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Introduction: Reverse shoulder arthroplasty (RSA) was originally developed for treating rotator cuff arthropathy but is now commonly used for rheumatoid arthritis (RA)-related shoulder degeneration. While previous studies have identified RA to be a risk factor for complications following total shoulder arthroplasty, its specific impact on RSA outcomes remains unclear. This study aims to evaluate the post-operative medical and implant-related complications, and healthcare utilization, among RA patients undergoing RSA. Methods: A retrospective analysis of patients undergoing RSA was conducted using a national administrative claims database from 2010 to 2023. Patients who underwent RSA with and without RA were identified using corresponding diagnoses and procedural codes. Patients with RA who underwent RSA had propensity score matched to a control on a 1:5 basis. The control group consisted of patients who did not have RA and underwent RSA for any other indication. Results: A total of 7232 of RSA patients with RA were matched to 36,054 control patients. The RA cohort had significantly higher rates of 90-day medical complications when compared to the control (p < 0.001), with the highest rates in urinary tract infections (OR: 9.69), pulmonary embolisms (OR: 9.69), and the need for blood transfusions (OR:9.41). Patients with RA had significantly greater odds of developing all implant-related complications within 2 years compared to the control group (p < 0.001). This cohort also had significantly higher fall rates (p < 0.001) and mean lengths of stay (3.42 vs. 2.0 days, p < 0.0001). Conclusions: RSA patients with prior diagnoses of RA face a higher risk of implant-related and medical complications, falls, and prolonged hospital stays compared to the control. These findings suggest that RA is an independent risk factor for reverse total shoulder arthroplasty. Therefore, these patients should be closely monitored post-operatively to reduce complications, cost of care, and length of stay. Level of Evidence: III, retrospective case–control study [ABSTRACT FROM AUTHOR]

This article compares two forms of electrical stimulation therapy, Transcutaneous Electrical Nerve Stimulation (TENS) and H-Wave® Device Stimulation (HWDS), for managing chronic musculoskeletal pain. TENS and HWDS have different technical parameters and applications, with HWDS providing longer-term pain relief and other therapeutic benefits. HWDS has received more FDA clearances for pain and neuromuscular conditions compared to TENS. Studies show mixed results for TENS, with some showing no improvement in pain scores and others showing slight short-term improvement in functional disability. In contrast, studies consistently demonstrate significant pain reduction, improved function, and overall quality of life with HWDS. Further research is needed to improve both therapies. [Extracted from the article]

Background: Intra-articular injections are commonly used to manage joint pathologies, including osteoarthritis. While conventional ultrasound (US) guidance has generally improved intra-articular injection accuracy, forefoot and midfoot joint interventions are still often performed without imaging guidance. This pilot study aims to evaluate the efficacy of office-based, portable ultrasound (P-US) guided intra-articular injections for forefoot and midfoot joint pain caused by various degenerative pathologies. Methods: A retrospective analysis was conducted on a series of consecutive patients who underwent P-US guided intra-articular injections following a chief complaint of forefoot or midfoot joint pain. Patients reported their pain levels using the Visual Analog Scale (VAS) pre-injection and at 3 months follow-up. The procedure was performed by an experienced foot and ankle surgeon using a linear array transducer for guidance, and a 25-gauge needle was used to inject a combination of 2 cc 1% lidocaine and 12 cc of Kenalog (40 mg/ml). Complications and pain scores were analyzed using a paired t-test and p < 0.05 was considered significant. Results: We included 16 patients, 31% male and 69% female with a mean age (±SD) of 61.31 (±12.04) years. None of the patients experienced immediate complications following the intervention. The mean pre-injection VAS score was significantly reduced from 5.21 (±2.04) to a mean of 0.50 (±1.32) at 3 months follow-up (P < 0.001). Thirteen patients reported complete resolution of pain at the 3-month follow-up. No adverse events were reported throughout the duration of the study. Conclusion: This pilot study suggests P-US-guided intra-articular injections offer a safe and effective method for managing forefoot and midfoot joint pain caused by various arthritic pathologies. Further research is warranted to establish the long-term efficacy and comparative effectiveness of P-US-guided injections in larger patient cohorts as compared to non-image guided injections. [ABSTRACT FROM AUTHOR]

Introduction The existing treatment modalities for knee osteoarthritis (OA) do not actually address the pathology. Biological therapies, including those using material derived from perinatal tissues, represent a ground-breaking approach to alleviating the symptoms of OA of the knee. Source of data Current scientific literature published in PubMed (MEDLINE), Embase and Scopus databases. Trials registered in various clinical trial databases. Areas of agreement Perinatal tissues including Wharton's jelly (WJ) and associated mesenchymal stem cells (MSCs) can be used for the management of knee OA. Areas of controversy The efficacy of WJ and associated MSCs in the management of knee OA is still controversial. Growing points The use of WJ and associated MSCs in the management of knee OA is safe and appears to be effective. Areas timely for developing research The present published evidence suggests that WJ tissue and associated MSCs offer an encouraging alternative for the management of knee OA. The published in vitro , preclinical and clinical investigations demonstrate the therapeutic potential of WJ and promote further research in this field to provide symptomatic relief to patients suffering from OA, aiming also to regenerate the osteoarthritic hyaline cartilage, with disease-modifying effects. Future adequately powered randomized controlled trials should be undertaken to establish whether WJ is helpful in the management of OA of the knee. [ABSTRACT FROM AUTHOR]