A retrospective cohort analysis of arthroscopic Bankart repair with or without remplissage in patients with off-track Hill-Sachs lesion evaluated for functional outcomes, recurrent instability, and range of motion

2020 ◽  
Vol 29 (2) ◽  
pp. 273-281 ◽  
Author(s):  
Vivek Pandey ◽  
Lohith Gangadharaiah ◽  
Sandesh Madi ◽  
Kiran Acharya ◽  
Shalini Nayak ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Bankart Repair ◽  
Recurrent Instability ◽  
Arthroscopic Bankart Repair ◽  
Retrospective Cohort Analysis

Risk Factors for Recurrence After Arthroscopic Instability Repair—The Importance of Glenoid Bone Loss >15%, Patient Age, and Duration of Symptoms: A Matched Cohort Analysis

2020 ◽  
Vol 48 (12) ◽  
pp. 3036-3041
Author(s):  
Travis J. Dekker ◽  
Liam A. Peebles ◽  
Andrew S. Bernhardson ◽  
Samuel I. Rosenberg ◽  
Colin P. Murphy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Loss ◽  
Cohort Analysis ◽  
Glenoid Bone Loss ◽  
Bankart Repair ◽  
Recurrence Rates ◽  
Recurrent Instability ◽  
Duration Of Symptoms ◽  
Arthroscopic Bankart Repair ◽  
The Mean

Background: Glenoid bone loss (GBL) has been implicated as a risk factor for failure of arthroscopic anterior glenohumeral instability repair. Although certain amounts of GBL are associated with higher recurrence rates, there are limited studies on successes versus failures in these cohorts. Purpose: To compare the outcomes of arthroscopic Bankart repair in patients with and without GBL to determine a threshold percentage of GBL that predicts success. Study Design: Cohort study; Level of evidence, 2. Methods: All consecutive patients who underwent arthroscopic Bankart repair for anterior shoulder instability between 2004 and 2013 were prospectively enrolled. Patients with ≤25% GBL were included. Patients with no GBL were grouped and compared with those having 5% to 25% GBL. Outcomes included Single Assessment Numerical Evaluation, Western Ontario Shoulder Index, and American Shoulder and Elbow Surgeons scores, with evidence of recurrent instability. Patients with and without GBL were statistically compared with respect to outcomes and recurrence rates. Results: Of 434 eligible patients, the cases of 405 (45 female, 360 male; mean age, 27.5 years [range, 18-47 years]) were followed for a mean 61 months (range, 48-96 months). There were 189 (46.6%) with no GBL and 216 (53.3%) with GBL; the mean GBL of the latter cohort was 15% (range, 5%-25%). The mean duration of instability symptoms was 7.9 months (range, 1-21 months) and was significantly longer in the GBL group ( P < .05). The mean recurrence rate was 14.8%, which was significantly greater in patients presenting with GBL versus those with none (48/216 [22.2%] vs 12/189 [6.3%]; P < .01). Within the GBL group, GBL ≥15%, duration of symptoms >5 months, and younger age (<20 years) were independent risk factors for failure ( P < .01). Patients with any GBL had >4-times greater odds of recurrence after arthroscopic stabilization (odds ratio, 4.21; 95% CI, 2.16-8.21). Moreover, patients presenting for arthroscopic Bankart repair with GBL ≥15% had nearly 3-times greater odds of recurrent instability. Conclusion: GBL ≥15% in an active patient population portends to increased odds of recurrent instability events and inferior clinical outcomes after arthroscopic Bankart repair. Furthermore, nonmodifiable risk factors, such as age (<20 years) and duration of symptoms before presentation (>5 months), significantly affect risk of recurrence and should be key factors when counseling patients on risk of failure and determining the ideal procedure for the individual patient.

scholarly journals Inpatient vs outpatient evaluation of suspected paraneoplastic cerebellar degeneration

2020 ◽  
pp. 10.1212/CPJ.0000000000000854
Author(s):  
Natalie Witek ◽  
Mitra Afshari ◽  
Yuanqing Liu ◽  
Bichun Ouyang ◽  
Deborah Hall
Keyword(s):  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Cohort Analysis ◽  
Cerebellar Degeneration ◽  
Paraneoplastic Cerebellar Degeneration ◽  
Class Iii ◽  
Retrospective Cohort Analysis ◽  
To Receive

Objective:To determine the differences in outcomes of adult ataxic patients initially evaluated for paraneoplastic cerebellar degeneration (PCD) as inpatients or outpatients.Methods:In this retrospective cohort analysis, diagnosis, workup, and functional outcomes based on change in modified Rankin Scale (mRS) were compared between patients with ataxia who underwent workup for PCD initially as inpatients versus outpatients between March 2011 and June 2018 at Rush University Medical Center.Results:There were 78 patients included in the analysis; 59% were women, and the average age at symptom onset was 57 ± 19.5 years. Nineteen patients (24.3%) underwent evaluation as inpatients and 59 (75.6%) as outpatients. Admitted patients were more likely to receive immunotherapy (73.7% vs. 20.3%, p<0.0001) and received it faster than outpatients (0.40 months for inpatients, interquartile range (IQR) 0.03-1 vs. 6.6 months for outpatients, IQR 2-11.7; p=0.01). A greater percentage of inpatients improved based on mRS compared to those who underwent evaluation as outpatients (52.63% vs. 22.81%, p=0.01).Conclusions:More patients improved from baseline in the inpatient cohort.Classification of Evidence:This study provides Class III evidence that for patients undergoing initial evaluation for paraneoplastic cerebellar degeneration, patients undergoing inpatient evaluation have better outcomes compared to those undergoing outpatient evaluation.

scholarly journals Bennett’s Fracture Repair—Which Method Results in the Best Functional Outcome? A Retrospective Cohort Analysis and Systematic Literature Review of Patient-Reported Functional Outcomes

2020 ◽  
Author(s):  
Benjamin Langridge ◽  
Michelle Griffin ◽  
Mo Akhavani ◽  
Peter E. Butler
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Bennett’S Fracture ◽  
Retrospective Cohort Analysis ◽  
Patient Reported ◽  
Wire Fixation

AbstractSurgical fixation of Bennett’s fracture of the thumb is critical to prevent functional impairment; however, there is no consensus on the optimal fixation method. We performed an 11-year retrospective cohort analysis and a systematic literature review to determine long-term patient-reported outcomes following Bennett’s fracture fixation. Retrospective cohort analysis identified 49 patients treated with Kirschner (K)-wire fixation, 85% returned to unrestricted movement during hand therapy. Forty-seven patients (96%) completed the disabilities of the arm, shoulder, and hand (DASH) questionnaires at a mean of 5.55 years from injury, with a mean score of 7.75. Systematic literature review identified 14 studies with a cumulative 541 patients. Fixation included open or percutaneous methods utilizing K-wires, tension band wiring, lag screws, T-Plates, external fixation, and arthroscopic screw fixation. Functional outcomes reported included DASH, quickDASH (qDASH), and visual analogue scores. Superficial wound infection occurred in 4 to 8% of percutaneous K-wire fixation. Open reduction internal fixation (ORIF) methods were associated with a 4 to 20% rate of reintervention and 5 to 28% rate of persistent paresthesia. Closed reduction with percutaneous K-wire fixation should be the first choice surgical method, given excellent, long-term functional outcomes, and low risk of complications. ORIF should be utilized where closed reduction is not achievable; however, the current evidence does not support one method of ORIF above another.

Are perceptual disorder signs in diplegic cerebral palsied children stable over time? A retrospective cohort analysis

2020 ◽  
Vol 72 (2) ◽  
Author(s):  
Silvia Alboresi ◽  
Alice Sghedoni ◽  
Giulia Borelli ◽  
Stefania Costi ◽  
Laura Beccani ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Retrospective Cohort Analysis ◽  
Over Time

Recurrence and Revision Rates With Arthroscopic Bankart Repair Compared With the Latarjet Procedure in Competitive Rugby Players With Glenohumeral Instability and a Glenoid Bone Loss <20%

2021 ◽  
Vol 49 (4) ◽  
pp. 866-872
Author(s):  
Luciano A. Rossi ◽  
Ignacio Tanoira ◽  
Tomás Gorodischer ◽  
Ignacio Pasqualini ◽  
Maximiliano Ranalletta
Keyword(s):  
Bone Loss ◽  
Functional Outcomes ◽  
Return To Sport ◽  
Glenoid Bone Loss ◽  
Bankart Repair ◽  
Latarjet Procedure ◽  
Glenohumeral Instability ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Rugby Players

Background: There is a lack of evidence in the literature comparing outcomes between the arthroscopic Bankart repair and the Latarjet procedure in competitive rugby players with glenohumeral instability and a glenoid bone loss <20%. Purpose: To compare return to sport, functional outcomes, and complications between the arthroscopic Bankart repair and the Latarjet procedure in competitive rugby players with glenohumeral instability and a glenoid bone loss <20%. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2010 and February 2018, 130 competitive rugby players with anterior shoulder instability were operated on in our institution. The first 80 patients were operated on with the arthroscopic Bankart procedure and the other 50 with the open Latarjet procedure. Return to sport, range of motion (ROM), the Rowe score, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences, reoperations, and complications were also evaluated. Results: In the total population, the mean follow-up was 40 months (range, 24-90 months) and the mean age was 24.2 years (range, 16-33 years). Ninety-two percent of patients were able to return to rugby, 88% at their preinjury level of play. Eighty-nine percent of patients in the Bankart group and 87% in the Latarjet group returned to compete at the same level ( P = .788). No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe and ASOSS scores showed statistical improvement after operation ( P < .01). No significant difference in functional scores was found between the groups The Rowe score in the Bankart group increased from a preoperative mean (± SD) of 41 ± 13 points to 89.7 points postoperatively, and in the Latarjet group, from a preoperative mean of 42.5 ± 14 points to 88.4 points postoperatively ( P = .95). The ASOSS score in the Bankart group increased from a preoperative mean of 53.3 ± 3 points to 93.3 ± 6 points postoperatively, and in the Latarjet group, from a preoperative mean of 53.1 ± 3 points to 93.7 ± 4 points postoperatively ( P = .95). There were 18 recurrences (14%). The rate of recurrence was 20% in the Bankart group and 4% in the Latarjet group ( P = .01). There were 15 reoperations (12%). The rate of reoperation was 16% in the Bankart group and 4% in the Latarjet group ( P = .03). There were 6 complications (5%). The rate of complications was 4% in the Bankart group and 6% in the Latarjet group ( P = .55). The proportion of postoperative osteoarthritis was 10% in the Bankart group (8/80 patients) and 12% (6/50 patients) in the Latarjet group ( P = .55). Conclusion: In competitive rugby players with glenohumeral instability and a glenoid bone loss <20%, both the arthroscopic Bankart repair and the Latarjet procedure produced excellent functional outcomes, with most athletes returning to sport at the same level they had before the injury. However, the Bankart procedure was associated with a significantly higher rate of recurrence (20% vs 4%) and reoperation (16% vs 4%) than the Latarjet procedure.

Preeclampsia and low sodium: a retrospective cohort analysis and literature review

2020 ◽  
Author(s):  
Serena Xodo ◽  
Fabiana Cecchini ◽  
Lisa Celante ◽  
Alice Novak ◽  
Emma Rossetti ◽  
...  
Keyword(s):  
Literature Review ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Low Sodium ◽  
Retrospective Cohort Analysis
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