Bioabsorbable poly-L/D-lactide (96/4) scaffold arthroplasty (RegJoint™) for trapeziometacarpal osteoarthritis: a 3-year follow-up study

2017 ◽  
Vol 43 (4) ◽  
pp. 413-419 ◽  
Author(s):  
Simo Mattila ◽  
Mari Ainola ◽  
Eero Waris
Keyword(s):  
Degradation Process ◽  
High Rate ◽  
Subjective Improvement ◽  
Level Of Evidence ◽  
Revision Procedure ◽  
Follow Up Study ◽  
Trapeziometacarpal Osteoarthritis ◽  
High Incidence ◽  
Tissue Reactions

The poly-L/D-lactide joint scaffold (RegJoint™) has recently been associated with adverse tissue reactions and osteolysis after partial trapeziectomy for trapeziometacarpal osteoarthritis. Twenty-two of 23 patients previously operated on with this scaffold were re-examined at a mean follow-up of 3.3 years (range 36–53 months). Overall, the results showed an unacceptably high rate of adverse tissue reactions related to the degradation process of the implant, resulting in a revision procedure in three patients. At final follow-up, at which point the implant had completely degraded, there were no signs of ongoing adverse tissue reactions. There was a significant decrease in pain, increase in strength and subjective improvement in function at final follow-up compared with the pre-operative results in patients who had not undergone revision surgery. However, owing to the high incidence of adverse tissue reactions, the use of the implant has been discontinued in the treatment of trapeziometacarpal osteoarthritis. Level of evidence: IV

scholarly journals Current Perspectives on Neonatal Screening for Propionic Acidemia in Japan: An Unexpectedly High Incidence of Patients with Mild Disease Caused by a Common PCCB Variant

2021 ◽  
Vol 7 (3) ◽  
pp. 35
Author(s):  
Go Tajima ◽  
Reiko Kagawa ◽  
Fumiaki Sakura ◽  
Akari Nakamura-Utsunomiya ◽  
Keiichi Hara ◽  
...  
Keyword(s):  
Neonatal Screening ◽  
Acid Metabolism ◽  
Neonatal Period ◽  
Propionic Acidemia ◽  
Cardiac Complications ◽  
Mild Disease ◽  
Follow Up Study ◽  
Organic Acid Metabolism ◽  
High Incidence

Propionic acidemia (PA) is a disorder of organic acid metabolism which typically presents with acute encephalopathy-like symptoms associated with metabolic acidosis and hyperammonemia during the neonatal period. The estimated incidence of symptomatic PA in Japan is 1/400,000. The introduction of neonatal screening using tandem mass spectrometry has revealed a far higher disease frequency of approximately 1/45,000 live births due to a prevalent variant of c.1304T>C (p.Y435C) in PCCB, which codes β-subunit of propionyl-CoA carboxylase. Our questionnaire-based follow-up study reveals that most of these patients remain asymptomatic. However, reports on symptomatic patients exhibiting cardiac complications such as cardiomyopathy and QT prolongation have been increasing. Moreover, there were even cases in which these cardiac complications were the only symptoms related to PA. A currently ongoing study is investigating the risk of cardiac complications in patients with neonatal screening-detected PA caused by this common variant.

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

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.

Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Francesco Smeraglia ◽  
Sergi Barrera-Ochoa ◽  
Gerardo Mendez-Sanchez ◽  
Morena A. Basso ◽  
Giovanni Balato ◽  
...  
Keyword(s):  
Young Patients ◽  
Hand Surgery ◽  
Dash Score ◽  
Level Of Evidence ◽  
Interpositional Arthroplasty ◽  
Trapeziometacarpal Osteoarthritis ◽  
Select Group ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Surgical Treatments

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97–144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV

scholarly journals Pyrocardan Trapeziometacarpal Joint Arthroplasty—Medium-Term Outcomes

2020 ◽  
Vol 9 (06) ◽  
pp. 509-517
Author(s):  
James Logan ◽  
Susan E. Peters ◽  
Ruby Strauss ◽  
Silvia Manzanero ◽  
Gregory B. Couzens ◽  
...  
Keyword(s):  
Case Series ◽  
Postoperative Outcome ◽  
Preoperative Assessment ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Original Series ◽  
Surgery Outcome ◽  
Trapeziometacarpal Osteoarthritis ◽  
Patient Reported

Abstract Objective Pyrocardan trapeziometacarpal interposition implant is a free intra-articular spacer composed of pyrocarbon. This biconcave resurfacing implant, both ligament and bone-stock sparing, is indicated for use in early-to-moderate stage trapeziometacarpal osteoarthritis. It was hypothesized that the postoperative outcome measures of the Pyrocardan implant would be comparable to those seen with ligament reconstruction and tendon interposition (LRTI) surgeries and those reported by the designer of the implant, Phillipe Bellemère, but that strength would be greater than for LRTI. Methods In this prospective case series, 40 Pyrocardan implants were performed in 37 patients. Average age was 58 years (range: 46–71). Patients were assessed preoperatively, 3 months, 6 months, 1 year, 2 years, and beyond (long term) wherever possible. Results There have been no major complications or revision surgeries for the series. Average follow-up was 29 months (range: 12 months–7 years). Twenty-eight joints were assessed at over 2 years post index surgery. Outcome measure scores improved from preoperative assessment to the most recent follow-up equal or greater than 2 years. Average grip strength at 2 years was 30 kg, as compared with 19.6 kg in an age-matched cohort who underwent trapeziectomy and 25 kg in Bellemère's original series of Pyrocardan implants. Conclusions Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis. Patient-reported clinical outcomes were at least equivalent to LRTI and are comparable to Bellemère's original series. Grip and pinch strength appear to be better than LRTI. Level of Evidence This is a Level III, prospective observational cohort study.

scholarly journals Limited Open Reduction and Internal Fixation of Calcaneal Fractures

2019 ◽  
Vol 41 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Anne K. Bremer ◽  
Lukas Kraler ◽  
Lars Frauchiger ◽  
Fabian G. Krause ◽  
Martin Weber
Keyword(s):  
Wound Healing ◽  
Internal Fixation ◽  
Open Reduction ◽  
Case Series ◽  
Functional Results ◽  
High Rate ◽  
Calcaneal Fractures ◽  
Retrospective Case ◽  
Level Of Evidence

Background: The treatment of displaced intra-articular calcaneal fractures remains a challenge and the optimal approach is still controversial. The main reason to avoid the extended lateral approach is the high complication rate due to wound healing problems. We report on 16 years of experience with a standardized limited open reduction and internal fixation technique. Methods: Between 2001 and 2017, we prospectively followed 240 consecutive patients operatively treated for a displaced intra-articular calcaneal fracture. Patients with open, multiple, bilateral, extra-articular, and Sanders IV fractures and those lost to follow-up were excluded. A lateral subtalar approach was used, with a cast for 8 weeks and full weightbearing allowed after 12 weeks. Follow-up examinations were scheduled until 24 months. Subjective and clinical assessment included gait abnormality, subtalar and ankle range of motion, and stability and alignment. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score was calculated. Alignment was analyzed on standard radiographs. In total, 131 patients were excluded. The remaining 109 patients were followed for a minimum of 24 months (34.4 ± 14.2 [range, 24-102] months). Results: The mean AOFAS score was 87 ± 13 (range, 32-100). “Excellent” and “good” results, as well as hindfoot motion with “normal/mild” and “moderate” restrictions, were seen in 80% of patients. Early reoperations were performed for insufficient reduction (2 patients), delayed wound healing (debridement, 3 patients), and hematoma (1 patient). Late revisions were arthrodesis (3 patients), medializing calcaneal osteotomy (1 patient), and implant removal (53 patients; 49%). Conclusion: The presented approach has remained unmodified for 16 years and resulted in consistently good functional results. The main disadvantage was the high rate of heel screw removal. Level of Evidence: Level IV, retrospective case series.

A Long-term Retrospective Follow-up Study of Patients Treated with Prophylactic Lithium Carbonate

1987 ◽  
Vol 150 (2) ◽  
pp. 175-179 ◽  
Author(s):  
C. Page ◽  
S. Benaim ◽  
F. Lappin
Keyword(s):  
Side Effects ◽  
Complete Remission ◽  
Lithium Carbonate ◽  
Favourable Outcome ◽  
Lithium Level ◽  
Follow Up Study ◽  
High Incidence ◽  
Average Serum

Patients suffering from unipolar and bipolar affective illness, who began treatment with prophylactic lithium carbonate during a 5-year period, were followed up and 59 out of 101 interviewed. Most had been taking lithium for at least 13 years: 49% had a complete remission, 41% a partial but significant response, and 10% no response. No specific individual or illness factor was found to correlate with favourable outcome, and no correlation between average serum lithium level and outcome. No side-effects could be associated specifically with the long-term use of lithium, but there was a surprisingly high incidence of clinical hypothyroidism.

The Expectation of Outcome from Maintenance Therapy in Chronic Schizophrenic Patients

1976 ◽  
Vol 128 (3) ◽  
pp. 246-250 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
Maintenance Therapy ◽  
Patient Population ◽  
Significant Proportion ◽  
Community Services ◽  
Neuroleptic Drugs ◽  
Follow Up Study ◽  
High Incidence ◽  
Schizophrenic Patients ◽  
Long Acting

SummaryThe results from a prospective follow-up study of a group of schizophrenic patients suggest that a significant proportion (41 per cent) are likely to relapse during a two-year period despite the prescription of long-acting injectable neuroleptic drugs. Some will relapse because of a failure of the regime, but others (32–37 per cent) because the pharmacological protection of these drugs would appear to be less effective in certain patients. Even with the major advantages of the long-acting injectable neuroleptics over oral medication, the schizophrenic patient population remains a group with a high incidence of psychiatric and social morbidity which continues to require the full resources of both the hospital and community services.

Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 465-469 ◽  
Author(s):  
Raphaëlle Dumartinet-Gibaud ◽  
Nicolas Bigorre ◽  
Guy Raimbeau ◽  
Jérome Jeudy ◽  
Yann Saint Cast
Keyword(s):  
Survival Rate ◽  
First Year ◽  
Implant Survival ◽  
Level Of Evidence ◽  
Technical Errors ◽  
Lack Of Information ◽  
Trapeziometacarpal Osteoarthritis ◽  
Long Run ◽  
Lost To Follow Up

In this retrospective study, we report a series of 80 Arpe prostheses for trapeziometacarpal osteoarthritis in 63 patients. Twenty-seven prostheses (20 patients) were lost to follow-up. Twenty-one were revised, eight of them during the first year after operation. The calculated cumulated implant survival rate was 85% at 10 years but could be lower due to the lack of information on the patients lost to follow-up. The number of complications due to technical errors was high; but after we had done 30 cases, the number of early revisions decreased markedly. At follow-up, 23 of 32 thumbs were totally free of pain, and the patients were satisfied with 31 thumbs. We conclude that the implant survival declines progressively in the long run, with a survival rate of 80% after 15 years of follow-up and a further decline thereafter. We also found that this surgery was difficult to master. We advise selecting this implant for thumb trapeziometacarpal osteoarthritis with caution. Level of evidence: IV

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