Three-ligament tenodesis for chronic scapholunate injuries: short-term outcomes in 203 patients

2019 ◽  
Vol 45 (4) ◽  
pp. 383-388 ◽  
Author(s):  
Julia Blackburn ◽  
Mark J. W. van der Oest ◽  
Ralph Poelstra ◽  
Ruud W. Selles ◽  
Neal C. Chen ◽  
...  
Keyword(s):  
Decision Making ◽  
Analogue Scale ◽  
Ligament Reconstruction ◽  
Scapholunate Ligament ◽  
Short Term ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Joint Decision ◽  
Clinically Significant ◽  
And Function

In this cohort study, we report on short-term outcomes of 203 patients (203 wrists) who underwent scapholunate ligament reconstruction using a three-ligament tenodesis technique between December 2013 and December 2017. Patients completed the Patient Rated Wrist Evaluation questionnaire and a visual analogue scale for pain online before surgery and at 3 months and 1 year after surgery. We also measured the range of movement before surgery, in 150 patients 3 months after surgery, and in 90 patients 1 year after surgery. The patients reported clinically significant improvements in both pain and function postoperatively, with continuing improvement at both 3 and 12 months. We conclude that the short-term outcomes of this procedure are generally good in term of patients’ function, satisfaction, and pain relief, but about 20% of the operated wrists did not improve. Our data may help patients and surgeons in joint decision-making regarding treatment for chronic scapholunate injuries. Level of evidence: III

Patient-reported outcomes and function after reinsertion of the triangular fibrocartilage complex by open surgery

2021 ◽  
Vol 103-B (4) ◽  
pp. 711-717
Author(s):  
Reinier Feitz ◽  
Mark J. W. van der Oest ◽  
Elisabeth P. A. van der Heijden ◽  
Harm P. Slijper ◽  
Ruud W. Selles ◽  
...  
Keyword(s):  
Analogue Scale ◽  
Open Surgery ◽  
Patient Reported Outcomes ◽  
Open Repair ◽  
Triangular Fibrocartilage Complex ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Triangular Fibrocartilage ◽  
Clinically Significant ◽  
And Function

Aims Patients with a triangular fibrocartilage complex (TFCC) injury report ulnar-sided wrist pain and impaired function. The surgical procedure of TFCC reinsertion aims to improve function in patients with this injury in whom conservative treatment has failed. The purpose of this study was to investigate the outcomes of open TFCC reinsertion. Methods The study involved 274 patients who underwent open repair of the TFCC between December 2013 and December 2018. The patients completed the Patient-Rated Wrist Evaluation (PRWE) questionnaire, and scored pain and function using a visual analogue scale (VAS). Range of motion (ROM) was assessed by experienced hand therapists. Results Clinically significant improvements were reported in pain, function, and grip strength in 220 patients (80%) three and 12 months postoperatively. Conclusion These data will help surgeons to make decisions about the outcomes of open repair of the TFCC and to counsel patients appropriately. Level of evidence: III Cite this article: Bone Joint J 2021;103-B(4):711–717.

Acute and Subacute Changes in Hip Strength and Range of Movement After Arthroscopy to Address Chondrolabral Pathology

2019 ◽  
Vol 47 (8) ◽  
pp. 1939-1948 ◽  
Author(s):  
Matthew D. Freke ◽  
Kay Crossley ◽  
Kevin Sims ◽  
Trevor Russell ◽  
Patrick Weinrauch ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Repeated Measures ◽  
External Rotation ◽  
Case Series ◽  
Hip Pain ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Hip Strength ◽  
Hip Flexion ◽  
And Function

Background:Hip pain is associated with reduced muscle strength, range of movement (ROM), and function. Hip arthroscopy is undertaken to address coexistent intra-articular pathologies with the aim of reducing pain and improving function.Purpose:To evaluate changes in strength and ROM in a cohort with chondrolabral pathology before surgery to 3 and 6 months after hip arthroscopy.Study Design:Case series; Level of evidence, 4.Methods:Sixty-seven individuals with hip pain who were scheduled for hip arthroscopy were matched with 67 healthy controls. Hip strength and ROM were collected preoperatively and at 3 and 6 months postoperatively. Repeated measures analysis of variance evaluated whether strength and ROM differed between limbs and among time points. Bonferroni post hoc tests determined differences in hip strength and ROM among testing times and between the hip pain group and matched controls.Results:Hip extension, internal rotation (IR), external rotation (ER), and adduction ( P < .040) strength were greater at 3 months after surgery; all directions, including flexion, abduction, and squeeze, were greater at 6 months ( P < .015). Hip flexion ROM was greater at 3 months after surgery ( P = .013). Flexion, IR, and ER ROM was greater at 6 months ( P < .041). At 6 months, IR ROM ( P = .003) and flexion, IR, and ER strength ( P < .005) remained less than matched controls.Conclusion:With the exception of squeeze and flexion, all directions of hip strength and hip flexion ROM are significantly improved 3 months after arthroscopy to address chondrolabral pathology. By 6 months after arthroscopy, strength in all directions and flexion and rotation ROM are significantly improved in both limbs, but hip flexion, IR, and ER strength and IR ROM remain significantly less than that of healthy matched controls in both limbs.

scholarly journals Anatomical ligament reconstruction with allograft in chronic acromioclavicular dislocations restores joint stability and function. Short-term outcomes in 14 cases

2021 ◽  
Vol 28 (3) ◽  
Author(s):  
Miguel Angel Ruiz Ibán ◽  
Raquel Ruiz Díaz ◽  
Ignacio De Rus Aznar ◽  
Andrea Paniagua González ◽  
Cristina Victoria Asenjo Gismero ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Joint Stability ◽  
Short Term ◽  
And Function ◽  
Anatomical Ligament Reconstruction

Ulnar head replacement and sigmoid notch resurfacing arthroplasty with minimum 12-month follow-up

2019 ◽  
Vol 44 (9) ◽  
pp. 957-962 ◽  
Author(s):  
Nicholas J. Clark ◽  
Nicholas Munaretto ◽  
Bassem T. Elhassan ◽  
Sanjeev Kakar
Keyword(s):  
Short Term ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Excellent Outcome ◽  
Ulnar Head ◽  
Pain Scores ◽  
Feasible Option ◽  
And Function ◽  
Joint Arthritis

Our study aimed to report the short-term outcomes of patients who underwent partial ulnar head replacement and distal radial ulnar joint interposition arthroplasty. From 2012 to 2016, nine patients underwent this procedure with mean follow-up of 27 months (range 12–55). Seven of the nine patients had previously undergone surgical intervention on the ipsilateral wrist. The procedure resulted in substantial improvements in pain and function. Mayo Wrist Score improved from 37 preoperatively to 73 postoperatively, and six patients achieved a good or excellent outcome. Visual analogue pain scores decreased from 7 preoperatively to 1 postoperatively. Grip improved from 20 kg preoperatively to 30 kg postoperatively. There was no significant change in wrist range of motion. Two patients underwent revision surgery to improve wrist motion. We conclude that over short-term follow-up the procedure provides a feasible option for distal radial ulnar joint arthritis. Level of evidence: IV

Mid-term results of ligament tenodesis in treatment of scapholunate dissociation: a retrospective study of 20 patients

2015 ◽  
Vol 41 (1) ◽  
pp. 56-63 ◽  
Author(s):  
A. Elgammal ◽  
B. Lukas
Keyword(s):  
Retrospective Study ◽  
Ligament Reconstruction ◽  
Salvage Surgery ◽  
Dash Score ◽  
Scapholunate Ligament ◽  
Level Of Evidence ◽  
Secondary Osteoarthritis ◽  
Mid Term Results

The purpose of this retrospective study was to assess the modified Brunelli technique for the treatment of chronic irreparable complete scapholunate ligament rupture, causing a reducible carpal malalignment without secondary osteoarthritis. A total of 20 patients were treated using this technique. At a mean follow-up period of 24 months (range 6–53, SD 15), pain on a visual analogue scale had improved from 6 (range 3–10) to 3 (range 0–7). Function measured with the DASH score had improved from 37 (range 11–90) to 20 (range 0–53). Range of motion was reduced in flexion by a mean of 19° (range 10–45), and in extension by a mean of 14° (range 0–35). Mean grip strength at last follow-up was 81% of the uninjured hand (range 50–100%) Three patients developed scapholunate advanced collapse (stage II) requiring salvage surgery. Scapholunate ligament reconstruction with the modified Brunelli technique showed satisfactory results in this study. Extended studies are needed to determine the long-term benefits of this reconstructive procedure. Level of evidence: IV.

A Patient-Reported Comparison of Trapeziectomy with Swanson Silastic Implant or Sling Ligament Reconstruction

1999 ◽  
Vol 24 (4) ◽  
pp. 453-455 ◽  
Author(s):  
M. E. LOVELL ◽  
D. NUTTALL ◽  
I. A. TRAIL ◽  
J. STILWELL ◽  
J. K. STANLEY
Keyword(s):  
Retrospective Review ◽  
Ligament Reconstruction ◽  
The Other ◽  
Short Term ◽  
Patient Reported ◽  
Silastic Implant ◽  
Swanson Implant ◽  
And Function ◽  
Carpometacarpal Osteoarthritis

A retrospective review of two types of operations for carpometacarpal osteoarthritis of the thumb was done for patients operated on between 1991 and 1996. Follow-up ranged from 18 to 90 months (mean 62 months). Fifty-eight Swanson Silastic arthroplasties and 56 sling excision arthoplasties were reviewed. Eight patients with Swanson arthroplasties underwent removal of the implant. Eight patients in the sling excision group required further surgery. These patients were excluded from further analysis. Questionnaires about pain, general satisfaction and function were sent to the other patients and 87 responses were received (sling 45, implant 42). In the implant group significantly better results were obtained for pain at 1 year, carrying a milk bottle and taking a handbrake off a car, and overall function. We conclude that trapeziectomy combined with Swanson implant gives better results in the short term if there are no complications of the operation.

scholarly journals Indications for gastrocsoleus lengthening in ambulatory children with cerebral palsy: a Delphi consensus study

2020 ◽  
Vol 14 (5) ◽  
pp. 405-414
Author(s):  
Erich Rutz ◽  
James McCarthy ◽  
Benjamin J. Shore ◽  
M. Wade Shrader ◽  
Matthew Veerkamp ◽  
...  
Keyword(s):  
Decision Making ◽  
Cerebral Palsy ◽  
Surgical Anatomy ◽  
Delphi Consensus ◽  
Surgical Indications ◽  
Training Experience ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Paediatric Orthopaedic ◽  
And Function

Purpose Equinus is the most common deformity in cerebral palsy (CP) and gastrocsoleus lengthening (GSL) is the most commonly performed surgery to improve gait and function in ambulatory children with CP. Substantial variation exists in the indications for GSL and surgical technique. The purpose of this study was to review surgical anatomy and biomechanics of the gastrocsoleus and to utilize expert orthopaedic opinion through a Delphi technique to establish consensus for surgical indications for GSL in ambulatory children with CP. Methods A 17-member panel, of Fellowship-trained paediatric orthopaedic surgeons, each with at least 9 years of clinical post-training experience in the surgical management of children with CP, was established. Consensus for the surgical indications for GSL was achieved through a standardized, iterative Delphi process. Results Consensus was reached to support conservative Zone 1 surgery in diplegia and Zone 3 surgery (lengthening of the Achilles tendon) was contraindicated. Zone 2 or Zone 3 surgery reached general agreement as a choice in hemiplegia and under-correction was preferred to any degree of overcorrection. Agreement was reached that the optimum age for GSL surgery was 6 years to 10 years and should be avoided in children aged under 4 years. Physical examination measures with the child awake and under anaesthesia were important in decision making. Gait analysis was supported both for decision making and for assessing outcomes, in combination with patient reported outcomes (PROMS). Conclusions The results from this study may encourage informed practice evaluation, reduce practice variability, improve clinical outcomes and point to questions for further research. Level of Evidence V

A Bird in the Hand Isn’t Good for Long

2018 ◽  
Vol 65 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Stefan Scherbaum ◽  
Simon Frisch ◽  
Maja Dshemuchadse
Keyword(s):  
Decision Making ◽  
Cognitive Control ◽  
The Other ◽  
Decision Task ◽  
Short Term ◽  
Additional Time ◽  
Control Processes ◽  
Folk Wisdom ◽  
Study Participants ◽  
Insight Into

Abstract. Folk wisdom tells us that additional time to make a decision helps us to refrain from the first impulse to take the bird in the hand. However, the question why the time to decide plays an important role is still unanswered. Here we distinguish two explanations, one based on a bias in value accumulation that has to be overcome with time, the other based on cognitive control processes that need time to set in. In an intertemporal decision task, we use mouse tracking to study participants’ responses to options’ values and delays which were presented sequentially. We find that the information about options’ delays does indeed lead to an immediate bias that is controlled afterwards, matching the prediction of control processes needed to counter initial impulses. Hence, by using a dynamic measure, we provide insight into the processes underlying short-term oriented choices in intertemporal decision making.

EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

2019 ◽  
pp. 121-131
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Functional Capacity ◽  
External Rotation ◽  
Treatment Protocol ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Before And After ◽  
In The Beginning ◽  
And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

scholarly journals BattleNet: Capturing Advantageous Battlefield in RTS Games (Student Abstract)

2020 ◽  
Vol 34 (10) ◽  
pp. 13849-13850
Author(s):  
Donghyeon Lee ◽  
Man-Je Kim ◽  
Chang Wook Ahn
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Real Time ◽  
Large Scale ◽  
Outcome Predictor ◽  
Short Term ◽  
Rts Game

In a real-time strategy (RTS) game, StarCraft II, players need to know the consequences before making a decision in combat. We propose a combat outcome predictor which utilizes terrain information as well as squad information. For training the model, we generated a StarCraft II combat dataset by simulating diverse and large-scale combat situations. The overall accuracy of our model was 89.7%. Our predictor can be integrated into the artificial intelligence agent for RTS games as a short-term decision-making module.

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