knee osteoarthritis: preliminary findings.

Objectives: The purpose is to report preliminary data on clinical response to dehydrated cell and protein concentrate (dCPC) versus corticosteroid (CSI). Design: A single-site prospective, randomized controlled single-blinded trial of patients with knee osteoarthritis. Methods: Pain and function were assessed using a visual analog scale (VAS), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Emory Quality of Life (EQOL) measure at 1, 2, 3, 6, 9 and 12 months. Results: 51 patients were enrolled at the time of analysis (27 dCPC, 24 CSI). Both groups demonstrated improvement on the VAS, KOOS and EQOL. Largest differences were observed at 2 (p = 0.05), 3 (p = 0.012) and 6 months (p < 0.001) with a decrease of 1.66 in VAS at 6 months for dCPC (95% CI: -2.67 to -0.65) and 1.34 (95% CI: -2.37 to -0.3) for CSI. Time-averaged measures showed no difference between groups (p = 0.20). Limited data at 9 and 12 months trended toward improvement in the dCPC group. Conclusion: dCPC products may be used as a treatment for knee osteoarthritis. Larger trials are warranted. Clinical Trial Registration: NCT03710005 (ClinicalTrials.gov).

The purpose of this study was to discuss preliminary data from a clinical trial comparing a single injection of an amniotic-derived tissue product (dehydrated cell and protein concentrate [dCPC]) to corticosteroid for the treatment of knee osteoarthritis. The study took place at a single institution. 51 patients were enrolled at the time of analysis (27 dCPC, 24 corticosteroid). Both groups demonstrated improvement in pain and function 6 months after treatment. There was a larger improvement in the amniotic-derived tissue product group, but this did not reach a level of statistical significance. There were limited data beyond 6 months, but this trended toward a continued improvement in the amniotic-derived tissue product group. Findings suggest that these amniotic derived tissue products may be used as a treatment for knee osteoarthritis, but larger studies are needed.

Running Mechanics and Metabolic Responses With Water Bottles and Bottle Belt Holders.

PURPOSE: To determine whether differential kinematics, kinetics, rates of energy use, and cardiopulmonary responses occur during running with water bottles and bottle belt holders compared with running only. METHODS: Trained runners (N = 42; age 27.2 [6.4] y) ran on an instrumented treadmill for 4 conditions in a randomized order: control run (CON), handheld full water bottle (FULL; 16.9 fluid oz; 454 g), handheld half-full water bottle (HALF; 8.4 fluid oz; 227 g), and waist-worn bottle belt holder (BELT; hydration belt; 676 g). Gas exchange was measured using a portable gas analyzer. Kinetic and kinematic responses were determined by standard 3-dimensional videographic techniques. Interactions of limb side (right and left) by study condition (CON, FULL, HALF, and BELT) were tested for rates of oxygen use and energy expenditure and kinematic and kinetic parameters. RESULTS: No significant limb-side × condition interactions existed for rates of oxygen use or energy expenditure. A significant interaction occurred with sagittal elbow flexion (P < .001). Transverse pelvic-rotation excursions differed on average 3.8° across conditions. The minimum sagittal hip-flexion moment was higher in the right leg in the HALF and BELT conditions compared with CON (P < .001). CONCLUSIONS: Carrying water by hand or on the waist does not significantly change the kinematics of running motion, rates of oxygen use and energy expenditure, or cardiopulmonary measures over short durations. Runners likely make adjustments to joint moments and powers that preserve balance and protect the lower-extremity joints while maintaining rates of oxygen use and energy expenditure.