Recent Advances and Developments in the Management of Soft Tissue Injuries

Abstract

Although most attention is given to bones in trauma and orthopaedics, soft tissues form a crucial component of the musculoskeletal system. Soft tissue injuries can occur with fractures and without and include a wide and heterogeneous range of injuries. In this issue we cover a range of these topics including tendon and ligament injuries around the knee, wrist and spine with a relevant emphasis on sports injuries. We also discuss recent tissue engineering developments and preclinical studies in dealing with these difficult injuries. We also look at the use of prophylactic antibiotics in preventing infection of traumatic injuries, the current evidence for the management and soft tissue debridement of open fractures, and compartment syndrome. ACL rupture is a common injury, particularly among young sporting adults. Early onset osteoarthritis can be a devastating and difficult to manage consequence of such an injury. The techniques for reconstructing the ACL are advancing all the time, but the effect that this has on the progression of osteoarthritis is less well understood. Many factors affect the development of osteoarthritis following an ACL injury, including direct and indirect trauma to the articular cartilage, associated meniscal injuries, chronic tibiofemoral joint instability, and multiple enzymatic pathways. Norris et al., discuss the effect of Anterior Cruciate Ligament (ACL) reconstruction on the progression of osteoarthritis. Their review summarises the current evidence surrounding each of these areas, and describe some of the recent developments that may have an impact on the management of these injuries in the future. Lateral wedges were originally proposed to manage medial compartment osteoarthritis of the knee but recent reviews suggest that lateral wedges do not affect disease progression. Malvankar et al., present a systematic review of the recent literature looking at how effective lateral wedge orthotics are in treating medial compartment osteoarthritis of the knee. The authors performed a systematic review to