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Published online: 25 March 2014# ISS 2014

The dilemma of medical marijuana use by rheumatologypatientsFitzcharles M, et al.Arthritis Care Res 2014; doi 10.1002/acr22267

The authors from McGill University in Montreal (Canada)state that rheumatologists should not currently berecommending medical marijuana for relief of chronic pain.They state there is an absence of data on appropriate dosingand lack of efficacy for evidence. Surveys in Canada havesuggested that arthritis pain has been the diagnosis for twothirds of Canadians who are authorized users of medicalmarijuana. Cannabinoids have been shown to be efficaciousin treating neuropathic pain and pain from cancer. The authorspoint out that the mechanisms of pain in these conditions aredifferent from the peripheral/nociceptive pain of rheumaticdiseases.

Strong Evidence against platelet—rich plasma injectionsfor chronic lateral epicondylar tendinopathy: a systematicreview.Robert-Jande Vos, et al.Br J Sports Med doi: 10.1136-bjsports2013-093281

From the databases of Pubmed, EMBASE, CINAHL andseveral others such as Scopus and Google Scholar, six studieswere included of which four were considered to be of highquality, to determine the efficacy of platelet rich plasma (PRP)in the treatment of chronic lateral epicondylar tendinopathy.Three high quality studies (75 %) and two low quality studiesshowed no significant benefit at final follow-up measurementwhen compared with a control group. The authors concludethat the evidence is strong that FRP injections are not

efficacious in the management of chronic lateral elbowtendinopathy.

Factors associated with meniscal tears and chondral le-sions in patients undergoing anterior Cruciate ligamentreconstruction. A prospective study.Kluczynski MA, et al.Am J Sports Med (2013) 41, 12, 2,759–2,765

Data were collected prospectively from 541 patients undergo-ing ACL reconstruction. Logistic regression was used to cal-culate adjusted odds ratios and 95 % confidence intervals forpredictors of meniscal tears, tear management and chondralinjuries. There were a total of 211 lateral meniscal tears, 197medial meniscus tears and 82 chondral injuries. Obesity andage were associated with chondral injuries; males had moremedial and lateral meniscectomies. Surgery performed within6 weeks resulted in more lateral meniscal repairs and fewermedial meniscectomies. Sports related injuries had fewer me-dial meniscal tears. An increasing number of instability epi-sodes led to more medial meniscal tears and more medialmeniscectomies.

Radiographic findings after pubic symphysiotomy. Meantime to follow up of 41.6 yearsGalbraith JG et al.JBJS(AM) 2014;96:e3(1–7)

Pubic symphysiotomy is a surgical procedure in which thepubic symphysis is divided to facilitate vaginal delivery incases of obstructed labor. There apparently has been arenewed interest on the part of obstetricians in performing this

Skeletal Radiol (2014) 43:847–848DOI 10.1007/s00256-014-1878-6

operation. The retrospective case control study was performedto report on the long term radiographic findings for patientswho had undergone symphysiotomy with a group of age andparity matched controls. Twenty-five patients comprised eachgroup. The authors found late onset high grade sacro-iliacjoint osteoarthritis (using the Kellgren Lawrence scoring sys-tem) to be as high as 80 % in the symphysiotomy groupcompared to the control group (16 %) attributed to pelvic

instability. The authors stated this has not been previouslydiscussed and that orthopaedic surgeons may increasingly becalled upon to assess and treat the complications of long terminstability.

Abstracted by M. Sundaram, M.D.June 2014

848 Skeletal Radiol (2014) 43:847–848