scholarly journals Labral reconstruction with polyurethane implant

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. i34-i40
Author(s):  
Marc Tey-Pons ◽  
Bruno Capurro ◽  
Raúl Torres-Eguia ◽  
Fernando Marqués-López ◽  
Alfonso Leon-García ◽  
...  
Keyword(s):  
Primary Repair ◽  
Hip Osteoarthritis ◽  
Standard Of Care ◽  
Clinical Results ◽  
Magnetic Resonance Images ◽  
Tissue Loss ◽  
Polyurethane Scaffold ◽  
Patient Reported ◽  
Meniscal Substitution

Abstract Surgical treatment of labral injuries has shifted from debridement to preservation over the past decades. Primary repair and secondary augmentation or reconstruction techniques are aimed at restoring the labral seal and preserving or improving contact mechanics. Currently, the standard of care for non-repairable tears favours the use of auto- or allografts. As an alternative, we present our initial experience using a synthetic, off-the-shelf polyurethane scaffold for augmentation and reconstruction of segmental labral tissue loss or irreparable labral damage. Three patients aged 37–44 (two male, one female) with femoroacetabular impingement without associated dysplasia (Wiberg > 25°) or osteoarthritis (Tönnis <2) were included in this series. Labral reconstruction (one case) and augmentation (two cases) were performed using a synthetic polyurethane scaffold developed for meniscal substitution (Actifit®, Orteq Ltd, London, UK) and adapted to the hip. Clinical results were analysed with patient-reported outcomes (PROMs) using non-arthritic hip score (NAHS) and daily live activities hip outcome score (DLA HOS) and magnetic resonance images (MRI) at 2- and 4-year follow-up. Clinically improvement was seen in all PROMs at 4 years. The NAHS scores improved from 57.7 to 82.3 (50.9% improvement) and HOS from 59 to 79.3 (35.3% improvement). Last follow-up MRIs confirmed the presence of the scaffold; however, the scaffold signal was still hyperintense compared to native labrum. There was no shrinkage in any scaffold and no progression to hip osteoarthritis seen. Reconstruction or augmentation of segmental labral defects with a polyurethane scaffold may be an effective procedure. At 4 years after implantation, our small cases series resulted in improved hip joint function, reduced pain and scaffold preservation on follow-up imaging.

scholarly journals Short (6 mm) and Regular Dental Implants in the Posterior Maxilla–7-Years Follow-up Study

2021 ◽  
Vol 10 (5) ◽  
pp. 940
Author(s):  
Jakub Hadzik ◽  
Paweł Kubasiewicz-Ross ◽  
Izabela Nawrot-Hadzik ◽  
Tomasz Gedrange ◽  
Artur Pitułaj ◽  
...  
Keyword(s):  
Survival Rate ◽  
Dental Implants ◽  
Clinical Results ◽  
Implant Survival ◽  
Implant Survival Rate ◽  
Short Implants ◽  
Posterior Maxilla ◽  
Patient Reported ◽  
Bone Level

Short 6 mm dental implants are considered as an alternative to the maxillary sinus elevation and bone augmentation procedure where there is a reduced alveolar ridge height. The aim of this study was to compare the implant survival rate between short dental implants (6 mm) and regular length implants (11–13 mm) when placed in combination with bone grafting and loaded with a single non splinted crown, seven years after placing the implant. It was conducted as a controlled clinical study of 30 patients with partial edentulism in the posterior maxilla. The protocol included radiological and clinical evaluation of the C/I ratio (length of the superstructure divided by the length of the implant crestal part), marginal bone level (MBL), ultrasonography measurement of soft tissue surrounding implant (STT), patient-reported outcomes, and biological and technical complications. A total number of 28 implants (93%) remained integrated during follow-up period. MBL of 0.50 and 0.52 mm was observed for short implants and regular implants, respectively. MBL was checked for correlation with STT, and a negative correlation was found between MBL: STT. Our study has demonstrated a significantly lower implant survival rate for short implants compared to regular implants (87% compared to 100%). Despite the loss of several implants, good clinical results were achieved in the remaining implants in both groups. It is, therefore, worth considering short implants as an alternative to regular implants with a sinus lift surgery.

scholarly journals Satisfactory patient-reported outcomes at 5 years following primary repair with suture tape augmentation for proximal anterior cruciate ligament tears

2021 ◽  
Author(s):  
Graeme P. Hopper ◽  
Joanna M. S. Aithie ◽  
Joanne M. Jenkins ◽  
William T. Wilson ◽  
Gordon M. Mackay
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patient Reported Outcomes ◽  
Primary Repair ◽  
Cruciate Ligament ◽  
Acl Repair ◽  
Patient Reported ◽  
Activity Scale ◽  
Anterior Cruciate ◽  
Suture Tape

Abstract Purpose An enhanced understanding of anterior cruciate ligament (ACL) healing and advancements in arthroscopic instrumentation has resulted in a renewed interest in ACL repair. Augmentation of a ligament repair with suture tape reinforces the ligament and acts as a secondary stabilizer. This study assesses the 5-year patient-reported outcomes of primary repair with suture tape augmentation for proximal ACL tears. Methods Thirty-seven consecutive patients undergoing ACL repair with suture tape augmentation for an acute proximal rupture were prospectively followed up for a minimum of 5 years. Patients with midsubstance and distal ruptures, poor ACL tissue quality, retracted ACL remnants and multiligament injuries were excluded. Patient-reported outcome measures were collated using the Knee Injury and Osteoarthritis Outcomes Score (KOOS), Visual Analogue Pain Scale (VAS-pain), Veterans RAND 12-Item Health Survey (VR-12) and the Marx Activity Scale. Patients with a re-rupture were identified. Results Three patients were lost to follow-up leaving 34 patients in the final analysis (91.9%). The mean KOOS at 5 years was 88.5 (SD 13.8) which improved significantly from 48.7 (SD 18.3) preoperatively (p < 0.01). The VAS score improved from 2.3 (SD 1.7) to 1.0 (SD 1.5) and the VR-12 score improved from 35.9 (SD 10.3) to 52.4 (SD 5.9) at 5 years (p < 0.01). However, the Marx activity scale decreased from 12.4 (SD 3.4) pre-injury to 7.3 (SD 5.2) at 5 years (p = 0.02). Six patients had a re-rupture (17.6%) and have since undergone a conventional ACL reconstruction for their revision surgery with no issues since then. These patients were found to be younger and have higher initial Marx activity scores than the rest of the cohort (p < 0.05). Conclusion Primary repair with suture tape augmentation for proximal ACL tears demonstrates satisfactory outcomes in 28 patients (82.4%) at 5-year follow-up. Six patients sustained a re-rupture and have no ongoing problems following treatment with a conventional ACL reconstruction. These patients were significantly younger and had higher initial Marx activity scores. Level of evidence Level IV.

scholarly journals Arthroscopic Primary Repair of Proximal Anterior Cruciate Ligament Tears: With or Without Additional Suture Augmentation?

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0006 ◽  
Author(s):  
Anne Jonkergouw ◽  
Jelle P. van der List ◽  
Gregory S. DiFelice
Keyword(s):  
Range Of Motion ◽  
Patient Reported Outcomes ◽  
Suture Anchor ◽  
Primary Repair ◽  
Cruciate Ligament ◽  
Type I ◽  
Acl Repair ◽  
Patient Reported ◽  
Anterior Cruciate

Objectives: Over the last years, arthroscopic primary repair of anterior cruciate ligament (ACL) tears has shown excellent results owing to appropriate patient selection (only repairing proximal ACL tears and good tissue quality), minimal invasive surgery (arthroscopy) and focus on early range of motion. Some surgeons have repaired proximal ACL tears without suture augmentation while others have used internal suture augmentation to reinforce and thus protect the repaired ligament during range of motion. No studies have yet compared the two surgical techniques. The objective of this study was to compare failure rates, reoperation rates and patient-reported outcomes of arthroscopic primary repair with versus without suture augmentation. Methods: A retrospective search for all patients treated with suture anchor arthroscopic primary ACL repair between April 2008 and June 2016 was performed. All patients with isolated proximal ACL tears (type I) were included. Since the development of internal suture augmentation, this reinforcement was added to the repaired ACLs. Minimum follow-up length was 1.0 years. Results: A total of 56 patients were included (mean age 33 years (range: 14 - 57), 59% male) of which 28 (50%) patients received additional suture augmentation. Mean follow-up was 2.3 years (range: 1.0-9.2). Six of all patients had reruptured their repaired ACL (10.7%), of which four underwent uncomplicated ACL reconstruction and two were treated conservatively. Four reruptures were initially treated with primary repair only (4/28, 14.3%) and two patients with additional suture augmentation (2/28, 7.1%; p = 0.431). During follow-up, three patients underwent reoperation (5.4%; two for medial meniscus tear (one in each group) and one for tibial suture anchor removal of the suture augmentation). Patient-reported outcomes have so far been collected in 20 patients without reruptures (currently collecting), with mean Lysholm score of 96, modified Cincinnati 94, SANE 93, pre-injury Tegner 6.7, postoperative Tegner 6.3 and subjective IKDC 91. Objective IKDC was A in 90%, B in 5%, C in 5%. Conclusion: In this study, the total failure rate of arthroscopic primary ACL repair was 10.7% and was lower with additional suture augmentation (7.1%) than primary repair alone (14.3%). Patients with failed ACL repair underwent uncomplicated primary ACL reconstruction. We recommend adding suture augmentation in high-risk patients (i.e. adolescents, ones with hyperlaxity, high contact sports), to protect the repaired ligament, especially during early range of motion. These data support treating type I proximal ACL tears with arthroscopic primary repair.

Microcannula Utilization for Injectable Facial Fillers: Standard of Care?

2018 ◽  
Vol 35 (4) ◽  
pp. 189-197 ◽  
Author(s):  
Kian Karimi ◽  
Chester F. Griffiths ◽  
Alex Reivitis ◽  
Austin Davis-Hunter ◽  
Elizabeth Zhang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Standard Of Care ◽  
Dermal Filler ◽  
Popular Method ◽  
Patient Reported ◽  
Clinical Series ◽  
Filler Injections

The microcannula technique has become an increasingly popular method for injecting cosmetic fillers. Previous studies have illustrated that the microcannula technique allows filler to be injected with less pain, swelling, and essentially no bruising. This study is a retrospective clinical series examining 247 patients who have undergone dermal filler injections using the microcannula technique from 2011 to 2016 with a single injector, Kian Karimi. The purpose of this study is to assess the frequency of adverse events associated with injections such as bruising and swelling. All 666 recorded patient visits from 2011 to 2016 were analyzed using electronic medical records based on the criteria that the patients had cosmetic filler using the microcannula technique by the surgeon investigator. Of the 666 filler treatments using the microcannula technique, 3 treatments (0.5%) produced adverse events on the day of service, and 32 treatments (4.8%) produced adverse events at 2-week follow-up. In total, 5.4% of treatments produced adverse events. At the 2-week follow-up, 5.7% of treatments using the 25-gauge microcannula produced adverse events ( P = .830); 3.9% of treatments using the 27-gauge microcannula produced adverse events ( P = .612]). Only 3 patients were treated with the 30-gauge microcannula, and 1 patient reported adverse events on the day of service. None of the treatments using the 30-gauge microcannula produced adverse events at the 2-week follow-up ( P = .160). The data support that the microcannula technique is a safe and effective alternative to hypodermic needles for the injection of dermal filler to minimize common adverse events.

scholarly journals Comparison of MPFL Repair Versus MPFL Reconstruction for Refractory Patella Instability in Patients Under 18 Years Old

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0018
Author(s):  
Seth L. Sherman ◽  
Derek W. Geeslin ◽  
Daniel W. Hogan ◽  
John W. Welsh ◽  
Joseph M. Rund ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Primary Repair ◽  
Mpfl Reconstruction ◽  
Patella Instability ◽  
Subjective Outcome ◽  
Recurrent Instability ◽  
Patient Reported ◽  
Outcome Scores ◽  
Reconstruction Group

Background: The medial patellofemoral ligament (MPFL) is the primary soft-tissue restraint against lateral patellar displacement. Surgery to address MPFL incompetence is the current gold standard for recurrent patellofemoral instability. In the young patient, controversy remains regarding the role of MPFL repair in the setting of recurrent patella instability. Hypothesis/Purpose: Our purpose was to investigate subjective outcomes and complication profile of consecutive cohorts under age 18 undergoing MPFL repair or MPFL reconstruction. Our hypothesis was that the MPFL reconstruction group would have higher subjective outcome scores and a lower complication profile. Methods: Following IRB approval, a retrospective review of prospectively collected data identified a consecutive cohort of patients undergoing soft tissue stabilization for recurrent patella instability. Surgery was performed by a single sports fellowship trained surgeon between 2011-2019. MPFL repair was performed on patients prior to November 2015 and MPFL reconstruction with allograft from December 2015 to present. Patients undergoing concomitant bony realignment procedures were included. Patient reported outcomes (PROs) were collected including PROMIS, KOOS, IKDC, Marx, Tegner, and SANE scores. Complications requiring re-operation (i.e., infection, stiffness, recurrent instability) were recorded. Results were analyzed statistically. Results: The cohort was comprised of 43 patients (53 knees), with 15 males (34.9%), and 28 females (65.1%). The MPFL-Repair cohort had 22 patients (24 knees) and the MPFL-Reconstruction had 25 patients (29 knees). The average age of the MPFL-Repair cohort was 14.82 (range 10.5-17.8) and the average age of the MPFL-Reconstruction group was 15.59 (13.0-17.7). At final follow-up (minimum 6 months), there were no statistically significant differences between cohorts for KOOS Pain (p=0.4126), KOOS symptoms (p=0.7990), KOOS ADL (p=0.4398), KOOS Sport Rec (p=0.3357), KOOS QOL (p=0.8707), Global Physical Health (p=0.9736), Global Mental Health (p=0.1724), Physical Function (p=0.8077), Pain Interference (p=0.9740), Mobility T-Score (p=0.0634), Marx activity score (p=0.0844), Tegner Score (p=0.0752), IKDC (p=0.2646), and SANE score (p=0.0811). Regarding complications requiring re-operation, there was 1 knee in the MPFL-Reconstruction group (3.4%) that required further surgery (1 for fracture) and 9 knees in the MPFL-Iso cohort (37.5%) that required re-operation (1 for fracture, 8 for recurrent instability). The difference in complication rate was statistically significant (p=0.0012). Conclusion: In patients under 18 years old undergoing surgery for refractory patella instability, both MPFL allograft reconstruction and MPFL primary repair demonstrated no difference in subjective outcome scores at midterm follow-up. MPFL primary repair had significantly increased rate of complication requiring re-operation, particularly recurrent patella instability requiring revision to MPFL reconstruction. Tables/Figures: [Table: see text][Table: see text][Table: see text]

scholarly journals Development of a Therapeutic Exercise Program for Patients With Osteoarthritis of the Hip

2010 ◽  
Vol 90 (4) ◽  
pp. 592-601 ◽  
Author(s):  
Linda Fernandes ◽  
Kjersti Storheim ◽  
Lars Nordsletten ◽  
May Arna Risberg
Keyword(s):  
Physical Function ◽  
Randomized Clinical Trials ◽  
Joint Stiffness ◽  
Exercise Program ◽  
Hip Osteoarthritis ◽  
Peak Torque ◽  
Therapeutic Exercise ◽  
Physical Test ◽  
Patient Reported

Background and Purpose No detailed exercise programs specifically for patients with hip osteoarthritis (OA) have been described in the literature. This lack of data creates a gap between the recommendation that people with OA should exercise and the type and dose of exercises that they should perform. The purpose of this case report is to describe and demonstrate the use of a therapeutic exercise program for a patient with hip OA. Case Description A 58-year-old woman with hip OA completed a 12-week therapeutic exercise program (TEP) with a 6-month follow-up. The patient reported hip pain, joint stiffness, and limited physical function, and she had decreased hip range of motion (ROM) at baseline. Outcomes The patient performed 19 sessions during the TEP, with a mean of 19.5 exercises per session. She increased the resistance in 3 of 5 strength (force-generating capacity) training exercises and achieved the highest degree of difficulty in all functional exercises. During the TEP and follow-up, the patient reported improvements in pain, joint stiffness, and physical function. Performance improved on the following physical tests: isokinetic peak torque strength (60°/s) in hip extension (40%), hip flexion (27%), knee extension (17%), and knee flexion (42%); hip ROM extension (8°); and 6-minute walk distance (83 m). Discussion The patient experienced less pain and improved physical function and physical test outcomes after intervention and at the 6-month follow-up. The main challenges when prescribing an exercise program for a patient with hip OA are monitoring the exercises to provide improvements without provoking persistent pain and motivating the patient to achieve long-term adherence to exercising. Randomized clinical trials are needed to evaluate the efficacy of this TEP in patients with hip OA.

scholarly journals Non-Anatomic Proximal Realignment for Recurrent Patellar Dislocation Does Not Sufficiently Prevent Redislocation

2012 ◽  
Vol 6 (1) ◽  
pp. 114-117 ◽  
Author(s):  
Turgay Efe ◽  
Julia Seibold ◽  
Markus Geßlein ◽  
Karl Schüttler ◽  
Jan Schmitt ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Patellar Dislocation ◽  
Subjective Assessment ◽  
Clinical Results ◽  
Patient Reported Outcome ◽  
Recurrent Patellar Dislocation ◽  
Term Outcome ◽  
Proximal Realignment ◽  
Patient Reported

Several operative techniques have been described for recurrent patellar dislocation. Clinical results vary depending on the procedure and indication. The present study aimed to evaluate the clinical outcome of Insall’s proximal realignment for recurrent patellar dislocation at mid-term follow-up. Forty-five patients were reviewed with a mean follow-up period of 49 months after having undergone Insall’s procedure. Outcome measures included reports of redislocations, complications, patient-reported outcome scores (Kujala, Tegner activity scale) and subjective assessment. No statistically significant improvements (p < 0.05) in patient-reported outcome measures were noted. Sixteen patients (35%) had poor to fair results using the Kujala score. Subjective assessment revealed that 12 patients (27%) were dissatisfied with the outcome of their surgery and would not undergo the same procedure. Ten patients (22%) had suffered from redislocation at the latest follow-up. In 4 cases (9%), intra-articular knee hematoma occurred which required arthroscopic intervention. The overall mid-term outcome of the present study shows low patient satisfaction. Non-anatomic realignment for recurrent patellar dislocation does not adequately prevent redislocation.

scholarly journals The effect of platelet-rich plasma in patients with early hip osteoarthritis: a pilot study

2020 ◽  
Author(s):  
Victor Ortiz-Declet ◽  
David A Iacobelli ◽  
Muriel R Battaglia ◽  
Cammille C Go ◽  
David R Maldonado ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Hip Osteoarthritis ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Harris Hip Score ◽  
Post Injection ◽  
Mri Findings ◽  
Outcome Score ◽  
Patient Reported

Abstract We investigate whether platelet-rich plasma (PRP) injections can improve symptoms and function in patients with mild to moderate osteoarthritis (OA). Data were prospectively collected and retrospectively reviewed for all patients receiving PRP intra-articular hip injections between February 2017 and June 2017. The inclusion criteria were patients with a well-preserved joint space (Tönnis 0 or 1) whose magnetic resonance imaging (MRI) findings demonstrated degenerative joint disease or a Tönnis grade of 2. The patient-reported outcomes (PROs) used were the modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome TOOL (iHOT-12), Single Assessment Numeric Evaluation (SANE) and Mental and Physical aspects of the Veteran RAND 12 Item Health Survey (VR-12M and VR-12P). The visual analog scale (VAS) was utilized to indicate pain. Nine patients (11 hips) were eligible for inclusion. All PROs and VAS improved from pre- to post-injection. These improvements were present at the 3-month follow-up visit and stable until the 12-month follow-up. There was statistically significant improvement for mHHS (P &lt; 0.001), HOS-ADL (P = 0.006), iHOT-12 (P = 0.003) and VR-12M (P = 0.005) at 12 months post-injection. Similarly, VAS improved from 4.1 to 2.3, although the change was not statistically significant. PRP injections significantly improved PROs in all measured scales at time points up to a year after intervention, except for VR-12P and HOS-SSS. In conclusion, patients with early OA of the hip had significant improvement of patient-reported functional outcomes up to 12 months after PRP intra-articular injections.

scholarly journals Intra-articulaar treatment with Hylan G-F 20 under ultrasound guidance in hip osteoarthritis. Clinical results after 12 months follow-up

Reumatismo ◽  
2011 ◽  
Vol 57 (1) ◽  
Author(s):  
A. Migliore ◽  
S. Tormenta ◽  
C. Valente ◽  
U. Massafra ◽  
L.S. Martin Martin ◽  
...  
Keyword(s):  
Ultrasound Guidance ◽  
Hip Osteoarthritis ◽  
Clinical Results

scholarly journals Clinical results following robotic navigation guidance for sacroiliac joint fusion in 36 patients

2022 ◽  
Vol 52 (1) ◽  
pp. E6
Keyword(s):  
Clinical Improvement ◽  
Sacroiliac Joint ◽  
Clinical Results ◽  
Guidance System ◽  
Robotic Navigation ◽  
Vas Score ◽  
Patient Reported ◽  
Vas Scores ◽  
The Mean

OBJECTIVE In this study, the authors aimed to describe a new technique of sacroiliac joint (SIJ) fusion using a robotic navigation guidance system and to document clinical results with patient-reported visual analog scale (VAS) scores. METHODS Patients diagnosed with SIJ dysfunction were surgically treated using 2 hydroxyapatite (HA)–coated, threaded screws with the aid of the robotic navigation system. In a total of 36 patients, 51 SIJs were fused during the study period. Patients’ VAS scores were used to determine clinical improvement in pain. Postoperative imaging at routine intervals during the follow-up period was also performed for assessment of radiological fusion. In addition, complication events were recorded, including reoperations. RESULTS All 36 patients had successful fusion evidenced by both CT and clinical assessment at the final follow-up. Two patients underwent reoperation because of screw loosening. The mean preoperative VAS score was 7.2 ± 1.1, and the mean 12-month postoperative VAS score was 1.6 ± 1.46. This difference was statistically significant (p < 0.05) and demonstrated a substantial clinical improvement in pain. CONCLUSIONS Robotic navigation–assisted SIJ fusion using 2 HA-coated, threaded screws placed across the joint was an acceptable technique that demonstrated reliable clinical results with a significant improvement in patient-reported VAS pain scores.

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