UPFRONT | Roundup PATIENT CARE Surgery may not benefit tennis elbow patients: study San Diego, Calif. – Surgical approaches to treating tennis elbow may not offer addi-tional benefit to patients, ac-cording to research presented at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day in San Diego. The study, a ran-domized, double-blinded clinical trial, explored patient responses to a common sur-gery aimed at repairing a damaged elbow, compared to a placebo procedure. The study analyzed 13 pa-tients who underwent surgery to remove a degenerated por-tion of their extensor capri radialis brevis (ECRB), com-pared to a group of 13 who received an incision over their lateral elbow and no further repair. Patients included had experienced symptoms of tennis elbow for more than 6 months, and attempted at least two non-surgical treat-ment approaches such as physical therapy, massage therapy, acupuncture, or splinting/bracing, but had no symptom relief over that pe-riod. “Our data shows both groups experienced signifi-cant improvements in pain measures by 26 weeks after surgery, including frequency of pain with activity,” commented lead author Mar-tin Kroslak from the Ortho-paedic Research Institute in Sydney, Australia. “Further, these results were consistent or improved after one to four years of follow-up, with no significant difference between the two groups at any point.” Patients were required to complete questionnaires, in-dicating symptoms including pain frequency and severity with activity and rest, during sleep, and also difficulty pick-ing up objects or twisting motions. Frequency of elbow pain during activity was the primary outcomes measure for each group. Both groups were treated with the same rehab, including ice applica-tion, stretching, and strength-ening rehab program within two weeks of surgery. At two-and-a-half-year follow-up, 22 patients completed a ques-tionnaire and 11 returned for exam. “Managing chronic tennis elbow is a challenge for a large portion of the active population,” noted Kroslak. “Our research demonstrates the challenges in outlining a treatment plan for these pa-tients, and the continued work to be done in develop-ing both surgical and non-op-erative approaches.” PUBLIC HEALTH Manitoba government hints at change in subsidies for chiropractic services WINNIPEG – Manitoba Health Minister Kelvin Goertzen says he has met with representatives of the Manitoba Chiropractors Association to talk about future funding. The province has been hint-ing for weeks that subsidies for chiropractic services, which cost the government nearly $12 million annually, are going to be reduced. Under a five-year contract signed by the previous NDP government, chiropractors bill Manitoba Health $12.30 per patient visit, with a maximum of 12 visits per patient subsidized each year. The contract between the government and the Manitoba Chiropractors Association is set to expire in March 2020, but Goertzen won’t say whether it’s being renegotiated. He expects talks with the association to wrap up in the next week few weeks. An official with the province’s chiropractors’ association will only confirm discussions are taking place with the govern-ment. “We are not opening their contract without their consent, but we’ve had a number of discussions about what that might look like,” said Goertzen. “There are different things that we could do in-contract and out of contract. But I think the approach that we’ve taken is that we want to do this in a co-operative way.” The minister noted the gov-ernment has asked for broad buy-in from the health sector to get spending under control, and chiropractors understand that. Kelvin Goertzen, Manitoba Minister of Health, Seniors and Active Living “It’s fair to say the premier has indicated that this is an ‘all hands on deck effort’ to ensure that we have sustainability in the health-care system today, tomorrow and into the future,” he said. There are currently more than 250 chiropractic doctors in Manitoba. The profession was recently the subject of a CBC News investigative report that highlighted claims made by a handful of chiropractors in Manitoba that are “at odds with public health advice,” the CBC story said. A source close to the com-munity expressed concern the CBC report nitpicked certain information that do not neces-sarily represent the views of the majority of chiropractors in Manitoba. As of this writing, the source confirms the association is still in talks with the government. (Winnipeg Free Press) – The Canadian Press with files from Mari-Len De Guzman June 2017 Canadian Chiropractor 7 www.canadianchiropractor.ca
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