scholarly journals Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement: Updated mean 7 year follow-up

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0037
Author(s):  
Christopher M. Larson ◽  
M. Russell Giveans ◽  
Rebecca Stone McGaver ◽  
Katelyn N. Weed
Keyword(s):  
Outcome Measures ◽  
Femoroacetabular Impingement ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Acetabular Labrum ◽  
Labral Refixation ◽  
Group 2 ◽  
Patient Related Outcome ◽  
Group 1

Objectives: The acetabular labrum provides sealing function and a degree of hip joint stability. Previous early (16 month) and mid-term (mean 3.5 years) follow-up of this cohort reported better patient related outcome measures in the refixation group. To update the results of labral refixation versus focal labral excision/debridement in a cohort of patients who underwent arthroscopic correction of femoroacetabular impingement (FAI). Methods: We reported patients who underwent labral debridement/focal labral excision during a period before the development of labral repair techniques. Patients with labral tears thought to be repairable with our current arthroscopic technique were compared with patients who underwent labral refixation. In 46 hips, the labrum was focally excised/debrided (group 1); in 54 hips, the labrum was refixed (group 2). Outcomes were measured with modified-Harris-Hip-Score (mHHS), Short Form-12 (SF-12), and a visual-analog-scale (VAS) for pain preoperatively and postoperatively. Results: Mean age was 33 years in group 1 and 28 years in group 2 with mean follow-up of 7 years (range, 2-13.6 years). At mean follow-up, subjective outcomes were significantly improved (P<.01) for both groups compared with preoperative scores. The mHHS (P=.004), SF-12 (P=.016), and VAS pain scores (P<.001) were all significantly better for refixation group compared with debridement group. Although most recent outcomes for both groups fell at mean 7 years’ follow-up in comparison to 16 month and 3.5 year follow-up, the disparity between groups was greater in favor of labral refixation. Good-to-excellent results were 47.7% in debridement and 82.4% in refixation (p<.001), and failure rates were 31.8% (debridement) and 13.7% (refixation group) (p =.034). There were 4 revisions in the debridement group and none in the refixation group. Conclusion: Longer term follow-up comparing focal labral debridement/excision to refixation revealed a decrease in patient related outcome scoring and good/excellent results in both groups. Ultimately, there was a greater drop in outcome measures and good/excellent results in the debridement group and better maintenance of results in the refixation group at mean 7 years follow-up.

Equality in Hip Arthroscopy Outcomes Can Be Achieved Regardless of Patient Socioeconomic Status

2021 ◽  
pp. 036354652110469
Author(s):  
Benjamin R. Saks ◽  
Vivian W. Ouyang ◽  
Elijah S. Domb ◽  
Andrew E. Jimenez ◽  
David R. Maldonado ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Hip Arthroscopy ◽  
Labral Tear ◽  
Harris Hip Score ◽  
Group 4 ◽  
Patient Reported ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Access to quality health care and treatment outcomes can be affected by patients’ socioeconomic status (SES). Purpose: To evaluate the effect of patient SES on patient-reported outcome measures (PROMs) after arthroscopic hip surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Demographic, radiographic, and intraoperative data were prospectively collected and retrospectively reviewed on all patients who underwent hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear between February 2008 and September 2017 at one institution. Patients were divided into 4 cohorts based on the Social Deprivation Index (SDI) of their zip code. SDI is a composite measure that quantifies the level of disadvantage in certain geographical areas. Patients had a minimum 2-year follow-up for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), International Hip Outcome Tool—12, and visual analog scale (VAS) for both pain and satisfaction. Rates of achieving the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) were calculated for the mHHS, NAHS, and VAS pain score. Rates of secondary surgery were also recorded. Results: A total of 680 hips (616 patients) were included. The mean follow-up time for the entire cohort was 30.25 months. Division of the cohort into quartiles based on the SDI national averages yielded 254 hips (37.4%) in group 1, 184 (27.1%) in group 2, 148 (21.8%) in group 3, and 94 (13.8%) in group 4. Group 1 contained the most affluent patients. There were significantly more men in group 4 than in group 2, and the mean body mass index was greater in group 4 than in groups 1 and 2. There were no differences in preoperative radiographic measurements, intraoperative findings, or rates of concomitant procedures performed. All preoperative and postoperative PROMs were similar between the groups, as well as in the rates of achieving the MCID or PASS. No differences in the rate of secondary surgeries were reported. Conclusion: Regardless of SES, patients were able to achieve significant improvements in several PROMs after hip arthroscopy for FAIS and labral tear at the minimum 2-year follow-up. Additionally, patients from all SES groups achieved clinically meaningful improvement at similar rates.

scholarly journals Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years

2013 ◽  
Vol 5 (3) ◽  
pp. 20 ◽  
Author(s):  
Régis Pailhé ◽  
Nicolas Reina ◽  
Etienne Cavaignac ◽  
Akash Sharma ◽  
Valérie Lafontan ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Hip Resurfacing ◽  
Harris Hip Score ◽  
Preliminary Results ◽  
Total Hip ◽  
Group 2 ◽  
Group 1

There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the <em>Partial Pelvic Replacement Hip Project </em>by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS) and Postel-Merle d’Aubigné (MDA) score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1) [100 Durom® (Zimmer Inc., Warsaw, IN, USA) and 42 Birmingham Hip Resurfacing® (Smith &amp; Nephew, Memphis, TN, USA)] and 278 patients with total hip arthroplasty (group 2). The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% <em>vs</em> 1.79% in group 2 (P&lt;0.0001). In group 1 we observed 6 complications only concerned males with Durom® implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time.

Prevention of Sapheno-Femoral and Sapheno-Popliteal Recurrence of Varicose Veins by Forming a Partition to Contain Neovascularization

1998 ◽  
Vol 13 (1) ◽  
pp. 3-9 ◽  
Author(s):  
G. M. Glass
Keyword(s):  
Effective Treatment ◽  
Outcome Measures ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Morphological Examination ◽  
Surgical Exploration ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: To test the hypothesis that sapheno-femoral recurrence of varicose veins may be prevented by containment of neovascularization. Design: Prospective minimum 4-year follow-up by surgical exploration and morphological examination of recurrent vessels in all limbs with clinical or phlebographic evidence of sapheno-femoral recurrence. Setting: Varicose vein clinic of a teaching hospital. Interventions: Sapheno-femoral ligation and multiple ligation (group 1); sapheno-femoral ligation, interposition of cribriform fascia and multiple ligation (group 2); sapheno-femoral ligation, interposition of artificial implant and stripping (group 3). Main outcome measures: Incidence of sapheno-femoral recurrence. Results: The incidence of sapheno-femoral recurrence through neovascularization was lower ( p < 0.001) in groups 2 and 3 after containment of neovascularization at the sapheno-femoral junction by cribriform fascia or artificial implant than in group 1 after ligation alone (3% and 1% vs 25%, respectively). The incidence of recurrent or persistent varices distal to the groin was lower ( p < 0.001) after stripping (group 3, 57%) than after multiple ligation (group 1, 93%; group 2, 81%). Conclusions: Sapheno-femoral ligation, interposition of cribriform fascia or artificial implant at the sapheno-femoral junction, and stripping is a more effective treatment of varicose veins than sapheno-femoral ligation and multiple ligation.

Hip Arthroscopy for Femoroacetabular Impingement in Adolescents: 10-Year Patient-Reported Outcomes

2020 ◽  
Vol 49 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Travis J. Menge ◽  
Karen K. Briggs ◽  
Michael D. Rahl ◽  
Marc J. Philippon
Keyword(s):  
Patient Satisfaction ◽  
Femoroacetabular Impingement ◽  
Revision Surgery ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Duration Of Symptoms ◽  
Patient Reported

Background: Previous studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) in individuals 18 years of age and older. Long-term outcome data in the adolescent population, however, are limited. Purpose: To report 10-year outcomes after hip arthroscopy in adolescents with symptomatic FAI. Study Design: Case series; Level of evidence, 4. Methods: Prospectively collected data were analyzed on adolescent patients younger than 18 years of age who had hip arthroscopy between March 2005 and 2009 with a minimum 10-year follow-up. Patients were included if they were diagnosed with symptomatic FAI and an associated labral tear that was treated with repair. Patients were excluded if they had previous hip procedures, acetabular dysplasia (lateral center-edge angle, <20°), avascular necrosis, previous hip fracture or dislocation, or Legg-Calve-Perthes disease, or refused to participate. The primary patient-reported outcome measure was the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale. In addition, the HOS—Sport, modified Harris Hip Score (mHHS), 12-Item Short Form Health Survey (SF-12), and patient satisfaction were collected. Failure was defined as patients having to undergo revision arthroscopy. Results: There were 60 patients (70 hips) who met inclusion criteria and had a 10-year follow-up. The mean age of the cohort was 16 ± 1.2 years, with 21 male and 49 female hips. Seven hips (10%) required revision hip arthroscopy. All revisions occurred in female patients and were associated with global laxity as well as longer duration of symptoms before time of surgery. At a mean follow-up of 12 years (range, 10-14 years), patients who did not undergo revision surgery had significant improvements from preoperatively to postoperatively in HOS-ADL (from 64 to 92; P < .01), HOS–Sport (from 40 to 86; P < .01), mHHS (from 56 to 88; P < .01), and SF-12 Physical Component Summary (from 41 to 54; P < .01). The median patient satisfaction was 10 out of 10 (very satisfied). Conclusion: Hip arthroscopy for FAI with labral repair resulted in excellent patient-reported outcomes and satisfaction at a minimum of 10 years of follow-up. There was a 10% rate of revision surgery, which was associated with global laxity and longer duration of symptoms before surgery, which should be considered in patient selection.

scholarly journals Invasive Electromagnetic Field Treatment in Osteonecrosis of the Femoral Head: A Prospective Cohort Study

2014 ◽  
Vol 8 (1) ◽  
pp. 125-129 ◽  
Author(s):  
C. Windisch ◽  
W. Kolb ◽  
E. Röhner ◽  
M. Wagner ◽  
A. Roth ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Grafting ◽  
Harris Hip Score ◽  
Total Hip ◽  
Group 2 ◽  
Modified Harris Hip Score ◽  
Group 1

Introduction : The purpose of this prospective cohort study was to compare the surgical treatment of non-ONFH in adulthood by curettage and bone grafting with treatment by curettage and bone grafting in combination with invasive electromagnetic field treatment using Magnetodyn®. This was assessed by examining whether electromagnetic field treatment has a positive additive effect on the clinical parameters modified Harris Hip Score according to Haddad, Cook and Brinker, Merle d'Aubigné hip score and visual analogue scale, and on the subsequent need for treatment by total hip arthroplasty. Materials and Methodology : The prospective, non-randomised study included 35 patients with unilateral or bilateral osteonecrosis of the femoral head. These were divided into two groups according to the surgical treatment regime and assessed over a 12-month follow-up period. The study group (Group 1) comprised 19 patients (14 men and 5 women) with a total of 22 non-ONFH, who underwent minimally invasive curettage, bone grafting and electromagnetic field treatment (Magnetodyn®) by implantation of a bipolar induction screw. The control group (Group 2) comprised 16 patients (12 men and 4 women) with a total of 18 non-ONFH, who underwent minimally invasive curettage and bone grafting without Magnetodyn® therapy. At the initial pre-operative examination and the 6 and 12-month follow-up, all patients were assessed by clinical examination and radiological monitoring, and by bilateral hip MRI. The clinical evaluation was based on the modified Harris Hip Score according to Haddad, Cook and Brinker, the Merle d`Aubigné hip score and the visual analogue scale (VAS). Results : At the time of follow-up, total hip arthroplasty (THA) had been performed in four patients in Group 1 (18%). In Group 2, four patients (22%) had received a THA (n.s.). Both procedures led to an improvement in the clinical scores (Harris Hip Score, Merle d`Aubigné score and VAS), although no significant difference was observed. Conclusion : The authors conclude that electromagnetic field treatment with Magnetodyn®, using the special signal protocol applied here, as an adjunct to curettage and autologous bone grafting to treat non-ONFH, does not produce better clinical results and does not offer better prophylaxis for the avoidance of total hip arthroplasty over all ARCO stages.

scholarly journals Arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) in adolescents—5-year follow-up

2021 ◽  
Author(s):  
Søren Winge ◽  
Sophie Winge ◽  
Otto Kraemer ◽  
Christian Dippmann ◽  
Per Hölmich
Keyword(s):  
Physical Function ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Periacetabular Osteotomy ◽  
Impingement Syndrome ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Center Edge ◽  
Femoroacetabular Impingement Syndrome

ABSTRACT To report the minimum 5-year outcome after hip arthroscopy with labral repair in adolescents. From 2011 to 2014, 29 consecutive patients with a mean age 16.3 years (range 12.7–19.8 years) underwent hip arthroscopy treatment for femoroacetabular impingement syndrome. Patient-related outcome measures (PROMs) including modified Harris Hip Score (mHHS), Visual Analog Scale (VAS) for pain and Copenhagen Hip and Groin Outcome Score (HAGOS) were used preoperatively and at follow-up (FU). Percentage of patients achieving minimum clinically important difference (MCID) and substantial clinical benefit (SCB) for mHHS and HAGOS were determined. Mean FU was 6.7 years (range 5–9.6 years), and a 100% FU was accomplished. Significant improvements were seen for all PROMs at FU in patients not having a periacetabular osteotomy (PAO) with VAS pain score improving from mean 62 to 9, mHHS from 58 to 94 and HAGOS improved in all subgroups. For mHHS, SCB changes were achieved by 76% and MCID by 76% of the patients. Percentage of patients achieving MCID for HAGOS subgroups were 81% for pain, 67% for symptoms, 76% for physical function in daily living, 76% for physical function in sport and recreation, 81% for participation in physical activities and 81% for hip-related quality of life. Two patients had revision hip arthroscopy. PAO was later performed in three patients. The risk of further surgery with center edge (CE) bony edge (CEB) &lt;30° was 42% and 0% with CEB ≥30°. Adolescents having hip arthroscopy with labral repair and resection of cam and pincer morphology achieve significant improvements at mean 6.7 years of FU. CEB &lt; 30° increases the risk of further surgery.

scholarly journals Arthroscopic Correction of Sports-Related Femoroacetabular Impingement in Competitive Athletes: 2-Year Clinical Outcome and Predictors for Achieving Minimal Clinically Important Difference

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198967
Author(s):  
Karen Mullins ◽  
David Filan ◽  
Patrick Carton
Keyword(s):  
Femoroacetabular Impingement ◽  
Minimal Clinically Important Difference ◽  
Sports Participation ◽  
Labral Repair ◽  
Successful Outcome ◽  
Harris Hip Score ◽  
Clinically Important Difference ◽  
Patient Reported ◽  
Competitive Athletes

Background: A growing body of literature supports surgical intervention for femoroacetabular impingement (FAI) in young, active athletes. However, factors likely to influence results in this cohort are less clearly defined. Purpose: To quantify changes in validated patient-reported outcome measures (PROMs) and determine whether differences in baseline athlete demographic characteristics, intraoperative findings, and surgical techniques are associated with achieving improved outcomes and minimal clinically important difference (MCID) after arthroscopic management of sports-related FAI. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected from competitive athletes who underwent hip arthroscopy between January 2009 and February 2017. Athletes who underwent primary arthroscopic correction of sports-related FAI with labral repair were included providing they had a Tönnis grade ≤1 and a lateral center-edge angle ≥20°, excluding significant articular cartilage injury and lateral rim dysplasia. The modified Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index, University of California Los Angeles activity scale, and 36-Item Short Form Health Survey were used to measure outcomes at the 2-year follow-up. MCID was measured using 3 methods: a mean change method, a distribution-based method, and the percentage of possible improvement (POPI) method. Multivariate regression models were used to assess a number of diagnostic and surgical variables associated with good outcome and achieving MCID at follow-up. Results: At 2-year follow-up, statistically significant improvements were observed for all PROMs ( P < .001 for all), and 84% of athletes continued to play sport. Higher preoperative PROM scores reduced the likelihood of achieving MCID; however, returning to play was the strongest predictor of reaching MCID in this athletic cohort. Using absolute score change (mean change or distribution method) to calculate MCID was less accurate owing to ceiling effects and dependence on preoperative PROM scores. Conclusion: Athletes undergoing arthroscopy for sports-related FAI can expect a successful outcome and continued sports participation at 2 years postoperatively. The majority of athletes will achieve MCID. The POPI method of MCID calculation was more applicable to higher functioning athletic cohorts. Reduced preoperative PROM scores and the ability to return to sport increased the likelihood of achieving MCID in this population.

Arthroscopic Labral Treatment in Adolescents: Clinical Outcomes With Minimum 5-Year Follow-up

2019 ◽  
Vol 47 (4) ◽  
pp. 870-875 ◽  
Author(s):  
Jody M. Litrenta ◽  
Brian H. Mu ◽  
Austin W. Chen ◽  
Itay Perets ◽  
Victor Ortiz-Declet ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Outcome Measures ◽  
Hip Arthroscopy ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Labral Tears ◽  
Patient Reported

Background: The success of hip arthroscopy has led to increased application in younger populations. However, hip arthroscopy remains a challenging procedure, and its safety and efficacy in the adolescent population have been controversial. Most existing literature on outcomes in such patients contains only short-term follow-up, and a paucity of evidence is available regarding long-term outcomes in adolescents. Purpose: To report on clinical outcomes at a minimum 5-year follow-up in patients younger than 18 years who underwent arthroscopic treatment of labral tears. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively reviewed on all patients younger than 18 years who underwent hip arthroscopy in a tertiary hip preservation setting at a single institution. Patients were excluded if they had previous ipsilateral hip conditions or surgery. All patients underwent either labral repair or debridement for treatment of a labral tear. Patient-reported outcome measures were recorded at 3 months and at 1, 2, or a minimum of 5 years. These included the modified Harris Hip Score (mHHS), Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale (HOS-SSS), visual analog scale, and patient satisfaction. Additionally, the abbreviated International Hip Outcome Tool and Short Form Health Survey were collected at latest follow-up. Results: The study included 44 hips in 32 patients that underwent arthroscopic labral repair (86.4%) or labral debridement (13.6%) between April 2008 and April 2011, with latest follow-up at a mean of 69.2 months (range, 60.0-89.9 months) postoperatively. The average age at surgery was 16.3 years (range, 14.2-17.9 years), and 39 hips from female patients. Statistically significant improvements were seen in all patient-reported outcome measures from preoperative to minimum 5-year follow-up. Improvements were noted at 1-year follow-up and maintained at minimum 5-year follow-up. At the latest follow-up, the Patient Acceptable Symptomatic State was achieved in 95.5% of patients for the mHHS and 72.7% for the HOS-SSS. Two patients subsequently underwent secondary arthroscopy on the ipsilateral hip; however, the survivorship of all hips was 100%. Conclusion: Hip arthroscopy for the treatment of labral tears in adolescents remains a technically challenging procedure that should be approached with appropriate caution. The results of the present study on a population treated in a specialized hip preservation center demonstrate that hip arthroscopy is a safe procedure with stable improvement in patient-reported outcome measures at 5 years.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

scholarly journals Effects of posterior tibial slope on the mid-term results of medial unicompartmental knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Zhijie Chen ◽  
Kaizhe Chen ◽  
Yufei Yan ◽  
Jianmin Feng ◽  
Yi Wang ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Tibial Slope ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group 3 ◽  
Group 2 ◽  
Postoperative Knee ◽  
Group 1

Abstract Objective To evaluate the effect of medial posterior tibial slope (PTS) on mid-term postoperative range of motion (ROM) and functional improvement of the knee after medial unicompartmental knee arthroplasty (UKA). Methods Medical records of 113 patients who had undergone 124 medial UKAs between April 2009 through April 2014 were reviewed retrospectively. The mean follow-up lasted 7.6 years (range, 6.2–11.2 years). Collected were demographic data, including gender, age, height, weight of the patients. Anteroposterior (AP) and lateral knee radiographs of the operated knees were available in all patients. The knee function was evaluated during office follow-up or hospital stay. Meanwhile, postoperative PTS, ROM, maximal knee flexion and Hospital for Special Surgery (HSS) knee score (pre−/postoperative) of the operated side were measured and assessed. According to the size of the PTS, patients were divided into 3 groups: group 1 (<4°), group 2 (4° ~ 7°) and group 3 (>7°). The association between PTS and the knee function was investigated. Results In our cohort, the average PTS was 2.7° ± 0.6° in group 1, 5.6° ± 0.9° in group 2 and 8.7° ± 1.2° in group 3. Pairwise comparisons showed significant differences among them (p < 0.01). The average maximal flexion range of postoperative knees in each group was 112.4° ± 5.6°, 116.4° ± 7.2°, and 117.5° ± 6.1°, respectively, with significant difference found between group 1 and group 2 (p < 0.05), and between group 1 and group 3 (p < 0.05). However, the gender, age, and body mass index (BMI) did not differ between three groups and there was no significant difference between groups in terms of pre−/postoperative HSS scores or postoperative knee ROM. Conclusion A mid-term follow-up showed that an appropriate PTS (4° ~ 7°) can help improve the postoperative flexion of knee. On the other hand, too small a PTS could lead to limited postoperative knee flexion. Therefore, the PTS less than 4° should be avoided during medial UKA.

Sign in / Sign up

Export Citation Format

Share Document