Indications and Usefulness of Common Injections for Nontraumatic Orthopedic Complaints

Cato, Robert K.

doi:10.1016/j.mcna.2016.04.007

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…[24][25][26] Steroid injection into joints (intra-articular and surrounding musculature) is common for joints such as the knee and shoulder for various conditions and indications. 27 However, there is a lack of consensus regarding their efficacy, joint injections are considered to have beneficial effects on inflammation, pain, and joint function. 27 Although the intra-operative segment of the DISCO protocol (scar release, dilation, and steroid injection) was previously reported, the addition of post-operative cough exercise is a concept, originally described in this publication.…”

Section: Discussionmentioning

confidence: 99%

“…27 However, there is a lack of consensus regarding their efficacy, joint injections are considered to have beneficial effects on inflammation, pain, and joint function. 27 Although the intra-operative segment of the DISCO protocol (scar release, dilation, and steroid injection) was previously reported, the addition of post-operative cough exercise is a concept, originally described in this publication. The post-operative cough exercise serves as a physical therapy to preserve the effect of intra-operative glottic dilation, restore motion of joints and allow the formation of flexible scars.…”

Section: Discussionmentioning

confidence: 99%

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Dilation, Steroid Injection, and Cough Exercise for Correction of Posterior Glottic Stenosis

et al. 2022

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Objective To describe the DISCO protocol (Dilation, Steroid injection, and post‐operative Cough Exercise); a novel treatment for posterior glottic stenosis (PGS). Restoring glottic mobility in PGS is a major challenge. In orthopedic and plastic surgery, post‐operative physical therapy is associated with improved motion range and flexibility; yet, this principle was never applied to laryngeal surgery. Methods A retrospective cohort of PGS adult patients, treated by the DISCO protocol during 2018–2020. DISCO involves the following: scar release, glottic dilation, and steroid injection, followed by post‐operative cough as glottic physical therapy. Maximal glottic opening angle (MGOA), relative glottic opening area (RGOA), and relative glottic insufficiency area (RGIA) were calculated before and post‐operatively. Results Seventeen patients were included; PGS etiology was post‐intubation (n = 10), post‐irradiation (n = 3), both (n = 1) and joint sclerosis (n = 3). Six patients also had additional airway disorders. Sixteen patients were tracheostomy‐dependent. 2 (12%), 8 (47%) and 7 (41%) patients had type II, III and IV stenosis, respectively. Surgery included scar release, dilation and steroid injection alone in 7 patients; and additional unilateral sub‐mucosal arytenoidectomy in 10. The mean follow‐up was 17.5 months. There were no major complications. Successful outcomes (e.g., decannulation or permanent capping) were achieved in 14 (82%) patients with some restoration of joint movement. None had a persistent voice or swallowing complaints. Both MGOA and RGOA increased in all patients (p < 0.001). RGIA remained unchanged (p = 0.878). Conclusions The DISCO protocol is a novel, effective and safe approach for PGS correction that can be easily applied. It can restore vocal fold mobility and may expand the glottic airway without causing glottic insufficiency. Level of Evidence 4 Laryngoscope, 133:883–889, 2023

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dilation, Steroid Injection, and Cough Exercise for Correction of Posterior Glottic Stenosis

et al. 2022

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“…In these fields, a number of injectable agents, including glucocorticoids [25], hyaluronic acid derivatives [26], and botulinum toxin [27], have been used for the treatment of various musculoskeletal conditions. In the latest years, platelet-rich plasma therapy has been widely popularized for the local treatment of softtissue and musculoskeletal injuries such as osteoarthritis, ligament injuries, muscle tears, and tendinopathies [28].…”

Section: Sports and Rehabilitation Medicinementioning

confidence: 99%

Autologous Platelet-Rich Plasma Efficacy in the Field of Regenerative Medicine: Product and Quality Control

Popescu

Iliescu

Beiu

et al. 2021

BioMed Research International

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Platelet-rich plasma (PRP) has emerged as a significant regenerative therapy used alone or combined mainly with stem cells, autologous fat grafts, hyaluronic acid, and biomaterials in a variety of medical fields, especially in hair regrowth, wound healing, and sports and rehabilitation medicine. However, the results obtained with this biologic therapy are heterogeneous and conflicting. The observed disparities in the effectiveness of PRP therapies may be due to a lack of standardization in blood processing and preparation. This article is aimed at reviewing the main biological parameters that need to be documented for a thorough reporting of quantitative and qualitative characteristics of the PRP injected, to allow a comparison between the quality of samples and the clinically obtained results and advance the efforts towards treatment standardization.

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“…Nowadays, musculoskeletal diseases are one of the main reasons to seek a general practitioner's advice. Several previous studies [1][2][3][4] have demonstrated that corticosteroid injections are efficient in treating many conditions, such as tendinitis or aseptic arthritis for example. These injections can either be a first line treatment, an alternative therapeutic tool or a complement to the pharmaceutical and educational treatments.…”

Section: Introductionmentioning

confidence: 99%

How to Improve the Post-Graduate Training of General Practitioners in Performing Joint Injection? Analysis of Training Courses and Literature Review

2022

J Family Med Prim Care Open Acc

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Introduction:While several studies have shown the usefulness and effectiveness of articular and abarticular corticosteroid injections performed by general practitioners, the main limitation that has been identified in expanding the use of these acts in everyday practice lies in a lack of training. Thus, this study aimed to determine the best settings for training courses concerning this subject. Methods: Our study was composed of two parts: the first one consisted in a survey concerning the improvements induced by training courses in the context of continuing medical education on the participants' skills and degree of confidence, the second part was a review of the published literature about this topic. Results: As expected, every training program analysed through our survey generated improvements in the participants' confidence in performing articular or abarticular injections. Furthermore, these findings are reflected in an increase in the proportion of such skills that the trainees complete by themselves. These results were reinforced by similar findings raised by the literature review. Moreover, it highlighted that hands-on training courses seemed to be the most efficient and that the use of synthetic models appeared to be a suitable alternative to human bodies or corpses, surrounded by less ethical and logistic concerns. Conclusions: This study supports the expansion of training courses for general practitioners on articular and abarticular injections. It also suggests that they should be based on a hands-on training design, possibly with the use of manikins.

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Indications and Usefulness of Common Injections for Nontraumatic Orthopedic Complaints

Cited by 8 publications

References 30 publications

Dilation, Steroid Injection, and Cough Exercise for Correction of Posterior Glottic Stenosis

Dilation, Steroid Injection, and Cough Exercise for Correction of Posterior Glottic Stenosis

Autologous Platelet-Rich Plasma Efficacy in the Field of Regenerative Medicine: Product and Quality Control

How to Improve the Post-Graduate Training of General Practitioners in Performing Joint Injection? Analysis of Training Courses and Literature Review

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