Arthroscopic Resection of Dorsal Wrist Ganglion: Results and Rate of Recurrence Over a Minimum Follow-up of 4 Years

Background: Dorsal wrist ganglia are the most common soft tissue tumor type of the upper limb. Surgical resection, open or arthroscopic, is one of the most frequent procedures performed by hand surgeons. This study sought to perform an objective evaluation of the outcomes of arthroscopic resection of dorsal wrist ganglia and their recurrence rates over 4 years. Patients treated with arthroscopic resection were expected to have favorable outcomes and low complication rates after 4 years of follow-up. Methods: We evaluated 34 cases of dorsal wrist ganglia in patients who underwent arthroscopic resection. The patients were evaluated using the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcome measure, visual analog scale (VAS) for pain, range of motion of the wrist, palmar grip strength, rates of recurrence, and complications. Results: During the postoperative period, the QuickDASH score averaged 2.3 points, the mean residual pain by VAS was 0.54, full range of wrist movement was recovered by all patients, and the mean palmar grip strength was 29.4 kgf; there was 1 case with recurrence. There were no severe postoperative complications throughout the follow-up period. Conclusions: The outcomes, recurrence, and complications rates after 4 years of follow-up presented in this study support the use of arthroscopy as a treatment for dorsal wrist ganglion.

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EVALUATION OF THE RESULTS OF THE USE OF VEPTR IN PATIENTS WITH SCOLIOSIS

Coluna/Columna ◽

10.1590/s1808-185120161503147272 ◽

2016 ◽

Vol 15 (3) ◽

pp. 181-185

Author(s):

JOÃO PAULO SILVA ARAÚJO ◽

MARCOS ANDRÉ COSTA FERREIRA ◽

ANDRÉ FLAVIO FREIRE PEREIRA ◽

TULIO ALBUQUERQUE DE MOURA RANGEL ◽

RODRIGO CASTRO DE MEDEIROS ◽

...

Keyword(s):

Spinal Fusion ◽

Spinal Instrumentation ◽

Objective Evaluation ◽

Complication Rates ◽

Mean Values ◽

Fusion Methods ◽

The Mean ◽

Getulio Vargas ◽

Initial Correction

ABSTRACT Objective: Evaluation of the results of the use of VEPTR (Vertical Expandable Prosthetic Titanium Rib - Synthes Spine Co.(r), West Chester, Pennsylvania, USA) as an option in spinal instrumentation without fusion in younger children with scoliosis, considering the complications inherent to spinal fusion in this age group. Methods: Sixteen (16) patients with scoliosis, regardless of etiology, with a mean age of 5.2 (3-8) years, were followed up by Spine Surgery Group at Hospital Getúlio Vargas, Recite-PE, and were submitted to surgical correction of the deformity using VEPTR, from April/2009 to July/2014. The survey was conducted through medical register review, and photographic and radiographic records, with the measurement of pre- and postoperative curves by the Cobb method. Results: The mean values of Cobb angle in the preoperative period, in the immediate postoperative period and after the last distraction were, respectively, 84.1° (112°-60°), 55.4° (92°-16°) and 64.4° (100°-16°), with an average initial correction of 28.7° (34.1%) and final correction of 19.7° (23.4%). The mean follow-up was 23.1 (0-61) months with an average distraction of 3.1 (0-8). The complication rate in this study was 62.5%. Conclusion: The VEPTR presented considerable correction rates of scoliosis curves in patients whose age contraindicate the spinal fusion methods. It is necessary to improve the technique and the implant itself in order to reduce complication rates, which can be considered relatively high, in addition to the conduction of more studies with longer follow-up to determine the actual efficacy of the implant and the maintenance of long-term correction.

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Arthroscopic resection of dorsal wrist ganglion

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20162871 ◽

2016 ◽

Vol 2 (3) ◽

pp. 127 ◽

Cited By ~ 1

Author(s):

Mihir R Patel ◽

Ushma K Butala ◽

Vikram D Chauhan ◽

Nirlepsinh S Thakor

Keyword(s):

Range Of Motion ◽

Full Range ◽

Surgical Excision ◽

Benign Neglect ◽

Effective Treatment Modality ◽

Chondral Damage ◽

The Mean ◽

And Function ◽

Dorsal Wrist Ganglion

Background: The management of dorsal wrist ganglion ranges from benign neglect to surgical excision. The purpose of this study was to study the results of arthroscopic resection of dorsal wrist ganglion.Methods: Twenty one patients who had undergone arthroscopic dorsal wrist ganglion excision and a minimum of 3 months follow up were included. The preoperative complaint of cosmesis, pain, and duration of swelling, wrist range of motion and size of the ganglion were noted. The duration the patient took to return to a painless wrist with full range of motion was noted. Patient satisfaction with respect to cosmesis and function was noted.Results: The mean age was 23.3 years (range: 13 to 35 years). Pre-operative wrist pain was present in 17 patients and cosmesis was a complaint in 18 patients. 5 patients had a pre-operative restricted range of motion. The mean duration and size of the ganglion was 2.6 months (range: 2 to 4 months) and1.8cm (range: 1 to 3 cm) respectively. The mean duration of follow up was 14.6 months (range: 3 to 24 months). Arthroscopically, dorsal synovitis was present in 10 patients, triangular-fibro-cartilage-complex (TFCC) tear in 2 patients and chondral damage in 1 patient. The ganglion stalk was visualized in 14 patients. Complete painless wrist range of motion was obtained by 20 patients by 3 weeks post-operative. One patient had a recurrence. All the remaining patients were satisfied cosmetically and functionally with the results.Conclusions: Arthroscopic resection is an effective treatment modality for symptomatic dorsal wrist ganglion with good functional and cosmetic results.

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Outcomes and Postoperative Complications of Robot-Assisted Laparoscopic Hysterosacropexy: Initial Experience

Urologia Internationalis ◽

10.1159/000371726 ◽

2015 ◽

Vol 95 (1) ◽

pp. 44-49 ◽

Cited By ~ 1

Author(s):

Maria Angela Cerruto ◽

Carolina D'Elia ◽

Francesca Maria Cavicchioli ◽

Stefano Cavalleri ◽

Matteo Balzarro ◽

...

Keyword(s):

Uterine Prolapse ◽

Pelvic Organ ◽

Consecutive Series ◽

Complication Rates ◽

Early Complications ◽

Robot Assisted ◽

Female Patients ◽

The Mean ◽

Record Review

Background: Pelvic organ prolapse is a common condition, affecting about 50% of women with children. The aim of our study was to evaluate results and complication rates in a consecutive series of female patients undergoing robot-assisted laparoscopic hysterosacropexy (RALHSP). Materials and Methods: We performed a medical record review of female patients with uterine prolapse who had consecutively undergone RALHSP from February 2010 to 2013 at our department. Results: Fifteen patients were included in the analysis. All patients had uterine prolapse stage ≥II and urodynamic stress urinary incontinence. The mean age was 58.26 years. According to the Clavien-Dindo system, 4 out of 15 patients (26.6%) had grade 1 early complications and 1 patient had a grade 2 complication. At a median follow-up of 36 months, there was a significant prolapse relapse rate of 20% (3/15). Conclusion: In our hands RALHSP is easy to perform, with satisfying mid-term outcomes and a low complication rate.

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Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

Journal of Clinical Medicine ◽

10.3390/jcm10091865 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1865

Author(s):

Stefan M. Froschauer ◽

Matthias Holzbauer ◽

Dietmar Hager ◽

Oskar Kwasny ◽

Dominik Duscher

Keyword(s):

Grip Strength ◽

Clinical Assessment ◽

Complication Rates ◽

Proximal Row Carpectomy ◽

Prosthesis Implantation ◽

Total Wrist Arthroplasty ◽

Significant Difference ◽

Flexion Extension ◽

Wrist Arthroplasty

High complication rates in total wrist arthroplasty (TWA) still lead to controversy in the medical literature, and novel methods for complication reduction are warranted. In the present retrospective cohort study, we compare the outcomes of the proximal row carpectomy (PRC) method including total scaphoidectomy (n = 22) to the manufacturer’s conventional carpal resection (CCR) technique, which retains the distal pole of the scaphoid (n = 25), for ReMotion prosthesis implantation in non-rheumatoid patients. Mean follow-up was 65.8 ± 19.8 and 80.0 ± 28.7 months, respectively. Pre- and postoperative clinical assessment included wrist flexion-extension and radial-ulnar deviation; Disability of Arm, Shoulder, and Hand scores; and pain via visual analogue scale. At final follow-up, grip strength and satisfaction were evaluated. All complications, re-operations, and revision surgeries were noted. Clinical complications were significantly lower in the PRC group (p = 0.010). Radial impaction was detected as the most frequent complication in the CCR group (n = 10), while no PRC patients suffered from this complication (p = 0.0008). Clinical assessment, grip strength measurements, and the log rank test evaluating the re-operation as well as revision function showed no significant difference. All functional parameters significantly improved compared to preoperative values in both cohorts. In conclusion, we strongly recommend PRC for ReMotion prosthesis implantation.

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Arthroscopic Diagnosis and Treatment of Dorsal Wrist Ganglion

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2001.0620 ◽

2001 ◽

Vol 26 (6) ◽

pp. 547-549 ◽

Cited By ~ 41

Author(s):

S. NISHIKAWA ◽

S. TOH ◽

H. MIURA ◽

K. ARAI ◽

T. IRIE

Keyword(s):

Diagnosis And Treatment ◽

The Mean ◽

Dorsal Wrist Ganglion

Thirty-seven patients with dorsal wrist ganglia underwent arthroscopic resection. The mean follow-up was 20 months, and no complications were encountered. The ganglia were classified into three types according to their arthroscopic appearance. This classification helps to determine the amount of dorsal capsular resection required.

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Minilaparotomy Cholecystectomy as a Day Surgery Procedure: A Prospective Clinical Pilot Study

Scandinavian Journal of Surgery ◽

10.1177/145749690709600304 ◽

2007 ◽

Vol 96 (3) ◽

pp. 206-208 ◽

Cited By ~ 8

Author(s):

J. Harju ◽

M. Pääkkönen ◽

M. Eskelinen

Keyword(s):

Randomised Trial ◽

Operating Time ◽

Day Surgery ◽

Prospective Randomised Trial ◽

Wound Pain ◽

Average Operating ◽

Average Operating Time ◽

Study Support ◽

The Mean

Background and Aims: In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as a day surgery procedure. Patients and Methods: Thirty elective symptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27–68), the mean body mass index 29 kg/m2 (range 19–41). Gallstones were confirmed with ultrasound and the pre-operative liver laboratory tests were normal in all patients. A five (+/-2) centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter. Results: The average operating time was 51 minutes (range 30–105 minutes). Day surgery was possible in 25 cases (83%). Five patients (17%) stayed over night at the hospital. There were four (13%) conversions to conventional cholecystectomy. The average postoperative sick leave was 16 days (range 14–30). Two patients returned to hospital. One patient had wound pain, but no complication was found, and the patient was not admitted. One patient had a wound infection and spent 6 days in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients. Conclusions: The results of this study support the suitability of MC as a day surgery procedure, but a prospective randomised trial is needed to evaluate the relative advantages of MC and LC.

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Reduction and Association of the Scaphoid and Lunate: A Functional and Radiographical Outcome Study

Journal of Wrist Surgery ◽

10.1055/s-0038-1668154 ◽

2018 ◽

Vol 08 (01) ◽

pp. 037-042

Author(s):

William Aibinder ◽

Ali Izadpanah ◽

Bassem Elhassan

Keyword(s):

Range Of Motion ◽

Grip Strength ◽

High Rate ◽

Salvage Procedure ◽

Level Of Evidence ◽

Long Term Follow Up ◽

The Mean ◽

Ligament Disruption

Background Management of scapholunate (SL) ligament disruption is a challenging problem. The reduction and association of the scaphoid and lunate (RASL) procedure has been described with varying results. This study assessed the outcomes of the RASL procedure. Purpose The objective of this study was to assess the outcomes of patients undergoing the RASL procedure at our institution in regard to pain relief, range of motion, radiographic and functional outcomes, complications, and reoperations. Materials and Methods Twelve patients with symptomatic chronic SL instability underwent the RASL procedure. The mean age was 35 years. The mean time from injury to surgery was 40 weeks. The mean follow-up was 89 months. Outcomes included visual analog score for pain, wrist range of motion, grip strength, and Mayo Wrist Scores. Preoperative and postoperative radiographs were reviewed. Results Pain scores improved in 10 wrists. Range of motion and grip strength worsened. The average Mayo Wrist Score was 63.3. The mean SL diastasis and angle improved, but seven wrists developed progressive degenerative changes, with two requiring a salvage procedure. Symptomatic progressive screw lucency occurred in eight wrists requiring screw removal. Conclusion The RASL procedure can improve SL widening but has a high rate of early failure and reoperation. Following reoperation, long-term follow-up demonstrates reasonable long-term durability in some cases. Level of Evidence This is a Level IV, therapeutic case study.

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Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120959141 ◽

2020 ◽

Vol 8 (10) ◽

pp. 232596712095914

Author(s):

Justin C. Kennon ◽

Erick M. Marigi ◽

Chad E. Songy ◽

Chris Bernard ◽

Shawn W. O’Driscoll ◽

...

Keyword(s):

Clinical Outcomes ◽

Case Series ◽

Ulnar Collateral Ligament ◽

Ulnar Neuropathy ◽

Complication Rates ◽

Collateral Ligament ◽

Level Of Evidence ◽

Functional Scores ◽

The Mean

Background: The rate of elbow medial ulnar collateral ligament (MUCL) injury and surgery continues to rise steadily. While authors have failed to reach a consensus on the optimal graft or anchor configuration for MUCL reconstruction, the vast majority of the literature is focused on the young, elite athlete population utilizing autograft. These studies may not be as applicable for the “weekend warrior” type of patient or for young kids playing on high school leagues or recreationally without the intent or aspiration to participate at an elite level. Purpose: To investigate the clinical outcomes and complication rates of MUCL reconstruction utilizing only allograft sources in nonelite athletes. Study Design: Case series; Level of evidence, 4. Methods: Patient records were retrospectively analyzed for individuals who underwent allograft MUCL reconstruction at a single institution between 2000 and 2016. A total of 25 patients met inclusion criteria as laborers or nonelite (not collegiate or professional) athletes with a minimum of 2 years of postoperative follow-up. A review of the medical records for the included patients was performed to determine survivorship free of reoperation, complications, and clinical outcomes with use of the Summary Outcome Determination (SOD) and Timmerman-Andrews scores. Statistical analysis included a Wilcoxon rank-sum test to compare continuous variables between groups with an alpha level set at .05 for significance. Subgroup analysis included comparing outcome scores based on the allograft type used. Results: Twenty-five patients met all inclusion and exclusion criteria. The mean time to follow-up was 91 months (range, 25-195 months), and the mean age at the time of surgery was 25 years (range, 12-65 years). There were no revision operations for recurrent instability. The mean SOD score was 9 (range, 5-10) at the most recent follow-up, and the Timmerman-Andrews scores averaged 97 (range, 80-100). Three patients underwent subsequent surgical procedures for ulnar neuropathy (n = 2) and contracture (n = 1), and 1 patient underwent surgical intervention for combined ulnar neuropathy and contracture. Conclusion: Allograft MUCL reconstruction in nonelite athletes demonstrates comparable functional scores with many previously reported autograft outcomes in elite athletes. These results may be informative for elbow surgeons who wish to avoid autograft morbidity in common laborers and nonelite athletes with MUCL incompetency.

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Arthroscopic Debridement and Arthrolysis for the Treatment of Advanced Kienböck's Disease: 18-Month and 5-Year Postoperative Results

Journal of Wrist Surgery ◽

10.1055/s-0040-1722570 ◽

2021 ◽

Author(s):

Omer Ayik ◽

Mehmet Demirel ◽

Necmettin Turgut ◽

Okyar Altas ◽

Hayati Durmaz

Keyword(s):

Grip Strength ◽

Dash Score ◽

Arthroscopic Debridement ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Hand Grip ◽

Case Series Study ◽

The Mean ◽

Kienbock’S Disease

Abstract Background Salvage procedures, such as proximal row carpectomy, limited or total wrist arthrodesis, and wrist replacement, are generally preferred to treat advanced Kienböck's disease. However, these procedures are particularly aggressive and may have unpredictable results and potentially significant complications. Questions/Purpose This study aimed to present the short- to mid-term clinical and functional results of arthroscopic debridement and arthrolysis in the management of advanced Kienböck's disease. Patients and Methods Fifteen patients in whom Lichtman Stages IIIA to IIIC or IV Kienböck's disease was diagnosed and treated by arthroscopic wrist debridement and arthrolysis were included in this retrospective study. The mean age was 30 years (range: 21–45). The mean follow-up period duration was 36 months (range: 18–60). The Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS), wrist range of motion (ROM), and grip strength were measured preoperatively and then again at the final follow-up visit. Results The mean DASH and VAS scores improved from 41 (range: 31–52) and 7.1 (range: 6–8) preoperatively to 13 (range: 8–21) and 2 (range: 0–3; p < 0.001) at the final follow-up visit, respectively. The mean wrist flexion and extension values increased from 32 (range: 20–60 degrees) and 56 degrees (range: 30–70 degrees; p = 0.009) preoperatively to 34 (range: 10–65 degrees; p = 0.218) and 57 degrees (range: 30–70 degrees; p = 0.296) at the final follow-up appointment, respectively, although these findings were statistically insignificant. The mean strength of the hand grip increased from 22.7 (range: 9–33) to 23.3 (range: 10–34; p = 0.372). Conclusion Arthroscopic debridement and arthrolysis may improve wrist function and quality of life due to the preserved ROM and hand grip strength after short- to mid-term follow-up periods despite the radiographic progression of Kienböck's disease. Level of Evidence This is a Level IV, retrospective case series study.

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Results of an Interim Analysis of a Prospective Multicenter Study Assessing Radiographic and Patient Outcomes Following Triplanar Tarsometatarsal Arthrodesis with Early Weightbearing

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00498 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0049

Author(s):

Dane K. Wukich ◽

Robert D. Santrock ◽

Daniel C. Farber ◽

Abdi Raissi ◽

Avneesh Chhabra ◽

...

Keyword(s):

Hallux Valgus ◽

Multicenter Study ◽

Patient Reported Outcomes ◽

Metatarsal Osteotomy ◽

Recurrence Rates ◽

Prospective Multicenter Study ◽

Post Procedure ◽

Patient Reported ◽

The Mean

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: The majority of hallux valgus corrections are performed via a uniplanar metatarsal osteotomy approach in which the metatarsal is cut and shifted over in the transverse plane. This approach has demonstrated high long-term recurrence rates. Recent research demonstrates that 87% of hallux valgus deformities are three-dimensional with abnormal frontal-plane rotation of the metatarsal, which cannot be fully addressed with a uniplanar metatarsal osteotomy. While correction at the 1st tarsometatarsal (TMT) joint may provide the optimal surgical approach for 3D anatomic restoration at the apex of the deformity, 1st TMT fusion has historically involved an extended period of non-weightbearing. This study evaluates the clinical, radiographic, and patient-reported outcomes in patients undergoing instrumented triplanar 1st TMT arthrodesis (TTA) with a biplanar plating system and protected near-immediate weightbearing. Methods: This is a prospective multicenter study that will continue for 60 months post-operatively. Patients between 14-58 years old with symptomatic hallux valgus (intermetatarsal and hallux valgus angles between 10.0-22.0° and 16.0-40.0°, respectively) and no prior hallux valgus surgery on the operative foot are eligible for this study. Patients are treated with an TTA procedure using a biplanar plating system with protected near-immediate weightbearing. Outcomes (radiographic, range of motion (ROM), pain measured by visual analog scale (VAS), Manchester-Oxford Foot Questionnaire (MOxFQ), return to weightbearing and activities) are evaluated post-operatively. Two independent musculoskeletal radiologists reviewed radiographic data. These interim results are limited to patients completing at least 6 weeks of follow-up. Results: At time of data cut-off, 74 patients had undergone TTA with at least 6 weeks follow-up. The majority of patients were women (95%) with mean age 41.7 years. The mean (95% confidence interval) time to protected weightbearing in CAM boot was 8.0 (6.4, 9.7) days, return to work was 19.0 (13.6, 24.4) days, and return to full work was 31.5 (22.7, 40.2) days. There was a significant change in radiographic measures pre vs. post procedure and changes were maintained over time (Table). VAS pain score decreased 4 and 6 months post-procedure by 3.9 (3.2, 4.6) and 4.2 (3.5, 5.0), respectively. The mean MOxFQ Index Score pre-procedure was 53.3 (49.5, 57.1) and at month 6 had decreased to 18.6 (12.9, 24.2). Conclusion: These interim findings support that TTA with biplanar plating is successful in correcting the 3D hallux valgus deformity with early return to weightbearing and demonstrated favorable clinical and patient-reported outcomes. Patients were able to return to full, unrestricted work and activities within just a few months and had meaningful pain reduction after surgery. Patients will continue to be followed for up to 60 months. Clinical/radiographic healing at 12 months and recurrence rates at 24 months, as well as complications and patient satisfaction, will be evaluated. [Table: see text]

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