scholarly journals Cavovarus Foot Surgery Including a Peroneus Longus Transfer: A 2- to 6-Year Follow-up

2021 ◽  
Vol 6 (3) ◽  
pp. 247301142110210
Author(s):  
Anna E. Sprinchorn ◽  
Andrew D. Beischer
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Ligament Reconstruction ◽  
Lateral Ligament ◽  
Foot Surgery ◽  
Peroneus Longus ◽  
First Metatarsal ◽  
Vas Score ◽  
The Mean

Background: The primary aim of this longitudinal study was to describe patient satisfaction and clinical outcome at least 2 years following cavovarus foot surgery, utilizing a peroneus longus to brevis transfer, lateral ligament reconstruction, and corrective osteotomies of the first metatarsal, occasionally with the added calcaneal osteotomy. Methods: Sixteen patients (17 feet) were examined in 2010-2012, 3.5 (range, 2-6.5) years after cavovarus foot surgery performed in 2004-2010 utilizing a peroneus longus to brevis transfer, lateral ligament reconstruction, and osteotomy of the first metatarsal with or without additional calcaneal osteotomy. The mean age at surgery was 45 years. Evaluation at baseline before surgery and at follow-up assessed patient satisfaction, using the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. At follow-up, visual analog scale (VAS) score for pain at walking was recorded, and a clinical and radiographic evaluation was included. Results: The mean AOFAS score improved from 57 (SD 11) to 83 (SD 12.5) points, with an average score improvement of 25 score points (95% confidence interval 16-35, P < .0001). Postoperative VAS score for pain at walking was mean 2 (range, 0-6). All feet had a residual cavovarus both clinically and on the radiographs. Conclusion: Patient satisfaction and clinical outcome was shown to improve pre- to postsurgery at intermediate follow-up after peroneus longus to brevis transfer and metatarsal osteotomies with or without additional calcaneal osteotomies as part of a cavovarus foot correction. Level of Evidence: Level IV, case series.

scholarly journals Intra-Articular Opening Osteotomy Combined with Lateral Ligament Reconstruction for Varus Ankle Arthritis

2020 ◽  
Author(s):  
Yang Xu ◽  
Xing-chen Li ◽  
Chang-jun Guo ◽  
Xiang-yang Xu
Keyword(s):  
Ligament Reconstruction ◽  
Lateral Ligament ◽  
Anterior Surface ◽  
Ankle Arthritis ◽  
Aofas Score ◽  
Vas Score ◽  
Therapeutic Outcomes ◽  
Sf 36 ◽  
The Mean

Abstract Background One type of Takakura 3B ankle arthritis is varus talus with medial disital tibial platform erosion. Among these cases, the tibial anterior surface (TAS) angles are usually normal. The purpose of this study was to evaluate the therapeutic outcomes of intra-articular opening osteotomy combined with lateral ligament reconstruction for Takakura 3B ankle arthritis with medial disital tibial platform erosion. Methods From September 2009 to May 2016, 17 patients with Takakura 3B ankle arthritis were reviewed, including 3 male and 14 female patients. All underwent the operation of intra-articular opening osteotomy combined with lateral ligament reconstruction. All patients were available for analysis. The main outcome measurements included TT angle, AOFAS score, VAS score, SF-36 scale and AOS scale. Results All patients were followed for a mean follow-up of 87.2 months (range, 49 to 129 months). The VAS scale improved from 5.5 ± 1.6 to 2.3 ± 1.9. The mean AOFAS score improved from 47.7 ± 15.7 to 75.8 ± 12.0. The SF-36 scale improved from 41.6 ± 14.0 to 67.7 ± 14.6. The AOS improved from 60.9 ± 13.9 to 28.2 ± 17.7. The TT angle improved from 14.3 ± 5.0° to 5.3 ± 4.0°. Conclusion Intra-articular opening osteotomy combined with lateral ligament reconstruction is an effective method to treat varus ankle arthritis with medial disital tibial platform erosion.

scholarly journals Revision Meniscal Repair - Failure rates, clinical outcome and patient satisfaction

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0022
Author(s):  
Andreas Fuchs ◽  
Ferdinand Kloos ◽  
Gerrit Bode ◽  
Kaywan Izadpanah ◽  
Norbert Südkamp ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Revision Surgery ◽  
Meniscal Repair ◽  
Sports Participation ◽  
Lysholm Score ◽  
Failure Rates ◽  
The Mean ◽  
High Level

Aims and Objectives: Failure of isolated primary meniscal repair must be expected in 14% - 28%. Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of revision meniscal repair remain unclear. The purpose of this study was therefore to evaluate the clinical outcome and failure rates of revision meniscal repair in patients with re-tears or failed healing after previous isolated meniscal repair in stable knee joints. Materials and Methods: A chart review was performed to identify all patients undergoing revision meniscal repair between 08/2010 and 02/2016. Only patients without concomitant procedures, without ligamentous insufficiency, and a minimum follow-up of 24 months were included. The records of all patients were reviewed to collect patient demographics, injury patterns of the meniscus, and details about primary and revision surgery. Follow-up evaluation included failure rates, clinical outcome scores (Lysholm Score, KOOS Score), sporting activity (Tegner scale), and patient satisfaction. Results: A total of 12 patients with a mean age of 22 ± 5 years were included. The mean time between primary repair and revision repair was 27 ± 21 months. Reasons for failed primary repairs were traumatic re-tears in 10 patients (83%) and failed healing in two patients (17%). The mean follow-up period after revision meniscal repair was 43 months. Failure of revision meniscal repair occurred in 3 patients (25%). In two of these patients, re-revision repair was performed. At final follow-up, the mean Lysholm Score was 95.2 with a range of 90-100, representing a good to excellent result in all patients. The final assessment of the KOOS subscores also showed good to excellent results. The mean Tegner scale was 6.8 ± 1.8, indicating a relatively high level of sports participation. Ten patients (83%) were either very satisfied or satisfied with the outcome. Conclusion: In patients with re-tears or failed healing after previous isolated meniscal repair, revision meniscal repair results in good to excellent knee function, high level of sports participation, and high patient satisfaction. The failure rate is comparable to isolated meniscal repair. Therefore, revision meniscal repair is worthwhile in order to save as much meniscal tissue as possible.

Donor Site Morbidity After Lateral Ankle Ligament Reconstruction Using the Anterior Half of the Peroneus Longus Tendon Autograft

2016 ◽  
Vol 45 (4) ◽  
pp. 922-928 ◽  
Author(s):  
Chul Hyun Park ◽  
Woo-Chun Lee
Keyword(s):  
Ligament Reconstruction ◽  
Plantar Flexion ◽  
Lateral Ligament ◽  
Lateral Ankle ◽  
Ankle Ligament ◽  
Lateral Ankle Ligament ◽  
The Mean ◽  
Lateral Ankle Ligament Reconstruction ◽  
Ankle Plantar Flexion

Background: The anterior half of the peroneus longus tendon (AHPLT) has been reported to be an effective autograft for ligament reconstruction with respect to strength and safety. However, there is little information regarding donor site morbidity after harvesting the AHPLT. Furthermore, to the best of our knowledge, there has not been a study on the isokinetic evaluation of ankle plantar flexion and eversion after AHPLT harvesting. Purpose: To evaluate the clinical and radiographic results after lateral ankle ligament reconstruction using the AHPLT. We further investigated whether harvesting the AHPLT for lateral ankle ligament reconstruction decreases the strength of ankle plantar flexion and eversion. Study Design: Case series; Level of evidence, 4. Methods: Thirty consecutive patients (31 cases) were treated by anatomic lateral ligament reconstruction using the AHPLT. For the clinical assessment, visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Karlsson-Peterson scores were evaluated preoperatively and at the last follow-up. For the radiographic assessment, talar tilt angle and anterior talar displacement were measured preoperatively and at the last follow-up. The peak isokinetic torques for ankle plantar flexion at angular velocities of 30 and 120 deg/s and eversion at angular velocities of 30 and 60 deg/s were measured at a minimum of 1 year after surgery. Results: The mean VAS score improved significantly from 6.4 ± 1.7 preoperatively to 1.6 ± 1.5 at the last follow-up ( P < .001). The mean respective AOFAS and Karlsson-Peterson scores improved significantly from 57.2 ± 12.8 and 66.9 ± 13.6 preoperatively to 89.0 ± 10.0 and 93.3 ± 5.7 at the last follow-up ( P < .001). The mean talar tilt angle improved significantly from 15.3° ± 6.2° preoperatively to 3.4° ± 3.0° at the last follow-up ( P < .001), and the mean anterior talar displacement improved significantly from 10.2 ± 3.3 mm preoperatively to 6.3 ± 1.9 mm at the last follow-up ( P < .001). No significant differences were observed between the uninvolved and involved legs in the mean peak torque for plantar flexion at angular speeds of 30 deg/s ( P = .517) and 120 deg/s ( P = .347) or for eversion at angular speeds of 30 deg/s ( P = .913) and 60 deg/s ( P = .983). Conclusion: Anatomic lateral ligament reconstruction using the AHPLT showed good clinical and radiographic results without a significant decrease in the peroneus longus strength. Lateral ligament reconstruction using the AHPLT may be a good surgical option for the treatment of chronic ankle instability.

scholarly journals Comparison of clinical outcomes after anterior cruciate ligament reconstruction with autogenous hamstring tendons and peroneus longus allograft

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Rodi Ertoğrul ◽  
Hasan Basri Sezer ◽  
Raffi Armağan ◽  
Muharrem Kanar ◽  
Osman Tugrul Eren
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Peroneus Longus ◽  
The Mean ◽  
Anterior Cruciate ◽  
Autograft Group

In this study we reported the early clinical and functional results of 40 patients admitted to our hospital for anterior cruciate ligament reconstruction (20 with autogenous hamstring tendon graft and 20 with peroneus longus allograft)retrospectively between august 2012 and september 2014. All patients in the autograft group were male and only three patients in the allograft group were female. The mean age in the autograft group was 29,60±4,55 and 34,25±6,73 in the allograft group. The mean time period before the surgery was 10,35(1-84) months and the mean postoperative follow up time was 33,8(12-46) months. Only 2 patients in the autograft group and 4 patients in the allograft group were injured by direct trauma. We noted the patients’ occupation, activity level and sport activities. Joint effusion, pain and restriction in the joint motion were documented. Patients were evaluated with Lachman, anterior drawer and pivot shift tests at the last follow up examination. The joint instability was tested with KT 1000 and the muscle contractions were tested with Cybex devices. Modified Cincinnati, Lysholm and IKDC activity scale were used to evaluate the activity level of patients. There were no difference neither clinically, nor functionally between two groups at the last follow up (p>0,05).Taken into consideration the risks and advantages of autogenous hamstring graft and allograft use we conclude that the peroneus longus allograft is a reasonable option for anterior cruciate ligament reconstruction.

scholarly journals Intra-articular opening osteotomy combined with lateral ligament reconstruction for varus ankle arthritis

2020 ◽  
Author(s):  
Yang Xu ◽  
Xing-chen Li ◽  
Chang-jun Guo ◽  
Xiang-Yang Xu
Keyword(s):  
Ligament Reconstruction ◽  
Lateral Ligament ◽  
Anterior Surface ◽  
Ankle Arthritis ◽  
Aofas Score ◽  
Therapeutic Outcomes ◽  
Sf 36 ◽  
Vas Scores ◽  
The Mean

Abstract Background One type of Takakura 3B ankle arthritis is varus talus with medial disital tibial platform erosion. Among these cases, the talar anterior surface (TAS) angles are usually normal. The purpose of this study was to evaluate the therapeutic outcomes of intra-articular opening osteotomy combined with lateral ligament reconstruction for Takakura 3B ankle arthritis with medial disital tibial platform erosion.Methods From September 2009 to May 2016, 17 patients with Takakura 3B ankle arthritis were reviewed, including 3 male and 14 female patients. All underwent the operation of intra-articular opening osteotomy combined with lateral ligament reconstruction. All patients were available for analysis. The main outcome measurements included TT angle, AOFAS score, VAS scores, SF-36 scales and AOS scales.Results All patients were followed for a mean follow-up of 87.2 months (range, 49 to 129 months). The VAS scale improved from 5.53 ± 1.59 to 2.29 ± 1.90. The mean AOFAS score improved from 47.71 ± 15.73 to 75.82 ± 12.03. The SF-36 scale improved from 41.64 ± 13.95 to 67.69 ± 14.64. The AOS improved from 60.94 ± 13.91 to 28.18 ± 17.73. The TT angle improved from 14.29 ± 4.96 to 5.25 ± 3.96.Conclusion Intra-articular opening osteotomy combined with lateral ligament reconstruction is an effective method to treat varus ankle arthritis with medial disital tibial platform erosion.

scholarly journals Intra-articular opening osteotomy combined with lateral ligament reconstruction for varus ankle arthritis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yang Xu ◽  
Xing-chen Li ◽  
Chang-jun Guo ◽  
Xiang-yang Xu
Keyword(s):  
Subchondral Bone ◽  
Ligament Reconstruction ◽  
Lateral Ligament ◽  
Ankle Arthritis ◽  
Aofas Score ◽  
Bone Contact ◽  
Therapeutic Outcomes ◽  
Sf 36 ◽  
The Mean

Abstract Background Takakura 3B ankle arthritis is featured as obliteration of ankle space with subchondral bone contact. Among these patients, some have medial distal tibial platform erosion. It is hard to treat this kind of patients. The purpose of this study was to evaluate the therapeutic outcomes of intra-articular opening osteotomy combined with lateral ligament reconstruction for Takakura 3B ankle arthritis with medial distal tibial platform erosion. Methods From September 2009 to May 2016, 17 patients with Takakura 3B ankle arthritis were reviewed, including 3 male and 14 female patients. All underwent the operation of intra-articular opening osteotomy combined with lateral ligament reconstruction. All patients were available for analysis. The main outcome measurements included TT angle, AOFAS score, VAS score, SF-36 scale, and AOS scale. Results All patients were followed for a mean follow-up of 87.2 months (range, 49 to 129 months). The VAS scale improved from 5.5 ± 1.6 to 2.3 ± 1.9. The mean AOFAS score improved from 47.7 ± 15.7 to 75.8 ± 12.0. The SF-36 scale improved from 41.6 ± 14.0 to 67.7 ± 14.6. The AOS improved from 60.9 ± 13.9 to 28.2 ± 17.7. The TT angle improved from 14.3 ± 5.0° to 5.3 ± 4.0°. The TAS and TLS changed from 83.4 ± 2.6° and 77.5 ± 2.3° to 90.7 ± 2.3° and 78.6 ± 2.2°. However, the LTAS was not corrected significantly. Conclusion Intra-articular opening osteotomy combined with lateral ligament reconstruction is an effective method to treat varus ankle arthritis with medial distal tibial platform erosion.

scholarly journals Outcomes following Medial Patellofemoral Ligament Reconstruction with Allograft (177)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0029
Author(s):  
Danielle Markus ◽  
Eoghan Hurley ◽  
Edward Shontz ◽  
Kirk Campbell ◽  
Laith Jazrawi ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Recurrent Instability ◽  
Vas Score ◽  
Kujala Score ◽  
Patient Reported ◽  
The Mean ◽  
Low Rate

Objectives: Medial patellofemoral ligament reconstruction (MPFLR) using allograft tissue has several potential benefits including the absence of donor site morbidity, ability to predict graft parameters, and decreased operative time. The purpose of this study was to evaluate the outcomes of patients following MPFLR with allograft. Our hypothesis was that there would be a low rate of recurrent instability, and excellent clinical outcomes reported. Methods: A retrospective review of athletes who underwent MPFL Reconstruction, with a minimum of 12-month follow-up was performed. Recurrent instability (including re-dislocation and subluxation), Visual Analogue Scale (VAS) score, Kujala score, satisfaction, and whether they would undergo the same surgery again, were evaluated. Results: Overall, follow up was attained for 131 patients with 141 knees (73.4%). The mean patient age of 25.0 years, 67.4% females, and mean time to follow-up was 46.8 months (12-111). At final follow up, the mean VAS score was 1.4 ± 2.0, the mean Kujala score was 84.8 ± 15.6, the mean satisfaction score was 84% ± 26.0, and 117 (83.0%) would undergo the same procedure again if required. There was 17 (12.0%) patients that had recurrent instability, with 2 being re-dislocations (1.4%). A further procedure was performed in 14 patients (9.9%). There were no intra-operative complications in our series. Conclusions: There was a low rate of recurrent instability following MPFLR with allograft, with excellent patient reported outcomes, and a low complication rate.

scholarly journals Arthroscopic Abrasion Arthroplasty Is Not Superior to Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 791-796
Author(s):  
Dominik Rog ◽  
Tuna Ozyurekoglu ◽  
Kumar K. Karuppiah
Keyword(s):  
Ligament Reconstruction ◽  
Analog Scale ◽  
Vas Score ◽  
Pain Scores ◽  
The Poor ◽  
The Mean ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Cmc Joint

Background: A few arthroscopic options have been proposed for the treatment of early stages of the arthritis of the thumb carpometacarpal (CMC) joint. The purpose of this study was to compare the results of arthroscopic abrasion arthroplasty with ligament reconstruction and tendon interposition (LRTI). Methods: In this retrospective cohort study, 11 patients who underwent thumb CMC joint arthroscopic abrasion arthroplasty were compared with 15 patients who were randomly selected from a group of 80 LRTI arthroplasty patients during the same study period, with a minimum 1 year follow-up. Preoperative and postoperative evaluations included radiographs and measurements of grip strength, visual analog scale (VAS) pain scores, and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Results: The mean preoperative VAS score in both groups was 6.8. Mean preoperative DASH scores were 61.1 in the arthroscopy group and 67.4 in the LRTI group. Postoperative VAS score at final follow-up was 4.8 in the arthroscopy group and 1.2 in the LRTI group ( P < .05). Postoperative DASH scores 9 months after surgery were 23 for the LRTI group and 55.2 for the arthroscopy group ( P < .05). Eight patients in the arthroscopy group had a second surgery due to persistent pain. Conclusions: Patients undergoing arthroscopic abrasion arthroplasty had high revision rates, higher postoperative pain, and lower patient-rated outcomes than patients undergoing LRTI procedure. The poor results in the arthroscopy group may be secondary to the inherent instability of the CMC joint and lack of use of any biological or artificial interposition material.

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

Deep brain stimulation of the posterior limb of the internal capsule in the treatment of central poststroke neuropathic pain of the lower limb: case series with long-term follow-up and literature review

2020 ◽  
Vol 133 (3) ◽  
pp. 830-838 ◽  
Author(s):  
Andrea Franzini ◽  
Giuseppe Messina ◽  
Vincenzo Levi ◽  
Antonio D’Ammando ◽  
Roberto Cordella ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Lower Limb ◽  
Internal Capsule ◽  
Posterior Limb ◽  
Vas Score ◽  
The Mean ◽  
Deep Brain ◽  
Stimulation Of

OBJECTIVECentral poststroke neuropathic pain is a debilitating syndrome that is often resistant to medical therapies. Surgical measures include motor cortex stimulation and deep brain stimulation (DBS), which have been used to relieve pain. The aim of this study was to retrospectively assess the safety and long-term efficacy of DBS of the posterior limb of the internal capsule for relieving central poststroke neuropathic pain and associated spasticity affecting the lower limb.METHODSClinical and surgical data were retrospectively collected and analyzed in all patients who had undergone DBS of the posterior limb of the internal capsule to address central poststroke neuropathic pain refractory to conservative measures. In addition, long-term pain intensity and level of satisfaction gained from stimulation were assessed. Pain was evaluated using the visual analog scale (VAS). Information on gait improvement was obtained from medical records, neurological examination, and interview.RESULTSFour patients have undergone the procedure since 2001. No mortality or morbidity related to the surgery was recorded. In three patients, stimulation of the posterior limb of the internal capsule resulted in long-term pain relief; in a fourth patient, the procedure failed to produce any long-lasting positive effect. Two patients obtained a reduction in spasticity and improved motor capability. Before surgery, the mean VAS score was 9 (range 8–10). In the immediate postoperative period and within 1 week after the DBS system had been turned on, the mean VAS score was significantly lower at a mean of 3 (range 0–6). After a mean follow-up of 5.88 years, the mean VAS score was still reduced at 5.5 (range 3–8). The mean percentage of long-term pain reduction was 38.13%.CONCLUSIONSThis series suggests that stimulation of the posterior limb of the internal capsule is safe and effective in treating patients with chronic neuropathic pain affecting the lower limb. The procedure may be a more targeted treatment method than motor cortex stimulation or other neuromodulation techniques in the subset of patients whose pain and spasticity are referred to the lower limbs.

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