ABSTRACT
PURPOSE: The purpose of the present study was to evaluate 4 commercially available shoulder external rotation braces to determine their ability to achieve and maintain shoulder external rotation. In addition, for each brace, we collected patient-derived data on comfort level, ease of application, and ease of performing activities of daily living during brace wear. METHODS: Four commercially available shoulder external rotation braces were evaluated for their ability to achieve and maintain external rotation in 12 healthy subjects. RESULTS: Significant differences were noted between braces in their ability to achieve and maintain shoulder external rotation, as well as in their comfort ratings. CONCLUSIONS: We have shown that the commercially available shoulder external rotation braces evaluated in this study vary in (1) ability to achieve and maintain a desired position of external rotation of the shoulder, and (2) comfort ratings. CLINICAL RELEVANCE: Selection of an external rotation brace should involve consideration of the device's performance and comfort profile.
Subject(s)
Braces , Shoulder Joint , Humans , Patient Satisfaction , Range of Motion, Articular , Shoulder Dislocation/therapyABSTRACT
Metastatic tumors to the hand and wrist are rare, accounting for approximately 0.1% of all metastatic lesions to the skeleton. The biochemically mediated pathways of bone metastases, the location of the hand at the distal extremity, and the small amount of marrow in the bones of the hand and wrist account for the low prevalence of acrometastases. More rarely, hand dermatologic and soft tissue changes of paraneoplastic syndromes herald an occult malignancy.
Subject(s)
Bone Neoplasms/secondary , Hand , Paraneoplastic Syndromes , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Bone Neoplasms/physiopathology , Bone Neoplasms/therapy , Breast Neoplasms/pathology , Curettage , Fingers , Humans , Kidney Neoplasms/pathology , Lung Neoplasms/pathology , Magnetic Resonance Imaging , Physical Examination , Prognosis , Tomography, X-Ray ComputedABSTRACT
Osteoarthritis (OA) is a disabling joint disease for which there is currently no cure. It is characterized by the destruction of articular cartilage. One strategy that is being explored for protecting the cartilage in OA is the administration of transforming growth factor-beta, which in vitro antagonizes cartilage degradation initiated by catabolic stimulants such as interleukin-1 (IL-1). The problems associated with selective delivery of the growth factor to chondrocytes, undesirable side-effects on joint tissues, and short biological half-life have led us to explore modalities aimed at activating transforming growth factor-beta that is stored in the cartilage as latent complexes. Photodynamic therapy is a two-step protocol of tissue sensitization with a light-activatable chemical called a photosensitizer followed at some interval by irradiation with the appropriate wavelength visible light. Biological effects are typically elicited through oxygen-dependent photochemistry without heat generation. Transforming growth factor-beta1 can be activated by oxidative mechanism(s), prompting us to explore whether photodynamic technology can be harnessed to modulate cartilage metabolism. Disks of bovine articular cartilage were photosensitized by incubation with a chlorin(e6)-succinylated polylysine conjugate and irradiated with 1-2 J/cm2 red light (lambdamax = 671 nm). This two-step regimen dramatically inhibited IL-1-stimulated proteoglycan degradation and concomitantly increased latent and active transforming growth factor-beta1 in culture medium. This research may lead to the development of minimally invasive photodynamic therapy in which light is delivered to locally activate a chondroprotective program in photosensitized cartilage in the context of OA.
