scholarly journals Minimal Invasive Hallux Valgus Surgery

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0046
Author(s):  
Shay A. Tenenbaum ◽  
Ran Thein ◽  
Erel Ben Ari ◽  
Niv Dreiangel ◽  
Jason T. Bariteau ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Operating Time ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Minimal Invasive ◽  
Published Data ◽  
X Rays ◽  
Non Union ◽  
Patient Reported

Category: Bunion; Other Introduction/Purpose: Hallux valgus is one of the most common deformities of the adult foot, and can adversely affect quality of life, with common complaints including pain, footwear restrictions and cosmesis. Minimal Invasive Surgery (MIS) has re-emerged lately, gaining growing popularity as a surgical approach for surgical treatment of HV deformity. Advantages such as short operating time, quicker recovery, and fewer complications have attributed to MIS. However published data are still inconclusive. Methods: The study included 40 feet (33 pts) with hallux valgus treated with MIS technique, between Apr 20016 to March 2018. Patients were included only if pre- and postoperative weightbearing X-rays at final followup (min 6m) were available. The average age was 51.3 years (range, 21 to 77), with average follow-up of 12 months (range, 6 to 24). Patients’ radiographic records were studied to evaluate postoperative change in hallux valgus angle (HVA), intermetatarsal angle (IMA) and DMAA. Clinical outcome was recorded with Patient reported outcome questioners PROMS10 and MOXFQ. Results: Following surgery deformity was corrected with preoperative mean HVA of 29.8° and IMA of 14.4° compared to postoperative mean of 7.1° and 4.7°, respectively. Patient reported outcome measures recorded the efficacy of MIS for HV in terms of pain reduction and function improvement. In six feet surgery for hardware removal was performed. In one case non- union was treated with revision surgery. Conclusion: This study shows that MIS for HV is safe, effective and offers satisfactory surgical and clinical results.

Patient-reported outcome measures in hallux valgus surgery. A review of literature

2015 ◽  
Vol 21 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Joost C.M. Schrier ◽  
Leonieke N. Palmen ◽  
Cees C.P.M. Verheyen ◽  
Justus Jansen ◽  
Sander Koëter
Keyword(s):  
Hallux Valgus ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Review Of Literature ◽  
Patient Reported

MO883FATIGUE IS THE PREDOMINANT PATIENT-REPORTED OUTCOME MEASURE IN HEMODIALYSIS PATIENTS: RESULTS OF A MULTICENTER CROSS-SECTIONAL EPROMS STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Abdallah Guerraoui ◽  
Anne Kolko-Labadens ◽  
Mathilde Prezelin-Reydit ◽  
Philippe Chauveau ◽  
Catherine Lasseur ◽  
...  
Keyword(s):  
Health Status ◽  
Recovery Time ◽  
Patient Characteristics ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Dialysis Session ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Patient Reported

Abstract Background and Aims End Stage renal disease (ESRD) and hemodialysis are associated with a decrease in quality of life (QOL). Self-reported QOL symptoms are not always prioritized by the medical team, potentially leading to conflicting priorities with patients. Electronic patient-reported outcome measures (ePROMs) allow physicians to better describe these symptoms. The objective was to describe the prevalence of symptoms self-reported by HD patients. Method A multicenter cross-sectional study was conducted in three HD centers. Patients were included if they were 18 years old or over and treated with HD for at least three months in a center. Data were collected by the patient via a self-administered ePROMs questionnaire. Data included patient characteristics, post-dialysis fatigue and intensity, recovery time after a session, perceived stress, impaired sleep the day before the dialysis session, current state of health, and the one-year change. Results In total, we included 173 patients with a mean age of 66.2 years, a mean ± SD hemodialysis duration of 48.9 ± 58.02 months, mainly treated in self-dialysis unit (67%) and having at least one comorbidity (72.5%). The prevalence of fatigue was 72.1% [IC 95% 64.7% to 78.7%] with a mean severity score of 5.84± 2.12. 66.4% had a high level of stress (level B or C). Recovery time was more than 6 hours for 24.9% of patients and 78 % declared they had a better or unchanged health status than the previous year. The self-perceived health status of patients was 6.2± 2.12 and 77.5% [IC 95% 70.5% to 83.5%] of patients stated that they had not a worsened health status than the year before. No statistical differences were observed between centers for the PROMS. Despite significant differences in patient characteristics from the three centers including age, comorbidities or type of dialysis, no differences were found on the prevalence of the various PROMs, in favor of internally Conclusion Fatigue and stress were the main symptoms reported by HD patients. There was no association between symptoms reported and comorbidities clinical results of patients. The patient’s care teams should better consider these symptoms.

Modified Lapidus Versus Scarf Osteotomy Outcomes for Treatment of Hallux Valgus Deformity

2021 ◽  
pp. 107110072110137
Author(s):  
Megan E. Reilly ◽  
Matthew S. Conti ◽  
Jonathan Day ◽  
Aoife MacMahon ◽  
Bopha Chrea ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Retrospective Cohort ◽  
Patient Reported Outcome Measures ◽  
Valgus Deformity ◽  
Patient Reported Outcome ◽  
Measurement Information ◽  
Level Of Evidence ◽  
Scarf Osteotomy ◽  
Hallux Valgus Deformity ◽  
Patient Reported

Background: The Lapidus procedure and scarf osteotomy are indicated for the operative treatment of hallux valgus; however, no prior studies have compared outcomes between the procedures. The aim of this study was to compare clinical and radiographic outcomes between patients with symptomatic hallux valgus treated with the modified Lapidus procedure versus scarf osteotomy. Methods: This retrospective cohort study included patients treated by 1 of 7 fellowship-trained foot and ankle surgeons. Inclusion criteria were age older than 18 years, primary modified Lapidus procedure or scarf osteotomy for hallux valgus, minimum 1-year postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores, and minimum 3-month postoperative radiographs. Revision cases were excluded. Clinical outcomes were assessed using 6 PROMIS domains. Pre- and postoperative radiographic parameters were measured on anteroposterior (AP) and lateral weightbearing radiographs. Statistical analysis utilized targeted minimum-loss estimation (TMLE) to control for confounders. Results: A total of 136 patients (73 Lapidus, 63 scarf) with an average of 17.8 months of follow-up were included in this study. There was significant improvement in PROMIS physical function scores in the modified Lapidus (mean change, 5.25; P < .01) and scarf osteotomy (mean change, 5.50; P < .01) cohorts, with no significant differences between the 2 groups ( P = .85). After controlling for bunion severity, the probability of having a normal postoperative intermetatarsal angle (IMA; <9 degrees) was 25% lower ( P = .04) with the scarf osteotomy compared with the Lapidus procedure. Conclusion: Although the modified Lapidus procedure led to a higher probability of achieving a normal IMA, both procedures yielded similar improvements in 1-year patient-reported outcome measures. Level of Evidence: Level III, retrospective cohort.

scholarly journals Patient Reported Outcomes and Recurrence following 127 Primary Lapidus Surgeries for Hallux Valgus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0022
Author(s):  
Sara H. Galli ◽  
Nick Johnson ◽  
W. Hodges Davis ◽  
Robert B. Anderson ◽  
Carroll P. Jones ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Recurrence Rate ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Recurrence Rates ◽  
Repeat Surgery ◽  
Radiographic Outcomes ◽  
Patient Reported ◽  
Fair Poor

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: Treatment for symptomatic hallux valgus encompasses a spectrum of surgical options to appropriately address the degree of deformity. The modified Lapidus has emerged as a powerful surgical option to address moderate to severe deformity as well as hallux valgus with 1st ray hypermobility. Unlike metatarsal osteotomies, the literature is lacking in clinical and radiographic outcomes. Previous retrospective series have reported recurrence rates less than 15%, but our experience found a higher recurrence rate. We aimed to evaluate the effect of radiographic recurrence on patient reported outcome measures and satisfaction. Methods: After obtaining institutional board review approval, patients were identified by procedural billing codes from 2012- 2016. Only primary Lapidus surgeries were included. All patients were contacted and invited to return to obtain patient reported outcome scores (AOFAS, FAAM) and assess satisfaction. HVA>=20 at final follow-up was used to define recurrence. Data was analyzed utilizing statistical analysis software (SAS v9.4).328 surgeries were identified with 255 eligible and contacted for follow-up. 77 surveys were completed in person and 50 were completed over the phone or via email with total response rate of 50%. Results: Average follow-up was 59 months. 38% had radiographic recurrence (48/127), 24% perceived recurrence (30/125), and 9.5% had reoperation for recurrence (12/126). AOFAS scores were lower with radiographic recurrence (p=0.01) and perceived recurrence (p=0.003). FAAM-ADL scores were not different in radiographic recurrence (p=0.79) but were lower in perceived recurrence (p=0.001). Overall, satisfaction was good-excellent in 74% and fair-poor in 26%. For radiographic (p=0.03) and perceived recurrence (p<0.0001), there was lower satisfaction reported. 78% would repeat surgery. Decision to repeat surgery was not different for radiographic recurrence with 81% without vs 74% with recurrence (p=0.37) saying they would have surgery again. However, it was different for perceived recurrence with 84% without vs 59% with recurrence saying they would have surgery again (p=0.01). Conclusion: Despite a high radiographic recurrence rate (38%), only a portion perceived a recurrence (24%) and an even smaller proportion (9.5%) had a reoperation for the recurrence. Nonetheless, these results suggest radiographic and clinical outcomes are not as high as previously reported for the modified Lapidus procedure.

scholarly journals Non-restricted weight-bearing after modified Lapidus arthrodesis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Manuel Pellegrini ◽  
Giovanni Carcuro ◽  
Natalio Cuchacovic ◽  
Gerardo Muñoz ◽  
Marcelo Somarriva
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Clinical Results ◽  
Delayed Union ◽  
Rigid Fixation ◽  
X Rays ◽  
Non Union ◽  
Fixation Methods ◽  
First Ray

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Modified lapidus arthrodesis is performed in the treatment of different pathologies, including hallux valgus and osteoarthritis of the first cuneo-metatarsal joint. Complications of this procedure include delayed union and non-union, reported to be between 5 to 20%. To prevent them, prolonged foot unloading and rigid fixation methods have been proposed. We sought to investigate our clinical results and complications in patients operated on with a modified Lapidus arthrodesis and inmediate weight bearing in a rigid post-operative shoe. Methods: After IRB approval, we conducted a retrospective patient chart review in a single center. Dedicated foot and ankle orthopaedic surgeons performed all procedures. Patients were included if they were older than 18 years, had a minimum follow up of one year and agreed to participate in the study. Patients with neuropathy, revision arthrodesis or those with concomitant midfoot/hindfoot procedures were excluded. All patients were operated on with an inter-articular lag screw and a locking neutralization plate. Patients were allowed to weight bear without restriction in a rigid post-operative shoe from postoperative day one. An independent musculoskeletal radiologist evaluated bone consolidation of the arthrodesis in x-rays or CT scan, when available. Results: Fifteen patients (18 feet) with an average age of 47 years (15-66) met inclusion criteria. All patients were female. Mean follow up was 19 months (12-24). Surgical indications were: hallux valgus in 14 cases and cuneo-metatarsal osteoarthritis in one case. Consolidation rate was 94% (14/15). Average time for radiological consolidation was 11 weeks (7-27). One patient (6%) developed non-union and required a revision arthrodesis with bone grafting. No loss of radiological correction or malalignment of the first ray was observed at last follow-up. Conclusion: Our results suggest that modified lapidus arthrodesis with rigid fixation methods and non restricted weight bearing is a safe and effective alternative to manage first ray pathology. This approach may not increase non-union rates or affect the reduction obtained.

scholarly journals Qualität der Therapie von Speicheldrüsenerkrankungen

2020 ◽  
Vol 99 (S 01) ◽  
pp. S301-S335
Author(s):  
Orlando Guntinas-Lichius
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Minimal Invasive ◽  
Patient Reported

ZusammenfassungDie Behandlung von Speicheldrüsenerkrankungen stellt ein wichtiges Segment der HNO-Heilkunde dar. Von der Vielzahl von Speicheldrüsenerkrankungen sieht der einzelne HNO-Arzt allerdings möglicherweise nur wenige Fälle pro Jahr und chirurgische oder endoskopisch minimal-invasive Therapiekonzepte spielen eine wichtige Rolle. Daher kann der Erkenntnisgewinn nicht nur von prospektiven klinischen Studien getragen werden, sondern heute im Wesentlichen durch Meta-Analysen und potentiell auch von Registerdaten. Während eine Vielzahl guter Indikatoren vorhanden ist, um die Funktion der erkrankten Speicheldrüse und deren Besserung unter Therapie zu messen, sind Patient-reported outcome measures (PROMs) bislang nicht ausreichend entwickelt worden. Es ist zu fordern, dass diese Indikatoren auch konsequent in klinischen Studien eingesetzt werden. Perspektivisch könnten dieselben Indikatoren auch für Qualitätskontrollen in der ambulanten und stationären Routine angewandt werden. Die Rahmenbedingungen für einen qualitativ hochwertigen Wissenserwerb sind durch die HNO-Facharzt-Ausbildung, die Verpflichtung der Weiterbildung und durch zertifizierte Speicheldrüsen-Kurse prinzipiell sehr gut, die Vorgaben für spezifische Qualitätsstandards für die Behandlung von Patienten sind jedoch wenig ausgearbeitet. In Abgrenzung zu anderen Fachgebieten, die sich mit Speicheldrüsenerkrankungen beschäftigen, sollte die HNO-Heilkunde Standards mit hoher Qualitätsforderung für die Behandlung von Patienten mit Speicheldrüsenerkrankungen entwickeln.

scholarly journals Tönnis Grade 1 dysplastic hips have improved patient-reported outcome scores when intraarticular pathology is treated during periacetabular osteotomy

2021 ◽  
Author(s):  
Joseph A Panos ◽  
Claudia N Gutierrez ◽  
Cody C Wyles ◽  
Joshua S Bingham ◽  
Kristin C Mara ◽  
...  
Keyword(s):  
Periacetabular Osteotomy ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Labral Repair ◽  
Free Survival ◽  
Patient Reported ◽  
Outcome Scores ◽  
Tönnis Grade

ABSTRACT It is unclear whether treatment of intraarticular pathology should be performed during periacetabular osteotomy (PAO) to improve outcomes. Therefore, we asked: (i) What are the clinical results of PAO in patients with and without intraarticular intervention? (ii) Is there a difference in reoperations with and without intraarticular intervention? and (iii) Is there a difference in clinical results and reoperations depending on preoperative Tönnis Grade if intraarticular intervention is performed? Prospective evaluation of 161 PAO in 146 patients was performed. The cohort was 84.5% female, mean age was 26.7 ± 7.9 years and mean follow-up was 2.4 years; 112 hips had Grade 0 changes and 49 hips had Grade 1 changes. Patients were classified into three groups based on treatments during PAO: major (labral repair, femoral head–neck osteochondroplasty), minor (labral debridement, femoral/acetabular chondroplasty) or no intervention. A subset of eight patient-reported outcome measures (PROMs) was analyzed to determine whether the minimal clinically important difference (MCID) was achieved. Major, minor and no intervention groups exceeded the MCID in 5, 8 and 8, of 8 PROMs (P ≥ 0.20), respectively; intraarticular interventions did not influence reoperation-free survival (P ≥ 0.35). By Tönnis Grade, PROMs exceeding MCID decreased in Grade 1 versus 0 receiving no intervention (P &lt; 0.001) but did not decrease for either intervention (P ≥ 0.14); intraarticular interventions did not influence reoperation-free survival (P ≥ 0.38). Overall, intraarticular intervention was associated with excellent PROMs and reoperation-free survival. Although Grade 1 patients had fewer PROM which achieved MCID, intraarticular interventions attenuated this decrease, suggesting a therapeutic advantage of intraarticular procedures for more advanced pathology.

Kinematically Aligned Total Knee Arthroplasty Did Not Show Superior Patient-Reported Outcome Measures: An Updated Meta-analysis of Randomized Controlled Trials with at Least 2-Year Follow-up

2020 ◽  
Author(s):  
Shuhei Hiyama ◽  
Tsuneari Takahashi ◽  
Katsushi Takeshita
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Significant Difference ◽  
Patient Reported ◽  
Total Knee

AbstractKinematically aligned total knee arthroplasty (KATKA) was developed to improve the anatomical alignment of knee prostheses, assisting in restoring the native alignment of the knee and promoting physiological kinematics. Early clinical results were encouraging, showing better functional outcomes than with mechanically aligned total knee arthroplasty (MATKA). However, there have been concerns about implant survival, and follow-up at 10 years or more has not been reported. In addition, randomized controlled trials (RCTs) comparing KATKA with MATKA have reported inconsistent results. The current meta-analysis of RCTs with a minimum of 2 years of follow-up investigated the clinical and radiological differences between KATKA and MATKA. A systematic review of the English language literature resulted in the inclusion of four RCTs. The meta-analysis found no significant difference in any of the following parameters: postoperative range of motion for flexion (mean difference for KATKA − MATKA [MD], 1.7 degrees; 95% confidence interval [CI], −1.4 to 4.8 degrees; p = 0.29) and extension (MD, 0.10 degrees; 95% CI, −0.99 to 1.2 degrees; p = 0.86); Oxford Knee Score (MD, 0.10 points; 95% CI, −1.5 to 1.7 points; p = 0.90); Knee Society Score (MD, 1.6 points; 95% CI, −2.8 to 6.0 points; p = 0.49); and Knee Function Score (MD, 1.4 points; 95% CI, −4.9 to 7.8 points; p = 0.66). In addition, there was no significant difference between KATKA and MATKA in the rate of complications requiring reoperation or revision surgery (odds ratio, 1.01; 95% CI, 0.25–4.09; p = 0.99) or in the length of hospital stay (MD, 1.0 days; 95% CI, −0.2 to 2.2 days; p = 0.092). KATKA did not increase the number of patients with poor clinical results due to implant position, particularly for varus placement of the tibial component. In this meta-analysis based on four RCTs with a minimum of 2 years of follow-up, KATKA were only relevant to cruciate retaining TKA and could not be extrapolated to posterior stabilized TKA. Patient-reported outcome measures with KATKA were not superior to those with MATKA.

Modern trunnion designs do not affect clinically significant patient-reported outcomes

2019 ◽  
Vol 30 (6) ◽  
pp. 752-760
Author(s):  
Ugonna N Ihekweazu ◽  
Stephen Lyman ◽  
Yu-fen Chiu ◽  
Idelle Vaynberg ◽  
Geoffrey Westrich
Keyword(s):  
Patient Reported Outcomes ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Important Change ◽  
Study Cohort ◽  
Clinical Patient ◽  
Patient Reported ◽  
Long Term Impact ◽  
The Impact

Introduction: Trunnion geometry is known to vary between hip systems. Trunnionosis and the impact of trunnion design on total hip arthroplasty (THA) survival, has gained attention as a failure mechanism. We sought to report the differences in patient-reported outcome measures (PROMs) between the most commonly utilised modern THA trunnions. Methods: We reviewed primary unilateral THA patients from May 2007 to October 2011. The most frequently used stems were included. LEAS, HOOS subdomains, and SF-12 were obtained pre and post operatively while satisfaction was measured at 2 years after THA. Trunnions were grouped by taper geometry and manufacturer. The 2-year change in PROMs for each trunnion was compared to the pooled 2-year change in HOOS for all other trunnions. Results: 3950 THA patients were studied. 6 trunnion designs were evaluated from 5 manufacturers. The range in differences between the 2-year change in individual PROMs were as follows: HOOS pain (0.6–2.4), HOOS symptoms (0–3.8), HOOS ADL (0.4–4), and HOOS QOL (0.5–3.6). None of the differences in the 2-year change in PROMs reached a minimal clinically important change (MCIC), which we previously determined to be a minimum of 9 points for all HOOS domains. Conclusion: All of the trunnions designs utilised in our study cohort demonstrated excellent clinical results. Small differences were well below the known MCIC; and were not clinically relevant. The findings of this study should prompt further investigations into the long-term impact of trunnion design on clinical patient-reported outcomes.

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