Injuries and disorders of the musculoskeletal system cause pain and loss of function, thereby leading to disability. The goal of rehabilitation medicine is to restore function in individuals with disability. This article presents evidence from studies published from March 2015 to February 2016 in the area of orthopaedic rehabilitation. Original articles from the American Journal of Physical Medicine & Rehabilitation, The American Journal of Sports Medicine, Archives of Physical Medicine and Rehabilitation, The Clinical Journal of Pain, JAMA, The Journal of Bone & Joint Surgery, The Journal of Pain, Journal of Shoulder and Elbow Surgery, The New England Journal of Medicine, Physical Therapy, and PM&R were considered. We screened the manuscript titles and abstracts of these select journals and included articles that were considered to be of high impact and value to readers. This Update is divided into sections based on subspecialty areas in physical medicine and orthopaedic rehabilitation.
Joints and Arthroplasty
Intra-articular administration of hyaluronic acid is a pharmacological approach to the management of knee osteoarthritis. Several formulations of hyaluronic acid are commercially available. Altman et al. performed a meta-analysis of trials assessing the efficacy of hyaluronic acid formulations according to molecular weight1. Hyaluronic acid products with a molecular weight of ≥3,000 kDa had a pooled effect size of −0.52 (95% confidence interval [CI], −0.56 to −0.48) when pain reduction was the outcome. These were more efficacious than products that were <3,000 and >1,500 kDa and those that were ≤1,500 kDa in molecular weight.
Whole-body vibration mediates the activation of alpha (α) motor neurons, which cause muscle contractions, thereby leading to increased muscle strength2. A recent meta-analysis of 5 studies showed preliminary data for improved pain and function with whole-body vibration training among patients with knee osteoarthritis compared with controls2.
Total Knee Arthroplasty
With increasing emphasis on cost-containment and …
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