Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Neuromuscular diseases (NMD) vary widely with regard to their onset, progression, and symptoms, which include muscle weakness, sensory loss, pain, fatigue, and joint contractures. Owing to this diversity, creation of a unified exercise therapy approach is challenging.Current Concepts: Exercise recommendations for patients with NMD prioritize maintenance of patients’ current functional status, prevention of further decline, and provision of compensatory training. Conventionally, highintensity exercises are not recommended owing to the risks of overwork weakness and muscle injury. Recent studies indicate that tailored aerobic exercises can improve endurance, cardiovascular function, and overall health without worsening muscle injury. Flexibility exercises are essential to prevent joint contractures. Resistance training should focus on avoidance of high-intensity and eccentric exercises and on maintenance of rather than an increase in muscle strength.Discussion and Conclusion: Evidence regarding the benefits of exercise in patients with NMD is inconsistent. Aerobic exercise is usually safe and may help maintain function and increase maximal oxygen uptake; however, low-intensity exercise is preferred to avoid fatigue and muscle injury. Resistance training may help preserve muscle strength in some patients; however, high-intensity workouts are not should be avoided to mitigate the risk of muscle overload and injury. Tailored exercise programs designed according to disease characteristics are essential.. Further well-designed, large-scale studies are necessary to establish effective and safe exercise guidelines for patients with NMD.

Objectives: This research delves into the application of texture analysis in spine computed tomography (CT) scans and its correlation with bone mineral density (BMD), as determined by dual-energy X-ray absorptiometry (DXA).It specifically addresses the discordance between the 2 measurements, suggesting that certain spinal-specific factors may contribute to this discrepancy. Methods: The study involved 405 cases from a single institution collected between May 6, 2012 and June 30, 2021. Each case underwent a spinal CT scan and a DXA scan. BMD values at the lumbar region (T12 to S1) and total hip were recorded. Texture features from axial cuts of T12 to S1 vertebrae were extracted using gray-level co-occurrence matrices, and a regression model was constructed to predict the BMD values. Results: The correlation between CT texture analysis results and BMD from DXA was moderate, with a correlation coefficient ranging between 0.4 and 0.5. This discordance was examined in light of factors unique to the spine region, such as abdominal obesity, aortic calcification, and lumbar degenerative changes, which could poten tially affect BMD measurements. Conclusions Emerging from this study is a novel insight into the discordance between spinal CT texture analysis and DXA-derived BMD measurements, highlighting the unique influence of spinal attributes. This revelation calls into question the exclusive reliance on DXA scans for BMD assessment, particularly in scenarios where DXA scanning may not be feasible or accurate.

Purpose: Following the withdrawal of propacetamol in Europe owing to safety issues, the regulatory authority of South Korea requested a post-marketing surveillance study to investigate its safety profile. Materials and Methods: We conducted nested case-control and case-time-control (CTC) analyses of cases and controls identified for outcomes of interest, including anaphylaxis, thrombosis, and Stevens–Johnson syndrome (SJS), using the claims database of South Korea, 2010–2019. Risk-set sampling was used to match each case with up to 10 controls for age, sex, cohort entry date, and follow-up duration. Exposure to anaphylaxis, thrombosis, and SJS was assessed within 7, 90, and 30 days of the index date, respectively. We calculated odds ratios (OR) with 95% confidence intervals (CIs) using conditional logistic regression to assess the risk of outcomes associated with propacetamol. Results: We identified cases of anaphylaxis (n=61), thrombosis (n=95), and SJS (n=1) and matched them to controls (173, 268, and 4, respectively). In the nested case-control analysis, the ORs for anaphylaxis and SJS were inestimable given the small number of propacetamol users during the risk period; meanwhile, the OR for thrombosis was 1.60 (95% CI 0.71–3.62). In the CTC design, the effect estimate was only estimated for thrombosis (OR 0.56, 95% CI 0.09–3.47). Conclusion In both nested case-control and CTC analyses, propacetamol was not associated with an increased risk of anaphylaxis, thrombosis, or SJS. The findings from this study, which used routinely collected clinical data, provide reassuring real-world evidence regarding the safety of propacetamol in a nationwide population to support regulatory decision-making.

Methods: Thirty-one patients with multilevel cervical spondylotic myelopathy who required C6–C7 level decompression surgery were operated and followed up for 24 months. One group (15 patients) received C7 arcocristectomy without laminoplasty, and the other group (16 patients) received C7 laminoplasty. Flexion, neutral, and extension angles were measured using the Cobb method at C2–C7 to evaluate preoperative and postoperative radiographic parameters. Range of motion (ROM), ROM preservation rate of the cervical spine, C2–C7 sagittal vertical axis (SVA), and T1 slope were measured using C-spine lateral X-ray. The Visual Analog Scale (VAS) and modified Japanese Orthopedic Association (JOA) score were used to compare preoperative and postoperative clinical symptoms. Results: Flexion, neutral, extension angles of the cervical spine, C2–C7 SVA, T1 slope, ROM, ROM preservation rate, and modified JOA score were not significantly different between the two groups (p>0.05). In the C7 arcocristectomy group, the average postoperative VAS for axial neck pain was increased in 13.3% (2/15) of the patients, whereas in the C7 laminoplasty group, the average postoperative VAS was increased in 43.8% (7/16) of the patients (p=0.018). Conclusions C7 arcocristectomy, which preserves the C7 spinous process and posterior structures, is a useful technique for relieving axial neck pain.

Purpose: This study analyzed the effectiveness of arthroscopic anterior compartment debridement with posterior mini-open debridement in patients with mild or moderate primary elbow osteoarthritis (OA). The clinical results of arthroscopic anterior compartment debridement with posterior mini-open debridement were compared with that of arthroscopic both compartments debridement. Materials and Methods: Between January 2010 and December 2016, 46 patients diagnosed with elbow OA underwent arthroscopic anterior compartment debridement with posterior mini-open debridement or arthroscopic anterior and posterior compartments debridement arthroscopic surgery. Of these, 27 patients were finally included in this study. The data were collected retrospectively from the medical records. The subjects were divided into two groups according to the surgical procedure: group 1 (n=16) received arthroscopic anterior compartment debridement with posterior mini-open debridement surgery, and group 2 (n=11) received arthroscopic anterior and posterior compartments debridement surgery. The elbow flexion-extension range of motion (ROM), visual analog scale (VAS), Mayo Elbow Performance Score (MEPS) were analyzed for the clinical outcome before surgery and the last follow-up visit after surgery. Results: The average follow-up period was 21 months (15–32 months). All clinical outcomes (ROM, VAS, and MEPS) were improved after surgery compared to those before surgery (p<0.05) in both groups. Group 1 showed further improvement in flexion (p=0.001) and total ROM (p=0.011) than group 2. On the other hand, there was no significant difference in extension, VAS, and MEPS between the two groups. Conclusion In patients with primary elbow OA, arthroscopic anterior compartment debridement with posterior compartment mini-open technique produced an excellent clinical outcome after surgery and was particularly helpful in increasing flexion and the total ROM.

Purpose: To investigate the effect of regular monitoring of pulmonary function and ventilatory status on the initiation of non-invasive ventilation (NIV) between patients who were routinely monitored before receiving NIV and those who were not. Materials and Methods: This retrospective cohort study included subjects with Duchenne muscular dystrophy (DMD) who first received NIV between 2010 and 2019. The subjects were assigned to either the regular-follow-up (REG) group or the non-REG group, according to their follow-up status, before initiating NIV. We compared the number of emergent cases, the results of nocturnal ventilatory monitoring, and the pulmonary function of each group at initial ventilatory support. Results: In total, 73 subjects were enrolled in the REG group and 47 subjects in the non-REG group. There were significantly more emergency cases due to respiratory insufficiency in the non-REG group (12/47, 25.5%) than in the REG group (3/73, 4.1%). At the time of initial ventilatory support, hypoventilatory symptoms were more common and relatively severe in the non-REG group (37/47, 78.7%) than in the REG group (18/73, 24.7%). The average age at initial ventilatory support of the non-REG group was 2.15 years older than that of the subjects in the REG group. Moreover, subjects who were not regularly monitored exhibited greater deterioration in pulmonary function compared to those who were regularly followed up. Conclusion Regular evaluation of pulmonary function and ventilatory status before the onset of ventilatory insufficiency is crucial to reduce the risk of patients with DMD requiring emergency care due to ventilatory insufficiency.