The power of case reports
Editorial | Vol 4 | Issue 1 | January-June 2024 | page: 01-02 | Daniel Moya
DOI: https://doi.org/10.13107/jrs.2024.v04.i01.117
Author: Daniel Moya [1]
[1] Department of Orthopaedics. Buenos Aires British Hospital, Argentina.
Address of Correspondence
Dr. Daniel Moya,
Department of Orthopaedics. Buenos Aires British Hospital, Argentina.
E-mail: drdanielmoya@yahoo.com.ar
Editorial:
Medical education has currently a variety of tools as never before in the history of mankind. Options include everything from telepresence to virtual reality. However, interaction with patients remains, as in the past, an unsurpassed source of learning. Health-care practice provides learning about the way different pathologies manifest, their clinical course, and the response to different treatments.
A simple way to share that experience is through case reporting. A case report consists of a detailed description of significant clinical information of a case or a small group of patients, presenting pathologies not previously described, new therapeutic methodologies, or cases with an unusual response to treatment.
This type of study has often been underestimated because it is a category of publication with a low level of evidence [1-4] and does not have a high citation rate [1, 2, 4, 5]. These causes have led to case reports being a small segment of health publications [4].
However, these studies can provide important information [1-9]. Case reports can be the basis of future large-scale clinical studies [6], can reveal facts that often go unnoticed in large series of patients [3], and be the starting point for the development of new treatments [3]. They can demonstrate results in one or a few cases with therapeutic methods previously tested in animal experiments [4].
Case reports have made it possible to detect severe adverse effects [3, 4]. Nayak described that the teratogenic effect of thalidomide was identified through a case report of phocomelia [3].
We must also be aware that the publication of a case report is often the first step of a young colleague in the world of publications. That is why it should be encouraged. The publication of case reports allows even those who have less economic or institutional support for their academic activity to transmit their experience. It is a way to democratize scientific exchange and not depend only on supposed elites that end up transforming clinical research production groups into small aristocracies that generate only a one-way exchange.
Writing a case report has been described not only as an academic procedure but also as an art [8].
There is useful information in the literature about how to write this type of manuscripts [3, 4, 6, 8, 10]. Cases must be original and transmit information that has an impact on clinical practice. They must be structured like the rest of the publications, provide a complete and correct description of the case, and have solid bibliographic support.
Starting in this volume we will include case reports. On this occasion, they come from different colleagues from Ibero America. We also incorporated a new section that consists of critical reading of scientific publications related to regenerative medicine. Contributions, proposals, and criticisms will be welcome.
References
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- Shyam A, Editor-Journal of Orthopaedic Case Reports. Case reports and case series: Expanding the scope of journal of orthopaedic case reports. J Orthop Case Rep 2016;6:1-2.
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- Pierson DJ. How to read a case report (or teaching case of the month). Respir Care 2009;54:1372-8.
- Hess DR. What is evidence-based medicine and why should I care? Respir Care 2004;49:730-41.
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- Cohen H. How to write a patient case report. Am J Health Syst Pharm 2006;63:1888-92.
| How to Cite this article: Moya D | The Power of Case Reports. | Journal of Regenerative Science | Jan-Jun 2024; 4(1): 01-02. |
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Extracorporeal Shock Wave Therapy in Calcifying Tendonitis of the Shoulder. Case Report
Case Report | Vol 4 | Issue 1 | January-June 2024 | page: 03-05 | Oyama Arruda Frei Caneca Júnior
DOI: https://doi.org/10.13107/jrs.2024.v04.i01.119
Author: Oyama Arruda Frei Caneca Júnior [1]
[1] GOT – Orthopedics and Traumatology Group, Recife, Brazil.
Address of Correspondence
Oyama Arruda Frei Caneca Júnior,
GOT – Orthopedics and Traumatology Group, Recife, Brazil.
E-mail: oyama.arruda@gmail.com
Abstract
Calcific tendonitis in the shoulder is very common. Patients who do not improve with physical therapy treatment may benefit from shockwave treatment before an invasive procedure is indicated. The focused shockwave treatment has a high degree of recommendation in calcific tendonitis of the shoulder, according to several studies with a high level of evidence. This report shows a 58-year-old female patient with calcific tendonitis of the shoulder with pain for more than 6 months without response to medication and rehabilitation treatment. Four sessions of 3000 pulses were performed with a focused shockwave piezoelectric device, with a maximum level of energy of 0.4 mj/mm2. Pain remission and calcification resorption were verified 3 months after the last application. Extracorporeal Shockwave Treatment is a safe and effective alternative for calcific tendonitis of the shoulder.
Keywords: ESWT, calcific tendinopathy, shoulder
References:
1. Chianca V, Albano D, Messina C, Midiri F, Mauri G, Aliprandi A, et al. Rotator cuff calcific tendinopathy: From diagnosis to treatment. Acta Biomed 2018;89:186-96.
2. Moreira G. Tratado de Dor Musculo Esquelética. 2ª ed. Cap. 18. Dor no Ombro. São Paulo: Ed. Alef; 2022.
3. Bosworth BM. Calcium deposits in the shoulder and subacromial bursitis. J Am Med Assoc 1941;116:2477-82.
4. Kim MS, Kim IW, Lee S, Shin SJ. Diagnosis and treatment of calcific tendinitis of the shoulder. Clin Shoulder Elb 2020;23:210-6.
5. Gärtner J. Tendinosis calcarea: Results of treatment with needling. Z Orthop Ihre Grenzgeb 1993;131:461-9.
6. Tratado de Ondas de Choque. Sociedade Médica Brasileira de Tratamento Por Ondas de Choque. 1st ed., Cap. 7. Tratamento por Ondas de Choque em Patologias do Ombro. Sao Paulo: Ed Alef; 2022. P. 89-98.
7. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
8. Moya D, Ramón S, Guiloff L, Gerdesmeyer L. Current knowledge on evidence-based shockwave treatments for shoulder pathology. Int J Surg 2015;24:171-8.
| How to Cite this article: Caneca OAF Jr. Extracorporeal Shock Wave Therapy in Calcifying Tendonitis of the Shoulder. Case Report. Journal of Regenerative Science 2024;January-June;4(1):03-05 |
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Focused Shock Waves in Delayed Union and No-union after Intramedullary Nailing in Lower Limbs
Case Report | Vol 4 | Issue 1 | January-June 2024 | page: 06-08 | Josep Pous
DOI: https://doi.org/10.13107/jrs.2024.v04.i01.121
Author: Josep Pous [1]
[1] Orthopaedic Surgeon and Medical Director of CEMATEC, Barcelona, España.
Address of Correspondence
Dr. Josep Pous,
Orthopaedic Surgeon and Medical Director of CEMATEC, Barcelona, España.
E-mail: jpous@cematec.org
Abstract
Shock waves have changed medical therapy substantially. Accounting for the epidemiology of the treated diseases, this therapeutic tool may equal or even surpass the impact of extracorporeal shock wave lithotripsy. Lower limb fractures after intramedullary nailing generally heal without problems when there are good local conditions and no associated pathologies, but sometimes if the biomechanical or biological variables are not ideal, they can lead to a delay in healing or develop a non-union. Extracorporeal shock waves therapy is a treatment option in delayed union and no-union after intramedullary nailing in lower limbs cases in which there is mechanical stability of the fracture focus, as they can allow healing without the need for new surgeries.
Keywords: Extracorporeal shockwave therapy, Shock waves, Non-union, Delayed union
References:
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2. Zura R, Mehta S, Della Rocca GJ, Steen RG. Biological risk factors for nonunion of bone fracture. JBJS Rev 2016;4:e5.
3. Sadat-Ali M, Al-Omar HK, AlTabash KW, AlOmran AK, AlDakheel DA, AlSayed HN. Genetic influence of fracture nonunion (FNU): A systematic review. Pharmgenomics Pers Med 2023;16:569-75.
4. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
5. Zura R, Xiong Z, Einhorn T, Watson JT, Ostrum RF, Prayson MJ, et al. Epidemiology of fracture nonunion in 18 human bones. JAMA Surg 2016;151:e162775.
6. Tian R, Zheng F, Zhao W, Zhang Y, Yuan J, Zhang B, et al. Prevalence and influencing factors of nonunion in patients with tibial fracture: Systematic review and meta-analysis. J Orthop Surg Res 2020;15:377.
7. Rompe JD, Rosendahl T, Schöllner C, Theis C. High-energy extracorporeal shock wave treatment of nonunions. Clin Orthop Relat Res 2001;387:102-11.
8. Tamma R, Dell’Endice S, Notarnicola A, Moretti L, Patella S, Patella V, et al. Extracorporeal shock waves stimulate osteoblast activities. Ultrasound Med Biol 2009;35:2093-100.
9. Hofmann A, Ritz U, Rompe JD, Tresch A, Rommens PM. The effect of shock wave therapy on gene expression in human osteoblasts isolated from hypertrophic fracture non-unions. Shock Waves 2015;25:1:91-102.
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16. Sansone V, Ravier D, Pascale V, Applefield R, Del Fabbro M, Martinelli N. Extracorporeal shockwave therapy in the treatment of nonunion in long bones: A systematic review and meta-analysis. J Clin Med 2022;11:1977.
17. Wang CJ, Chen HS, Chen CE, Yang KD. Treatment of nonunions of long bone fractures with shock waves. Clin Orthop Relat Res 2001;387:95-101.
18. Cacchio A, Giordano L, Colafarina O, Rompe JD, Tavernese E, Ioppolo F, et al. Extracorporeal shock-wave therapy compared with surgery for hypertrophic long-bone nonunions. J Bone Joint Surg Am 2009;91:2589-97. Erratum in: J Bone Joint Surg Am 2010;92:1241.
19. Furia JP, Juliano PJ, Wade AM, Schaden W, Mittermayr R. Shock wave therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal-diaphyseal fractures. J Bone Joint Surg Am 2010;92:846-54.
20. Notarnicola A, Moretti L, Tafuri S, Gigliotti S, Russo S, Musci L, et al. Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid. Ultrasound Med Biol 2010;36:1306-13.
21. Schaden W, Mittermayr R, Haffner N, Smolen D, Gerdesmeyer L, Wang CJ. Extracorporeal shockwave therapy (ESWT)–first choice treatment of fracture non-unions? Int J Surg 2015;24:179-83.
22. Haffner N, Antonic V, Smolen D, Slezak P, Schaden W, Mittermayr R, et al. Extracorporeal shockwave therapy (ESWT) ameliorates healing of tibial fracture non-union unresponsive to conventional therapy. Injury 2016;47:1506-13.
23. Sandoval C, Valenzuela A, Rojas C, Brañes M, Guiloff L. Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series. Int J Surg 2017;9:36-40.
| How to Cite this article: Pous J. Focused Shock Waves in Delayed Union and No-union after Intramedullary Nailing in Lower Limbs. Journal of Regenerative Science 2024;January-June;4(1):06-08 |
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Treatment with Shockwave Therapy in a Patient with Joint Hypermobility and Temporomandibular Dysfunction
Case Report | Vol 4 | Issue 1 | January-June 2024 | page: 09-15| Claudio Lopes Simplicio, Angélle Aragonez Essado Jácomo, Guilherme Antonio Moreira de Barros
DOI: https://doi.org/10.13107/jrs.2024.v04.i01.123
Author: Claudio Lopes Simplicio [1], Angélle Aragonez Essado Jácomo [2], Guilherme Antonio Moreira de Barros [3]
[1] Orthopedics – Physiatrist – Antalgic Therapy, RJ Brazil Ortofisio Clinic – Instdor Clinic, Sao Paulo State University (UNESP), Botucatu – SP Brazil,
[2] Physiatrist – Pain Doctor, DF, Brazil.
[3] Antalgic Therapy and Palliative Care, Faculdade de Medicina de Botucatu, UNESP-SP, Brazil.
Address of Correspondence
Dr. Cláudio Simplicio,
Orthopedics – Physiatrist – Antalgic Therapy,RJ Brazil, Ortofisio Clinic – Instdor Clinic, Sao Paulo State University (UNESP), Botucatu – SP Brazil.
E-mail: drsimplicio@terra.com.br
Abstract
The text addresses the relationship between joint hypermobility (JH), Ehlers-Danlos Syndrome (EDS), and temporomandibular dysfunction (TMD) in patients, discussing the complexity, and comorbidities associated with these conditions. A clinical case is presented, along with the treatment, including focused shockwave therapy as a non-invasive therapeutic approach. The effectiveness of shockwave therapy is discussed in relation to pain relief and musculoskeletal system regeneration, based on studies and scientific evidence.
However, despite the potential benefits, further research is still needed to fully understand the effects of these therapies in patients with specific conditions, such as JHjoint hypermobility and ehlers-danlos syndrome (EDS. The safety and efficacy of shockwave therapy are also discussed, emphasizing the importance of following rigorous protocols to avoid complications.
This summary highlights the relevance of shockwave therapy in the treatment of TMD and other musculoskeletal conditions, providing a comprehensive view of therapeutic approaches and clinical considerations involved.
Keywords: Joint Hypermobility, Ehlers-Danlos Syndrome, Temporomandibular Joint Dysfunction Syndrome, Extracorporeal Shockwave Therapy
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41. Moya D, Ramón S, Guiloff L, Terán P, Eid J, Serrano E. Malos resultados y complicaciones en el uso de ondas de choque focales y ondas de presión radial en patología musculoesquelética [Poor results and complications in the use of focused shockwaves and radial pressure waves in musculoskeletal pathology]. Rehabilitacion (Madr). 2022 Jan-Mar;56(1):64-73. Spanish. doi: 10.1016/j.rh.2021.02.007. Epub 2021 Apr 5. PMID: 33832759.
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| How to Cite this article: Simplicio CL, Jácomo AAE, de Barros GAM. Treatment with Shockwave Therapy in a Patient with Joint Hypermobility and Temporomandibular Dysfunction. Journal of Regenerative Science | 2024; January-June;4(1):09-15. |
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A Diagnostic Mistake, Treated with Shock Waves: Dabska Tumor
Case Report | Vol 4 | Issue 1 | January-June 2024 | page: 16-19| Paul Germán Terán Vela, Felipe Sebastián Criollo Palacios, Estefanía Anabel Lozada Tobar, Luis Eduardo Guzmán Freire, Eloísa Abigael Nájera García
DOI: https://doi.org/10.13107/jrs.2024.v04.i01.125
Author: Paul Germán Terán Vela [1], Felipe Sebastián Criollo Palacios [2], Estefanía Anabel Lozada Tobar [1], Luis Eduardo Guzmán Freire [3], Eloísa Abigael Nájera García [2]
[1] Orthopaedic Surgeon, Orthopedic Specialties Center, Quito-Ecuador,
[2] NGC Diagnóstica, Orthopedic Oncology, Quito-Ecuador,
[3] Physician, Orthopedic Specialties Center, Quito-Ecuador.
Address of Correspondence
Dr. Paul Germán Terán Vela,
Orthopaedic Surgeon, Orthopedic Specialties Center, Quito-Ecuador.
E-mail: paulteranmd@gmail.com
Abstract
Papillary intralymphatic angioendothelioma (PILA) or Dabska tumor (DT) is a low-grade angiosarcoma. This vascular tumor usually has a higher incidence during childhood and occurs the most in the extremities and trunk. DT is locally aggressive, and no high metastatic potential is reported. We present a case of a 34-year-old female patient, treated with extracorporeal shock wave therapy (ESWT) for a misdiagnosis of left patellar tendinopathy. Due to the persistence and intensification of her symptoms, she is re-evaluated by Orthopedic Specialists. In magnetic resonance imaging studies, a mass was identified in the left external femoral condyle measuring approximately 10 mm with significant diffuse bone edema. Surgical resection was performed, and a PILA was identified by immunohistochemistry. In this case report, the complications of the use of focused ESWT and the histopathological characteristics of DT are discussed.
Keywords: Dabska tumor, Intralymphatic papillary angioendothelioma, Focused shock waves, Complications
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| How to Cite this article: Vela PGT, Palacios FSC, Tobar EAL, Freire LEG, García EAN. A Diagnostic Mistake, Treated with Shock Waves: Dabska Tumor. Journal of Regenerative Science 2024;January-June;4(1):16-19. |
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Regeneration of the Patellar Tendon with Radial Pressure Waves in a Sharp Injury: A Case Report
Case Report | Vol 4 | Issue 1 | January-June 2024 | page: 20-23 | A A Flores Salinas, G C Reyes Cordero, L B García Rodriguez, L C Villa Olivares
DOI: https://doi.org/10.13107/jrs.2024.v04.i01.127
Author: A A Flores Salinas [1], G C Reyes Cordero [2], L B García Rodriguez [3], L C Villa Olivares [4]
[1] Department of Rehabilitation Medicine, Medical Director of Physis Clinics, Chihuahua, Mexico,
[2] Department of Rheumatology, Hospital Ángeles, Chihuahua, Mexico,
[3] Department of Orthopedics and Traumatology, Hospital Central Universitario, Chihuahua, Mexico,
[4] Department of Radiology, Civil Pensions of the State of Chihuahua, Mexico.
Address of Correspondence
Dr. A A Flores Salinas,
Department of Rehabilitation Medicine, Medical Director of Physis Clinics, Chihuahua, Mexico.
Email- drazaelflores@hotmail.com
Abstract
Patellar tendon ruptures are rare injuries and are more commonly associated with predisposing factors and previous surgical procedures than with direct trauma. Acute partial-thickness tears are usually treated with immobilization and rehabilitation. The literature recommends surgical management of partial ruptures of the patellar tendon after 6 months of failure of conservative treatments and in acute cases with a compromise >50–55% of the tendon. Radial pressure wave therapy is a safe, non-invasive technique with scientific support in tissue regeneration; it is found as one of the therapeutic alternatives for the management of tendinopathy and partial ruptures of the patellar tendon. The present case report shows the effectiveness of radial pressure wave therapy in a shear injury of the patellar tendon, with a compromise of at least 70%. We have not found similar cases previously reported in the literature, highlighting its relevance.
Keywords: Patellar tendon, Radial pressure waves, Patellar tendon rupture, Cutting injury
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| How to Cite this article: Salinas AAF, Cordero GCR, Rodriguez LBG, and Olivares LCV. Regeneration of the Patellar Tendon with Radial Pressure Waves in a Sharp Injury: A Case Report. Journal of Regenerative Science 2024;January-June;4(1):20-23. |
