Transmucosal diverticular myotomy for the treatment of oesophageal diverticula associated with spastic motility disorders

Gut ◽  
2020 ◽  
Vol 69 (9) ◽  
pp. 1552-1554 ◽  
Author(s):  
Mayenaaz Sidhu ◽  
David J Tate ◽  
Michael J Bourke
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Motility Disorder ◽  
Adverse Outcomes ◽  
The Novel ◽  
Significant Morbidity ◽  
Motility Disorders ◽  
Endoscopic Techniques ◽  
Novel Technique

Thoracic oesophageal diverticula are often associated with spastic motility disorders. Despite correction of the underlying motility disorder, in a subgroup of patients, symptoms persist, primarily regurgitation. Surgical diverticulectomy is then proposed; however, as the approach is thoracoscopic or via thoracotomy, it is associated with significant morbidity and cost. Descriptions of endoscopic techniques for the treatment of symptomatic midoesophageal diverticula are few. We propose the novel technique of diverticular myotomy (DM) to treat this disorder. In this case series, we describe two patients who successfully underwent DM with no adverse outcomes and excellent clinical results at 24-month follow-up.

scholarly journals Arthroscopic Assisted Reconstruction of LT-Ligament: A Description of a New Technique

2020 ◽  
Author(s):  
Jan Ragnar Haugstvedt ◽  
István Zoltán Rigó
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Invasive Technique ◽  
The Novel ◽  
Level Of Evidence ◽  
Case Series Study ◽  
Functional Scores ◽  
Carpal Injury ◽  
A New Technique

Abstract Background Injuries of the lunotrirquetral ligament (LT lig) could be part of an extensive carpal injury and are then often treated at the time of the injury. However, when an injury of the LT ligament occurs alone, the injury is often missed. Treatment of this injury has traditionally been by open surgery, such as reattachment of the LT ligament, ligament reconstruction, or arthrodesis of the LT joint. These procedures needed a large exposure to the carpus running the risk of damaging the external ligaments, the nerves important for proprioception, and the capsule with the potential of scarring and adhesions. Materials and Methods We describe a novel arthroscopic assisted technique for reconstruction of the LT ligament. Using this less invasive technique, there is a possible advantage of lesser scarring and faster mobilization. Results We have performed this technique in two patients with more than 30 months follow-up. They both have great improvement of the functional scores. Conclusion The novel arthroscopic assisted technique for LT lig reconstruction is a technically demanding procedure; however, this obtains good clinical results with more than 30 months follow-up due to less exposure of the carpus. Level of Evidence This is a Level IV, case series study.

scholarly journals Return to Sports After Bone Marrow–Derived Cell Transplantation for Osteochondral Lesions of the Talus

Cartilage ◽  
2016 ◽  
Vol 8 (1) ◽  
pp. 80-87 ◽  
Author(s):  
Francesca Vannini ◽  
Marco Cavallo ◽  
Laura Ramponi ◽  
Francesco Castagnini ◽  
Simone Massimi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cell Transplantation ◽  
Case Series ◽  
Clinical Results ◽  
Osteochondral Lesions ◽  
Return To Sports ◽  
One Step ◽  
American Orthopaedic ◽  
Return To Activity

Objective Arthroscopic “one-step” technique based on bone marrow–derived cell transplantation (BMDCT) have achieved good results in repairing osteochondral lesions of the talus (OLT), overcoming important drawbacks of older techniques. It may be particularly adequate for the treatment of athletes in order to permit a safe and stable return to sports. The aim of this study was to report the results at 48 months of a series of athletes and the factors influencing the return to sports. Design Case series. A total of 140 athletes underwent a “one-step” BMDCT repair of OLT. All the patients had the cells harvested from the iliac crest, condensed and loaded on a scaffold, and then implanted. Patients were evaluated clinically by the American Orthopaedic Foot and Ankle Society (AOFAS) scores and Halasi score. Results AOFAS score improved from 58.7 ± 13.5 preoperatively to 90.6 ± 8.6 ( P < 0.005) at 24 months, and to 90.9 ± 10.7 at 48 months. Halasi score was 6.88 ± 1.8 preinjury, 4.08 ± 1.7 preoperatively, and 5.56 ± 2.0 at final follow-up. At the final follow-up, all the patients (beside 1 failure and 3 lost) were able to return to activity and 72.8% were able to resume sports at preinjury level. Conclusions “One-step” BMDCT repair of OLT had good clinical results that was durable over time in athletes, permitting a return to sports at preinjury level in the majority of patients. The preoperative presence of impingement and articular degeneration were the main negative prognostic factors.

scholarly journals Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

2018 ◽  
Vol 12 (1) ◽  
pp. 567-575
Author(s):  
D. Leonetti ◽  
B. Di Matteo ◽  
P. Barca ◽  
S. Cialdella ◽  
F. Traina ◽  
...  
Keyword(s):  
Functional Performance ◽  
Case Series ◽  
Clinical Results ◽  
Fracture Dislocation ◽  
Review Of Literature ◽  
Non Union ◽  
Fracture Dislocations ◽  
Neck Fracture ◽  
Talar Fractures

Introduction: Talar fractures are uncommon injuries, whose outcome is often characterized by the onset of serious complications. The aims of the present study are: 1) to review the available evidence concerning the outcome and complications of talar neck fractures; 2) to describe the clinical results and the rate of post-op complications in a series of patients treated surgically after talar fracture-dislocations. Materials and methods: The review of the literature was performed on the Pubmed, Embase and Web of Science databases and aimed at identifying clinical trials with at least 10 patients and dealing with surgical management of talar fracture-dislocation (Hawkins grade II to IV). All the papers were analyzed to extract data concerning common complications such as non-union, mal-union, infection, osteonecrosis and osteoarthtritis. The clinical arm of this paper included 26 patients (19 men and 7 women), who underwent fixation of displaced talar fracture by cannulated screws and were retrospectively evaluated, both clinically and radiographically, at a mean 51.2 ± 23.4 months of follow-up. Results: The evaluation through the AOFAS score revelead a loss of functional performance with respect to the pre-injury status. Four patients were re-operated within final follow up, whereas the remaining 22 presented excellent results in 2 cases, good results in 4 cases, fair results in 11 cases and poor results in 5 cases. Osteoarthritis and osteonecrosis incidence were 51.9% and 25.9% respectively. Sixteen studies were included in the review and it was confirmed that the most frequent complication was post-traumatic OA, followed by osteonecrosis and mal-union. A variable range in percentage of complications described should be ascribed to the low quality of trials currently available. Conclusion: Displaced talar fracture are challenging to treat and the outcomes at middle-term are often modest. Looking at complications, the present case series and the review of literature revealed that the most common one is peritalar OA. Osteonecrosis, traditionally regarded as the most fearsome adverse event, is relevant but less frequent than OA.

Does Transection of the Superficial MCL During HTO Result in Progressive Valgus Instability?

2021 ◽  
pp. 036354652110591
Author(s):  
Joo-Hwan Kim ◽  
Dong Jin Ryu ◽  
Sung-Sahn Lee ◽  
Seung Pil Jang ◽  
Jae Sung Park ◽  
...  
Keyword(s):  
Case Series ◽  
Preoperative Assessment ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Osteotomy Site ◽  
Tibial Osteotomy ◽  
Level Of Evidence ◽  
Valgus Stress ◽  
Valgus Instability

Background: During high tibial osteotomy (HTO), the superficial medial collateral ligament (sMCL) is cut or released at any degree to expose the osteotomy site and achieve the targeted alignment correction according to the surgeon’s preference. However, it is still unclear whether transection of sMCL increases valgus laxity. Purpose: We aimed to assess the outcomes and safety of sMCL transection, especially focusing on iatrogenic valgus instability. Study Design: Case series; Level of evidence, 4. Methods: Seventy-two patients (89 knees) who underwent medial open wedge HTO (MOWHTO) with transection of the sMCL between October 2013 and September 2018 were retrospectively investigated. Clinical evaluations, including the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner and Lysholm scores, were performed preoperatively and at 2 years postoperatively. The radiographic parameters hip-knee-ankle (HKA) angle, joint line convergence angle on standing radiographs (standing JLCA), and weightbearing line (WBL) ratio were assessed preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. To evaluate valgus laxity, we assessed the valgus JLCA and medial joint opening (MJO) at the aforementioned time points using valgus stress radiographs. Results: All clinical results at the 2-year follow-up were significantly improved compared with those obtained at the preoperative assessment ( P < .001). The postoperative HKA angle significantly differed from the preoperative one, and no significant valgus progression was observed during follow-up (preoperative, 8.5°± 2.7°; 3 months, –3.5°± 2.0°; 6 months, –3.2°± 2.3°; 1 year, –3.1°± 2.3°; 2 years, –2.9°± 2.5°; P < .001) The mean WBL ratio was 62.5% ± 9.0% at 2 years postoperatively. The postoperative valgus JLCA at all follow-up points did not significantly change compared with the preoperative valgus JLCA (preoperative, –0.1°± 2.1°; 3 months, –0.2°± 2.4°; 6 months, –0.1°± 2.5°; 1 year, 0.1°± 2.5°; 2 years, 0.2°± 2.2°) The postoperative MJO at all follow-up points did not significantly change compared with the preoperative MJO (preoperative, 7.1 ± 1.7 mm; 3 months, 7.0 ± 1.7 mm; 6 months, 6.9 ± 1.9 mm; 1 year, 6.7 ± 1.8 mm; 2 years, 6.8 ± 1.8 mm). Conclusion: Transection of the sMCL during MOWHTO does not increase valgus laxity and could yield desirable clinical and radiographic results.

scholarly journals Preliminary Experience Using Bioactive Glass Wedges for Cotton Osteotomy

2018 ◽  
Vol 3 (4) ◽  
pp. 247301141879686
Author(s):  
Tood Borenstein ◽  
Tyler Gonzalez ◽  
Janet Krevolin ◽  
Bryan Den Hartog ◽  
David Thordarson
Keyword(s):  
Bioactive Glass ◽  
Case Series ◽  
Clinical Results ◽  
Delayed Union ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Opening Wedge ◽  
Radiographic Outcomes ◽  
Initial Correction

Background: Medial cuneiform dorsal opening wedge (Cotton) osteotomy is often used for treating forefoot varus in patients undergoing surgery for stage II posterior tibialis tendon dysfunction. The goal of this study was to examine the radiographic outcomes of Cotton osteotomy with bioactive glass wedge to assess for both maintenance of correction and clinical results and complications. We hypothesized that bioactive glass wedges would maintain correction of the osteotomy with low complication rates. Methods: Between December 2015 and June 2016, the charts of 17 patients (10 female and 7 male) who underwent Cotton osteotomy using bioactive glass wedges were retrospectively reviewed. Patient age averaged 56.8 years (range, 16-84). The average follow-up was 6.5 months. Radiographs were reviewed to assess for initial correction and maintenance of correction of medial column sag as well as for union. Charts were reviewed for complications. Results: The medial column sag correction averaged 15.6% on the final postoperative lateral radiograph. Meary angle averaged 19 degrees (3.14-42.8 degrees) preoperatively and 5.5 degrees (0.4-20.7 degrees) at final follow-up. All patients achieved clinical and radiographic union. One patient developed neuropathic midfoot pain and was managed with sympathetic blocks. One patient had a delayed union that healed at 6 months without surgical intervention. No patients required the use of custom orthotics or subsequent surgical procedures. Conclusion: Cotton osteotomy with bioactive glass wedges produced consistent correction of the medial column with low risk. Level of Evidence: Level IV, case series.

scholarly journals Syndesmotic Fixation Utilizing a Novel Metal Screw: A Retrospective Case Series Reporting Early Clinical and Radiographic Outcomes

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0041
Author(s):  
Derek S. Stenquist ◽  
Brian Velasco ◽  
Patrick K. Cronin ◽  
Jorge Briceno ◽  
Christopher Miller ◽  
...  
Keyword(s):  
External Rotation ◽  
Case Series ◽  
Break Point ◽  
The Novel ◽  
Suture Button ◽  
Radiographic Outcomes ◽  
Clear Space ◽  
Anatomic Reduction ◽  
Screw Breakage

Category: Ankle Introduction/Purpose: Syndesmotic disruption occurs in nearly 1 in 5 ankle fractures and requires anatomic reduction and internal stabilization to maximize functional outcomes. There is growing evidence to support retaining syndesmotic hardware from both a functional and economic standpoint. However, although broken screws are typically of little consequence, the location of screw breakage can be unpredictable and cause painful bony erosion and difficulty with extraction. The purpose of this investigation is to report early clinical and radiographic outcomes of patients who underwent syndesmotic fixation using a novel metal screw with a more predictable break point and design features to allow for easier extraction. Methods: We performed a retrospective review of all consecutive patients who underwent syndesmotic fixation utilizing the novel syndesmotic screw over a one year period. Demographic data were obtained such as age, gender, fracture classification and relevant comorbidities. Screw specific data were obtained such as number of screws utilized and length. Screw loosening or breakage was documented. Postoperative radiographs were reviewed and tibiofibular overlap, tibiofibular clear space and medial clear space were measured. Results: 18 patients met inclusion criteria. Mean length of clinical follow-up was 4.67 months (range 0.5 to 8.5 months). Per the Lauge Hansen classification, 14 injuries were supination external rotation type, two were pronation abduction and two pronation external rotation type. Three screws (12.5%) fractured at the break point with no screws fracturing at a different location. 21 screws did not fracture with 10 (42%) of the screws demonstrated to be loose. There was no evidence of syndesmotic diastasis or mortise malalignment on final follow up of the cohort. No screws required removal during the study period. There were no other complications of any type (Table 1). Conclusion: Early reporting of outcomes is essential to maximize both safety and value in healthcare technology innovation. This study provides the first clinical data on a novel alternative to traditional screws and suture button devices for fixation of syndesmotic injuries. At short-term follow up, there were no complications and the novel screw provided adequate fixation to allow healing and prevent diastasis. While initial results are favorable, longer term follow-up is required to determine whether this novel implant can reduce rates of symptomatic hardware requiring removal, which could ultimately make them more cost- effective than suture-button fixation.

scholarly journals Chemical cauterization of peristomal granulomas with 50% trichloroacetic acid

2019 ◽  
Author(s):  
Rosaura Paczek ◽  
Luisa Passberg
Keyword(s):  
Trichloroacetic Acid ◽  
Therapeutic Option ◽  
Case Series ◽  
Clinical Results ◽  
Focal Lesions ◽  
Regular Treatment ◽  
Case Series Study ◽  
Chemical Cauterization ◽  
The Individual

Objetive: This study deals with the treatment of granulomas, one of the possible complications of the stomies, which are characterized as focal lesions, whose formation occurs due to the presence of aggressive agents to the tissues from the increase of the degree of cellularity and other tissue elements, generating annoyance and anxiety to patients. This study aims to describe the clinical results of the treatment of peristomal granulomas with the use of 50% trichloroacetic acid (TCA). Methods: This is a case series study, carried out by professionals in a referral center for the treatment of individuals with an ostomy in the city of Porto Alegre, state of Rio Grande do Sul. Results: The study sample consisted of 13 patients who underwent follow-up for treatment of peristomal granulomas with TCA. Data collection was performed during nursing consultations, based on the observation and photographic record of the granulomas, with subsequent evolution in the individual charts. Conclusion: It was concluded from this study that the regular treatment with TCA resulted in regression of the granulomas until their total disappearance, being this acid able to be considered, therefore, a potential therapeutic option; however, it is recommended to carry out further studies on its use in stomatherapy, seeking the use of more robust clinical research methodologies and with bias control.

scholarly journals Bipolar fresh osteochondral allograft of the shoulder

Joints ◽  
2013 ◽  
Vol 01 (04) ◽  
pp. 150-154 ◽  
Author(s):  
Sandro Giannini ◽  
Elisa Sebastiani ◽  
Alba Shehu ◽  
Matteo Baldassarri ◽  
Susanna Maraldi ◽  
...  
Keyword(s):  
Constant Score ◽  
Case Series ◽  
Clinical Results ◽  
Osteochondral Allograft ◽  
Level Of Evidence ◽  
Fresh Osteochondral Allograft ◽  
Post Traumatic ◽  
Glenohumeral Osteoarthritis ◽  
End Stage

Purpose: to describe an original technique and preliminary results of bipolar fresh osteochondral allograft implantation for the treatment of end-stage glenohumeral osteoarthritis. Methods: three patients underwent bipolar fresh osteochondral allograft implantation to the shoulder. Clinical and radiographical evaluations were carried out periodically through to final follow-up. Results: constant Score increased from 38.3 ± 2.9 preoperatively to 78.7 ± 16.2 at 12 months, 72.3 ±15.3 at 24 months, and 59.3 ± 22.0 at 34 months. Arthritis and partial reabsorption of the implanted surfaces were evident radiographically. Conclusions: the clinical results obtained in these patients seem to support the applicability of bipolar fresh osteochondral allograft implantation in the shoulder in subjects with severe post-traumatic arthritis and intact rotator cuff. The development of arthritis of the implanted surfaces, while not impacting the clinical result, is a cause of concern. Level of Evidence: level IV, therapeutic case series.

A 10-min novel technique for involutional entropion: Mini-incisional continuous ligation everting sutures

2021 ◽  
pp. 112067212110500
Author(s):  
Yong M Choi ◽  
Namju Kim
Keyword(s):  
Recurrence Rate ◽  
Surgical Outcome ◽  
Case Series ◽  
Interquartile Range ◽  
Retrospective Case ◽  
Novel Technique ◽  
Time To Recurrence ◽  
Involutional Entropion ◽  
Surgical Modality

Purpose To introduce a novel technique of mini-incisional continuous ligation everting sutures for correction of involutional entropion and report the surgical outcome. Methods A retrospective case series. Eighty-five eyelids of 77 patients who underwent correction of involutional lower lid entropion using mini-incisional continuous ligation everting sutures were included in this study. The medical records of patients with at least 24 months of follow-up after surgery were reviewed. We collected information on demographic and clinical characteristics, including sex, age at surgery, duration of follow-up, horizontal lid laxity, surgical outcomes, and complications. Main outcome measures were success of surgery, recurrence rate, time to recurrence, and risk factors for recurrence. Results The median (interquartile range) age at the time of surgery was 72.0 (65.5–78.0) years and the median (interquartile range) follow-up duration was 24.0 (24.0–42.5) months. Thirty-seven eyelids (43.5%) showed horizontal eyelid laxity on a lid distraction test The surgical outcome was successful in the majority of patients (94.1%) with a recurrence rate of 5.9% in the 2 years after surgery. Only female sex was significantly correlated with recurrence of entropion (odds ratio 9.466, 95% confidence interval 1.022 to 87.670, P  =  0.048). Conclusion This novel technique is a promising surgical modality for correction of lower lid involutional entropion because of its ease of application, simplicity, compatibility with anticoagulants, and low recurrence rate.

Clinical results of Visian implantable collamer lens implantation according to various sizes and implantation angles

2021 ◽  
pp. 112067212110334
Author(s):  
Bu Ki Kim ◽  
Young Taek Chung
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Implantable Collamer Lens ◽  
Retrospective Case ◽  
Significant Difference ◽  
Lens Implantation ◽  
Group A ◽  
The Mean ◽  
Group B

Purpose: To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle. Setting: Onnuri Smile Eye Clinic, Seoul, Republic of Korea. Design: Retrospective case series. Methods: This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical). Results: At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B ( p < 0.001), and when ICL was horizontally and vertically implanted in group C ( p = 0.021), respectively. And the mean SE was −0.11 ± 0.30, −0.34 ± 0.42, −0.3 ± 0.56 and −0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B ( p = 0.039), and when the ICL was horizontally and vertically implanted in group C ( p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C. Conclusions: The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.

Sign in / Sign up

Export Citation Format

Share Document