Musculoskeletal Injuries: Current Treatment Trends and Future Strategies

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 12810

Special Issue Editors


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Guest Editor
Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy
Interests: artroscopy; shoulder; knee; ankle; joint
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Guest Editor
Full Professor and Consultant in Trauma and Orthopaedic Surgery, Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128 Roma, Italy
Interests: spine surgery (scoliosis, spondylolisthesis, spinal stenosis, spinal disc herniation, myelopathy); hip, knee, and shoulder replacement surgery; foot surgery; hand surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal injuries are one of the most frequent occupational health issues, are very common in sports, and are related to an increasing aging population. Traumatic, pathological, and/or overuse conditions of joints may imply high disability and reduction of quality of life in people suffering from musculoskeletal injuries. Several intervention strategies have been employed to face musculoskeletal injuries, such as stretching and strengthening exercises to restore joints’ range of motion and reduce pain. Future strategies in musculoskeletal disorders should overcome the limitation of current treatment trends. New solutions based on the latest cutting-edge technologies must enhance the diagnostic phase, speed the healing process, and restore joints’ functionalities.

The Special Issue aims to discuss the current treatment trends in musculoskeletal injuries, as well as future strategies to achieve increasingly effective treatments.

Prof. Umile Giuseppe Longo
Prof. Vicenzo Denaro
Guest Editors

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Keywords

  • musculoskeletal injuries
  • quality of life musculoskeletal disorders
  • stretching exercises
  • strengthening exercises

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Published Papers (4 papers)

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12 pages, 529 KiB  
Article
Temporomandibular Disorders Slow Down the Regeneration Process of Masticatory Muscles: Transcriptomic Analysis
by Cinzia Sindona, Michele Runci Anastasi, Luigi Chiricosta, Agnese Gugliandolo, Serena Silvestro, Placido Bramanti, Piero Cascone and Emanuela Mazzon
Medicina 2021, 57(4), 354; https://doi.org/10.3390/medicina57040354 - 7 Apr 2021
Cited by 5 | Viewed by 2110
Abstract
Background and Objectives: Musculoskeletal injuries represent a pathological condition due to limited joint motility and morphological and functional alterations of the muscles. Temporomandibular disorders (TMDs) are pathological conditions due to alterations in the musculoskeletal system. TMDs mainly cause temporomandibular joint and masticatory muscle [...] Read more.
Background and Objectives: Musculoskeletal injuries represent a pathological condition due to limited joint motility and morphological and functional alterations of the muscles. Temporomandibular disorders (TMDs) are pathological conditions due to alterations in the musculoskeletal system. TMDs mainly cause temporomandibular joint and masticatory muscle dysfunctions following trauma, along with various pathologies and inflammatory processes. TMD affects approximately 15% of the population and causes malocclusion problems and common symptoms such as myofascial pain and migraine. The aim of this work was to provide a transcriptomic profile of masticatory muscles obtained from TMD migraine patients compared to control. Materials and Methods: We used Next Generation Sequencing (NGS) technology to evaluate transcriptomes in masseter and temporalis muscle samples. Results: The transcriptomic analysis showed a prevalent downregulation of the genes involved in the myogenesis process. Conclusions: In conclusion, our findings suggest that the muscle regeneration process in TMD migraine patients may be slowed, therefore therapeutic interventions are needed to restore temporomandibular joint function and promote healing processes. Full article
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10 pages, 593 KiB  
Article
Unicompartmental Knee Arthroplasty: Minimal Important Difference and Patient Acceptable Symptom State for the Forgotten Joint Score
by Umile Giuseppe Longo, Sergio De Salvatore, Vincenzo Candela, Alessandra Berton, Carlo Casciaro, Gaia Sciotti, Giada Cirimele, Anna Marchetti, Ilaria Piergentili, Maria Grazia De Marinis and Vincenzo Denaro
Medicina 2021, 57(4), 324; https://doi.org/10.3390/medicina57040324 - 1 Apr 2021
Cited by 22 | Viewed by 2983
Abstract
Background and Objectives: Unicompartmental knee arthroplasty (UKA) is a valid alternative to total knee arthroplasties (TKAs) in selected cases. After surgery, patients’ experience and satisfaction were traditionally evaluated by pre- and postsurgical scores and Patient-Reported Outcome Measures (PROMs). Otherwise, a statistically significant [...] Read more.
Background and Objectives: Unicompartmental knee arthroplasty (UKA) is a valid alternative to total knee arthroplasties (TKAs) in selected cases. After surgery, patients’ experience and satisfaction were traditionally evaluated by pre- and postsurgical scores and Patient-Reported Outcome Measures (PROMs). Otherwise, a statistically significant change does not necessarily correlate to a clinically meaningful improvement when measured using PROMs. To evaluate the real effect of a specific treatment and understand the difference between groups in a clinical trial, it is necessary to use a meaningful quantum of change on the score assessed. The minimal clinically important difference (MCID) and the Patient Acceptable Symptom State (PASS) can provide this meaningful change. This paper aimed to calculate the MCID and the PASS of the Forgotten Joint Score (FJS-12) after UKA. Materials and Methods: A total of 40 patients with a mean age 72.5 ± 6.4 years undergoing UKA were assessed preoperatively and six months postsurgery using the FJS-12 and the Oxford Knee Score (OKS). The baseline and 6-month postoperative scores were compared using the Wilcoxon signed ranks test. The correlation was calculated with Spearman’s rho. Both distribution-based approaches and anchor approaches were used to estimate MCID for the FJS-12. The 75th percentile and the Receiver operating characteristic (ROC) curve methods were used to calculate the PASS of FJS-12. Results: MCID estimates for normalized FJS-12 for UKA ranged from 5.68 to 19.82. The threshold of the FJS-12 with ROC method was 72.92 (AUC = 0.76). The cut-off value computed with the 75th percentile approach was 92.71. Conclusions: The MCID and PASS represent valid tools to assess the real perception of clinical improvement in patients who underwent UKA. The MCID value of FJS-12 was 12.5 for patients who underwent UKA. The value of the PASS for the FJS-12 in patients who underwent UKA was 72.92. Full article
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8 pages, 1962 KiB  
Technical Note
Less Invasive Fixation of Acute Avulsions of the Achilles Tendon: A Technical Note
by Umile Giuseppe Longo, Vincenzo Candela, Alessandra Berton, Calogero Di Naro, Giovanna Stelitano, Nicola Maffulli and Vincenzo Denaro
Medicina 2020, 56(12), 715; https://doi.org/10.3390/medicina56120715 - 19 Dec 2020
Cited by 4 | Viewed by 2577
Abstract
Purpose: Nowadays, surgical treatment of acute avulsions of the Achilles tendon represents a hard challenge. There is often the possibility that the calcaneus remains completely uncovered from the tendon, making the reinsertion of its distal stub complex. At the same time, the standard [...] Read more.
Purpose: Nowadays, surgical treatment of acute avulsions of the Achilles tendon represents a hard challenge. There is often the possibility that the calcaneus remains completely uncovered from the tendon, making the reinsertion of its distal stub complex. At the same time, the standard open surgical technique could cause difficult wound healing because of the weak blood supply, the increasing possibility of rupture, and the bacterial contamination. To overcome these risks, less invasive procedures should be considered. Methods: We developed an innovative minimally invasive procedure for fixation of acute avulsions of the Achilles tendon employing an integration of four longitudinal stab incisions and one distal semicircular Cincinnati incision. In this way, the distal Achilles tendon stub and the calcaneal insertion are exhibited. Results: We basted the tendon through percutaneous sutures performed across the four stab incisions with a Mayo needle threaded with Ultrabraid. The procedure is repeated with another loop of Ultrabraid. After having bruised the calcaneus bone insertion of the tendon, two sites for two suture anchors were prepared using a specific hole preparation device for the anchors’ footprint. Finally, we placed two suture anchors to reinsert the tendon to the calcaneal insertion. Conclusion: Our new less invasive technique is a promising alternative optional procedure for the Achilles tendon (AT) avulsion repair allowing clear exposure of the Achilles tendon insertion, maintaining the longitudinal wholeness of the dermis, and minimizing possible associated complications. Full article
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9 pages, 2577 KiB  
Case Report
Three-Dimensional Ankle Exercise with Combined Isotonic Technique for an Obese Subject with Plantar Fasciitis: A Case Study
by Kyung-Sun Lee and Du-Jin Park
Medicina 2020, 56(4), 190; https://doi.org/10.3390/medicina56040190 - 21 Apr 2020
Cited by 3 | Viewed by 3886
Abstract
Background and objectives: Obese people have many foot-related disorders and plantar fasciitis (PF) is the most common disorder among them. However, research on the role of therapeutic exercises in PF is lacking and there is no evidence to suggest its benefits. As such, [...] Read more.
Background and objectives: Obese people have many foot-related disorders and plantar fasciitis (PF) is the most common disorder among them. However, research on the role of therapeutic exercises in PF is lacking and there is no evidence to suggest its benefits. As such, a further insight into therapeutic exercises is needed within this group. This case study investigated the effect of three-dimensional (3D) ankle exercises using a combined isotonic (CI) technique on function and balance in an obese subject with PF. Material and methods: The subject in this study was a 28-year-old obese woman who was diagnosed with PF by an orthopedic surgeon. A 3D ankle exercise program was commenced three times a week for 15 min over 4 weeks. The evaluations were conducted at five intervals: pre-test, and at 1, 2, 3 and 4 weeks from the initiation of the intervention. The tests were conducted in the following order: the patient-specific functional scale test (PSFS), an ultrasound of the plantar fascia, the heel pressure and balance test, the pressure pain threshold (PPT), and the 4-way ankle strength test. Results: The mean score of the PSFS test reduced by 70.55% after 4 weeks of the intervention. The thickness of the plantar fascia and heel pressure measured during single-leg standing decreased by 6.67% and 10.37%, respectively, after 4 weeks of the intervention. The anteroposterior and medial-lateral balance ability showed improvements of 8.29% and 8.61%, respectively, after 4 weeks of the intervention. The PPT improved by 38.01% after 4 weeks of the intervention. In the 4-way ankle strength test, dorsiflexion, plantar flexion, inversion, and eversion increased by 14.46%, 9.63%, 4.3% and 13.25%, respectively, after 4 weeks of the intervention. Conclusion: 3D ankle exercises utilizing the CI technique were shown to be effective in improving foot function, pressure pain, and muscle strength in dorsiflexion and inversion in an obese patient with PF. Full article
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