Accuracy of Ultrasound Compared to Magnetic Resonance Imaging in the Diagnosis of Thumb Ulnar Collateral Ligament Injuries: A Prospective Case Series.

This prospective case series compared the accuracy of ultrasound (US) to magnetic resonance imaging (MRI) in differentiating complete displaced (CD) thumb ulnar collateral ligament (UCL) tears from nondisplaced injuries in 10 patients with suspected traumatic thumb UCL injuries. Ultrasound identified 100% (2 of 2) of MRI-documented CD tears, both of which were further confirmed during surgical repair. Ultrasound identified the absence of CD tears in the remaining 8 patients. Although MRI is the reference standard imaging modality for characterizing thumb UCL injuries, ultrasound should be considered an accurate, cost-effective, and alternative imaging modality to differentiate surgical versus nonsurgical thumb UCL injuries.

Intraarticular platelet-rich plasma injection in the treatment of knee osteoarthritis: review and recommendations.

Intraarticular platelet-rich plasma (PRP) injection has emerged as a promising treatment for knee osteoarthritis. Studies to date, including multiple randomized controlled trials, have shown that PRP is a safe and effective treatment option for knee osteoarthritis. Intraarticular PRP is similar in efficacy to hyaluronic acid, and seems to be more effective than hyaluronic acid in younger, active patients with low-grade osteoarthritis. Treatment benefits seem to wane after 6-9 mos. There are numerous PRP treatment variables that may be of importance, and the optimal PRP protocol remains unclear. Future investigations should control and analyze the effects of these variables in PRP treatment. High-quality randomized controlled trials are needed to optimize PRP treatment methods and better define the role of PRP in osteoarthritis management in the knee and, potentially, in other joints.

Golf after total knee arthroplasty: do patients return to walking the course?

BACKGROUND: Golf provides an opportunity for relatively low-impact exercise for nearly all age groups and is considered a recommended activity for patients after total knee arthroplasty. HYPOTHESIS: We hypothesized that total knee arthroplasty would afford patients increased ability to participate in and enjoy golf, allowing a large percentage of these patients to walk the golf course. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Surveys were sent to 151 golfers who had undergone primary total knee arthroplasty from 1995 to 2000. The detailed survey included 33 questions specific to the patients' golf performance, enjoyment of golf, frequency of participation, timing of return to play, presence of pain, use of a cart, and related golf-specific issues. RESULTS: We received and evaluated 93 responses (62%). Fifty-seven percent reported they had returned to golf within 6 months after total knee arthroplasty. Eighty-one percent of respondents reported golfing as frequently, or more frequently, than before knee replacement. Notably, golfers reported less pain while golfing after total knee arthroplasty than before (13% vs 83%; P < .0001), and 94% of respondents reported currently enjoying golf as much as or more than before surgery. Twenty-eight percent of respondents stated that they walked the course, rather than using a motorized golf cart, before surgery, while only 14% walked the course after surgery (P = .02). CONCLUSION: In this population of golfers, total knee arthroplasty reliably relieved pain that had been previously experienced while golfing, and increased or maintained this group's enjoyment of playing golf. However, 86% of these patients reported using a cart while golfing. Further patient education is needed regarding the potential health benefits of walking during golf after total knee arthroplasty.

Ultrasound-guided piriformis injection: technique description and verification.

Piriformis injections are commonly used in the evaluation and treatment of patients presenting with buttock pain syndromes. Because of its small size, deep location, and relation to adjacent neurovascular structures, the piriformis is traditionally injected by using electromyographic, fluoroscopic, computed tomographic, or magnetic resonance imaging guidance. This report describes and verifies a technique for performing ultrasound-guided piriformis injections. Ultrasound offers several advantages over traditional imaging approaches, including accessibility, compact size, lack of ionizing radiation exposure, and direct visualization of neurovascular structures. With appropriate training and experience, interested physiatrists can consider implementing ultrasound-guided piriformis injections into their clinical practices.