Clinical Evidence Regarding the Dynamic of Baker Cyst Dimensions after Intermittent Vacuum Therapy as Rehabilitation Treatment in Patients with Knee Osteoarthritis

The Baker cyst (BC), also known as the popliteal cyst or parameniscal cyst, is a fluid-filled sac that normally develops in the back of the knee, between the semimembranosus and medial head of the gastrocnemius. We aimed to evaluate the effectiveness of physiotherapy (10 days of treatment) that associates intermittent vacuum therapy (IVT) on the lower limbs in the treatment of the BC, respectively, in its size reduction. Sixty-five patients with knee osteoarthritis using Kellgren-Lawrence criteria and the presence of BC (ultrasonography evaluation), were divided into the Control and Vacuum groups. We collected the following features: sex, age, level of education, occupation, environment, body mass index, Knee Injury and Osteoarthritis Outcome Score, Western Ontario, and McMaster Universities Osteoarthritis Index, the Functional Independence Measurement, the Fall Risk Score, and the Visual Analog Scale were recorded at baseline and after 10 days. Both groups are similar in terms of demographic features. Regarding the clinical functional parameters, the results elicit a statistically significant change in all parameters between admission and discharge, including the echo volume at BC. Physical medicine and rehabilitation increase the autonomy of patients with BC. Clinical-functional improvement begins in the first 10 days of complex rehabilitation treatment; it is statistically significant and is not different between the two groups, which brings an additional argument for the effectiveness of conservative therapy in the treatment of BC. Although IVT has not demonstrated its superiority over classical balneo-physical therapy, additional research, and long-term monitoring are needed to provide additional arguments regarding this aspect.

The role of rehabilitation and anabolic treatment in severe os-teoporosis associated with significant vitamin D deficiency – case report

It is well known that vitamin D deficiency increases the risk of osteoporosis and that vertebral compressions fractures are a manifestation of osteoporosis. This paper presents the case of a patient with severe osteoporosis associated with vitamin D deficiency who developed over the course of two years multiple vertebral compression fractures. Method: We present the case of a 76-year-old caucasian female diagnosed with osteoporosis and significant vitamin D deficiency who was investigated for mechanical pain and functional deficit at the level of the spine and walking disorders. The patient was hospitalized in our Rehabilitation department twice. At the first hospitalization two years ago, the deficiency of vitamin D was found and the treatment was initiated. During the sec-ond hospitalization, biochemical and radiological investigations were per-formed to establish the diagnosis. Numerous vertebral compression fractures were dis-covered which were not re-vealed in the imaging investigations performed two years earli-er. She underwent symptomatic and appropriate medical rehabilitation treatment. Results and discussion: The evolution was fa-vorable after the hospitalization period, with a decrease in pain and functional deficit, as well as walking improvement. After endocrinological consultation it was decided to initiate therapy with Teriparatide which can decrease the risk of future fractures and reduce the back pain. Con-clusions: Adequate and prompt treatment of vitamin D deficiency and osteoporosis is very im-portant to avoid vertebral compression fractures or other complications of this disease. Physical and rehabilitation medicine also plays an important role in management of these patients.