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W4386728740 abstract "Orthopaedic surgery and rehabilitation medicine continue to remain synergistic fields of medicine. This Guest Editorial reviews articles published from March 2022 through February 2023. We considered articles from the American Journal of Physical Medicine & Rehabilitation, The American Journal of Sports Medicine, Clinical Journal of Sport Medicine, Archives of Physical Medicine and Rehabilitation, The BMJ (British Medical Journal), The Journal of Bone & Joint Surgery, JAMA (The Journal of the American Medical Association), Journal of Rehabilitation Medicine, Journal of Shoulder and Elbow Surgery, The New England Journal of Medicine, Pain Medicine, PM&R: The Journal of Injury, Function and Rehabilitation, Regional Anesthesia & Pain Medicine, Spine, and The Spine Journal. Shoulder Transtendinous rotator cuff repair for symptomatic partial-thickness rotator cuff tears has been linked to superior long-term biomechanical outcomes but is also associated with early postoperative stiffness and a slower rate of recovery. McBroom et al. examined an accelerated physical therapy protocol (passive and active-assisted range of motion at 2 to 4 weeks, active range of motion as early as 4 to 6 weeks, strengthening at 6 to 8 weeks, and earlier discontinuation of obligatory sling wear) and found significant improvement in active range of motion at 6 weeks and 3 months postoperatively compared with standard physical therapy1. The accelerated physical therapy cohort had no symptomatic retears, making this protocol a compelling option moving forward. Tiryaki et al. investigated the effectiveness of electromyographic biofeedback-guided rehabilitation in patients with massive rotator cuff tears and found a significant difference in the change in shoulder flexion strength and patient satisfaction from baseline to 6 weeks and from baseline to 12 months compared with those in the control group (exercises without electromyographic feedback)2. The authors concluded that electromyographic biofeedback can be used as an alternative method that increases patient satisfaction in exercise protocols. A glenohumeral joint corticosteroid injection is a common component of treatment for frozen shoulder, but the different landmark-guided injection approaches have not been thoroughly studied. Deng et al. compared the anterior and posterior approaches for glenohumeral joint injections and found that the anterior approach resulted in better pain severity reduction at 4, 8, and 12 weeks and faster and greater external rotation recovery3. If patients with adhesive capsulitis do not recover with conservative measures, manipulation under anesthesia (MUA) can be considered. Van der Stok et al. compared MUA alone, MUA with capsular distension, and MUA with capsular distension and countertraction and found that MUA with capsular distension and countertraction reduced the need for a second MUA and resulted in a faster improvement in functional outcome and reduction of pain compared with the other 2 groups4. Elbow In their systematic review and meta-analysis, Zhu et al. compared hypertonic dextrose prolotherapy with other nonoperative interventions for the treatment of lateral elbow tendinosis. At 12 weeks, dextrose prolotherapy reduced pain and Disabilities of the Arm, Shoulder and Hand (DASH) scores more than other interventions5. The studies used were limited by low power and lack of long-term follow-up but have suggested a role for dextrose prolotherapy in patients with lateral elbow tendinosis. Mansiz-Kaplan et al. conducted a double-blinded, randomized controlled trial (RCT) to compare the effects of perineural dextrose injection with those of a control consisting of a normal saline solution injection for ulnar neuropathy at the elbow6. The dextrose group showed greater improvements in pain, DASH score, ulnar nerve cross-sectional area, and motor nerve conduction velocity through week 12, demonstrating a role for prolotherapy for ulnar neuropathy. Hand Extracorporeal shock-wave therapy (ESWT) appears to be an emerging approach in the treatment of carpal tunnel syndrome. In an RCT of 72 patients with carpal tunnel syndrome, Öztürk Durmaz et al. compared the effectiveness of ESWT, a corticosteroid injection, and a resting hand splint (the control group) up to 12 weeks after treatment7. The study showed improvement in all groups, with no greater benefit of ESWT compared with the use of a splint. Unlike other studies in the literature, however, this study showed the corticosteroid injection to result in significantly better symptom relief compared with ESWT. In a prospective case series, Colberg et al. evaluated the functional outcomes of 60 patients with trigger finger who underwent an ultrasound-guided microinvasive trigger-finger release using an 18-gauge needle with a blade at the tip8. The QuickDASH (abbreviated version of the DASH), Nirschl, and numerical rating scale pain scores were evaluated and demonstrated significant functional improvement and resolution of mechanical symptoms with minimal adverse events. Hip Paskins et al. investigated the efficacy of hip osteoarthritis interventions in a single-blinded, parallel-group, 3-arm RCT9. Patients in all 3 groups received education and advice about medications, exercise, and weight loss. Two of the groups also received ultrasound-guided hip injections with either lidocaine alone or triamcinolone and lidocaine. There was a significant mean difference of −1.43 in pain intensity with ultrasound-guided injection of triamcinolone and lidocaine compared with conservative measures alone, demonstrating the effectiveness of corticosteroid injections for hip osteoarthritis. Varady et al. performed a retrospective cohort study to evaluate the incidence of osteonecrosis of the femoral head after intra-articular corticosteroid injections compared with hyaluronic acid hip injections10. The authors did not find a significant difference in the risk of developing osteonecrosis of the femoral head 2 years after corticosteroid injections, suggesting that the development of osteonecrosis of the femoral head is more likely related to disease progression rather than due to corticosteroid injections. Knee Genicular nerve radiofrequency ablation (RFA) is a conservative pain management technique used to treat chronic knee pain. In a systematic review, Fogarty et al. reported moderate-quality evidence for use of fluoroscopically guided genicular RFA for chronic knee pain11. Genicular RFA provided 49% to 74% of patients with ≥50% pain relief and was more likely to be successful than intra-articular corticosteroid injections or hyaluronic acid injections at the 6-month follow-up. Rivera-Brown et al. composed a narrative review emphasizing the importance of addressing biomechanical and neuromuscular deficits following surgical reconstruction of an anterior cruciate ligament (ACL) rupture, particularly asymmetries between the lower extremities12. There is evidence to support isokinetic strength testing and functional skill assessments to assist with appropriate return-to-sport progression following ACL reconstruction. In a clinical study of 28 subjects, Vieira de Melo et al. demonstrated that use of blood flow restriction with strengthening exercises following ACL reconstruction provided greater strength gains and physical function at 12 weeks postoperatively compared with strengthening exercises without blood flow restriction13. Foot and Ankle The surgical treatment of Achilles tendon rupture has generally been thought to result in a lower rerupture rate. In a multicenter RCT of 526 patients, Myhrvold et al. corroborated this by finding a rerupture rate of 6.2% in the nonoperative group and 0.6% in both the minimally invasive surgery group and the open repair group14. There was no difference in Achilles tendon Total Rupture Scores between the groups at 12 months after the injury. Surgically treated Achilles tendon ruptures undergo favorable tendon changes with early-loading treatment protocols; however, in an RCT, Rendek et al. revealed that loading of a nonoperatively treated Achilles tendon rupture at 2 weeks after the injury led to increased Achilles tendon thickness without an increase in the elastic modulus at 52 weeks after the injury15. There was no increase in adverse events associated with early loading and no difference in return to work or sport between the groups. High-volume injections have been used to treat midsubstance Achilles tendinopathy, with the theorized mechanism of action consisting of the disruption of neovascularization. In a double-blinded RCT, van Oosten et al. found no reduction in Doppler blood flow in 62 subjects with chronic midsubstance Achilles tendinopathy following a high-volume injection (50 mL) compared with a placebo (2-mL injection)16. The amount of post-injection hypervascularity did not correlate with clinical outcomes, suggesting that the disruption of neovessels may not be a mechanism of action of high-volume injection used to treat midsubstance Achilles tendinopathy. Spine In a prospective, longitudinal cohort study of adults with chronic low back pain, the feasibility of an evidence-based physical therapy program was adapted for telehealth using videoconferencing17. Up to 8 weekly sessions of telehealth physical therapy were used, and 126 participants enrolled. Acceptability, adoption, feasibility, and fidelity assessed using participant surveys and compliance with session attendance were included in implementation outcomes. Most participants reported general satisfaction with telehealth physical therapy (76.3%), but a smaller percentage of participants regarded the quality of telehealth physical therapy to be equal to in-person physical therapy (39.5%). At 10-week and 26-week follow-ups, participants reported significant improvement in low back pain-related disability, pain interference, physical function, pain intensity, and sleep disturbance from baseline, supporting the feasibility of telehealth physical therapy. Nested within the same study of patients, the authors used mixed-methods qualitative interviews and surveys of patient experience to characterize the working alliance, psychosocial risk, and patient-reported outcome measures to describe the experience of patients receiving telehealth physical therapy, including the concerns, advantages, and disadvantages that they may have encountered18. The advantages included convenience, time saving, and personalization; the disadvantages were lack of physical correction, difficulty making a personal connection with the therapist, and technology problems. This subset of participants endorsed a hybrid approach that might include both in-person and telehealth physical therapy. ESWT has emerged as a useful tool to treat a range of musculoskeletal conditions. Although the exact mechanism of ESWT is not completely understood, tissue regeneration and healing have been demonstrated after treatment. In a clinical trial, 34 patients with coccydynia were randomized to receive either ESWT or corticosteroid injection in the coccyx or sacrococcygeal junction19. Both groups had significantly decreased visual analog scale (VAS) pain with intervention; however, improvement at 6 months favored the group receiving ESWT. Arthroplasty A systematic review evaluated prehabilitation interventions for elective, unilateral total knee or hip arthroplasty in primary osteoarthritis20. Patient-reported health-care utilization and performance outcomes were assessed. Prehabilitation resulted in increased strength and reduced length of stay in 13 knee arthroplasty trials. Evidence for benefit with respect to pain, range of motion, and activities of daily living was low. The authors found no or insufficient evidence regarding all other outcomes. Also, 6 hip arthroplasty trials provided no or insufficient evidence regarding all evaluated outcomes. A large degree of heterogeneity among the programs limited strong conclusions. A multivariable, difference-in-difference model evaluated the effect of the U.S. Comprehensive Care for Joint Replacement (CJR) policy on post-acute care after total hip arthroplasty21. More than 350,000 Medicare beneficiaries before (2014 to 2015) and after (2017) CJR policy implementation were included. The results indicated that 47.6% of patients were discharged to the community and 52.4% of patients received institutional post-acute care. Patients in the CJR areas were 10% less likely to return to the community at 90 days after the policy. Despite high study power, no significant escalation of care was found after the CJR implementation. In a prospective RCT, Cheah et al. examined 125 patients after total shoulder arthroplasty and tested if multimodal care, including nonpharmacologic sleep hygiene interventions, zolpidem, and melatonin, would improve analgesia and sleep compared with the control group22. The intervention group consumed less morphine, had lower VAS pain scores on postoperative day 0, and objectively had improved sleep duration and quality. The length of hospital stay was unaffected. The results suggested that multimodal care with sleep hygiene interventions, zolpidem, and melatonin may benefit postoperative pain management and sleep. Pain Management In a double-blinded RCT of 99 patients undergoing arthroscopic rotator cuff repair, Alaia et al. compared the potential analgesic effects of buccally absorbed cannabidiol23. Three times a day for 14 days postoperatively, the experimental group received an oral, buccally absorbed tablet containing 25 mg of cannabidiol if the patient weight was <80 kg or 50 mg of cannabidiol if the patient weight was >80 kg, and the placebo group received a placebo tablet. Opioid consumption, satisfaction with pain control, and VAS pain scores were recorded, as well as liver function tests to assess for safety. VAS pain and satisfaction were better in the intervention group, with the differences being significant in the first 1 to 2 days; otherwise, there was no significant difference in the outcome measures. The authors concluded that buccally absorbed cannabidiol showed promise in immediate pain reduction after rotator cuff repair and had an acceptable safety profile. Another double-blinded RCT evaluated the effect of single-dose, preoperative intravenous tranexamic acid on early postoperative pain scores after rotator cuff repair24. Tranexamic acid primarily functions as an antifibrinolytic agent to reduce bleeding and stabilize blood clots. Although its primary purpose is not pain management, some evidence has suggested that tranexamic acid may have a secondary analgesic effect in certain clinical scenarios. Mackenzie et al. randomized 89 patients to either 2 g of intravenous tranexamic acid or placebo at induction of anesthesia. Tranexamic acid did not improve postoperative pain scores, but patients in the intervention group had lower rates of adhesive capsulitis and demonstrated a greater range of motion at 6 months. In a single-center RCT of 67 patients undergoing total shoulder arthroplasty, Jolissaint et al. compared a completely opioid-free, multimodal pain plan with a traditional opioid-containing treatment25. Pain was measured postoperatively on a numerical rating scale at various time points up to 6 weeks. The opioid-free pain management pathway proved to be safe and effective in patients undergoing total shoulder arthroplasty, with superior pain relief through 2 weeks. The authors also noted that there were no differences between the groups with regard to falls, delirium, or constipation, and no readmissions in the opioid-free pathway. A retrospective study was conducted at an urban academic center to assess the effectiveness of a multimodal, opioid-minimizing pain management regimen dubbed the “Lopioid” protocol and whether it was effective in decreasing narcotic use compared with a standard pain management protocol that used Schedule II narcotics after orthopaedic trauma surgery26. The authors secondarily studied the effect of postoperative pain control and medication-related complications. Of the 1,779 patients who underwent a surgical procedure for a traumatic fracture, the authors found that the Lopioid protocol was effective in decreasing the amount of Schedule II narcotics at discharge, changing the type of opioid medications prescribed, and resulting in lower pain scores at discharge. There was no difference in the need for formal pain management consultation or in medication-related complications. Orthobiologics In an RCT, Anz et al. compared the efficacy of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) as therapeutic agents for knee osteoarthritis27. Ninety patients received a single-dose, intra-articular knee injection and were followed for up to 24 months. Significant improvement in pain and function was seen in both modalities, with no significant difference at any time point between BMAC and PRP. This suggests that BMAC is not superior to PRP in treating knee arthritis. In an RCT, Zaffagnini et al. compared microfragmented adipose tissue (MFAT) injections and PRP for knee arthritis treatment28; 118 patients received a single injection and were followed for up to 24 months. Both modalities showed significant improvement in pain and function, with no significant difference between them. However, trends suggested that MFAT had more adverse events, whereas PRP was more often considered a failure. MFAT showed faster attainment of minimal clinical effectiveness for moderate to severe arthritis, and radiographic measurements showed no significant differences on the progression of the disease. Yokota et al. compared the effectiveness of 2 treatments for knee arthritis: cultured adipose-derived stem cells and stromal vascular fraction injections29. Outcomes of pain and function were assessed at multiple time points for 80 enrolled patients. Both treatments resulted in substantial improvements in pain and function overall. The adipose-derived stem cell group had a trend toward being more likely to achieve a positive clinical effect at 12 months, but the 2 groups equalized at 24 months. For moderate to severe knee arthritis, the adipose-derived stem cells yielded significantly better functional outcome and pain scores compared with the stromal vascular fraction, suggesting that the selection of adipose-derived stem cells over stromal vascular fraction may be warranted. PRP and corticosteroids are effective treatments for lateral elbow tendinosis; however, their cost-effectiveness had not been compared. A cost-benefit analysis was performed using Markov modeling on a base-case design of a 45-year-old patient with recalcitrant lateral elbow tendinosis, comparing a single injection of PRP with 40-mg/mL triamcinolone30. PRP showed a net monetary benefit of over $20,000 from a health-care perspective and $21,500 from a societal perspective over 5 years. PRP was concluded to be the dominant treatment. In a prospective study, 30 patients took PRP for lateral elbow tendinosis and underwent sequential imaging with magnetic resonance imaging (MRI) at 6-month increments31. The MRI scans were scored from 0 to 3, with 0 indicating a normal tendon and 3 indicating the worst possible condition. Pre-procedure baseline MRI scans had a mean score of 2.30 and the postoperative mean MRI scores were 1.97 at 1 month, 1.77 at 3 months, 1.13 at 6 months, 0.73 at 12 months, 0.60 at 18 months, and 0.33 at 24 months, indicating continuous tendon recovery over a 2-year period. A systematic review and meta-analysis of 11 studies and 641 patients was conducted to evaluate the efficacy of PRP compared with nonoperative treatments in treating partial-thickness rotator cuff tears32. PRP showed significantly better results for improving shoulder function and pain relief compared with both placebo and corticosteroid at all 3 follow-up windows. The study concluded that PRP is an effective treatment option for partial-thickness rotator cuff tears, particularly in the later stages (>8 weeks). Sports A retrospective analysis of 12 high school programs (14,461 athletes) from 2010 to 2017 found that high school athletes who sustained a concussion had a similarly elevated risk for musculoskeletal injury within a year, compared with collegiate athletes33. Gender and sport were controlled for in the analysis. These results suggest that neuromuscular rehabilitation and injury prevention protocols may be useful during the post-concussion period in high school athletics and that return-to-play criteria may need modification to reduce future musculoskeletal injury risk in this population. A monocentric study evaluated the efficacy of botulinum toxin injections in patients with chronic exertional compartment syndrome34. Initial pain reduction was reported by 11 of 16 patients, with 4 patients having partial efficacy and 7 patients having complete efficacy. Minor adverse effects were observed, but they had no functional impact. However, there was a likelihood of recurrence, especially among those with partial initial efficacy. Therefore, botulinum toxin may be used for chronic exertional compartment syndrome with moderate efficacy and low risk, but recurrence is expected. Parasports Parasports are competitive or recreational sports for people with disabilities and have started to gain more attention, rightfully so, over the past decade. Because of the strenuous nature of wheelchair sports with respect to the shoulder, shoulder pain is common among wheelchair athletes. Braaksma et al. performed a cross-sectional study analyzing different wheelchair propulsion techniques among those with and without shoulder pain35. They found that individuals with a spinal cord injury who experience shoulder pain propel their wheelchairs kinematically differently from those who do not experience pain; the pain group had a shorter cycle time, shorter recovery time, smaller contact angle, and lower variability in work performed per push compared with the group that did not experience pain. Identifying and working on these factors with these athletes may help to prevent or improve shoulder pain. Soo Hoo et al. investigated the prevalence of current shoulder pain and ultrasound metrics of shoulder pathology between wheelchair athletes, non-athletic wheelchair users, and non-wheelchair users36. The authors found that the majority of both athletic and non-athletic wheelchair users experienced shoulder pain, leading them to conclude that amateur wheelchair sports do not seem to be associated with an increased risk of shoulder pain, although overhead sports such as wheelchair basketball may represent a unique high-risk group. Sidiropoulos et al. examined weight shift and X-Factor during golf swing in veterans with lower-limb loss and found that golfers with a leading-limb amputation showed greater X-Factor values and golfers with a trailing-limb amputation demonstrated superior weight shift37. The authors emphasized the importance of golf-centered rehabilitation programs focusing on increased weight-bearing on the prosthetic limb, which can ultimately lead to increased participation and improved physical and mental health outcomes. Ultrasound Achilles and patellar tendinopathy can be persistent and can result in missed training time for runners. Cushman et al. was able to predict that asymptomatic runners (138 patients, with a mean age of 36.2 ± 12.0 years) were more likely (hazard ratio, 2.55) to develop Achilles or patellar tendon pain in the year following a half-marathon or a full marathon, if a runner displayed ultrasonographic changes on a pre-race evaluation38. Ultrasound can provide prompt insight into hand injuries to assist in timely management. Hoffman et al. published a cadaveric ultrasound study that confirmed visualization of the 4 pulleys of the thumb, the first ultrasound validation study of the annular thumb pulley system39. Prosthetics and Orthotics In a study conducted by Naderi et al., female runners with medial tibial stress syndrome who ran with arch-support foot orthoses had significantly increased perceived treatment effect and physical function at 6 weeks, reduction of pain at 6 weeks and 12 weeks, and reduction in medial tibial stress syndrome severity at 12 weeks after the injury than those who did not40. These results suggested that arch-support foot orthoses can accelerate return to play from medial tibial stress syndrome. Tuang et al. conducted a systematic review focused on the use of prophylactic knee braces for preventing ACL injury41. Prophylactic knee braces were found to be most useful in reducing ACL load or strain and maintaining knee motion in the coronal and transverse planes. However, these studies were limited by variance in experience level, the type of prophylactic knee brace, and laboratory methodologies, so the authors deferred specific recommendations on prophylactic knee brace usage. Honkonen et al. conducted an RCT comparing knee braces as nonoperative treatment after first-time traumatic patellar dislocation42. There was no significant difference in preventing redislocations between neoprene and motion-restricting knee braces. However, patients using the motion-restricted brace had less range of motion and more quadriceps muscle atrophy at 4 weeks and 3 months and worse functional outcomes at 6 months. Physiatry Societies and Upcoming Events There are 3 medical societies in the United States for physical medicine and rehabilitation (PM&R): the Association of Academic Physiatrists (AAP), the American Academy of Physical Medicine and Rehabilitation (AAPM&R), and the American Congress of Rehabilitation Medicine (ACRM). The 2024 AAP Annual Meeting will be in Orlando, Florida, from February 20 to 24, 2024. The 2024 AAPM&R Annual Assembly will be in San Diego, California, from November 7 to 10, 2024. The 2024 ACRM Annual Conference will be held in Dallas, Texas, from October 31 to November 3, 2024. Evidence-Based Orthopaedics The editorial staff of JBJS reviewed a large number of recently published studies related to the musculoskeletal system that received a higher Level of Evidence grade. In addition to articles cited already in this update, 4 other articles relevant to orthopaedic rehabilitation surgery are appended to this review after the standard bibliography, with a brief commentary about each article to help guide your further reading, in an evidence-based fashion, in this subspecialty area. Evidence-Based Orthopaedics Demyttenaere J, Martyn O, Delaney R. The impact of the COVID-19 pandemic on frozen shoulder incidence rates and severity. J Shoulder Elbow Surg. 2022 Aug; 31(8):1682-86. There is still much to be learned with regard to the long-term effects of COVID-19. In this retrospective cohort study, the incidence rates and severity of frozen shoulder were compared between the pandemic study period (March 2020 to January 2021) and a control period (1 year earlier). A relative increase of 39.8% in the incidence rate of idiopathic frozen shoulder was found between the two periods. However, no significant difference found in the severity was observed. This study provided data on the perceived increase in incidence of idiopathic frozen shoulder during the pandemic, but further research is needed to evaluate a causal relationship. Nalla S, Huang K, Spangenberg J, Chen L, Jayabalan P. The demographic and disability characteristics of individuals who regularly attend an urban adaptive fitness center: an observational study. PM&R. 2022 Dec;14(12):1454-60. People with disabilities have disproportionately lower rates of exercise compared with the non-disabled population, despite all of the known physical and psychosocial benefits of exercises. In this cross-sectional study, the authors sought to evaluate the demographic and disability characteristics of individuals who regularly attended a specialized urban adaptive fitness center, to provide a foundational understanding about the population that uses such resources. The mean patient age was 52.9 years, and the 3 diagnosis categories were spinal cord injury (30.2%), traumatic brain injury or stroke (36.5%), and other neurologic disease or chronic medical disease (33.3%). In this study, 96.8% exercised at least twice per week and 43.5% participated in adaptive sports. This study serves as a foundation for future studies to assess the impact of these facilities on the health and quality of life of individuals with disabilities. Stafford II CD, Keitt F, Irvin L. Health disparities in the management of ACL injuries: how socioeconomic status, insurance, and race influence care. PM&R. 2022 May;14(5):669-77. This narrative review investigated factors that may influence the management of ACL injuries. Twelve studies met inclusion criteria and represented a total of 219,708 participants. The barriers to the surgical management of ACL injury were the higher cost of surgical procedures, greater time to evaluation and treatment, lower socioeconomic status, lack of private insurance, and being identified as a racial minority. These findings suggest that health disparities and inequities exist in the care of ACL injury in patients with lower socioeconomic status, without commercial insurance, and in minority populations. This study highlights the importance of recognizing these disparities and inequities, which can hopefully lead the medical community to find methods to better care for these populations. Weghuber D, Barrett T, Barriento-Pérez, Gies I, Hesse D, Jeppesen OK, Kelly AS, Mastrandrea LD, Sørrig R, Arslanian S. Once-weekly semaglutide in adolescents with obesity. N Engl J Med. 2022 Dec; 387(24):2245-57. Healthy weight loss for overweight and obese individuals is one of the mainstays for the treatment of musculoskeletal disorders, especially those involving weight-bearing joints. In this double-blinded, parallel-group RCT, the 180 participants who completed the study had been randomly assigned in a 2:1 ratio to receive once-weekly subcutaneous semaglutide or placebo for 68 weeks, plus a lifestyle intervention. From baseline to 68 weeks, the mean change in body mass index was −16.1% in the semaglutide group and 0.6% in the placebo group. Also, at 68 weeks, 73% (95 of 131 patients) in the semaglutide group reached the weight loss goal of ≥5% compared with 18% (11 of 62 patients) in the placebo group. There were higher rates of gastrointestinal adverse events in the semaglutide group (62%) compared with the placebo group (42%) and of cholelithiasis in the semaglutide group (4%) compared with the placebo group (0%). Serious adverse events were reported in 11% of the semaglutide group and 9% of the placebo group. Although further studies are needed, this study provides more evidence regarding the use of semaglutide as a weight loss tool, which can, in turn, help to treat orthopaedic disorders." @default.
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W4386728740 title "What’s New in Orthopaedic Rehabilitation" @default.
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