Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years

2021 ◽  
pp. 175319342110245
Author(s):  
Bruno Lussiez ◽  
Cyril Falaise ◽  
Pascal Ledoux
Keyword(s):  
Prospective Study ◽  
Functional Outcomes ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Dual Mobility ◽  
The Mean ◽  
The Stability ◽  
A Prospective Study ◽  
Score Index

We report the results of a prospective study using a dual mobility trapeziometacarpal prosthesis (Touch®) in 107 patients with a minimum follow-up of 3 years. One-hundred and two patients (95%) were very satisfied or satisfied with the functional outcomes and the mean pain intensity in visual analogue scale decreased from 7.4 to 0.8 ( p < 0.001). Thumb opposition (Kapandji score) index increased from an average of 8.0 to 9.4, while the mean QuickDASH score improved from 38 preoperatively to 20 at follow-up ( p < 0.01). Key-pinch strength improved from 3.5 kg (range 0.5–9.5) to 5.5 kg (range 3.0–11.5). There was a 4.6% rate of complications, including cup loosening and wear of polyethylene, which required revision, but no cases of prosthetic dislocation were seen. Applying the dual mobility principle to trapeziometacarpal arthroplasty may significatively improve the stability of these prostheses. Radiolucent zones around the components of the prostheses are not systematic predictors of future loosening. Level of evidence: IV

Outcomes of cementless joint prosthesis versus tendon interposition for trapeziometacarpal osteoarthritis: a prospective study

2018 ◽  
Vol 44 (2) ◽  
pp. 151-158 ◽  
Author(s):  
Roman Cebrian-Gomez ◽  
Alejandro Lizaur-Utrilla ◽  
Emilio Sebastia-Forcada ◽  
Fernando A. Lopez-Prats
Keyword(s):  
Ligament Reconstruction ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Trapeziometacarpal Osteoarthritis ◽  
The Mean ◽  
A Prospective Study ◽  
Tendon Interposition ◽  
Mid Term Results ◽  
Dash Questionnaire

We compared 84 patients with the Ivory trapeziometacarpal prosthesis versus 62 with ligament reconstruction and tendon interposition arthroplasty performed for osteoarthritis. There were 134 women and 12 men with a mean age of 60 years. Prospective clinical assessment was made using the Quick Disability of the Arm, Shoulder and Hand (DASH) questionnaire, visual analogue scale for pain, range of motion, and grip and pinch strength. The mean follow-up was 4 years (range 2–5). Prosthetic replacement provided significantly better thumb abduction, adduction, pinch strength, QuickDASH, pain relief, satisfaction and a faster return to daily activities and previous work. Revision surgery was required for two patients in the prosthesis group, two for dislocation and one cup loosening, while in the ligament reconstruction group there were no revisions. We conclude that trapeziometacarpal prosthesis provides better mid-term results in terms of function compared with ligament reconstruction and tendon interposition for patients with Stages 2 and 3 osteoarthritis of the trapeziometacarpal joint. Level of evidence: II

Are the Classic and the Congruent Arc Latarjet Procedures Equally Effective for the Treatment of Recurrent Shoulder Instability in Athletes?

2020 ◽  
Vol 48 (9) ◽  
pp. 2081-2089
Author(s):  
Luciano A. Rossi ◽  
Ignacio Tanoira ◽  
Tomás Gorodischer ◽  
Ignacio Pasqualini ◽  
Domingo Luis Muscolo ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Bone Block ◽  
Return To Sports ◽  
Glenohumeral Instability ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Functional Scores ◽  
The Mean ◽  
Anterior Glenohumeral Instability

Background: There is a lack of evidence in the literature comparing outcomes between the classic and the congruent arc Latarjet procedures in athletes. Purpose: To compare return to sports, functional outcomes, and complications between the classic and the congruent arc Latarjet procedures in athletes with recurrent glenohumeral instability. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2009 and June 2017, 145 athletes with recurrent anterior glenohumeral instability underwent surgery with the Latarjet as a primary procedure in our institution. The classic procedure was used in 66 patients, and the congruent arc method was used in 79 patients. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sports activity, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography. Results: In the total population, the mean follow-up was 41.3 months (range, 24-90 months) and the mean age was 25.3 years (range, 18-45 years). In total, 90% of patients were able to return to sports; of these, 91% returned at their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistical improvement after operation ( P < .001). The Rowe score increased from a preoperative mean of 42.8 points to a postoperative mean of 95.2 points ( P < .01). Subjective pain during sports improved from 3.2 points preoperatively to 0.7 points at last follow-up ( P < .01). The ASOSS score improved significantly from a preoperative mean of 46.4 points to a postoperative mean of 88.4 points ( P < .01). No significant differences in shoulder ROM and functional scores were found between patients who received the classic vs congruent arc procedures. There were 5 recurrences (3.5%): 3 dislocations (2%) and 2 subluxations (1%). No significant difference in the recurrence rate was noted between groups. The bone block healed in 134 cases (92%). Conclusion: In athletes with recurrent anterior glenohumeral instability, the Latarjet procedure produced excellent functional outcomes. Most athletes returned to sports at their preinjury level, and the rate of recurrence was very low, regardless of whether the patients received surgery with the classic or congruent arc technique.

Assessment of scapholunate instability with dynamic computed tomography

2019 ◽  
Vol 45 (4) ◽  
pp. 375-382 ◽  
Author(s):  
Lionel Athlani ◽  
Kamel Rouizi ◽  
Jonathan Granero ◽  
Gabriela Hossu ◽  
Alain Blum ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Gap Size ◽  
Dynamic Computed Tomography ◽  
Level Of Evidence ◽  
Plain Radiographs ◽  
Scapholunate Instability ◽  
The Mean ◽  
A Prospective Study

We performed a prospective study to evaluate the values of dynamic four-dimensional computed tomography in assessing suspected chronic scapholunate instability. Forty patients were evaluated with radiographs, arthrography, and four-dimensional computed tomography. On plain radiographs and computed tomography, we found 16 patients with definite scapholunate instability, five with questionable scapholunate instability, and 19 with absence of scapholunate instability. We used four-dimensional computed tomography to evaluate the size of the scapholunate gap during radioulnar deviation. The mean and maximal values of the gap size were lowest in the patients with absence of scapholunate instability and highest in those with definite scapholunate instability. When comparing the scapholunate gap sizes of the patients with absent and questionable scapholunate instability, the range of the gap sizes was significantly higher in the patients with questionable scapholunate instability. We conclude that four-dimensional computed tomography aids assessment of chronic scapholunate instability, which allows the differentiation between patients without and those with definite or questionable scapholunate instability. Level of evidence: II

Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

2016 ◽  
Vol 42 (2) ◽  
pp. 188-193 ◽  
Author(s):  
M. Burnier ◽  
T. Awada ◽  
F. Marin Braun ◽  
P. Rostoucher ◽  
M. Ninou ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pinch Strength ◽  
Middle Phalanx ◽  
Level Of Evidence ◽  
Active Flexion ◽  
The Mean

The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal interphalangeal motion was 41°. The mean visual analogue scale score was 1.1. The mean QuickDASH score was 11. The mean pinch strength was 82% of the opposite side. Radiographs revealed one partial graft lysis. Level of evidence: IV

Giant Cell Tumours of Tendon Sheath: Classification and Recurrence Rate

2001 ◽  
Vol 26 (1) ◽  
pp. 72-75 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Prospective Study ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Tendon Sheath ◽  
Type I ◽  
Type Ii ◽  
Giant Cell Tumours ◽  
The Mean ◽  
A Prospective Study

Forty-three consecutive cases of giant cell tumour of tendon sheath were included in a prospective study. The tumours were classified into two main types, depending on whether the entire tumour was, or was not, surrounded by one pseudocapsule as assessed by the surgeon during surgery. Each type was then sub-classified according to the thickness of the capsule, lobulation of the tumour, the presence of satellite lesions, and the diffuse or multicenteric nature of the tumour: these factors were also assessed by the surgeon. The mean follow-up period was 4 (range, 2–6) years. None of the type I tumours ( n=30) recurred, but recurrence occurred in five out of 13 type II tumours. Second recurrences were seen with type II B and C, but not type II A tumours.

scholarly journals Evaluation of functional outcome following ORIF of bimalleolar fractures of the ankle-A prospective study of 30 patients

2020 ◽  
Vol 11 (4) ◽  
pp. 6051-6055
Author(s):  
Yeshwanth subash ◽  
Vishnu S ◽  
Damodharan
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Surgical Intervention ◽  
Early Mobilization ◽  
Foot And Ankle ◽  
The Mean ◽  
American Orthopaedic ◽  
A Prospective Study ◽  
Mean Time

Bimalleolar fractures are common injuries, and stable fracture patterns can be treated conservatively, while complicated, unstable fractures would require surgical intervention. This study aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures. This was a study of 30 patients with bimalleolar fractures who presented between January 2013 to January 2016 treated with ORIF with a follow-up period of 3 years. Functional outcome was performed with the AOFAS (American Orthopaedic Foot and ankle society) score. The mean age of the patients was 41.6 years. There was a female preponderance seen in our study with the left side being more commonly affected. The mean time to fracture union was 12.13 weeks, and we had excellent outcomes in 18 patients, good in 10, while two patients had a fair result. We did not lose any of our patients to follow up. All of our patients were happy with the functional outcome achieved. No significant complications were seen in our study. ORIF in bimalleolar fractures enables restoration of the ankle mortise to an anatomical position and facilitates early mobilization of the ankle resulting in good functional outcomes.

The Moovis® implant for trapeziometacarpal osteoarthritis: results after 2 to 6 years

2020 ◽  
Vol 45 (5) ◽  
pp. 477-482 ◽  
Author(s):  
Antoine Martins ◽  
Sébastien Charbonnel ◽  
Frédéric Lecomte ◽  
Lionel Athlani
Keyword(s):  
Analogue Scale ◽  
Pinch Strength ◽  
Trapeziometacarpal Joint ◽  
Level Of Evidence ◽  
Dual Mobility ◽  
Joint Replacements ◽  
Trapeziometacarpal Osteoarthritis ◽  
Contralateral Hand ◽  
Thumb Motion

In this retrospective study we reviewed the outcomes of 46 trapeziometacarpal joint replacements with the Moovis® prosthesis in 46 patients with painful osteoarthritis. The dual mobility design of this prosthesis aims to reduce prosthetic dislocation and subsidence. At follow-up 2 to 6 years (mean 5 years) after operation, pain was reduced from 6 to 0 on a visual analogue scale from 0 to 10. The scores of the Quick Disabilities of the Arm, Shoulder and Hand questionnaire improved significantly. Thumb motion and grip and pinch strength did not differ significantly from the contralateral hand. There were no radiographical signs of implant subsidence or loosening. No implant required revision. Forty-five patients rated the result as excellent or good. We conclude the Moovis® is a reliable and effective implant at short- to mid-term follow-up. Level of evidence: IV

scholarly journals Reinforced Aortic Root Reconstruction in Type A Aortic Dissection: A Prospective Study

2021 ◽  
Vol 24 (5) ◽  
pp. E828-E832
Author(s):  
Ahmed Elsharkawy ◽  
Ashraf El Midany ◽  
Ahmed Elwakeel ◽  
Eman Mahmoud ◽  
Ahmed Mohammed ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Prospective Study ◽  
Coronary Sinus ◽  
Aortic Root ◽  
Type A ◽  
Type A Aortic Dissection ◽  
Early Results ◽  
The Mean ◽  
A Prospective Study

Background: Type A aortic dissection is a challenging surgical emergency associated with high morbidity and mortality. Many techniques have evolved to repair the dissected sinus segments and restore aortic valve dynamics. Herein, we evaluate the early outcome of a novel technique for reconstruction of dissected aortic root. Methods: A prospective study was conducted on 300 patients to evaluate the early results of repair of dissected root in type A aortic dissection. The mean age was 59.65±8.52 years, and 76% of patients were males. All patients had four standard steps for aortic reconstruction: 1) commissural resuspension; 2) right coronary sinus reinforcement with pericardial and Dacron bands; 3) non-coronary sinus reinforcement using external Dacron patch; 4) circumferential inversion of adventitial layer of the root. Patients were followed up clinically, echocardiographically, and by CT scan. Results: The in-hospital mortality was 8%. The mean cross-clamp time was 120±30 minutes, and circulatory arrest time was 25+10 minutes. Twenty-seven patients (9%) experienced postoperative complications, including bleeding and acute kidney injury. During a mean follow-up time of 48±12 months, there were no recurrent aortic dissection, aortic dilatation, pseudoaneurysm, or progression of aortic regurgitation during the entire study period. Conclusions: This reconstructive technique technically is undemanding, feasible, safe, and durable with good early results. A larger cohort of patients with longer period of follow up should generate a more powerful evaluation of this technique.

scholarly journals Role of Biplane Double Supported Screw Fixation For Fracture Neck Femur In Elderly Population: A Prospective Study

2018 ◽  
Vol 12 (1) ◽  
pp. 514-524
Author(s):  
Anoop Kalia ◽  
Jagdeep Singh ◽  
Nasir Ali
Keyword(s):  
Total Hip Arthroplasty ◽  
Prospective Study ◽  
Hip Arthroplasty ◽  
Screw Fixation ◽  
Harris Hip Score ◽  
Total Hip ◽  
Fracture Neck Femur ◽  
The Mean ◽  
A Prospective Study

Introduction: The treatment of fracture neck femur varies according to the age of patient, the displacement of fracture fragments and the duration of the fracture. Various treatment options available for elderly are screw fixation, hemiarthroplasty and total hip arthroplasty. Materials and Methods: This is a prospective study done at authors institutes between January 2014- December 2016. 30 patients aged more than 50 years who sustained fracture neck femur were included in the study. 3 patients were lost to follow up and 2 patients died due to medical comorbidities. Out of the 25 remaining patients, 17 were males and 8 were females and they were operated by the biplane double supported screw fixation method (BDSF TECHNIQUE) and were followed up for a period of two years. The final Harris Hip Score at the last follow up was calculated. Results: Out of the 25 patients, the union was achieved in all the patients. The mean duration of union was 10 weeks. 1 patient had progressive femoral head resorption due to chondrolysis resulting in antalgic gait and unbearable pain and underwent total hip arthroplasty. The mean harris hip score was 81.2 Conclusion: In elderly patients with osteoporosis and in those patients who can not afford arthroplasty or in those patients where arthroplasty is contraindicated, BDSF method is an alternate method for fixing fracture neck femur.

Does Anchor Placement on the Glenoid Affect Functional Outcome After Arthroscopic Bankart Repair?

2018 ◽  
Vol 46 (10) ◽  
pp. 2466-2471 ◽  
Author(s):  
Jin-Young Park ◽  
Jae-Hyung Lee ◽  
Seok Won Chung ◽  
Kyung-Soo Oh ◽  
Young Min Noh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Functional Outcome ◽  
Functional Outcomes ◽  
Bankart Repair ◽  
Level Of Evidence ◽  
Ct Arthrography ◽  
Arthroscopic Bankart Repair ◽  
The Mean ◽  
Bankart Lesions

Background: In arthroscopic Bankart repair, anchor positions can affect glenoid labral height and functional outcomes. Purpose: To evaluate anchor placement on the glenoid during Bankart lesion repair and determine which placement would lead to better functional outcomes. Study Design: Cohort study; Level of evidence, 3. Method: This study included 90 patients (74 males, 16 females; average age, 23.7 years; range, 18-47 years) who underwent surgery for Bankart lesions between December 2009 and March 2014. The mean follow-up duration was 32.7 months (range, 26-48 months). We divided anchor positions into 2 groups: on the glenoid face and at the glenoid edge. The anchor position on the glenoid and the labral height were examined with computed tomography (CT) arthrography at 4.5-month follow-up, and Rowe scores were calculated at 2-year follow-up. Results: The group with the anchor placed on the glenoid face contained 63 patients, and the group with the anchor placed at the glenoid edge or rim contained 27 patients. Mean labral heights at 4.5 months postoperatively in the 2 groups were 5.4 ± 0.22 mm and 3.2 ± 0.16 mm, respectively ( P < .01), and mean Rowe scores at 2 years were 94.7 and 79.5, respectively ( P < .01). Rowe scores calculated at 2-year follow-up were significantly related to anchor position ( P < .01). Conclusion: Anchors positioned on the glenoid face resulted in the greatest restored labral height and better functional outcome (Rowe score). Thus, anchor placement on the glenoid face should be considered, as it may yield better functional outcome in arthroscopic Bankart repair.

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