May-June 2017 – To operate or not to operate, that is the question
As orthopaedic physiotherapists we see many conditions that can be managed either conservatively or with surgical interventions. Patients often seek the advice of their physiotherapist about whether surgery is necessary or if physiotherapy can manage their condition. In many situations the answer to this question is unclear and the factors that can influence recovery are vast. When trying to answer these questions we can turn to the literature but often again the evidence does not clearly support one management option over the other. In this edition of the ODR we took a look at some of the common conditions that are managed either surgically or conservatively.
Report from Chair
Summertime! Hope you are all enjoying some beautiful Canadian weather. Your NOD continues to work hard though the summer following our spring Strategic Planning meeting. One year has now passed since I came on as chair elect, and it has been a busy one. The learning curve has been steep but I am looking forward to transitioning into the chair role at our AGM at Symposium in October.
Sustaining an anterior cruciate ligament (ACL) rupture can be a devastating injury for young, active individuals, due to both the lengthy recovery time and long-term joint health implications, such as the future development of post-traumatic osteoarthritis (PTOA).1,2 Over 2 million ACL injuries occur annually worldwide3 or approximately 81 per 100,000 people suffer one in the general population between the ages of 10 to 64 years old.4 Of those injured, roughly half will develop PTOA within the next 10-20 years regardless of management.
This patient was a 26-year-old male, who suffered a left Achilles rupture on February 15 2015 while playing professional basketball. During a basketball game he planted his foot while stepping back and felt a pop in the back of his calf then took another step and was unable to weight bear. He was helped off the court by the physiotherapist and given ice and compression. He had immediate pain and swelling came on later in the evening.
We are fortunate to have a dedicated group of physiotherapists and surgeons from the Fowler Kennedy Sport Medicine Clinic in London, Ontario who have worked to put together many valuable resources that they share for public access on their website. We have chosen to highlight one conservative and one post-operative protocol in this edition that deal with femoroacetabular impingement of the hip.
The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) Member Organization Meetings were held in Cape Town, South Africa. The series of meetings including the General Assembly, Advisory Working Groups, and Standards Committee were held from July 1 to 4, 2017. We exchanged many ideas and much dialogue related to OMT opportunities,successes, and strategies for improvement and change during this period.
2013 Neer Award: predictors of failure of nonoperative treatment of chronic, symptomatic, full-thickness rotator cuff tears
Warren R.Dunn, MD, MPH, John E.Kuhn, MD, MS, Rosemary Sanders, BA, Qi An, MS, Keith M. Baumgarten, MD, Julie Y. Bishop, MD, Robert H. Brophy, MD, James L. Carey, MD, MPH, Frank Harrell, PhD, Brain G. Holloway, MD, Grant L. Jones, MD, C. Benjamin Ma, MD, Robert G. Marx, MD, MS, Eric C. McCarty, MD, Sourav K. Poddar, MD, Matthew V. Smith, MD, Edwin E. Spencer, MD, Armando F. Vidal, MD, Brain R. Wolf, MD, Msl, Rick W. Wright, Mdm, for the Moon Shoulder Group
Management options for femoroacetabular impingement: a systematic review of symptom and structural outcomes
J. Fairley, Y.Wang, A.J. Teichtah, M. Seneviwickrama, A.E. Wluka, S.R.E. Brady, S.M. Hussain, S.Liew, F.M. Cicuttini
Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial
Frederik O. Lambers Heerspink MD, Jos J.A.M. van Raay, MD, PhD, Rinco C.T. Koorevaar, MD, Pepijn J.M. van Eerden, MD, Robin E. Westerbeek, MD, Esther van,t Riet, PhD, Inge van den Akker-Scheek, PhD, Ronald L. Diercks, MD, PhD