Rotator cuff injuries are a common cause of shoulder pain and dysfunction, resulting from acute trauma or degenerative changes. These injuries, including partial and full-thickness tears, can significantly impair daily activities and reduce quality of life. Treatment options range from conservative measures, such as physical therapy and NSAIDs, to surgical interventions like arthroscopic repair. The choice of treatment depends on factors such as tear size, patient age, and activity level. This review compares the effectiveness of conservative treatment and surgical repair for rotator cuff injuries, focusing on pain relief, functional recovery, and complication rates. Conservative treatment is typically the first-line approach for partial-thickness tears or patients with lower physical demands. Physical therapy and nonsteroidal anti-inflammatory drugs are common modalities that can improve symptoms, particularly for smaller tears. Corticosteroid injections are also used to provide short-term relief, although their long-term benefits are less clear. For larger or full-thickness tears, surgery is often necessary due to the risk of progressive degeneration and persistent symptoms. Arthroscopic repair is particularly beneficial for younger or more active patients, offering superior long-term outcomes in terms of strength and function. Studies indicate that while conservative treatment and surgery may offer similar short-term outcomes for smaller tears, surgery provides better long-term recovery for more extensive injuries. Ultimately, the decision between conservative and surgical treatment should be individualized, considering tear size, patient age, activity level, and overall health. Surgery is recommended for full-thickness tears or when conservative treatment fails to yield sufficient improvement, while conservative management remains effective for many smaller tears.
Introduction Plantar fasciitis is one of the most common reasons for visits to orthopedic clinics. This tendinopathy can cause medial heel pain, stiffness, and tenderness on the plantar surface of the foot. Both conservative and surgical methods are employed in its treatment. Aim The aim of this study is to evaluate selected conservative treatment methods, such as stretching, the use of orthotic insoles, splints, injections, extracorporeal shockwave therapy, and taping, as well as surgical treatment options. The study presents a comparison of these methods in terms of their effectiveness, advantages, and disadvantages. State of Knowledge The plantar fascia is a stiff, connective tissue structure extending along the plantar surface of the foot. Biomechanical load on the fascia, which supports the medial longitudinal arch, can lead to degenerative changes that underlie plantar fasciitis. Symptoms include pain, particularly in the mornings and late evenings, which intensifies with palpation of the heel area. Summary (Conclusions) Conservative treatments for plantar fasciitis are effective in 90% of patients. There are no studies that conclusively demonstrate the superiority of one treatment method over another. Thus, the choice of therapy should be tailored to the patient's lifestyle, activity level, and financial capability. Surgical intervention is necessary in cases of chronic plantar fasciitis which remains resistant to conservative treatments.
Introduction: The term "tendinopathy" refers to pathological changes in tendons. The previously used term "tendonitis" does not fully capture the nature of the condition, as inflammatory changes, when present, are secondary to degenerative damage. Tendinopathies are quite common in the general population. Aim: The aim of this review is to characterize various types of tendinopathies, with a focus on both conservative and surgical treatment methods, in order to organize available information that may be helpful for clinicians in their practice. State of Knowledge: Chronic tendinopathies develop as a result of multiple factors. The most significant include improper exercise techniques, excessive strain, and musculoskeletal system abnormalities. Summary (Conclusions): The approach to tendinopathy treatment should vary depending on the patient's clinical condition and provoking factors. Physiotherapy plays the most important role, along with supportive methods such as analgesic pharmacotherapy and cryotherapy. Surgical intervention may be necessary in cases where conservative treatment fails.
Introduction Tennis Elbow, known also as Lateral Epicondylitis (LE) is a very common overuse injury affecting not only tennis players. Mainly, it causes pain, weakness in grip strength and difficulties with daily activities. Most patients are successfully treated with non-surgical methods but some of them eventually require surgical intervention. Aim of study The objective of this study is to evaluate both surgical and non-surgical treatment methods for Tennis Elbow and seeks to introduce doctors and patients to the assets and downsides associated with them. State of Knowledge Tennis Elbow occurs in 1-3% of adults, most likely when frequently performing repeated movements of flexion and extension of the elbow. At the early stages inflammation is present, after that the vascular hyperplasia and active fibroblasts occur. Most common risk factors are manual labour, ipsilateral rotator cuff tear, ipsilateral Carpal Tunnel Syndrome (CTS), female sex, dominant-side involvement, and hypertriglyceridemia. Summary (Conclusion) There is a wide range of available conservative treatment methods for Lateral Epicondylitis including physical therapy, various injections, and medication. They should be considered as the first line treatment showing high success rate for mild and moderate cases. Surgical methods have high success rates as well though they are considered more invasive and performed only on chronic patients. Best approach ought to be carefully selected for each patient based on severity of symptoms and patient needs.
Introduction: Developmental Dysplasia of the Hip (DDH) is an anatomical deformation resulting from abnormal formation of the structures that make up the hip joint. Due to abnormal biomechanics patients with hip dysplasia usually develop radiographic osteoarthritis. Aim of the study: Despite the introduction of screening tests in children, DDH remains an issue among adults. For this group of patients, it is essential to begin treatment as early as possible to prevent early-onset osteoarthritis of the hip joint. In adults it is often too late to implement non-invasive methods such as braces or orthoses. Therefore, in this study, we aim to describe other treatment options for adults with DDH, considering both surgical and non-surgical methods. In the following work, we present both the advantages and complications associated with these surgical methods. Additionally, we describe the non-surgical alternative method of progressive resistance training (PRT) and consider the possibilities of combining it with surgical techniques. We also discuss the potential for pharmacological treatment. Material and Methods: Review of studies available through open-access sources on PubMed, Google Scholar, and the National Library of Medicine. Conclusions: The decision to quickly implement an appropriate treatment plan is crucial for improving the patient's quality of life. The choice of treatment method should consider the patient's age and the severity of the disease. Adults with DDH are most often qualified for surgical procedures, which include periacetabular osteotomy (PAO) and total hip replacement (THR). However, for some patients, surgical procedures may be contraindicated or impossible, and in such cases, other non-invasive methods, such as resistance training or appropriate pharmacotherapy, should be considered. Keywords: hip joint, osteoarthritis, surgery, conservative therapy, hip, Surgical Correction
Introduction Disc herniation is a displacement of an intervertebral disc, most often caused by degeneration of its outer layer, the annulus fibrosus. This condition can cause various symptoms such as numbness, pain, muscle weakness or lose of sensation. While many patients can be successfully treated with non-surgical methods, some of them some require surgical intervention. Aim of study The objective of this study is to evaluate both surgical and non-surgical treatment methods for herniated disc and seeks to introduce doctors and patients to the advantages and disadvantages associated with them. State of Knowledge Disk herniation occurs when disk material prolapses beyond intervertebral disk’s space. The symptoms may arise when displaced material start to compress major structures located nearby, such as spinal nerves. The most common causes include age-related degeneration, repetitive movements, obesity, trauma or genetic predisposition. Summary (Conclusion) Disk herniation can be managed with various non-surgical and surgical methods. Conservative treatment should be considered as first line treatment showing high success rate for mild to moderate cases in long term relief and preventing recurrence of symptoms. Surgical options offer better short-term relief for sever and more advanced cases but carry greater risks of side effects and involve longer recovery time. Best approach should be carefully selected based on the severity of symptoms and patient needs.