July 02, 2007

Here's my future

Here's the health round-up (kendo is taking a back seat).

  • BP is fully controlled.
  • Sciatica is significantly improved.
  • Shoulder surgery :

First published on November 27, 2006, doi:10.1177/0363546506294855
This version was published on January 1, 2007

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The American Journal of Sports Medicine 35:53-58 (2007)
© 2007 American Orthopaedic Society for Sports Medicine

Arthroscopic Distal Clavicle Resection in Athletes

A Prospective Comparison of the Direct and Indirect Approach

Kevin M. Charron, MD, Anthony A. Schepsis, MD  and Ilya Voloshin, MD

From the Department of Orthopaedic Surgery, Division of Sports Medicine, Boston University Medical Center, Boston, Massachusetts

* Address correspondence to Anthony A. Schepsis, MD, Director of Sports Medicine, Professor of Orthopaedic Surgery, Boston University Medical Center, 720 Harrison Avenue #808, Boston, MA 02118.

Background: The clinical success of arthroscopic distal clavicle resection for athletes has been well documented. There are, however, no published studies that prospectively compare the recovery rates in athletes as well as the outcomes of the indirect versus direct approaches. 

Hypothesis: Both procedures are equally successful; however, the direct approach affords faster return to sports. 

Study Design: Randomized controlled clinical trial; Level of evidence, 2. 

Methods: Thirty-eight consecutive athletes with osteolysis of the distal clavicle or isolated posttraumatic arthrosis of the acromioclavicular joint without instability underwent arthroscopic distal clavicle resection. The patients were randomized into 2 groups: a direct superior approach and an indirect subacromial approach. American Shoulder and Elbow Surgeons and Athletic Shoulder Scoring System scores were measurable outcomes. 

Results: Thirty-four athletes were available for a minimum 2-year follow-up. The 2 groups were similar, including preoperative American Shoulder and Elbow Surgeons and Athletic Shoulder Scoring System scores. Both groups demonstrated significant improvement in both scores at final follow-up when compared with preoperative scores (P < .001). The direct group demonstrated higher American Shoulder and Elbow Surgeons (82 vs 64) and Athletic Shoulder Scoring System (74 vs 56) scores at week 2 (P < .001) and week 6 (American Shoulder and Elbow Surgeons, 88 vs 77; Athletic Shoulder Scoring System, 87 vs 73) (P < .001). At final follow-up, both groups demonstrated excellent clinical outcomes, even though there was a statistical difference in scores, with the direct group scoring better (American Shoulder and Elbow Surgeons, 95.7 vs 91.2; Athletic Shoulder Scoring System –94.9 vs 88.3). The direct group demonstrated faster return to sports (mean, 21 days) than the indirect group (mean, 42 days) (P < .001). Radiographic analysis demonstrated an equivalent resection. One patient in each group had a clinically insignificant increase in coracoclavicular distance. 

Conclusions: Both the direct superior approach and the indirect subacromial approach to the arthroscopic distal clavicle resection result in successful clinical outcome with clinically insignificant difference at final follow-up. Athletes treated with the direct superior approach improved faster clinically and returned to sports earlier. 

Key Words: acromioclavicular joint • Mumford • arthroscopic • osteolysis • distal clavicle resection

I'm going to have to do a review of the medical literature re: shoulder injuries and kendo. Dr. Stan says I'll be better than new.

April 09, 2007

This is more like it

Today the BP is 120/86.  Maybe the combination of Atacand/HCT and Coreg-CR is finally kicking in. No practice tomorrow evening, off to Lewiston, ID to lecture on diabetes management.

September 21, 2005

Global Warming - ON MARS

NASA scientists report that " . . . carbon dioxide deposits at Mars' south pole shrink for three consecutive Martian summers. They suggest there may be a climate change in progress."  Must be the SUV driving Martians since there are no humans there (unless you count these guys or maybe this guy). 

Oh wait, could it be due to solar activity which drives the Martian weather as well as the Earth's?

August 02, 2005

Avoid the Muffin Top!

534muffin_purseThere's a whole new reason to work at kendo, the muffin top, the unsightly roll of fat that spills over between too tight pants and cropped tops.  Kendo has an extremely high energy expenditure (about 18.5 KCal/min for a person my weight). 
There is no drug which is safe and effective to promote weight loss (as an endocrinologist I could make a fortune if there was) and the only solution is to eat less and exercise more.  So if you want to avoid the "muffin top" eat less and exercise more.

Hat tip for the muffin top to Michelle Malkin.

June 30, 2005

Kendo Practice - Robot!

Kumdo_robotKorean scientists have invented a robot opponent for kendo practice.  Full story here.   Would this violate Asimov's Laws of Robotics?

June 15, 2005

William Shatner: Who is He?

This is a howler about William Shatner.  Enjoy.

Hat tip:  Jonah Goldberg.

May 25, 2005

Blogger Fingers His Own Murderer

Bizarre tale of a blogger fingering his own murderer.   

HT:  The Volokh Conspiracy

May 16, 2005

Star Trek

Ncc1701OK, this will label me an ubergeek but Lileks  has a great Bleat today as a Star Trek retrospective.  His Worf - Troi dialogue is hilarious.  A must read today.

May 09, 2005

Kendo Practice

My weight continues to decline on the South Beach Diet and I've gone from 235 to 223 so far.  The first several days were water weight but I'm now losing about 0.5 lbs per day.  My measurements are improving as well.  My waist size is down 3" and my pants are getting looser.  At this rate I will have to get some new duds in the near future.

My kendo was stronger Friday as well.  My energy level continues to improve and my fatigue symptoms are diminished post exercise.  I found that taking a 30 gm protein shake after exercise improves my next day fatigue and muscle soreness.

I was the sempai Friday evening and got to lead the warm-up stretches and exercises.  I had recently read an article about warm-ups and stretching  posted on the website of the Devise Sensei's Shoshin Kendo Dojo in Trinidad. 

This article makes the excellent point that muscles need to be warmed up before they can be stretched.  So I changed the order of the warm up and stretching exercises.  I had the fellow kenshi groaning by the end of the warm-up but I felt better and looser before beginning the main part of the class.

Lasik Surgery

My wife had Lasik Surgery last week and has done extremely well.  Her pre-treatment visual acuity was 20/250 OS and 20/300 OD, with binocular visual acuity being 20/250.  Her current acuity is 20/25 and 20/30 and her binocular vision is 20/20.  She has had an excellent outcome. 

Anyone have any thoughts on the issue?  Comments are welcome.

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