Total hip replacement (THR) is most often performed to treat end-stage symptomatic osteoarthritis. Patients typically present with increasing pain, restricted mobility and stiffness. In this procedure, the femoral head and part of the femoral neck are excised. The acetabulum is enlarged and an acetabular cup is inserted. The femoral head is replaced by a femoral component, the stem of which is inserted into the medullary canal of the femur. The components can be either cemented in place or press-fit (cementless). The THR concept was popularised by Sir John Charnley in the 1960s and although, over half a century of development has resulted in incremental improvements, the procedure is not dramatically different from the one he described. However, over the last two decades there have been significant changes in the types of bearing surfaces used. Metal on polyethylene continues to be the workhorse for the majority of cases. In the young and active, bearing surfaces with low wear rate are increasingly used. Since the early 1960s, THR has played an important role in alleviating pain and restoring mobility to millions of people. The cost-effectiveness of THR in treating advanced osteoarthritis makes it one of the most successful of all surgical interventions.

This study sought to investigate the prevalence of laparoscopic surgeon injury/illness symptoms and evaluate associations between symptoms and operating room ergonomics.Although laparoscopic procedures significantly benefit patients in terms of decreased recovery times and improved outcomes, they contribute to mental fatigue and musculoskeletal problems among surgeons. A variety of ergonomic interventions and applications are implemented by surgeons to reduce health problems. Currently, there is a gap in knowledge regarding a surgeon's individual assessment of the operating room, an assessment that, in turn, would prompt the implementation of these interventions.A new survey instrument solicited information from surgeons (N = 61) regarding surgeon demographics, perception, frequency of operating room equipment adjustment, and self-reported symptoms. Surgeons responded to questions addressing safety, ergonomics, and fatigue in the operating room, using a 5-point Likert-type scale that included the option undecided.Surgeons who responded undecided were more likely to experience symptoms of injury/illness than respondents who were able to assess the features of their operating rooms. Symptoms were experienced by 100% of participants. The most prevalent symptoms were neck stiffness, back stiffness, and back pain.This study supports hypotheses that surgeons are experiencing body part discomfort and indicators of fatigue that may be associated with performing laparoscopy. Results suggest that awareness, knowledge, and utilization of ergonomic principles could protect surgeons against symptoms that lead to occupational injury.The purpose of this brief report is to convey the importance of ergonomic principles in the operating room, specific to laparoscopic surgery and surgeon injury/illness symptoms.

Objective To assess the prevalence of musculoskeletal symptoms at four different anatomical sites and the impact of menopause, age, and other factors on musculoskeletal symptoms. Methods Generally healthy women aged 35-64 years were recruited from a general community in Beijing, People's Republic of China. Data were collected with a questionnaire including the basic conditions, menopausal status, and frequency of musculoskeletal symptoms (rarely, occasionally or frequently) during the previous 2 weeks at the neck, lower back, knee and other sites. The prevalences of frequent symptoms were calculated for each site. Results A total of 743 women were enrolled in the study; 33.4% complained of frequent lower back pain, 31.0% of frequent knee pain, 29.7% of frequent neck pain, 25.6% of joint pain at other sites, 23.6% of joint stiffness and 21.1% of hand joint swelling. Postmenopausal women experienced a significantly higher prevalence of musculoskeletal symptoms compared with premenopausal women. There was a peak in prevalence of musculoskeletal symptoms at early postmenopause. The prevalences of neck pain and lower back pain were not associated with age, but did increase during the perimenopausal stage. The prevalences of knee pain, joint stiffness and hand joint swelling increased significantly with age. Higher body mass index (BMI) was related to increased prevalences of knee pain, joint stiffness and hand joint swelling. Logistic regression analysis showed odds ratios for knee pain, joint stiffness and hand joint swelling of 2.256, 1.865 and 1.955, respectively, in the obese women (BMI ≥ 28 kg/m(2)), compared with women with normal BMI (< 24 kg/m(2)). Conclusion Menopause is known to be a time of increased musculoskeletal symptoms, but the association of musculoskeletal symptoms with age and BMI also should be considered.

To describe the work-related musculoskeletal disorders among on-job dental surgeons.To identify the musculoskeletal disorders in terms of perception of pain and stiffness experienced by the dental surgeons due to the rigors of dental work, to determine the prevailing working environment with particular reference to dental work station in relation to musculoskeletal disorders, and to find the association between pain and stiffness experienced by the dental surgeons and the selected socio-demographic variables.The study was conducted on 30 graduated dental surgeons having a work experience of 1 year or more, post graduates and faculty members of various specialties at Yenepoya Dental College Hospital, Mangalore. The subjects were selected randomly from the hospital and they were given closed-ended questionnaire to find out perception of pain and stiffness experienced in the past 6 months. The observation of the working environment was done by walk-through observational survey.The study showed that 6.6% dental surgeons always experienced shoulder pain, while 83.3% dental surgeons sometimes experienced back pain and 70% sometimes experienced neck pain. Majority of the dental surgeons (73.3%) experienced stiffness in the back and 23.3% experienced severe pain in their neck. It was observed that the number of patients attended per day by the dental surgeons had a significant association (P = 0.024) with the pain they experienced in their hip/thigh region. The frequency of pain experienced by the dental surgeons in the hip/thigh and knee joints also showed a significant association (P = 0.037) with the height of the dental surgeons.The study revealed that various socio-demographic variables contributed to the musculoskeletal disorders experienced by the dental surgeons. However, the number of patients attended per day by the dental surgeons vis-à-vis pain experienced in the back, wrist, and hip/thigh was significant.

The use of backpack increased substantially among the school children. Studies have shown that carrying a backpack cause to develop different symptoms of musculoskeletal disorders among the carrier of the backpack. In India there are fewer studies available in literature which explains the musculoskeletal discomfort among the school children. This study aimed at to find out the prevalence of different musculoskeletal problems among the school children. In a retrospective study data were collected for twenty two students. The main diagnostic criteria were pressure mark (redness or swelling) over neck and shoulder corresponding to the straps of the backpack, stooping posture while carrying the back pack, pain or stiffness in the neck, upper back and shoulders predominantly while carrying the back pack and absence of these symptoms during school holidays. Results revealed that pain in the upper back (40%), neck (27%) and shoulder (20%) were most prevalent body regions followed by forearm and wrist pain (7%) and low back (6%). Results further revealed that all the students participated in this study have a pressure mark over shoulder. 54.55% of the children were diagnosed with myofascial pain and rest with thoracic outlet syndrome.

To describe the immediate effects of ischemic compression (IC) as a trigger point therapy in a case of a patient with neck pain. The application of IC is a safe and effective method to successfully treat elicited myofascial trigger points. The purpose of this method is to deliberate the blockage of blood in a trigger point area in order to increase local blood flow. This washes away waste products, supplies necessary oxygen and helps the affected tissue to heal. In this case study, we treated a 27-year-old female patient with a medical report of neck pain for at least four months. The physical examination revealed a neck pain and stiffness at the left side and pain increases when moving the neck. An active myofascial trigger point was found in the left trapezius muscle. The following data were recorded: active range of motion of cervical rachis measured with a cervical range of motion instrument, basal electrical activity of the left trapezius measured with electromyography, and pressure tolerance of the myofascial trigger point measured with visual analogue scale, assessing local pain evoked by the application of 2.5 kg/cm2 pressure with an analogue algometer.Immediately after application of the IC, all measured parameters improved compared to base line. The application of IC has been shown effective in the treatment of myofascial trigger points in a patient with neck pain. The results show a relation between active range of motion of cervical rachis, basal electrical activity of the trapezius muscle and myofascial trigger point sensitivity.In this case of a patient with neck pain, active range of motion of cervical rachis, basal electrical activity of the trapezius muscle and myofascial trigger point sensitivity gaining short-term positive effects with the application of one single ischemic compression session. Nevertheless, randomized controlled double-blinded studies should be conducted in future to examine the effectiveness of this ischemic compression technique in case of the presence of myofascial trigger points in the neck.

Some musculoskeletal disorders of the upper extremity are not readily classified. The study objective was to determine if there were symptom patterns in self-identified repetitive strain injury (RSI) patients.Members (n = 700) of the Dutch RSI Patients Association filled out a detailed symptom questionnaire. Factor analysis followed by cluster analysis grouped correlated symptoms.Eight clusters, based largely on symptom severity and quality were formulated. All but one cluster showed diffuse symptoms; the exception was characterized by bilateral symptoms of stiffness and aching pain in the shoulder/neck.Case definitions which localize upper extremity musculoskeletal disorders to a specific anatomical area may be incomplete. Future clustering studies should rely on both signs and symptoms. Data could be collected from health care providers prospectively to determine the possible prognostic value of the identified clusters with respect to natural history, chronicity, and return to work.

: Neurofibromatosis is a group of genetic disorders that affect the development and growth of nerve cell tissues. These disorders include tumors of myelin-producing supportive cells that grow on nerves and can cause changes in bone formation, skin integrity, and nerve transmission. Common musculoskeletal impairments associated with neurofibromatosis type 1 (NF 1) include cervical pain, muscle weakness, muscle stiffness, headaches, and postural deviations.: This case study describes successful physical therapy management and outcomes for cervical pain and headaches in a 17-year-old girl with a 16-year history of NF 1. Difficulties in driving, studying, lifting, and participating in recreational activities were all associated with the patient's pain, decreased cervical range of motion, decreased scapular strength, and postural deviations.: Physical therapy interventions included posture training, dynamic shoulder/scapular strengthening, cervical stabilization, stretching, ultrasound, interferential current, and a progressive home exercise program.: By the end of 13 weeks (20 sessions) of physical therapy, the patient was completely pain free, demonstrated increased cervical range of motion, and had improvements in scapular strength. She returned to full and unrestricted recreational activities, driving, studying, and household chores. Furthermore, scores on the Neck Disability Index improved from 44 of 50 (complete disability) to 2 of 50 (no disability).: Physical therapy may be a viable option for conservative management of musculoskeletal dysfunction and functional limitations resulting from NF 1.

The aim of this study was to survey the occurrence of musculoskeletal disorders in the population of gynecologists and general surgeons performing laparoscopic surgery.A questionnaire was distributed to 558 general surgeons and gynecologists and 378 were answered (68%). Descriptive data analysis and statistical calculations were performed.One or more disturbing symptoms were common among laparoscopists. More than 70% of the laparoscopists had one or more symptom. Pain was the most common symptom followed by fatigue and stiffness. Lower back, neck, and shoulders were most frequently affected. Headache and visual discomfort were also reported. Longer workload over time and ageing resulted in significantly more disorders (P<0.01). Female physicians had significantly more disorders (P<0.01).This study revealed musculoskeletal disorders in a majority of laparoscopists. The laparoscopic technique often requires static and tiring work positions, sometimes extreme, which can explain musculoskeletal disorders among general surgeons and gynecologist.