OKOJ

OKOJ, Volume 8, No. 10


Chondrosarcoma

Chondrosarcomas represent a heterogeneous collection of malignant tumors that produce cartilage matrix as a hallmark to the disease. The tumors vary in their clinical presentation, radiographic appearance, and biologic aggressiveness. Depending on the grade of the lesion, recommended treatment for chondrosarcoma is surgical curettage or wide resection. There is no current role for adjuvant therapies. This article reviews the presentation, pitfalls, and treatment of these challenging malignancies.

    • Keywords:
    • cartilage neoplasm

    • bone tumor

    • mesenchymal chondrosarcoma

    • dedifferentiated chondrosarcoma

    • clear cell chondrosarcoma. primary chondrosarcoma

    • enchondroma

    • Subspecialty:
    • Musculoskeletal Oncology

Methods of Pain Management

The goals of effective pain control in orthopaedic surgery are to meet the humanitarian need for pain relief and to facilitate the patient’s rehabilitation and return to normal function. A variety of pharmacologic pain management options is available, including oral and intravenous opioids, patient-controlled analgesia, epidural injections, neural blocks, and nonsteroidal anti-inflammatory drugs. In addition, nonpharmacologic approaches, including transcutaneous electrical nerve stimulation, acupuncture, and medical hypnosis, are burgeoning as orthopaedic surgeons and patients increasingly adopt alternative pain control methods to supplement conventional medicine. Ultimately, a multimodal approach to pain management is often the best option for the patient, as it allows the orthopaedic surgeon to tailor an appropriate, individualized prescription.

    • Keywords:
    • pain management

    • pain control

    • preemptive analgesia

    • opioid analgesics

    • intravenous patient-controlled analgesia

    • nonsteroidal anti-inflammatory drugs

    • acetaminophen

    • aspirin

    • COX-2 inhibitors

    • local anesthetic

    • regional anesthetic

    • neural blocks

    • transcutaneous electrical nerve stimulation

    • continuous passive motion

    • acupuncture

    • medical hypnosis

    • multimodal analgesia

    • Subspecialty:
    • Pain Management

    • Basic Science

The Evaluation and Management of Rotator Cuff Arthropathy

Rotator cuff tear arthropathy describes a clinical constellation of rotator cuff insufficiency, degenerative arthritis of the glenohumeral joint, and superior migration of the humeral head. Patients with this condition present with pain and limited function secondary to poor active shoulder motion. When a conservative management program fails to improve a patient’s symptoms, surgical intervention is recommended. Surgical options for patients with symptomatic rotator cuff tear arthropathy include hemiarthroplasty and reverse total shoulder arthroplasty.

    • Keywords:
    • rotator cuff arthropathy

    • rotator cuff tear arthropathy

    • arthroscopy

    • hemiarthroplasty

    • reverse total shoulder arthroplasty

    • Subspecialty:
    • Shoulder and Elbow

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