British medical bulletin
-
British medical bulletin · Dec 2024
Allograft versus autograft ACL reconstruction in skeletally immature patients: a systematic review.
Anterior cruciate ligament (ACL) injuries in children and adolescents with open physes are common. ⋯ Children who undergo allograft ACL reconstruction demonstrate similar functional outcomes to those who undergo autograft ACL reconstruction. Although allografts allow a faster return to sport, the greater laxity, the reduced activity level, and the higher failure and reoperation rates make their use dubious as a first-choice option for ACL reconstruction in skeletally immature patients.
-
This article reviews the ethical issues surrounding obesity in public health and clinical contexts. We examine how obesity intersects with medical and social norms that raise questions of liberty, fairness, safety, and effectiveness or consequences. ⋯ Post-genomic explanations, such as exposure to endocrine disrupting toxins, and development of epigenomics and microbiomics in the form of personalized nutrition are two developing areas we identify.
-
British medical bulletin · Nov 2024
Percutaneous repair of the Achilles tendon with one knot offers equivalent results as the same procedure with two knots. A comparative prospective study.
The present prospective comparative study included patients with acute Achilles tendon rupture (ATR) who underwent percutaneous repair with one knot compared to percutaneous repair with two knots. ⋯ The modified technique offered similar objective and subjective outcome measures, in addition to reduced operative time.
-
British medical bulletin · Nov 2024
Management of knee osteoarthritis using bone marrow aspirate concentrate: a systematic review.
Knee osteoarthritis (OA) is a common degenerative joint condition and a major cause of disability in the general population. ⋯ BMAC is a valuable source of mesenchymal stem cells, offering potential benefits in attenuating the inflammatory pathway associated with knee OA. Intra-articular injection of BMAC has shown effectiveness in clinical trials improving functional outcomes of knee OA patients. The superiority of BMAC over other orthobiological treatments cannot be assessed because of conflicting results.
-
British medical bulletin · Sep 2024
ReviewPharmacological management of secondary chronic spinal cord injury: a systematic review.
Spinal cord injury (SCI) may bring lifelong consequences for affected patients and a high financial burden to the health care system. ⋯ Different approaches exist for the pharmacological management of secondary chronic SCI. One of the most investigated drugs, 4-aminopyridine, improves central motor conduction and shows improvement in neurological signs. Positive results in different areas have been observed in patients receiving the anti-spastic drugs tizanidine and baclofen or Granulocyte colony-stimulating factor. Growth hormone showed only minimal or no significant effects, and the therapy of secondary chronic SCI with riluzole has been poorly researched to date.