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This document is a curriculum for training in orthobiologics, which provides a framework for education and training in the field. It is primarily targeted towards physiatrists, but can be modified for physicians from other specialties. The curriculum focuses on orthobiologic treatments that align with current U.S. Food and Drug Administration guidelines and does not advocate for any specific treatment modality. It includes core and specialized competencies, and is designed to be adaptable to diverse training needs. The curriculum was developed by a group of subject matter experts and will be updated as the field of orthobiologics evolves. [Extracted from the article]

This article explores the treatment options for adhesive capsulitis, or frozen shoulder. It presents two different perspectives on the best approach for treating this condition: ultrasound-guided hydrodilatation (HD) plus steroid injection and ultrasound-guided intra-articular steroid injection. The authors provide evidence and studies to support their respective viewpoints. They also emphasize the importance of early intervention and discuss the potential benefits of joint manipulation after the procedure. While some studies suggest that intra-articular steroid injections are more effective in reducing pain and improving function in the short term, there is no clear evidence on the optimal approach for corticosteroid injection. The authors conclude that intra-articular steroid injections using ultrasound guidance are the preferred approach for treating adhesive capsulitis, but further research on hydrodilatation is needed. [Extracted from the article]

The purpose of this review was to summarize the current literature pertaining to ultrasound‐guided percutaneous A1 pulley release procedures. We searched PubMed, Cochrane Library, Embase, and Web of Science for clinical studies examining ultrasound‐guided percutaneous A1 pulley release. A total of 17 studies involving 749 procedures were included in this review. The overall success rate was 97%. There were 23 minor complications (4 cases of hematomas, 15 cases of persistent pain, and 4 cases of transient numbness) and no major complications reported. Ultrasound‐guided A1 pulley release is an effective and safe procedure for the treatment of trigger fingers and thumb. [ABSTRACT FROM AUTHOR]

Background: Multiple studies demonstrate poor musculoskeletal palpation accuracy of physiatry residents. With the growing use of ultrasound clinically, it could serve as a powerful educational tool. However, there are no published studies examining the efficacy of ultrasound-aided education at the bedside, where much learning takes place during postgraduate training.Objective: To determine if brief ultrasound-aided teaching improves residents' accuracy and confidence of musculoskeletal palpation.Design: Before/After Trial.Setting: Academic Institution.Participants: Ten physical medicine and rehabilitation residents were voluntary participants.Intervention: Each resident was given a survey to assess confidence in palpating the hook of the hamate and medial calcaneal tubercle. They then attempted to palpate and place a marker over these two structures in a model patient. Marker placement accuracy was verified by ultrasound. Faculty spent less than 1 minute per landmark, sonographically teaching its correct localization. The resident, after moving to a new model patient, was then re-tested on accurate marker placement for both landmarks. A repeat survey to assess confidence was administered.Main Outcome Measurements: Preintervention and postintervention accuracy and confidence of correct localization of both landmarks.Results: We used McNemar's and Wilcoxon's tests to determine whether the intervention improved the location accuracy and confidence of successful palpation, respectively. Confidence level of correct localization of two landmarks improved on average from 4.3 to 8.15 on a scale of 10 after intervention. Of 20 palpation attempts, 11 correctly placed the marker postintervention after an incorrect placement, 8 made no change, and one changed from correct to incorrect placement. The odds of improvement in accuracy was 11 (95% confidence interval [CI] 1.60-473.47, P < .01). Both tests showed significant improvements after the intervention at the significance level of .05.Conclusions: Brief, ultrasound-aided teaching increases accuracy and confidence of residents' musculoskeletal palpation. [ABSTRACT FROM AUTHOR]

Background: Adaptive sports programs are increasing across the country and there is a paucity of research investigating the epidemiology and sports injury risk factors in non-elite athletes.Objective: To assess the demographics, training regime, and injuries incurred by adaptive athletes participating in local adaptive sports clubs and to assess the athletes' type of medical care and prevalence of those with spasticity.Design: Descriptive cross-sectional study.Setting: Local area adaptive sports teams and programs.Participants: Sixty-one athletes participating in wheelchair basketball, wheelchair rugby, sled hockey, and adaptive rowing were surveyed, with a response rate of 70.5%.Interventions: Completion of self-report survey.Outcome: Report of injury prevalence, injury characteristics, type of medical care, and assessment of frequency and severity of spasticity using the Penn Spasm Frequency Scale.Results: Most athletes (86%) trained or competed in their main sport 9-12 months per year. Most athletes (79.1%) trained at least 4 hours per week. In the past 12 months, 39.5% of athletes surveyed sustained an injury that required them to miss practice or a competition, with 58.8% of these athletes having sustained a significant injury. Many of those injured (64.7%) had never participated in an injury prevention or conditioning program. Injury prevalence by sport was 42.9% in wheelchair rugby, 60% in sled hockey, 44% wheelchair basketball, and 0% in adaptive rowing. The most commonly injured body parts were the shoulder (52.9%) and wrist (52.9%).Conclusions: This study shows that non-elite adaptive sports athletes sustain similar types of injuries as noted in published reports of elite athletes but could be provided with less injury prevention education and access to medical care. This area will require future study, especially investigating injury risk factors within specific sports and diagnoses.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]

Carpal tunnel syndrome is the most common entrapment neuropathy, resulting in 500,000 carpal tunnel release (CTR) surgeries and a total cost of more than 2 billion dollars annually in the United States. Although initially performed via a large (3-5 cm) palmar incision, CTR techniques have continually evolved to reduce incision size, recovery times, postoperative pain, and improve cosmesis and clinical outcomes. More recently, multiple authors have reported excellent results after ultrasound-guided carpal tunnel release (USCTR) using a variety of techniques, and one prospective randomized trial reported faster recovery after USCTR compared with traditional mini-open CTR. However, there is a paucity of data with respect to changes in the median nerve after USCTR. This case report presents the functional outcomes and pre- and postprocedure ultrasound images of a patient after USCTR with 3-month follow-up. LEVEL OF EVIDENCE: V. [ABSTRACT FROM AUTHOR]