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This review aims to critically analyze the scientific literature on silent manipulation (SM) and offer an expert opinion on how past research translates to clinical practice. SM is a new treatment method for adhesive capsulitis, commonly known as frozen shoulder, in which a patient is treated with shoulder manipulation following an ultrasound-guided cervical nerve root block. SM showed good results in the short term, with improvements in range of motion (ROM), pain, and clinical scores. The results in patients with diabetes mellitus (DM) were also good but were slightly worse than those in patients without DM. In addition to showing good clinical results, postprocedure magnetic resonance imaging revealed that 13.3% of patients had an articular labrum injury, and 50% had humeral bone bruising. Since this treatment method is new, reports on treatment results are limited, with only short-term results being available. Results have been reported since 2017, but the improvements in the ROM are comparable to those achieved by arthroscopic capsular release. SM is a safe and inexpensive procedure with good short-term results. However, there are still very few reports on long-term results and complications, and additional research and long-term observations are required in the future.

BackgroundThe purpose of this study was to evaluate return to sports (RTS) after opening wedge high tibial osteotomy (OWHTO) in elderly patients and associated factors affecting RTS.MethodsSeventy-four patients (mean age 68 years) who underwent OWHTO were enrolled. Clinical outcomes were evaluated using the Knee Society Score (KSS). Patients were asked regarding types of sports activities and their levels of participation within preoperative 1 year and postoperative 1 year. Levels of participation in sports and recreational activities were examined using the Tegner activity scale. The outcomes were compared between two age groups (≥ 70 years vs. ResultsOf the 74 patients overall, 59 participated in at least one sport preoperatively, and 55 returned to sports postoperatively (RTS 93%). The KSS knee score and function score were significantly improved after surgery in both age groups (P P P = 0.16), respectively. RTS was reported by 24 of 25 (96.0%) in the age ConclusionsThe rate of RTS after OWHTO was high in patients aged 70 years and older with low-impact level. OWHTO is a preferred surgical option for elderly patients who desire RTS.

Spontaneous osteonecrosis of the knee (SONK) causes acute atraumatic knee pain, and meniscus tears may be associated with the pathogenesis of SONK. The purpose of this study was to investigate the relationship of the type of meniscus tear and medial meniscus extrusion with SONK on the medial femoral condyle in patients who underwent surgical treatment with high tibial osteotomy due to severe knee pain.We enrolled 98 patients with 102 knees who underwent medial opening wedge high tibial osteotomy (OWHTO) under the diagnosis of medial femoral condyle osteonecrosis at our hospital from December 2003 to January 2020. Based on the Koshino classification, cases of SONK were classified as stage 1-4. The relationships of demographic data, X-rays and MRI images, including femorotibial angle (FTA), meniscus tear type, and medial meniscus extrusion (MME), with the stage and volume of SONK were investigated.Ninety-eight patients (29 males and 69 females), with an average age at surgery of 69.2 ± 9.6 years and Body mass index(BMI) of 61.0 ± 17.6 kg/mAll patients with SONK had coexisting meniscus tears, most menisci had medial extrusion, and a positive correlation was observed between MME and SONK volume.