22 Long-Term Clinical and Radiographic Outcomes of Scoliosis

2022 ◽  
Keyword(s):  
Radiographic Outcomes

Clinical, functional and radiographic outcomes after revision total hip arthroplasty with tapered fluted modular or non-modular stems: a systematic review

2021 ◽  
pp. 112070002110043
Author(s):  
Antonios A Koutalos ◽  
Sokratis Varitimidis ◽  
Konstantinos N Malizos ◽  
Theofilos Karachalios
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Clinical Results ◽  
Fracture Rate ◽  
Revision Total Hip Arthroplasty ◽  
Term Survival ◽  
Total Hip ◽  
Radiographic Outcomes

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.

scholarly journals Intermediate to Long Term Clinical and Radiographic Outcomes of Triple Arthrodesis: A 422 Case Retrospective Review

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0025
Author(s):  
Jesse King ◽  
Karl Henrikson ◽  
Thomas Harper ◽  
Mike Anderson ◽  
Chris Stauch ◽  
...  
Keyword(s):  
Infection Rate ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Triple Arthrodesis ◽  
Non Union ◽  
Radiographic Outcomes ◽  
Diabetic Status ◽  
Radiographic Data

Category: Ankle Arthritis, Hindfoot Introduction/Purpose: Triple arthrodesis is a commonly performed surgical treatment for hindfoot arthritis and deformity. No study has clearly delineated correlates of both clinical and radiographic outcomes in a sample size this large. The purpose of this study is to explore predictive and demographic outcome measures with long-term followup after triple arthrodesis. Methods: With IRB approval, an institutional radiology database was queried for patients undergoing triple arthrodesis between 2004 and 2016, by a single surgeon at a single institution. A total of 465 cases were identified. Pre- and post-operative clinical and radiographic data was collected retrospectively. Demographic and predictive data included: age, Body Mass Index (BMI), American Society of Anesthesiologists Score (ASA), Charleston Comorbidity Index (CCI), diabetic status, osteoporosis, hypothyroidism, and neuromuscular disease status. Clinical outcomes including infection rate, reoperation rate and clinical nonunion were recorded. Unintended return to the operating room defined clinical failure. Radiographic data including non-union rate, pre- and post- operative ankle degenerative joint disease was also recorded. Statistical analysis was then performed to evaluate the relationship between predictive measures and various outcomes including reoperation, infection, and non-union rates. 23 cases were lost to follow-up. Results: A total of 442 feet (397 patients) were analyzed. The average age was 54 years (14 to 85) with the majority of cases being female (60%). Average follow up was 593 days (40 to 4079). Overall failure rate was 13.7% with clinical nonunion rate of 4.5%. Infection rate was 5.9%. Mortality rate was 0% at 2 years post-operatively. Predictors of failure included: increased BMI, elevated ASA, history of diabetes, underlying neuromuscular disorder (Figure 1). We found no significant difference between pre and post-operative degenerative joint disease rates in the midfoot (9.4%, 12.5%) and ankle (11.7%,13.7%), respectively. Conclusion: Triple arthrodesis is a highly effective procedure for treating hindfoot arthritis. Certain predictive measures including BMI, ASA score, diabetic status and underlying neuromuscular disorders significantly correlate with radiographic union. Additionally, diabetic status significantly correlates with infection status postoperatively. An understanding of these predictive measures may help surgeons in their preoperative planning to improve their clinical and radiographic success rates.

Functional and Radiographic Outcomes of Minimally Invasive Intramedullary Nail Device (MIIND) for Moderate to Severe Hallux Valgus

2020 ◽  
pp. 107110072096967
Author(s):  
Carlo Biz ◽  
Alberto Crimì ◽  
Ilaria Fantoni ◽  
Jacopo Tagliapietra ◽  
Pietro Ruggieri
Keyword(s):  
Hallux Valgus ◽  
Case Series ◽  
Radiographic Outcomes ◽  
Case Series Study ◽  
Significant Correction ◽  
The Mean ◽  
Series Study ◽  
Severe Hallux Valgus

Background: This study was aimed at assessing clinical and radiographic outcomes of the Minimally Invasive Intramedullary Nail Device (MIIND) to correct moderate to severe hallux valgus (HV) and the long-term persistence of its effects. Methods: This case series study involved 100 patients, 84 women and 16 men (mean age, 59 years), who underwent the MIIND procedure with a mean follow-up of 97 months. Assessment was performed preoperatively, postoperatively, at 6 and 12 months, and at last follow-up. Clinical outcomes were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and patient satisfaction. Intermetatarsal angle (IMA), metatarsophalangeal hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and tibial sesamoid position were assessed. Statistical analysis was performed. Results: The mean AOFAS score improved from 57.9 to 90.5 points, VAS scale was 1.5 ± 2.0, and patients’ satisfaction was 8.7 ± 1.4. The mean correction of the HVA and IMA showed a significant correction; however, the effect of time was not statistically significant on DMAA. Sex ( P = .047), severity ( P = .050), associated procedures ( P = .000), and preoperative angle ( P = .000) showed significant association with HVA correction and its persistence over time. Age was not statistically significant. Complications were 9 cases of superficial wound infection and 6 recurrences. Conclusions: The MIIND technique proved a viable procedure to correct moderate to severe HV with a low rate of complications and recurrence, producing significant correction of most radiographic parameters assessed and their persistence, even at long term. Level of Evidence: Level IV, case series study.

Long-Term Clinical and Radiographic Outcomes After Open Reduction for Missed Monteggia Fracture-Dislocations in Children

2009 ◽  
Vol 91 (6) ◽  
pp. 1394-1404 ◽  
Author(s):  
Koichi Nakamura ◽  
Kazuhiko Hirachi ◽  
Shigeharu Uchiyama ◽  
Masatoshi Takahara ◽  
Akio Minami ◽  
...  
Keyword(s):  
Open Reduction ◽  
Monteggia Fracture ◽  
Radiographic Outcomes ◽  
Fracture Dislocations ◽  
Missed Monteggia

scholarly journals Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Carlo Biz ◽  
Andrea Angelini ◽  
Marco Zamperetti ◽  
Filippo Marzotto ◽  
Silvano Pierluigi Sperotto ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Late Complications ◽  
Anatomical Reconstruction ◽  
Consecutive Series ◽  
Tibial Pilon ◽  
Radiographic Outcomes ◽  
Case Series Study ◽  
Pilon Fractures

Introduction. The goal of this retrospective, observational, case series study was to evaluate the medium-long-term clinical and radiographic results of the three most common surgical osteosynthesis techniques used for the treatment of articular tibial pilon fractures: ORIF, MIPO, and EF. Materials and Methods. A consecutive series of patients with articular pilon fractures who underwent surgery at our institution were enrolled in this study. Fractures were classified according to the Müller AO classification system. Overall outcomes took the following into account: radiographic quality of reduction, evaluated using Ovadia and Beals’ criteria; clinical assessment, evaluated using the AOFAS questionnaire; and general health, evaluated with the SF36-v2 Health Survey. Results. A total of 94 articular pilon fractures (34 type 43-B and 60 43-C) were evaluated with a mean follow-up of 56.34 months (range 33–101). The techniques used were ORIF, MIPO, and EF in 63 (67%), 17 (18.9%), and 14 cases (14.1%), respectively. According to Ovadia and Beals’ criteria, good, fair, and poor results were reported in 61 (64.89%), 26 (27.66%), and 7 (7.45%) cases, respectively. The mean AOFAS score was 82.41 for MIPO, 79.83 for ORIF, and 50.57 for EF, respectively. Thirty-nine patients (41.49%) presented early and/or late complications. Conclusion. Satisfactory outcomes using the three different techniques were reported. In particular, the radiographic outcomes were inversely proportional to the fracture comminutions and statistically different between internal and external osteosynthesis, but comparable between ORIF and MIPO techniques. On the other hand, the clinical outcomes were closely related to the soft tissue conditions and the anatomical reconstruction of the joint.

30. The Impact of Preoperative DEXA Scores Following Arthroplasty on Long-Term Clinical and Radiographic Outcomes: A Five-Year Follow-up Study

2008 ◽  
Vol 8 (5) ◽  
pp. 15S
Author(s):  
Richard D. Guyer ◽  
Fred Geisler ◽  
Mohammed Majd ◽  
Richard T. Holt ◽  
John Regan ◽  
...  
Keyword(s):  
Follow Up Study ◽  
Radiographic Outcomes ◽  
The Impact

scholarly journals Does Anterior Cruciate Ligament Reconstruction Improve Functional and Radiographic Outcomes Over Nonoperative Management 5 Years After Injury?

2018 ◽  
Vol 46 (9) ◽  
pp. 2103-2112 ◽  
Author(s):  
Elizabeth Wellsandt ◽  
Matthew J. Failla ◽  
Michael J. Axe ◽  
Lynn Snyder-Mackler
Keyword(s):  
Nonoperative Management ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Quadriceps Strength ◽  
Nonoperative Treatment ◽  
Joint Effusion ◽  
Long Term Outcomes ◽  
Radiographic Outcomes ◽  
Anterior Cruciate

Background: Current practice patterns for the management of anterior cruciate ligament (ACL) injury favor surgical reconstruction. However, long-term outcomes may not differ between patients completing operative and nonoperative treatment of ACL injury. Differences in outcomes between operative and nonoperative treatment of patients in the United States is largely unknown, as are outcomes in long-term strength and performance measures. Purpose: To determine if differences exist in 5-year functional and radiographic outcomes between patients completing operative and nonoperative treatment of ACL injury when both groups complete a progressive criterion-based rehabilitation protocol. Study Design: Cohort study; Level of evidence, 2. Methods: From an original group of 144 athletes, 105 participants (mean ± SD age, 34.3 ± 11.4 years) with an acute ACL rupture completed functional testing (quadriceps strength, single-legged hop, and knee joint effusion testing; patient-reported outcomes) and knee radiographs 5 years after ACL reconstruction or completion of nonoperative rehabilitation. Results: At 5 years, patients treated with ACL reconstruction versus rehabilitation alone did not differ in quadriceps strength ( P = .817); performance on single-legged hop tests ( P = .234-.955); activity level ( P = .349-.400); subjective reports of pain, symptoms, activities of daily living, and knee-related quality of life ( P = .090-.941); or presence of knee osteoarthritis ( P = .102-.978). When compared with patients treated nonoperatively, patients treated operatively did report greater global ratings of knee function ( P = .001), and lower fear ( P = .035) at 5 years but were more likely to possess knee joint effusion ( P = .016). Conclusion: The current findings indicate that favorable outcomes can occur after both operative and nonoperative management approaches with the use of progressive criterion-based rehabilitation. Further study is needed to determine clinical algorithms for identifying the best candidates for surgical versus nonoperative care after ACL injury. These findings provide an opportunity to improve the educational process between patients and clinicians regarding the expected clinical course and long-term outcomes of operative and nonoperative treatment of ACL injuries.

HemiCAP Knee Implants: Mid- to Long-Term Results

Cartilage ◽  
2019 ◽  
pp. 194760351989473
Author(s):  
Jens Ole Laursen ◽  
Christian Backer Mogensen ◽  
Helene Skjøt-Arkil
Keyword(s):  
Femoral Condyle ◽  
Survival Rates ◽  
Long Term Results ◽  
Radiographic Examination ◽  
Vas Score ◽  
Radiographic Outcomes ◽  
Potential Risk Factors ◽  
And Function

Purpose The aim of the study was to investigate the long-term outcomes of the Focal Femoral Condyle Resurfacing Prosthesis (HemiCAP) using clinical and radiographic assessments, and to evaluate the revision and survival rates. Methods Clinical evaluation was performed in those not revised and was able to participate. This was a prospective single-center cohort study of HemiCAP patients with 7 to 10 years of clinical and radiographic follow-up. The clinical examination included the Knee Society Score (KSS) and visual analogue scale (VAS) score. The radiographic examination included the Kellgren-Lawrence (KL) grade. Survival was estimated by Kaplan-Meier survival analysis, and potential risk factors for revision was evaluated by a regression analysis. Results Of the 62 patients with 64 HemiCAP prostheses, 37 were HemiCAP condyle, 11 HemiCAP PF, and 16 HemiCAP Wave; 27 (42%) were revised—HemiCAP condyle 17 (42%), HemiCAP PF 4 (36%), HemiCAP Wave 6 (37%), and 1 died. Examinations were performed on 31 patients (86%). When compared with the preoperative data, there were significant increases in the KSS objective (mean = 51.5, standard deviation [SD] = 5.9 vs. mean =94.2, SD = 5.0) and function (mean = 51.0, SD = 6.2 vs. mean = 93.7, SD = 4.8) scores, a decrease in the VAS score (mean = 7.1, SD = 0.7 vs. mean = 2.7, SD = 1.7) and a decrease in the KL lateral score (mean = 1.1, SD = 0.3 vs. mean = 0.6, SD = 0.6). The mean follow-up was 7.3 years (SD 1.4) with minimum 4.2 years and maximum 10.2 years. No failures occurred in the series beyond 5 years. Conclusions As hypothesized, we found good clinical and radiographic outcomes, and for those patients who did not require revisions, there were long-term improvements in disability and function. This suggests that patient selection is a key element to successfully applying these devices in clinical practice.

A Comparative Study Between Darrach and Sauvé-Kapandji Procedures for Post-Traumatic Distal Radioulnar Joint Dysfunction

Hand ◽  
2019 ◽  
pp. 155894471985544 ◽  
Author(s):  
Svenna H. W. L. Verhiel ◽  
Sezai Özkan ◽  
Marco J. P. F. Ritt ◽  
Neal C. Chen ◽  
Kyle R. Eberlin
Keyword(s):  
Patient Reported Outcomes ◽  
Distal Radioulnar Joint ◽  
Reoperation Rate ◽  
Measurement Information ◽  
Radioulnar Joint ◽  
Radiographic Outcomes ◽  
Radiographic Measurements ◽  
Patient Reported ◽  
Post Traumatic

Background: There are various treatments for post-traumatic distal radioulnar joint (DRUJ) dysfunction. The present study aimed to assess differences in long-term patient-reported outcomes on physical function, pain, and satisfaction between the Darrach and Sauvé-Kapandji procedures. Secondary aims were to describe the radiographic outcomes and to assess the difference in rate and type of complications and reoperations between these 2 procedures. Methods: We retrospectively analyzed 85 patients who had a post-traumatic DRUJ derangement and had been treated by either a Darrach (n = 57) or Sauvé-Kapandji procedure (n = 28). Fifty-two patients (61%) completed patient-rated outcomes surveys at a median of 8.4 years after their procedure. Radiographic measurements consisted of ulnar distance, radioulnar distance, and ulnar gap (only in Sauvé-Kapandji group). Results: There were no significant differences in Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Function score, pain score, satisfaction score, complications, and reoperations between patients who had a Darrach procedure or a Sauvé-Kapandji procedure. Seventeen patients (30%) in the Darrach group experienced a complication, and 14 patients (50%) in the Sauvé-Kapandji group experienced a complication ( P = .09). The most common complication was instability of the ulnar stump (n = 10), followed by symptoms of the dorsal sensory branch of the ulnar nerve (n = 8). Patients who underwent a Sauvé-Kapandji procedure had more reoperations for excision of heterotopic ossification. Conclusions: Darrach and Sauvé-Kapandji procedures show comparable long-term patient-reported outcomes in treatment of post-traumatic DRUJ dysfunction. Complication and reoperation rate are relatively high, with non-significant differences between the 2 procedures.

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