Fragmented palmar metacarpophalangeal sesamoids in dogs: a long-term evaluation

2001 ◽  
Vol 14 (01) ◽  
pp. 7-14 ◽  
Author(s):  
P. D. Koblik ◽  
J. G. Whitehair ◽  
P. H. Kass ◽  
C. Bradley ◽  
K. G. Mathews
Keyword(s):  
Conservative Therapy ◽  
Treatment Time ◽  
Incidental Finding ◽  
Age At Onset ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Blinded Manner ◽  
Term Evaluation

SummaryLong-term clinical and radiographicresponse to surgical and conservativemanagement of 22 dogs with fragmentedsesamoids was evaluated. Mean follow-up was 3.6 years (range = 3 monthsto 11.0 years).Initial (retrospective) and follow-up(prospective) radiographs of the affectedpalmar sesamoids and associatedmetacarpophalangeal joints were evaluatedusing a graded scoring system. A lameness evaluation and physicalexamination were performed at followupin a blinded manner. In addition,owners were asked to complete a questionnaireregarding their pet’s thoraciclimb lameness.There was not any difference betweengroups (sesamoidectomy, conservativemanagement, incidental finding)in age at onset, duration of lamenessprior to therapy, body weight at treatment, time to follow-up, number ofaffected joints, nor owner perceptionsof whether they thought the lamenessimproved, resolved, or recurred, andwhether or not they were pleased withthe outcome.Sesamoid fragmentation treated bysesamoidectomy resulted in significantlygreater progression of radiographicchanges that were consistentwith degenerative joint disease.Chronic lameness resolved or improvedto the point of owner satisfactionwith conservative therapy in most cases. Continued lameness, or recurrent,although improved lameness associatedwith heavy activity, occurred followingsurgical extirpation of the affectedsesamoids in many cases. Given thesefindings, a more conservative approachto the treatment of chronic lamenessassociated with sesamoid fragmentationmay be warranted.Long-term clinical and radiographic response to surgical and conservative management of 22 dogs with fragmented sesamoids was evaluated. Mean follow-up was 3.6 years. Sesamoid fragmentation treated by sesamoidectomy resulted in significantly greater progression of radiographic changes that were consistent with degenerative joint disease. Chronic lameness resolved or improved to the point of owner satisfaction with conservative therapy in most cases. Continued or recurrent lameness was common following sesamoidectomy. Conservative therapy should be attempted prior to sesamoidectomy for dogs with chronic lameness associated with palmar metacarpophalangeal sesamoid fragmentation.

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.

Clinical Evaluation and Long-Term Follow-Up of Dogs Having Coronoidectomy for Elbow Incongruity

2003 ◽  
Vol 39 (5) ◽  
pp. 473-478 ◽  
Author(s):  
Margaret Puccio ◽  
Dominic J. Marino ◽  
Joseph D. Stefanacci ◽  
Brian McKenna
Keyword(s):  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Disease Entity ◽  
Radiographic Findings ◽  
Clinical Presentations ◽  
Long Term Follow Up ◽  
The Mean ◽  
Joint Incongruity

A retrospective study was performed describing the clinical presentations, radiographic findings, and surgical outcomes of 17 dogs (18 elbows) following medial coronoidectomy for the treatment of elbow joint incongruity as a sole disease entity. Complete resolution of lameness was achieved in 100% of the cases. The mean radiographic arthrosis grade progressed in 70% of the cases. Results of this study indicate that resolution of clinical lameness may be achieved with medial coronoidectomy in dogs with elbow incongruity; however, progression of degenerative joint disease with unknown, long-term clinical significance can be expected after surgery.

Traumatic Coxofemoral Luxation in Dysplastic Dogs Managed with a Triple Pelvic Osteotomy: Results in four Dogs

1997 ◽  
Vol 10 (03) ◽  
pp. 136-140 ◽  
Author(s):  
D. D. Lewis ◽  
S. C. Kerwin ◽  
S. T. Murphy
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
External Rotation ◽  
Pelvic Osteotomy ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Contralateral Limb ◽  
Norberg Angle

SummaryTriple pelvic osteotomy (TPO) was used in the treatment for traumatic coxofemoral luxations in four adult, large breed dogs with hip dysplasia. Initial closed reductions failed in three and one dog had an initial closed reduction and subsequent open reduction of the coxofemoral luxation that failed. Hip dysplasia was thought to be a prominent factor contributing to the reluxation. TPO successfully maintained reduction of the coxofemoral luxation in all of the dogs. An increase in dorsal acetabular coverage of the femoral head following TPO was demonstrated by an increased Norberg angle. The improved congruency was thought to maintain reduction of the femoral head in the acetabulum and decrease stresses on the joint capsule, allowing healing to occur. Long-term (median: 343, mean ± SD: 406 ± 226 days follow-up) function of the affected limb was comparable to the contralateral limb. Three of the four dogs did not have radiographic progression of coxofemoral degenerative joint disease of the affected joint and differences in the progression of degenerative joint disease were not evident between the affected and the contralateral coxofemoral joint. A decrease in abduction and external rotation and an increase in internal rotation following TPO was noted in the affected coxofemoral joint. Our results establish the utility of this procedure in dysplastic dogs with traumatic coxofemoral luxations.Triple pelvic osteotomy used in the treatment for traumatic coxofemoral luxation in four adult, large breed dogs with hip dysplasia successfully maintained reduction and resulted in satisfactory limb function in all patients.

scholarly journals Proximal interphalangeal joint replacement with an unconstrained pyrocarbon prosthesis (Ascension®): a long-term follow-up

2012 ◽  
Vol 38 (6) ◽  
pp. 680-685 ◽  
Author(s):  
G. Heers ◽  
H. R. Springorum ◽  
C. Baier ◽  
J. Götz ◽  
J. Grifka ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Limited Range ◽  
Degenerative Joint Disease ◽  
Proximal Interphalangeal Joint ◽  
Joint Disease ◽  
Long Term Results ◽  
Complication Rates ◽  
Limited Range Of Motion

There have been limited publications that report long-term outcomes of pyrocarbon implants. This report describes both clinical and radiographic long-term results for patients who have been treated with pyrocarbon proximal interphalangeal implants. Thirteen implants in ten patients are reported for an average follow-up of 8.3 years (range 6.2–9.3). All patients were suffering from degenerative joint disease. Five of the 13 digits were free of pain, the remaining eight digits had mild to moderate pain (visual analogue scale 2–5). The average active range of motion was 58° (SD 19°) at latest examination. X-ray results were unremarkable in six digits with an acceptable position of the prosthesis. However, in seven patients significant radiolucent lines (≥ 1 mm) were observed. Three prostheses demonstrated a migration of the proximal component, and one a subsidence of the distal component. Our study does not support the use of this implant for treatment of osteoarthritis of the finger joint owing to high complication rates and limited range of motion.

scholarly journals A 16-year prospective cohort study to evaluate effects of long-term fluctuations in obesity indices of prediabetics on the incidence of future diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shahla Safari ◽  
Maryam Abdoli ◽  
Masoud Amini ◽  
Ashraf Aminorroaya ◽  
Awat Feizi
Keyword(s):  
High Risk ◽  
Transition Probabilities ◽  
Clinical Settings ◽  
High Tendency ◽  
Mean Values ◽  
Latent Markov Model ◽  
Term Evaluation ◽  
Obesity Indices

AbstractThis study aimed to evaluate the patterns of changes in obesity indices over time in prediabetic subjects and to classify these subjects as either having a low, moderate, and high risk for developing diabetes in the future. This study was conducted among 1228 prediabetics. The patterns of changes in obesity indices based on three measurements including first, mean values during the follow-up period, and last visit from these indices were evaluated by using the latent Markov model (LMM). The mean (standard deviation) age of subjects was 44.0 (6.8) years and 73.6% of them were female. LMM identified three latent states of subjects in terms of change in all anthropometric indices: a low, moderate, and high tendency to progress diabetes with the state sizes (29%, 45%, and 26%), respectively. LMM showed that the probability of transitioning from a low to a moderate tendency to progress diabetes was higher than the other transition probabilities. Based on a long-term evaluation of patterns of changes in obesity indices, our results reemphasized the values of all five obesity indices in clinical settings for identifying high-risk prediabetic subjects for developing diabetes in future and the need for more effective obesity prevention strategies.

Long-Term Evaluation of the Roux-Elmslie-Trillat Procedure for Patellar Instability

2005 ◽  
Vol 33 (8) ◽  
pp. 1220-1223 ◽  
Author(s):  
Joseph R. Carney ◽  
Timothy S. Mologne ◽  
Michael Muldoon ◽  
Jay S. Cox
Keyword(s):  
Confidence Interval ◽  
Case Series ◽  
Level Of Evidence ◽  
Long Term Effect ◽  
Functional Scores ◽  
Study Population ◽  
Term Evaluation ◽  
Subluxation Of The Patella

Background Few published articles exist reporting the long-term evaluation of the Roux-Elmslie-Trillat procedure. Purpose To assess the long-term effect of the Roux-Elmslie-Trillat procedure in preventing recurrent subluxation and dislocation of the patella. Study Design Case series; Level of evidence, 4. Methods Eighteen patients who underwent the Roux-Elmslie-Trillat procedure for dislocation or subluxation of the patella were identified from a group previously evaluated at a mean follow-up of 3 years. The prevalence of recurrent subluxation or dislocation at a mean follow-up of 26 years was compared with the prevalence reported at the mean follow-up of 3 years. Although not the focus of this study, Cox functional scores were obtained from the smaller group and compared with the results at the 3-year follow-up. Results Seven percent (95% confidence interval, 0.00-0.32) of the patients had recurrent subluxation at 26 years compared with 7% (95% confidence interval, 0.03-0.13) of the study population reported at 3 years (P = 1.00). Fifty-four percent (95% confidence interval, 0.27-0.79) rated their affected knee as good or excellent at 26 years compared with 73% (95% confidence interval, 0.64-0.81) of the larger study population reported at 3 years (P = .14). Conclusion The prevalence of recurrent subluxation and dislocation in patients with patellofemoral malalignment who underwent the Roux-Elmslie-Trillat procedure for dislocation or subluxation of the patella is similar at 3 and 26 years after the procedure. The long-term functional status of the affected knee in patients who underwent the Roux-Elmslie-Trillat procedure declined.

Long-Term Evaluation of Ifosfamide-Related Nephrotoxicity in Children

2009 ◽  
Vol 27 (32) ◽  
pp. 5350-5355 ◽  
Author(s):  
Odile Oberlin ◽  
Oumaya Fawaz ◽  
Annie Rey ◽  
Patrick Niaudet ◽  
Vita Ridola ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Renal Toxicity ◽  
Moderate Dose ◽  
Median Dose ◽  
Glomerular Function ◽  
Term Evaluation ◽  
Grade 3 ◽  
Length Of Interval

PurposeIfosfamide is widely used in pediatric oncology but its nephrotoxicity may become a significant issue in survivors. This study is aimed at evaluating the incidence of late renal toxicity of ifosfamide and its risk factors.Patients and MethodsOf the 183 patients prospectively investigated for renal function, 77 treated for rhabdomyosarcoma, 39 for other soft tissue sarcoma, 39 for Ewing's sarcoma, and 28 for osteosarcoma were investigated at least 5 years after treatment. No patients had received cisplatin and/or carboplatin. Glomerular and tubular functions were graded according to the Skinner system.ResultsThe median dose of ifosfamide was 54 g/m2(range, 18 to 117 g/m2). After a median follow-up of 10 years, 89.5% of patients had normal tubular function, and 78.5% had normal glomerular function rate (GFR). Serum bicarbonate and calcium were normal in all patients. Hypomagnesemia was observed in 1.2% and hypophosphatemia in 1%. The tubular threshold for phosphate was reduced in 24% of the patients (grade 1 in 15%, grade 2 in 8%, and grade 3 in 0.5%). Glycosuria was detected in 37% of the patients but was more than 0.5 g/24 hours in only 5%. Proteinuria was observed in 12%. Ifosfamide dose and interval from therapy to investigations were predictors of tubulopathy in univariate and multivariate analysis. In a multivariate analysis, an older age at diagnosis and the length of interval since treatment had independent impacts on the risk of abnormal GFR.ConclusionRenal toxicity is moderate with a moderate dose of ifosfamide. However, since it can be permanent and can get worse with time, repeated long-term evaluations are important, and this risk should be balanced against efficacy.

Primary Total Hip Arthroplasty for Gunshot Injury-Induced Secondary Arthritis of the Hip: What Are the Outcomes?

2017 ◽  
Vol 01 (04) ◽  
pp. 200-204 ◽  
Author(s):  
Roby Abraham ◽  
Joseph Scollan ◽  
Patrick Mixa ◽  
Denis Cherkalin ◽  
Jeffrey Varghese ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Total Hip ◽  
Hip Function ◽  
Post Traumatic ◽  
Traumatic Arthritis ◽  
Primary Total Hip Arthroplasty

AbstractGunshot wound (GSW) injuries around the hip joint can lead to debilitating post-traumatic arthritis, requiring a technically demanding primary total hip arthroplasty (THA). These surgeries are often complicated by bullet debris, extensive scaring, prior operations, and altered local anatomy. Although most literature focuses on acute management of GSW around the hip, a few reports detail the mid-term outcomes of GSW patients with primary THA for post-traumatic arthritis. The purpose of this study was to assess the outcomes and complications associated with THA in nine patients with secondary arthritis due to prior GSW injuries. At a mean follow-up of 35 months (range 12–60 months), significant improvement was shown in hip function, activity, and pain levels, and was similar to the outcomes of 18 patients who underwent primary THA for degenerative joint disease. While technically demanding, THA seems to reduce pain and improve function safely and effectively for patients with GSW-induced hip arthritis.

scholarly journals Caudoventral hip luxation in a miniature pig

2017 ◽  
Vol 47 (7) ◽  
Author(s):  
Carolina Silveira Braga ◽  
Brunna de Souza Barni ◽  
Marcele de Souza Muccillo ◽  
Emerson Antonio Contesini ◽  
Marcelo Meller Alievi
Keyword(s):  
General Anesthesia ◽  
Treatment Option ◽  
Postoperative Period ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Miniature Pig ◽  
Pelvic Limb ◽  
Hip Luxation ◽  
Viable Treatment

ABSTRACT: A miniature pig was examined because of left pelvic limb lameness after falling from a short height. Clinical examination and radiographs of the pelvic region revealed a left caudoventral hip luxation. Surgical reduction of luxation was performed on the patient under general anesthesia using a transarticular pinning technique. Postoperative radiographs confirmed that the luxation was reduced, the joint was aligned, and the transarticular pinning was correct. The transarticular pin was removed 21 days after it was surgically inserted. The limb was fully functional in the immediate postoperative period. Nine months after the surgery, the patient could use the limb properly, but mild degenerative joint disease was observed via radiographic follow-up. This technique may be a viable treatment option for the repair of caudoventral hip luxation in miniature pigs.

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