Long-Term Follow-up of Capsular Interposition Arthroplasty for Hallux Rigidus

2017 ◽  
Vol 39 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ettore Vulcano ◽  
Andy L. Chang ◽  
David Solomon ◽  
Mark Myerson
Keyword(s):  
Patient Satisfaction ◽  
Short Form ◽  
Case Series ◽  
Hallux Rigidus ◽  
Interposition Arthroplasty ◽  
Patient Satisfaction Score ◽  
Long Term Follow Up ◽  
The Mean

Background: Capsular interposition arthroplasty is a joint- and motion-sparing procedure that has been shown as an effective alternative to fusion. This study aimed to evaluate patient function and satisfaction after long-term follow-up. Methods: Sixty-four patients were treated with capsular interposition arthroplasty for hallux rigidus by the senior author performed between February 1998 and July 2011. Twenty-two patients could not be reached for follow-up and were thus excluded from the analysis. Therefore, 42 remaining patients were evaluated using the visual analog scale (VAS), Foot Function Index (FFI), Short Form 12 (SF-12), and patient satisfaction scores. The mean follow-up was 11.3 (range, 4-16) years. Results: The mean VAS for pain was 7.9 preoperatively and 1.8 postoperatively ( P = .003). The mean preoperative SF-12 physical score was 42.0 vs 64.2 postoperatively ( P = .02). The mean preoperative SF-12 mental score was 50.7, while the postoperative SF-12 mental score was 54.6 ( P = .01). The total FFI score also significantly improved, with a preoperative value of 98.3 and a postoperative mean score of 49.6 ( P = .001). The mean patient satisfaction score was 7.4 of 10. Overall, 39 of 42 patients (92.9%) stated they would have the surgery again. Four of the 42 patients (9.5%) required conversion to hallux metatarsophalangeal fusion at a mean of 6.1 years after the index procedure secondary to pain, but no other complications were reported. Conclusion: Capsular interposition arthroplasty was a safe and effective treatment for severe hallux rigidus. These longer term results demonstrate a high level of patient satisfaction. Level of Evidence: Level IV, retrospective case series.

scholarly journals Long-term follow-up of neodymium:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis

2018 ◽  
Vol 46 (9) ◽  
pp. 3692-3697 ◽  
Author(s):  
Hehua Ye ◽  
Jiming Zhang ◽  
Yiyong Qian
Keyword(s):  
Nd:Yag Laser ◽  
Case Series ◽  
Anterior Capsule ◽  
Long Term Study ◽  
Before And After ◽  
Long Term Follow Up ◽  
The Mean ◽  
Anterior Capsulotomy

Objective To investigate the long-term safety and efficacy of Nd:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis. Methods We retrospectively analyzed a consecutive case series of Nd:YAG laser anterior capsulotomy in patients with anterior capsular phimosis, who were treated between November 2012 and April 2014. Data collected included risk factors, interval between surgery and capsulotomy, best-corrected visual acuity (BCVA), and diameter of anterior capsule opening before and after Nd:YAG laser anterior capsulotomy. Results Eleven eyes of 11 patients were included in the study. The mean follow-up time was 30.1 ± 4.5 months (range: 26–42 months). At the last follow-up, the mean diameter of the anterior capsule opening was 5.1 ± 0.2 mm, which was significantly greater than the diameter before laser capsulotomy (2.2 ± 0.8 mm). BCVA remained stable or improved in nine eyes (81.8%) following capsulotomy. No patients experienced recurrence of phimosis. Conclusions In a long-term study of >2 years, we found that Nd:YAG laser anterior capsulotomy is safe and effective for the treatment of anterior capsule phimosis.

Long-Term Follow-up of Arthroscopic Treatment of Lateral Epicondylitis

2008 ◽  
Vol 36 (2) ◽  
pp. 254-260 ◽  
Author(s):  
Champ L. Baker ◽  
Champ L. Baker
Keyword(s):  
Case Series ◽  
Lateral Epicondylitis ◽  
Operative Management ◽  
High Rate ◽  
Functional Score ◽  
Level Of Evidence ◽  
Long Term Follow Up ◽  
The Mean

Background In a previously published report of the authors’ arthroscopic technique of operative management of recalcitrant lateral epicondylitis, they demonstrated short-term success with the procedure in their patients. Hypothesis Arthroscopic management of patients with lateral epicondylitis can produce clinical improvement and have successful long-term outcomes. Study Design Case series; Level of evidence, 4. Methods Forty patients (42 elbows) with lateral epicondylitis who had not responded to nonoperative management were treated with arthroscopic resection of pathologic tissue. Thirty of these patients (30 elbows) were located for extended follow-up. At a mean follow-up of 130 months (range, 106–173 months), patients were asked to use a numeric scale to rate their elbow pain from 0 (no pain) to 10 (severe pain). Patients were also asked to rate their elbows according to the functional portion of the Mayo Clinic Elbow Performance Index. Results The mean pain score at rest was 0; with activities of daily living, 1.0; and with work or sports, 1.9. The mean functional score was 11.7 out of a possible 12 points. No patient required further surgery or repeat injections after surgery. One patient continued to wear a counterforce brace with heavy activities. Twenty-three patients (77%) stated they were “much better,” 6 patients (20%) stated they were “better,” and 1 patient (3%) stated he was the same. Twenty-six patients (87%) were satisfied, and 28 patients (93%) stated they would have the surgery again if needed. Conclusion Arthroscopic removal of pathologic tendinosis tissue is a reliable treatment for recalcitrant lateral epicondylitis. The early high rate of success in patients was maintained at long-term follow-up.

Long-term Follow-up of Cheilectomy for Treatment of Hallux Rigidus

2019 ◽  
Vol 40 (10) ◽  
pp. 1114-1121 ◽  
Author(s):  
Eliezer Sidon ◽  
Ryan Rogero ◽  
Timothy Bell ◽  
Elizabeth McDonald ◽  
Rachel J. Shakked ◽  
...  
Keyword(s):  
Case Series ◽  
Hallux Rigidus ◽  
Long Term Results ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
First Metatarsophalangeal Joint ◽  
Significant Difference ◽  
Long Term Follow Up

Background:Hallux rigidus is the most common arthritic condition in the foot. First metatarsophalangeal joint cheilectomy produces satisfactory results in retrospective studies with reported good to excellent results in up to 97% and pain relief and function in 92%. The results of cheilectomy for higher grades of hallux rigidus are less favorable. The purpose of this study was to evaluate the long-term functional results and survivorship of cheilectomy for treatment of hallux rigidus.Methods:This was a retrospective, questionnaire-based study investigating the long-term results of cheilectomy for treatment of hallux rigidus. The preoperative arthritic grade was graded retrospectively according to the Hattrup and Johnson (H&J) grading system. A questionnaire was administered via email or telephone that included questions regarding pain recurrence following surgery, current functional status, and satisfaction with the operation. Kaplan-Meier survival analysis was performed to estimate survival time between arthritic grades. We reviewed 165 patients (169 feet) with an average follow-up of 6.6 (5.0-10.9) years.Results:The overall survival rate (painless at the time of last follow-up) was 70.4% (119 feet), with no significant difference between the 3 H&J arthritic grades. Most of the recurrences (28 feet, 75%) were at the first 2 years following the surgery. Nine feet (5.3%) had a second procedure at a mean postoperative time of 3.6 (range, 1.6-7.4) years. Of the 169 feet, 117 (69.3%) reported being satisfied or very satisfied and 127 (75.1%) indicated they would repeat the operation under the same circumstances.Conclusion:Our study supports the use of cheilectomy for treatment of hallux rigidus (grade 1-3 Coughlin and Shurnas) as a reliable procedure with favorable results. At long-term follow-up, patients who underwent cheilectomy had a low revision rate and a moderately low rate of pain recurrence.Level of Evidence:Level IV, retrospective case-series.

S279 – Augmentation Rhinoplasty with Permacol and Cartilage Grafts

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P168-P168 ◽  
Author(s):  
Thirupathirajan Thinakararajan ◽  
Venkat R Srinivasan
Keyword(s):  
Patient Satisfaction ◽  
Senior Author ◽  
Augmentation Rhinoplasty ◽  
Historical Cohort ◽  
Cartilage Grafts ◽  
Satisfactory Outcome ◽  
Long Term Follow Up ◽  
The Mean

Objectives Assessment of outcome and patient satisfaction following augmentation rhinoplasty with cartilage & Permacol and safety of Permacol. Methods Permacol is a biomaterial derived from porcine dermis, modified by chemical processing. Patients with Permacol augmentation were compared with a historical cohort of patients who had cartilage augmentation. Patients, who had cartilage grafts, were retrospectively reviewed for a period of 3 years, from 2001 to 2004. Patients in the Permacol group were prospectively studied from 2003 to 2006. The senior author performed all operations. All the patients had supra-tip depression. The outcome was measured by clinical assessment, evaluation of photographs, and patient satisfaction. Results A total 24 patients had augmentation rhinoplasty-12 with cartilage and 12 with Permacol. Their age ranged from 19 to 54 years (mean 30). The mean follow-up for cartilage grafts was 33 months and for Permacol 26 months, with a minimum of 12 months for both groups. Cartilage grafts were harvested from the septum in 7 patients and from the pinna in 5 patients. All 12 patients with cartilage augmentation had satisfactory outcome. In the Permacol group, 11 out of 12 were satisfactory with the outcome. In 1 patient, Permacol graft extruded within 2 months. Conclusions Permacol graft compared very well, in terms of outcome and safety, with cartilage for augmentation of nasal dorsum. Apart from 1 case of extrusion (8%), there were no other complications. Permacol graft is readily available and easy to handle and contour. Long-term follow-up is needed for further assessment.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals Long-Term Follow-Up of Denosumab Discontinuers with Multiple Vertebral Fractures in the Real-World: A Case Series

2021 ◽  
Author(s):  
Liana Tripto-Shkolnik ◽  
Yair Liel ◽  
Naama Yekutiel ◽  
Inbal Goldshtein
Keyword(s):  
Real World ◽  
Vertebral Fractures ◽  
Clinical Laboratory ◽  
Case Series ◽  
High Risk Group ◽  
Imaging Data ◽  
Long Term Follow Up ◽  
Multiple Vertebral Fractures

AbstractDenosumab discontinuation is associated with rapid reversal of bone turnover suppression and with a considerable increase in fracture risk, including a risk for multiple vertebral fractures (MVF). Long-term follow-up of patients who sustained MVF after denosumab discontinuation has not been reported. This case-series was aimed to provide a long-term follow-up on the management and outcome of denosumab discontinuers who initially presented with multiple vertebral fractures. Denosumab discontinuers were identified from a computerized database of a large healthcare provider. Baseline and follow-up clinical, laboratory, and imaging data were obtained from the computerized database and electronic medical records. The post-denosumab discontinuers MVF patients consisted of 12 women aged 71±12. Osteoporotic fractures were prevalent before denosumab discontinuation in 6 of the patients. The majority received bisphosphonates before denosumab. MVF occurred 134±76 days after denosumab discontinuation. The patients were followed for a median of 36.5 (IQR 28.2, 42.5) months after MVF. Two patients passed-away. Two patients suffered recurrent vertebral fractures. Following MVF, patients were treated inconsistently with denosumab, teriparatide, oral, and intravenous bisphosphonates, in various sequences. Two patients underwent vertebroplasty/kyphoplasty. This long-term follow-up of real-world patients with MVF following denosumab discontinuation reveals that management is inconsistent, and recurrent fractures are not uncommon. It calls for clear management guidelines for patients with MVF after denosumab discontinuation and for special attention to this high-risk group.

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

Risk of hemorrhage from de novo cerebral aneurysms

2013 ◽  
Vol 118 (1) ◽  
pp. 58-62 ◽  
Author(s):  
William J. Kemp ◽  
Daniel H. Fulkerson ◽  
Troy D. Payner ◽  
Thomas J. Leipzig ◽  
Terry G. Horner ◽  
...  
Keyword(s):  
Risk Factors ◽  
De Novo ◽  
Patient Age ◽  
Patient Âgé ◽  
Long Term Follow Up ◽  
De Novo Aneurysm ◽  
The Mean ◽  
Risk Of Hemorrhage

Object A small percentage of patients will develop a completely new or de novo aneurysm after discovery of an initial aneurysm. The natural history of these lesions is unknown. The authors undertook this statistical evaluation a large cohort of patients with both ruptured and unruptured de novo aneurysms with the aim of analyzing risk factors for rupture and estimating a risk of subarachnoid hemorrhage (SAH). Methods A review of a prospectively maintained database of all aneurysm patients treated by the vascular neurosurgery service of Goodman Campbell Brain and Spine from 1976–2010 was performed. Of the 4718 patients, 611 (13%) had long-term follow-up imaging. The authors identified 27 patients (4.4%) with a total of 32 unruptured de novo aneurysms from routine surveillance imaging. They identified another 10 patients who presented with a new SAH from a de novo aneurysm after treatment of their original aneurysm. The total study group was thus 37 patients with a total of 42 de novo aneurysms. The authors then compared the 27 patients with incidentally discovered aneurysms with the 10 patients with SAH. A statistical analysis was performed, comparing the 2 groups with respect to patient and aneurysm characteristics and risk factors. Results Thirty-seven patients were identified as having true de novo aneurysms. This group had a female predominance and a high percentage of smokers. These 37 patients had a total of 42 de novo aneurysms. Ten of these 42 aneurysms hemorrhaged. De novo aneurysms in both the SAH and non-SAH group were anatomically small (< 10 mm). The estimated risk of hemorrhage over 5 years was 14.5%, higher than the expected SAH risk of small, unruptured aneurysms reported in the ISUIA (International Study of Unruptured Intracranial Aneurysms) trial. There was no statistically significant correlation between hemorrhage and any of the following risk factors: hypertension, diabetes, tobacco and alcohol use, polycystic kidney disease, or previous SAH. There was a statistically significant between-groups difference with respect to patient age, with the mean patient age being significantly older in the SAH aneurysm group than in the non-SAH group (p = 0.047). This is likely reflective of longer follow-up and discovery time, as the mean length of time between initial treatment and discovery of the de novo aneurysm was longer in the SAH group (p = 0.011). Conclusions While rare, de novo aneurysms may have a risk for SAH that is comparatively higher than the risk associated with similarly sized, small, initially discovered unruptured saccular aneurysms. The authors therefore recommend long-term follow-up for all patients with aneurysms, and they consider a more aggressive treatment strategy for de novo aneurysms than for incidentally discovered initial aneurysms.

Sign in / Sign up

Export Citation Format

Share Document