Table Of Content

Principles of Orthopedic Practice for Primary Care Providers Jeff rey N. Katz Cheri A. Blauwet Andrew J. Schoenfeld Editors 123 Principles of Orthopedic Practice for Primary Care Providers Jeffrey N. Katz • Cheri A. Blauwet Andrew J. Schoenfeld Editors Principles of Orthopedic Practice for Primary Care Providers Editors Jeffrey N. Katz Cheri A. Blauwet Department of Orthopedic Surgery Departments of Physical Medicine and Brigham and Women’s Hospital, Rehabilitation and Orthopedic Surgery Harvard Medical School Brigham and Women’s Hospital/ Boston, MA, USA Spaulding Rehabilitation Hospital, Harvard Medical School Andrew J. Schoenfeld Boston, MA, USA Department of Orthopedic Surgery Brigham and Women’s Hospital, Harvard Medical School Boston, MA, USA ISBN 978-3-319-68660-8 ISBN 978-3-319-68661-5 (eBook) https://doi.org/10.1007/978-3-319-68661-5 Library of Congress Control Number: 2017960169 © Springer International Publishing AG 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Foreword More than a third of symptoms and complaints reported to primary care physicians are musculoskeletal in nature. Therefore, primary care providers are the frontline clinicians for most orthopedic and musculoskeletal disorders. The basic premise of this book Principles of Orthopedic Practice for Primary Care Providers, edited by Drs. Katz, Blauwet, and Schoenfeld, is to provide a concise educational tool and quick reference to primary care providers in order to give them a framework for diagnosis and early treatment of common musculoskeletal disorders. The editors have put together a comprehensive collection of chapters that provide an overview of the most common disorders that affect the upper and lower extremities as well as the spinal column. A primer on basic physical examination of the various musculoskeletal systems and imaging guidelines are nicely organized and presented for practical application. The general practitioner should be able to develop a differential diagnosis quickly and then determine when a referral to a specialist may be indicated for more definitive treatment. One unique feature of this book is that all the senior authors are faculty of the Brigham and Women’s Hospital and Harvard Medical School. Most of the senior authors are nationally and internationally acclaimed experts in orthopedic surgery, physical medicine and rehabilitation, and rheumatology. The interdisciplinary nature of this book by the surgical and nonoperative experts in musculoskeletal medicine should provide a balanced approach to these common entities for which our patients seek care. This book should help fulfill our goal of providing the high- est quality patient care as all health care providers become more educated and effi- cient in the way they handle patients with musculoskeletal disorders. Boston, MA, USA James D. Kang v Preface Musculoskeletal disorders are prevalent, disabling, and costly. In fact, the direct medical and disability costs associated with musculoskeletal disorders exceed 3% of the gross domestic product in the USA, with similar impacts in other Western countries. These disorders occur in people of all ages, races, and ethnicities, lasting days in some instances and a lifetime in others. Our capacity to diagnose these conditions accurately and treat them effectively has expanded dramatically over the last several decades with the use of advanced imaging and sophisticated rehabilitative and surgical approaches. Technological advances notwithstanding, the foundation of quality musculoskeletal care remains to be careful history taking and physical examination coupled with an understand- ing of the differential diagnosis and natural history of common musculoskeletal disorders and the circumstances in which referral to musculoskeletal specialists is appropriate. Patients with musculoskeletal problems generally seek care from their primary care providers, who must make the critical initial assessment of the diagnosis, treatment pathway, and necessity for further testing and referral. This is a tall order. We are musculoskeletal specialists who work closely with our community of primary care providers. We created this book to help primary care providers everywhere develop greater comfort with the recognition and early management of the more prevalent musculoskeletal disorders. The chapter authors are active clinicians with practices based at Brigham and Women’s Hospital in Boston. The book includes chapters on disorders affecting the spine, the upper extremities, and the lower extremities. Within each of these broad anatomic categories, individual chapters focus on one or a cluster of related entities. Each chapter covers the clinical presentation of the problem(s), differential diagnosis, indications for diagnostic testing, evidence-based recommendations for initial nonoperative treatment, and indications for surgical referral. We are privileged to work with and learn daily from a community of dedicated primary care providers and of superb musculoskeletal specialists, many of whom are chapter authors of this volume. We are further privileged to care for a vibrant vii viii Preface community of patients in the Boston area, who teach us more about musculoskeletal disorders each day. Finally, we are privileged to have the support of our lov- ing families and in particular of our spouses—Susan Zeiger, Erin Schoenfeld, and Eli Wolff. Boston, MA Jeffrey N. Katz Boston, MA Cheri A. Blauwet Boston, MA Andrew J. Schoenfeld Contents Part I Axial Spine 1 Axial Neck and Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Jay M. Zampini Part II Cervical Spine 2 Cervical Radiculopathy and Myelopathy . . . . . . . . . . . . . . . . . . . . . . . 21 Amandeep Bhalla and James D. Kang Part III Lumbar Spine 3 Lumbar Disc Herniation and Radiculopathy . . . . . . . . . . . . . . . . . . . . 37 Christopher M. Bono 4 Degenerative Lumbar Spinal Stenosis and Spondylolisthesis . . . . . . 47 Daniel G. Tobert and Mitchel B. Harris Part IV Osteoporosis 5 Osteoporosis, Vertebral Compression Fractures, and Cement Augmentation Procedures . . . . . . . . . . . . . . . . . . . . . . . . . 63 Marco L. Ferrone and Andrew J. Schoenfeld Part V Hip 6 Hip Soft Tissue Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Eziamaka C. Obunadike and Cheri A. Blauwet 7 Femoroacetabular Impingement, Labral Tears, Abductor Tendon Tears, and Hip Arthroscopy . . . . . . . . . . . . . . . . . . 99 Scott D. Martin ix x Contents 8 Total Hip Arthroplasty and the Treatment of Hip Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Michael J. Weaver Part VI Shoulder 9 Shoulder Soft Tissue Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Robert C. Spang III and Courtney Dawson 10 Shoulder Instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Marie E. Walcott and Arnold B. Alqueza 11 Glenohumeral Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Michael J. Messina and Laurence D. Higgins Part VII Elbow 12 Elbow Osteoarthritis and Soft Tissue Injuries . . . . . . . . . . . . . . . . . . . 179 George S.M. Dyer and Stella J. Lee Part VIII Hand 13 Hand and Wrist Soft Tissue Conditions . . . . . . . . . . . . . . . . . . . . . . . . 207 Brandon E. Earp 14 Hand and Wrist Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Beverlie L. Ting and Barry P. Simmons Part IX Nerve Entrapment 15 Upper Extremity Nerve Entrapment . . . . . . . . . . . . . . . . . . . . . . . . . . 253 Ariana N. Mora and Philip E. Blazar Part X Knee 16 Knee Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269 Jeffrey N. Katz and Thomas S. Thornhill 17 Cartilage Defects, Osteochondritis, and Osteonecrosis . . . . . . . . . . . . 279 Brian Mosier, Tom Minas, and Andreas H. Gomoll 18 Meniscal and Ligamentous Injuries of the Knee . . . . . . . . . . . . . . . . . 291 Emily M. Brook and Elizabeth Matzkin 19 Anterior Knee Pain: Diagnosis and Treatment . . . . . . . . . . . . . . . . . . 313 Kaitlyn Whitlock, Brian Mosier, and Elizabeth Matzkin Contents xi Part XI Foot and Ankle 20 Ankle Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331 Eric M. Bluman, Christopher P. Chiodo, and Jeremy T. Smith 21 Soft Tissue Disorders of the Ankle . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339 Jeremy T. Smith, Eric M. Bluman, and Christopher P. Chiodo 22 Midfoot Arthritis and Disorders of the Hallux . . . . . . . . . . . . . . . . . . . 361 Christopher P. Chiodo, Jeremy T. Smith, and Eric M. Bluman 23 Foot and Ankle Plantar Fasciitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373 James P. Ioli Part XII Bone Stress Injuries 24 Bone Stress Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383 Adam S. Tenforde Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399

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Primary care providers (physicians, nurse practitioners, physician assistants) make decisions on a daily basis regarding treatments for musculoskeletal problems, including referrals to physical therapists, orthopedic surgeons and other specialists. Despite the large number of patients presenting wit