Preliminary Experience With Polyvinyl Alcohol Hydrogel Implant for Pathology of the Second Metatarsal Head

2019 ◽  
Vol 40 (11) ◽  
pp. 1304-1308 ◽  
Author(s):  
Mark Glazebrook ◽  
Joel Morash ◽  
Meshal Alhadhoud ◽  
Timothy R. Daniels
Keyword(s):  
Surgical Technique ◽  
Polyvinyl Alcohol ◽  
Activities Of Daily Living ◽  
Range Of Motion ◽  
Daily Living ◽  
Short Form ◽  
Metatarsal Head ◽  
Sf 36 ◽  
Second Metatarsal

Background: There is no consensus regarding which surgical technique is most beneficial for pathology of the second metatarsophalangeal joint. We report the use of polyvinyl alcohol hydrogel synthetic cartilage implant hemiarthroplasty for pathology of the second metatarsal head that has failed nonoperative treatment and present 5 cases with a minimum 15 months of follow-up. Methods: The technique for synthetic cartilage hemiarthroplasty of the second metatarsal head is described. The postoperative protocol included weightbearing as tolerated for 2 weeks and moderate limitations in activities of daily living to respect wound healing, followed by physiotherapy for range of motion exercises. Charts for patients who underwent this procedure between 2015 and 2017 were retrospectively reviewed. Outcome measures collected postoperatively included a pain visual analog scale, Short-Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, and Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) current level of function percentages. Results: At 15 to 38 months of follow-up, patients reported little to no pain and good range of motion, with no complications. Mean outcome measure scores were 89 for FAAM ADL, 75 for FAAM Sports, 44.4 for SF-36 PCS, and 52.1 for SF-36 MCS. Conclusion: This preliminary study of synthetic cartilage hemiarthroplasty for treatment of joint-destructive conditions of the second metatarsal head demonstrated good outcomes and no complications in 5 cases at a mean 25 months of follow-up. Large prospective cohort studies are needed to prove the efficacy and safety of this new surgical technique for the treatment of pathology of the second metatarsal head. Level of Evidence: Level IV, retrospective case series.

Autologous Osteochondral Graft for Early Posttraumatic Arthritis of Tibiotalar Joints After Comminuted Pilon Fractures in Young Patients

2019 ◽  
Vol 41 (1) ◽  
pp. 69-78 ◽  
Author(s):  
Xi Liu ◽  
Jingjing An ◽  
Hui Zhang ◽  
Yaxing Li ◽  
Yu Chen ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Short Form ◽  
Young Patients ◽  
Joint Surface ◽  
Posttraumatic Arthritis ◽  
Osteochondral Graft ◽  
Tibiotalar Joint ◽  
Sf 36 ◽  
Pilon Fractures

Background: Posttraumatic arthritis of tibiotalar joints after AO/OTA type C3 pilon fractures, especially in young patients with a significant osteochondral defect in the tibial plafond joint surface, is a challenging situation. We report a joint-preserving technique using autologous osteochondral graft in combination with ankle distraction and supramalleolar osteotomy (SMOT), if necessary, to improve its outcome. Methods: Seventeen patients with an average age of 32.1 years with Takakura grade 1 to 3A posttraumatic arthritis of the tibiotalar joint after AO/OTA type C3 pilon fractures received osteochondral autograft transplantation, ankle distraction, and SMOT, when supramalleolar malalignment was present, between February 2010 and November 2015. The visual analog scale (VAS), Short-Form 36 (SF-36) score, American Orthopaedic Foot & Ankle Society (AOFAS) score, and ankle range of motion were used for outcome analysis. Radiographic assessment of any SMOT and the apparent joint space was performed. Fourteen patients were followed for an average of 18 months. Results: The VAS, SF-36, and AOFAS scores as well as the ankle range of motion all improved significantly at the last follow-up after the surgery ( P < .01). No deep surgical site infection, donor site complication, nonunion, osteochondral block loosening, or resorption was noted. No secondary arthrodesis was needed at the end of follow-up. Conclusion: Autologous osteochondral graft transplantation in combination with ankle distraction and SMOT was a promising joint-preserving technique for early posttraumatic arthritis of tibiotalar joint after severe pilon fractures in young patients. Level of Evidence: Level IV, case series.

scholarly journals Complementarity of the Mini-Nutritional Assessment and Activities of Daily Living for predicting follow-up mortality risk in elderly Taiwanese

2012 ◽  
Vol 109 (4) ◽  
pp. 658-666 ◽  
Author(s):  
Alan C. Tsai ◽  
Li-Chin Lee ◽  
Jiun-Yi Wang
Keyword(s):  
Nutritional Status ◽  
Activities Of Daily Living ◽  
Mortality Risk ◽  
Daily Living ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Physical functional ability and nutritional status are two major indicators for predicting the risk of mortality in older adults. The present study examined the complementarity of the Activities of Daily Living (ADL) and the Mini-Nutritional Assessment (MNA) for predicting follow-up 4-year all-cause mortality risk in elderly Taiwanese. We analysed data of the ‘Survey of Health and Living Status of the Elderly in Taiwan’, a population-based longitudinal cohort study which involved 2872 men and women of ≥ 65 years old at baseline (1999). We rated their functional dependency with the ADL scale and nutritional status with the MNA (both the long form, LF and the short form, SF) at baseline, and analysed the complementarity of the two scales in predicting follow-up 4-year all-cause mortality with Cox regression analysis and the net reclassification improvement (NRI) to quantify the improvement. The results showed that both ADL and MNA offered improvement in predicting follow-up mortality risk beyond that predicted by either one alone according to the Akaike information criterion and the NRI. The MNA-SF was nearly as effective as the MNA-LF in improving the predictive ability of the ADL. The present study suggests that the MNA (especially the SF because of its simplicity and time-saving feature) together with the ADL scale might be of value for predicting the mortality risk of frail elderly living in various settings.

scholarly journals Relationship between activities of daily living and depression among older adults and the quality of life of family caregivers

2018 ◽  
Vol 5 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Hui Xie ◽  
Pei-Wen Chen ◽  
Long Zhao ◽  
Xuan Sun ◽  
Xian-Jie Jia
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Family Caregivers ◽  
Psychological Health ◽  
Daily Living ◽  
Short Form ◽  
Summary Score ◽  
Sf 36

Abstract Objective The purposes of this study were to explore the associations of activities of daily living (ADL) and depression among older adults with family caregivers’ quality of life and provide evidence for improving family caregivers’ quality of life. Methods Older adults (n=395) and their family caregivers (n=395) were selected as participants. The ADL scale and Geriatric Depression Scale were used to assess ADL and depression among older adults, and the 36-Item Short Form Health Questionnaire (SF-36) was used to assess family caregivers’ quality of life. Descriptive statistics and multiple linear regression were used to analyze the data. Results The older adults’ ADL and depression scores were 21±7 and 11±6, respectively. Approximately 69.9% of older adults had declining or severely impaired ADL, and 47.1% had mild or moderate-to-severe depression. Family caregivers’ mean quality of life score was 529±100. There was a negative correlation of older adults’ ADL and depression with caregivers’ quality of life. The correlation coefficient between ADL and the SF-36 mental component summary score was stronger than it was with the SF-36 physical component summary score. Conclusions The ADL and depression of older adults influenced family caregivers’ quality of life. Psychological health deserves closer attention, especially that of caregivers of disabled older adults.

scholarly journals The analysis of quality of life using SF-36 among patients with myasthenia gravis in South Korea

2021 ◽  
Author(s):  
Juhyeon Kim ◽  
Jin Myoung Seok ◽  
Misong Choi ◽  
Byoung Joon Kim ◽  
Ansuk Jeong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myasthenia Gravis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Short Form ◽  
Short Form Health Survey ◽  
Form Health ◽  
Sf 36 ◽  
Short Form Health

Abstract PurposePatients with Myasthenia gravis (MG) have poor health related quality of life (HRQoL), which negatively affects their activities of daily living. The purpose of this study was to analyze factors affecting HRQoL in patients with MG using the 36-Item Short-Form Health Survey (SF-36).MethodsWe prospectively studied patients with confirmed diagnosis of MG. Patients, who presented to the neuromuscular outpatient clinic, at a Samsung medical center in South Korea in a four-month period. Severity of MG was assessed by the Myasthenia Gravis Composite Scale (MGCS) and HRQoL was assessed by the 36-Item Short-Form Health Survey (SF-36) and activities of daily living was assessed by the Korean version of Myasthenia Gravis-specific Activities of Daily Living scale (K-MG-ADL).ResultsA total of 120 patients with MG were invited to participate in the study.We analyzed the difference of SF-36 score according to demographic and clinical characteristics in our MG patients. Significant differences were found according to sex, career change, marital status, MG type, and thymoma.ConclusionBy analyzing the specifics of the HRQoL, the current study demonstrated that this should be reflected in the treatment guidelines for MG patients.

Abstract WP358: A Population-Based Study of Intracerebral Hemorrhage Outcomes: The BASIC Project

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Julius Griauzde ◽  
Lynda D Lisabeth ◽  
Chengwei Li ◽  
Brisa N Sanchez ◽  
Erin Case ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Intracerebral Hemorrhage ◽  
Activities Of Daily Living ◽  
Mexican Americans ◽  
Daily Living ◽  
Short Form ◽  
Population Based ◽  
Population Based Study ◽  
Coma Scale

Background: We evaluated 3-month neurologic, functional, cognitive, and quality of life (QOL) outcomes in intracerebral hemorrhage (ICH) overall, and by sex and ethnicity in a population-based community study. Methods: Spontaneous ICH patients were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) project from November 2008 to December 2013. Demographics and Glasgow Coma Scale were abstracted from medical records. Outcomes assessed included neurologic (National Institute of Health Stroke Scale (NIHSS): range, 0-42), functional (activities of daily living/instrumental activities of daily living: range 1-4, higher worse), cognitive (Modified Mini-Mental State Examination (mMMSE): range, 0-100), and QOL (Short-form Stroke Specific QOL scale: range, 0-5, higher better). Ethnic and sex differences were assessed with Tobit regression adjusted for age, sex or ethnicity, and presenting Glasgow Coma Scale. Results: A total of 245 patients completed baseline interviews, with 103 (42%) dying prior to follow-up, leaving 142 eligible for outcome assessment. 3-month follow up was completed on 100 (neurologic), 107 (functional), 79 (cognitive), and 83 (QOL) participants. Median age was 66 (interquartile range (IQR), 58.0-77.0). The overall median 3-month NIHSS was 2.0 (IQR, 1.0-6.0), with other baseline characteristics and outcomes shown in Table 1. Cognitive outcomes were worse in Mexican Americans (MA) compared to non-Hispanic Whites (NHW) after multivariable adjustment (MA scoring 13.3 mMMSE points lower than NHW (95% CI: 5.8, 20.7; p=.0005)). There was no difference by sex or ethnicity in neurological, functional, or QOL outcomes either before or after adjustment. Conclusions: In this population-based study, ICH survivors have remarkably favorable neurologic, functional, cognitive and QOL outcomes. There is an important disparity for worse cognitive outcome in MAs compared with NHWs.

Midterm Outcomes of Polyvinyl Alcohol Hydrogel Hemiarthroplasty of the First Metatarsophalangeal Joint in Advanced Hallux Rigidus

2016 ◽  
Vol 38 (3) ◽  
pp. 243-247 ◽  
Author(s):  
Timothy R. Daniels ◽  
Alastair S. E. Younger ◽  
Murray J. Penner ◽  
Kevin J. Wing ◽  
Sara Lyn Miniaci-Coxhead ◽  
...  
Keyword(s):  
Polyvinyl Alcohol ◽  
Functional Outcomes ◽  
Short Form ◽  
Case Series ◽  
Hallux Rigidus ◽  
Radiographic Evaluation ◽  
First Metatarsophalangeal Joint ◽  
Sf 36 ◽  
Pva Hydrogel

Background: Hallux rigidus is the most common arthritic condition of the foot. A randomized clinical trial of first metatarsophalangeal (MTP) joint hemiarthroplasty with a polyvinyl alcohol (PVA) hydrogel implant (Cartiva) demonstrated pain relief and functional outcomes equivalent to first MTP arthrodesis at 2 years postoperation, with no cases of implant fragmentation, wear, or bone loss. We prospectively determined 5-year outcomes of first MTP hemiarthroplasty with the PVA hydrogel implant. Methods: Patients who underwent first PVA hydrogel MTP hemiarthroplasty in the previously reported trial were evaluated at 5 years postoperatively. Patients underwent physical examination and radiographic evaluation and completed a pain VAS, the Short-Form-36 (SF-36), and the Foot and Ankle Ability Measure (FAAM) sports subscale and activities of daily living (ADL) subscale. At the time of this study, 29 patients had reached 5 years’ follow-up. Two were lost to follow-up, leaving 27 patients with mean age 56.1 (range, 40.1-71.9) years. Mean follow-up was 5.4 (range, 4.9-6.4) years. Results: Postoperative active MTP natural joint dorsiflexion and peak MTP dorsiflexion were mean 18.2 (range, 10.0-30.0) and 29.7 (range, 10.0-45.0) degrees, respectively. Pain VAS, SF-36 PCS, FAAM ADL, and FAAM Sports scores demonstrated clinically and statistically significant improvements. Radiographically, no patient demonstrated changes in implant position, implant loosening or subsidence, or implant wear. One implant was removed because of persistent pain and converted to fusion 2 years postoperation. Conclusion: Five years following first MTP hemiarthroplasty with a PVA hydrogel implant, functional outcomes improved significantly, pain was reduced significantly, and the implant demonstrated excellent survivorship. Level of Evidence: Level IV, prospective case series.

scholarly journals The Association Between Knee Pain, Symptoms, Function and Quality af Life After Anterior Cruciate Ligament Reconstruction at Short-Term Follow-Up

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Selmin Gülbahar ◽  
Hüseyin Aydoğmuş ◽  
Merve Velioğlu ◽  
Ebru Şahin ◽  
Hasan Tatari ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Acl Reconstruction ◽  
Daily Living ◽  
Mental Component Summary ◽  
Short Term ◽  
Sf 36 ◽  
The Mean ◽  
Pain Symptoms

Objectives: To investigate the associations between pain, symptoms, function and knee-related quality of life (QOL) after ACL reconstruction at short-term follow-up Methods: Twenty patients who had undergone ACL reconstruction were included in the study. Knee Injury and Osteoarthritis Outcome Score-Turkish (KOOS-T) was used to evaluate knee pain, other symptoms (symptoms), activities of daily living and sport and recreation (Sport/Rec). Quality of life was assessed with Short Form (SF)-36. Lysholm knee scoring scale was used for clinical evaluation. Results: The mean age of patients was 28. 2 ± 5.5 and the mean time passed after surgery was 38.22 ± 24.7 weeks. A significant correlation (p<0, 05) was found between KOOS-T pain, activities of daily living subscales and all SF-36 subscale scores and both physical component and mental component summary scores. KOOS symptoms and Sports/Rec subscales were correlated with physical and social functioning subscale scores and mental component summary scores of SF-36. Symptoms subscale was also correlated with vitality subscale of SF-36. There was no correlation between SF-36 scores and age and time passed after surgery. Lysholm score was also correlated with most of the subscales of SF-36 but especially with physical component summary score. Conclusion: The QOL of patients who had undergone ACL reconstruction was significantly correlated with pain and activities of daily living. The mental health subscales of SF-36 also correlated with pain, symptoms, ADL and Sports/Rec suggesting that apart from the physical impairment, mental health is also an important clinical issue in patients who had undergone ACL reconstruction.

scholarly journals Multimorbidity, Disadvantage, and Trends in Disability-Free Life Expectancy: The CFAS Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 641-641
Author(s):  
Andrew Kingston ◽  
Holly Bennett ◽  
Louise Robinson ◽  
Lynne Corner ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Expectancy ◽  
Longitudinal Data ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Health Conditions ◽  
Disadvantaged Groups ◽  
Disability Free Life Expectancy ◽  
Reported Health

Abstract The combined contribution of multi-morbidity and socio-economic position (SEP) to trends in disability free life expectancy (DFLE) is unknown. We use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Multi-morbidity was constructed from nine self-reported health conditions and categorised as 0-1, 2-3, 4+ diseases. In 1991 and 2011, shorter total and disability-free years were associated with greater multi-morbidity. Between 1991 and 2011, gains in life expectancy and DFLE were observed at all levels of multi-morbidity, the greatest gain in DFLE being 4 years for men with 0-1 diseases. As multi-morbidity is more prevalent in more disadvantaged groups, further analyses will investigate whether SEP differences remain at all levels of multi-morbidity.

Comparing durability of water- and land-based exercise benefits among older adults in South Korea: A randomized controlled trial with 1-year follow-up

2021 ◽  
pp. 1-11
Author(s):  
Se Jun Oh ◽  
Sang Heon Lee
Keyword(s):  
Exercise Intervention ◽  
External Rotation ◽  
Short Form ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Aquatic Exercise ◽  
Step Test ◽  
Sf 36 ◽  
Partial Weight

BACKGROUND: Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. OBJECTIVE: The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. METHODS: Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). RESULTS: Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p< 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. CONCLUSION: Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.

scholarly journals The effect of a 24-week training focused on activities of daily living, muscle strengthening, and stability in idiopathic inflammatory myopathies: a monocentric controlled study with follow-up

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Maja Špiritović ◽  
Barbora Heřmánková ◽  
Sabína Oreská ◽  
Hana Štorkánová ◽  
Olga Růžičková ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Substantial Proportion ◽  
Controlled Study ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Local Inflammatory Response ◽  
Secondary Outcomes

Abstract Background The structural and functional changes of the skeletal muscles in idiopathic inflammatory myopathies (IIM) caused by inflammation and immune changes can be severely disabling. The objective of this study was to assess the effect of a 24-week program combining a supervised training of activities of daily living (ADL), resistance, and stability with home exercise for improving muscle function, compared to a daily home-based exercise representing the regular outpatient care. Methods Fifty-seven patients with IIM were consecutively and non-selectively enrolled in an intervention (IG, n = 30) or control (CG, n = 27) group. Both groups were provided a standard-of-care pharmacological treatment and follow-up. Only the IG underwent the supervised intervention twice a week for 1 h per session. At baseline, 12, 24, and 48 weeks, all patients were assessed by an assessor blinded to the intervention for primary outcomes: muscle strength (Manual Muscle Testing of eight muscle groups [MMT-8]) and endurance (Functional Index-2 [FI-2]), and secondary outcomes: stability and body composition. Secondary outcomes also included questionnaires evaluating disability (Health Assessment Questionnaire [HAQ]), quality of life (Short Form 36 [SF-36]), depression (Beck’s Depression Inventory-II [BDI-II]), and fatigue (Fatigue Impact Scale [FIS]), and analysis of the systemic and local inflammatory response and perceived exertion to assess the safety of the intervention. Results Twenty-seven patients in the IG and 23 in the CG completed the entire program and follow-up. At week 24, compared to deterioration in the CG, we found a significant improvement in the IG in muscle strength (mean % improvement compared to baseline by 26%), endurance (135%), disability (39%), depression (26%), stability (11%), and basal metabolism (2%) and a stabilization of fitness for physical exercise. The improvement was clinically meaningful (a 24-week change by >20%) in most outcomes in a substantial proportion of patients. Although the improvement was still present at 48 weeks, the effect was not sustained during follow-up. No significant increase in the systemic or local expression of inflammatory markers was found throughout the intervention. Conclusions This 24-week supervised intervention focused on ADL training proved to be safe and effective. It not only prevented the progressive deterioration, but also resulted in a significant improvement in muscle strength, endurance, stability, and disability, which was clinically meaningful in a substantial proportion of patients. Trial registration ISRCTN35925199 (retrospectively registered on 22 May 2020).

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