జర్నల్ ఆఫ్ స్పోర్ట్స్ మెడిసిన్ & డోపింగ్ స్టడీస్

Knee pain is transmitted via peripheral nerves. Once a medical or orthopedic surgical musculoskeletal approach has failed to relieve this chronic problem, then a partial kneedenervation should be considered. In 1994 the medial and lateral retinacular nerveswere described, and these are the main source for knee joint pain. A nerve block ofeach of these nerves followed by observation of increased stair climbing and kneelingwith a decrease in the visual analog scale of > 5 predicts a 90% success rate for partial knee denervation. This approach, pioneered by Dellon, is applicable to patients withpersistent pain after partial or total knee arthroplasty, and to those with sports injuriesand pain after ligament reconstruction, and for those too young for joint replacement.This review includes description of the neuroanatomy, the nerve block technique, thesurgical approach and the results of Dellon’s partial knee denervation over the pasttwenty years.

Cryogenic burns are rare. They are therapeutic challenge to physicians in the absence any clear accepted management guidelines. We present a patient who was referred to our National Burns Unit having sustained a full thickness burn after the application of a brand name sub-zero producing aerosol spray. These are advocated as a method of rapid analgesia for muscular strain. To our knowledge this is the first reported case in the English literature.

The importance of exercise has been widely accepted by the public, professional organizations and the medical community, and the number of people around the world who practice day-to-day regular physical activity has recently increased. Physical activity is a primary requirement for the maintenance and promotion of health. However, intense exercise induces an increase in substrate utilization by the working muscles, resulting in an increased use of oxygen. This rise in oxygen consumption combined with the activation of specific metabolic pathways during or after exercise results in the generation of Reactive Oxygen Species (ROS). These substances are produced naturally by oxidative metabolic processes and are highly reactive. ROS can be useful in some situations; for example, macrophages use hydrogen peroxide to destroy bacteria. ROS increases during high-intensity exercise and its production is related to a large number of diseases, such as emphysema, inflammatory diseases, atherosclerosis, cancer and aging. During evolution, living organs developed an endogenous mechanism to minimize the damage caused by ROS, termed the antioxidant defense system. The imbalance between the production of ROS and the removal of these compounds by the antioxidant defense system causes a condition known as oxidative stress. This interesting paradox is exemplified by the hypothesis that physical exercises known to promote appropriate standards of health are also related to increased ROS production, which in turn closely correlate with various diseases. Recent publications have shown that ROS produced by exercise in adequate amounts may be linked to exercise benefits, both for health and for athletic performance. Thus, the aim of this article is to examine the close association between physical exercise and the production of ROS through an extensive literature review.