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JRPMS 2021

Review Article JRPMS, Vol 5, No 1, March 2021, p.1-7
The action of anti-resorptive drugs on the survival of total knee and hip arthroplasty
Ioannis Pitropakis
Keywords: Antiresorptive agents, Bisphosphonates, Implant survival
Total knee and hip arthroplasty are major surgical procedures performed in patients with severe osteoarthritis and their incidence has significantly increased in the last 30 years. A number of etiological factors such as low grade infections, stress shielding and degradation products have been, however, shown to endanger the survival of the implants. The prevention of mechanically induced implant loosening has been the aim of many studies investigating, among other things, whether pharmaceutical agents used for the treatment of osteoporosis can positively influence the survival of the arthroplasty implants. We conducted a search of the published literature (PubMed) to identify studies that assessed the effects of anti-resorptive agents (bisphosphonates, denosumab, raloxifene, bazedoxifene, calcitonin) on the outcome and longevity of total arthroplasty of the hip and knee. We found 24 studies for THR, 8 studies for TKR and 2 studies with reference in both hip and knee arthroplasty. Most studies assessed the effects of oral bisphosphonates. Significant difference in BMD is observed after 6 months of postoperative antiosteoclastic therapy with better results and lower revision rate in cemented TKA. Only 2 studies were found assessing the effects of denosumab on implant survival, while no studies were found on SERMs and calcitonin.
Review Article JRPMS, Vol 5, No 1, March 2021, p.8-14
The importance of the cardiovascular system to the frailty syndrome of the elderly
Elias Hountis
Keywords: Cardiovascular system, Elderly people, Frailty, Muscular system, Osteoporosis
“Frailty syndrome“ is usually associated with the elderly and is regarded as a generalized state of increased sensitivity that affects mainly the muscular as whell as the cardiovascular system. The correlation between osteoporosis and the poor state of the muscular system, the loss of muscle strength that occurs with aging creates an increased propensity for falls. The correlation between cardiovascular disease and osteoporosis has been vastly attributed to the effects of osteogenic factors such as BMP’s (bone morphogenetic proteins), ALP (alkaline phosphatas), OPN (osteopontin) and MPG (matrix Gla protein) on vascular calcifications.Currently, a number of studies are seeking to establish a common pathway also between frailty and cardiovascular disease and the importance of interactions between those two systems. in this short article we are presenting some of these new data.
Review Article JRPMS, Vol 5, No 1, March 2021, p.15-19
Types of regional anesthesia in orthopedic surgery and the role of the nurse
Nickoletta Vassou
Keywords: Nurse’s role, Orthopedic surgery, Perioperative and postoperative care, Preoperative, Regional anesthesia
Anesthesia, and, more specifically, regional anesthesia which is the focus of this review, is the most commonly used method in orthopedic surgery and is considered a rather complicated and delicate procedure. Therefore, nurses working in the anesthesiology department are of great importance due to the services and support they provide to both doctors and patients, by facilitating the anesthesiologist during the procedure as well as by monitoring, treating and supporting the patient. Nonetheless, the role of these nurses is generally understudied in scientific research and needs further investigation. For the purpose of this review a variety of articles relevant to orthopedic surgery, regional anesthesia and the role of nurse working in anesthesiology departments were gathered and analyzed in order to highlight the importance of the services they provide, using empirical evidence.
Review Article JRPMS, Vol 5, No 1, March 2021, p.20-24
Physical therapy intervention in early-stage femoral head osteonecrosis
Angelos Konstantonis
Keywords: Femoral head, Non-operative treatment, Physical therapy, Osteonecrosis
Osteonecrosis of the femoral head is a progressively destructive disease of multifactorial origin. The etiology and pathogenesis of osteonecrosis of the femoral head are not yet clear. Management alternatives for the treatment of osteonecrosis of the femoral head consist of non-operative and operative treatment. The efficacy of non-operative treatment alone is the subject of heated debate in the literature. The purpose of this article is to review, update and summarize the non-operative treatment, particularly physical therapy modalities in patients with avascular necrosis of the femoral head in early stages. According to current literature these methods mainly include restriction techniques, electromagnetic stimulation, shockwave, immobilization-traction and rehabilitation training. Despite the evidence that these modalities when applied alone improve motor-function, pain relief and delay disease progression mainly through angiogenesis, osteogenesis and tissue regeneration, there is need for more research to elucidate their role and duration in early stages of avascular necrosis of the femoral head.
Mini Review JRPMS, Vol 5, No 1, March 2021, p.25-28
Nurses as educators of diabetic foot patients
Antonia Tassiou
Keywords: Nurse, Diabetic foot education, Prevention, Care, Rehabilitation
The present article is a mini review on the multi-faceted role of the nurse in relation to the education of the patient with diabetic foot disease, a severe medical condition with worldwide prevalence and immense financial and clinical implications. We present a mini review based on scientific articles written in English concerning the role of the nurse in the areas of prevention, care and rehabilitation focusing on their contribution in educating the diabetic foot patients and their relatives to recognize the symptoms of diabetic foot, helping them follow simple and basic rules that will prevent the onset or further development of the disease, informing them as to the available treatment options during care and eventually supporting them in the road to lead a fulfilling life.
Review Article JRPMS, Vol 5, No 1, March 2021, p.29-34
Advanced Nursing Practice in Orthogeriatrics
Anastasia Margioula, Stavroula Rizou
Keywords: Advanced nursing practice, Fracture, Older adults, Orthogeriatric
In the last few decades, all the countries aim to combine the improvement of the quality of health care with the reduction of health costs. In order to harmonize the above-mentioned contradictory goals, newly enhanced roles, as in the case of Advanced Nursing Practice, have been introduced, initially in the private sector and more recently in the public hospital setting. The orthogeriatric advanced nursing practitioners’ role is valuable for providing pain relief, diagnosing and treating postoperative delirium, deep vein thrombosis, and secondary infections, preventing subsequent injuries and pressure sores, helping patients deal with postoperative constipation, and assist them in early mobilizing. After patients’ discharge from the hospital, their role is essential for ensuring the patients are adhering to their osteoporotic treatment and have the adequate skills to prevent falls. Their role is significant for older adults living in nursing homes or long-term care facilities. Their care is cost-effective compared to regular care.
Οriginal Article JRPMS, Vol 5, No 1, March 2021, p.35-40
Comparison of functional outcomes between teriparatide and vitamin D3 in distal end radius fractures of osteoporotic patients
Prakash D. Samant, Rohit M. Sane, Rajendraprasad R. Butala, Aditya M. Sane
Keywords: Distal end radius fracture, Functional Outcome, Osteoporosis, Teriparatide, Vitamin D3
Objectives: The objective of this study was to evaluate and compare the efficacy of teriparatide (osteoanabolic agent) versus vitamin D3 supplementation to improve functional outcomes in osteoporotic patients with distal end radius fractures (DERF). Methods: We conducted a prospective, randomized clinical study to compare the functional outcomes. Sixty osteoporotic DERF patients, treated with either conservative or surgical management were randomized to receive either teriparatide (20 mcg/day) or vitamin D3 (1000 IU/day) for a period of 3 months, along with calcium (500 mg/day) supplementation. The treatment outcomes were evaluated pre and post-management (1-month and 3-months) by Green and O’Brien scale, Patient-rated Wrist Evaluation (PRWE) scale, and Sarmiento scale. Results: There was a significant difference between the two groups at 3-months post-management. Teriparatide showed a significantly greater improvement of functional outcome (P=0.036) and patient-reported outcome (P<0.001) in comparison to vitamin D3 in total Green and O’Brien score and PRWE score, respectively. Conclusion: Teriparatide supplementation was effective and resulted in greater improvement in functional and radiologic outcomes in comparison to vitamin D3. Adjuvant teriparatide therapy may be a therapeutic option to improve the functional outcomes in DERF of osteoporotic patients.
Οriginal Article JRPMS, Vol 5, No 1, March 2021, p.41-47
Correlates of localized musculoskeletal pain in overweight female health care professionals
Mikkel Iwanoff Kolind, Malte Bue Kongstad, Astrid Winther Hansen, Sille Haugbølle Thomhav, Karen Søgaard, Jeanette Reffstrup Christensen
Keywords: Body mass index, Fat percentage, Muscle strength, Obesity, Workplace Health Promotion
Objectives: The risk of musculoskeletal pain increases when there is an imbalance between work demands and physical capacity. Work in elder care requires frequent periods of high mechanical loading. Body weight can further amplify this load, while muscle strength may lessen the relative strain on the musculoskeletal system. The purpose of this study was to assess the correlation between body composition, muscular strength and localized musculoskeletal pain intensity in overweight female health care professionals. Methods: A sample of 139 overweight female health care professionals working in elder care were included in the analyses. Associations between BMI, fat percentage, waist circumference, muscle strength and localized pain intensity were assessed using Kendall’s rank correlation. Results: Significant associations were found between musculoskeletal pain in the right shoulder and BMI (rτ=0.194; p=0.035), whereas upper back pain was associated with fat percentage and waist circumference (rτ=0.212; p=0.023 and rτ=0.212; p=0.024, respectively). Conclusions: Results indicate high BMI, fat percentage, and waist circumference may be contributing factors of localized musculoskeletal pain intensity of the upper body in overweight female health care professionals. These results may help guide the design of future workplace health promotion programmes.