Primary Care and Rehab

Continuity of care

Got knee pain? The best tool for evaluating knee pain among middle-aged patients is an x-ray

Knee pain is common among Americans age 40 and up. Nearly 1 in 17 people visit doctors’ offices each year for knee pain or injuries from osteoarthritis—a progressive “wear and tear” disease of the joints. Those odds increase … READ MORE

Is the complex primary total knee arthroplasty glass half full or half empty?

Total knee arthroplasty as we know it today, for the vast majority of patients, is really a resurfacing of the knee. Approximately a centimeter of bone is shaved off all of the surfaces of each bone and replaced with metal and/or … READ MORE

Electronic health records ‘inflict enormous pain’ on doctors

Electronic health records slow doctors down and distract them from meaningful face time caring for patients. Hidden treasure. View from behind a cataloging desk, Army Medical Library, Washington, DC, ca. 1955. National Library of … READ MORE

Themes patients focus on when selecting treatment for OA

Investigators of this study identified key themes, such as the characteristics of a treatment and the time and money investment required, which guide patients with hip or knee osteoarthritis when they decide on a treatment option. … READ MORE

You’ll know when you’re ready: When the time is right for joint replacement surgery

Pool Exercises for Joint Pain, Arthritis Foundation. Background. While some studies have identified patient readiness as a key component in their decision whether to have total joint replacement surgery (TJR), none have examined how … READ MORE

Activity limitations and pain in patients scheduled for total knee arthroplasty

This paper reports the functional and activity limitations among persons scheduled for TKA, stratified by preoperative pain level. About one-fifth of subjects in the cohort reported Low WOMAC Pain scores (0–25) prior to surgery. … READ MORE

Knee OA brace experts revisit persistent issues

By using the brace, people can reduce their pain and increase their function. Absolutely, these should be tried before going through any kind of surgical technique. It’s a noninvasive therapy that is relatively low-cost. Eric … READ MORE

New approaches to orthotic management in children with cerebral palsy

Practitioners look to novel ways of using familiar lower limb orthotic alternatives to complement new technology. No single treatment is appropriate for every child, but it is generally agreed that the sooner intervention is started … READ MORE

All in the hips – professional golfers more likely to have different shaped hip joints

Lack of success on the fairway may not be due to your swing – it could be your hips that are to blame. New research from the University of Warwick has found that professional golfers are more likely to have different shaped … READ MORE

OpenNotes reaches 10 million

The OpenNotes movement is excited to share a milestone — 10 million Americans can now read their medical notes securely online. Overwhelmingly, patients agree that reading their notes helps them feel more in control of their health … READ MORE

Patellofemoral pain in adolescence: much more prevalent than appreciated

Patellofemoral pain is common among adolescents. Musculoskeletal conditions are not unique to the adult population. From the age of 5–9 years to the age of 10–14 years there is an almost fourfold increase in the years lived … READ MORE

Minorities less likely to have knee replacement surgery, more likely to have complications

Minority populations have lower rates of total knee replacement (TKR) utilization but higher rates of adverse health outcomes associated with the procedure, according to a new study appearing in today’s issue of the Journal of … READ MORE

To brace or not to brace? Bracing for neuromuscular conditions

There is no doubt about it: braces are a pain. Sometimes they are a literal pain, causing pain for your child. And sometimes they are a more figurative pain in the rear end—difficult to deal with, difficult to get on and off, … READ MORE

9 things no one ever tells you about getting a knee replacement

After 20 years of pain and icing her knee nightly, Sue Minutaglio of Westchester NY, knew she couldn’t put off a knee replacement any longer. What she didn’t know was what a long, grueling road was ahead of her. “After 2 … READ MORE

Exercise as effective as surgery for middle aged patients with knee damage

Study raises questions over widespread practice without supporting evidence. Exercise therapy is as effective as surgery for middle aged patients with a common type of knee injury known as meniscal tear (damage to the rubbery discs … READ MORE

CP studies assess advantages of flexible AFOs for children

The flexibility of an ankle foot orthosis (AFO) does not necessarily affect walking economy in children with cerebral palsy (CP), but more flexible AFOs may be particularly beneficial for sports activities in higher-performing … READ MORE

Walk this way: New metric could help kids with cerebral palsy

For more than 20 years, clinicians working with children with cerebral palsy have been gathering “a deluge of data” to understand and treat their patients’ walking difficulties. But they still weren’t sure which children with … READ MORE

Bad news for creaky knees: We can’t regrow cartilage as adults

The fallout from nuclear bomb testing decades ago is now helping researchers better understand knee joints. By tracking radioactive carbon absorbed in knees, a team of Danish researchers has found that the structure of cartilage is … READ MORE

The horse is the therapist

With hippotherapy, the horse provides the therapy. Three-year-old Jack Foster sat on his mother’s lap as she wrapped a towel carefully around his neck. “Jack has cerebral palsy and low muscle tone,” said his mother, Emily … READ MORE

As walking movement grows, neighbourhood walkability gains attention

Come join us at our next Walk with a Doc! Location: Confederation Park, Calgary Walk Information: We walk on the 2nd Friday of Every Month! at 8:50 am To Register, please call Sandi Gowriluk 403-284-3726 ext. 206 David Sabgi MD, … READ MORE

Canada spends over $400 million on medicine that harms seniors

Canada spends more than $400 million annually on drugs prescribed to seniors even though the medicines should be avoided for older patients, according to new UBC research. PEI doctor warns about dangers of over-medication. Dr. Roland … READ MORE

Relief for joints besieged by arthritis

If you live long enough — that is, beyond 50 or 60 — chances are one or more of your joints, probably your knees or hips, will become arthritic. And if pain or stiffness begin to seriously limit your ability to enjoy life and … READ MORE

Quality of physiotherapist led orthopaedic triage compared with standard practice in primary care

Physiotherapist-led orthopaedic triage, where physiotherapists diagnose and determine management plans, aims to enhance effectiveness and provide the best care. However, scientific evidence for the effectiveness of this model of care … READ MORE

Gender, gait and knee OA: Kinematic data have rehab implications

In the moment: Rehabilitation.. Women with and without knee osteoarthritis (OA) demonstrate greater knee abduction and hip adduction during gait than their male counterparts, according to research from Canada that supports the … READ MORE

Benefits of psychological care in pain management

Doctors should consider cognitive therapies as potential first-line treatment. Increasing practitioner skepticism about the long-term safety of opioid pain medications for treating chronic pain and compelling evidence showing the … READ MORE

Wait two weeks to shower following knee replacement surgery?

It may not be necessary for knee replacement patients to wait up to two weeks after surgery before showering, as many surgeons now require, new research indicates. Loyola University Health System May 11, 2016 Rob Greenfield. Photo … READ MORE

Benefits of exercise for children with cerebral palsy supported by study of elite paralympic athletes

For highly trained Paralympic athletes with cerebral palsy (CP), bone mineral density and other measures of body composition are similar to those of able-bodied adults of similar age, reports a study in the American Journal of … READ MORE

Improving surgery outcomes for children with cerebral palsy

Children with cerebral palsy frequently undergo invasive surgeries — lengthening tendons, rotating bones, transferring muscles to new locations — in hopes of improving their physical ability to walk or move. Walk-DMC is a new, … READ MORE

Current thinking in surgical approaches to meniscus repair

With a Torn Meniscus, the Clock Is Ticking. Not so long ago, surgeons thought that the meniscus was a vestigial structure. If it was damaged, we cut it out. But the more we have learned, the more we understand about the necessity of … READ MORE

Mobility plays important role in development for toddlers with disabilities

Typical toddlers simultaneously spend about three hours a day in physical activity, play and engagement with objects such as toys, while their peers with mobility disabilities are less likely to engage in all of those behaviors at the … READ MORE

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