Dr. Prodromos presented the "Diagnosis and Treatment of Knee Disorders" to a room full of chiropractic doctors on October 19, 2017.
Health Care News
Recent Meta-Analysis Shows Hamstring Grafts equally as stable as patellar tendon grafts but with significantly fewer complications
The authors analyzed all prospective randomized studies comparing hamstring and patellar tendon grafts to come to the above conclusion. Here is how the authors stated their findings: “Contemporary 4-strand HT ACL reconstruction is comparable with the PT technique in terms of clinical stability and postoperative functional status across most parameters studied. The HT technique carries lower risk of postoperative complications such as anterior knee pain, kneeling discomfort, and extension deficit. Primary ACL reconstruction using the 4-strand HT technique achieves clinical results that are comparable with the PT technique with significantly less postoperative complications.”
When I began my Orthopaedic Sportsmedicine practice in 1985 ACL reconstruction was generally reserved for young athletes. Over the years the acceptable age for reconstruction has gradually increased. Several studies have shown good outcomes in patients in their 50s. But what about even older individuals? There has been very little data in patients over 60 years of age. However a recent European study looked at a cohort of a dozen patients between 60 and 63 years of age with no significant arthritic changes in their knee at presentation. All patients had restoration of knee stability by ACLR, with no major complications. 10 of 12 patients resumed their prior sports activities. Follow-up was 2-6 years and there was no significant progression of arthritis. Ratings were greatly improved overall. While all patients in their 60s are not candidates this study shows that for a selected group in this age range ACL reconstruction is beneficial.
Yes you read that correctly. A new study from McMaster University found an increased death rate in all users of prescription anti-depressants. This is particularly alarming because these drugs are everywhere, with an almost unbelievable estimated rate of 1 in 8 adults in America now taking them. They also found that the increased death rate, a staggering 33% in patients without cardiovascular disease, was less pronounced in patients with cardiovascular disease, possibly because these drugs have a blood thinning effect. They conclude “The results support the hypothesis that ADs (Anti-Depressants) are harmful in the general population but less harmful in cardiovascular patients.” A recent Newsmax report also states “critics suggest that many people taking anti-depressants may not actually need them, with scientific studies showing psychotherapy, cognitive behavioral therapy, and other treatment approaches are as effective as drugs, or more so. But doctors routinely prescribe the pills because of long waiting lists for therapy.”
The FDA has warned for more than a decade that anti-depressant drugs cause an increased risk of suicidal thinking, feeling, and behavior in people under the age of 25. But now a new study from Sweden has correlated increased use of anti-depressants with an increase in “completed” suicides, ie deaths. The researchers conclude “The previous assumptions that treatment with antidepressants would lead to a drastic reduction in suicide rates, are incorrect for the population of young women. On the contrary, it was found that an increasing tendency of completed suicides follow the increased prescription of antidepressants.”