scholarly journals Using arthroscopy combined with fluoroscopic technique for accurate location of the bone tunnel entrance in chronic ankle instability treatment

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shijun Wei ◽  
Dongsheng Fan ◽  
Fang Han ◽  
Ming Tang ◽  
Changwang Kong ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Bone Tunnel ◽  
Lateral Ligament ◽  
Graft Tension ◽  
The Mean ◽  
Tunnel Entrance

Abstract Background Minimally invasive reconstruction techniques are used for anatomical ligament construction of the lateral collateral ligament complex of the ankle, but the two key elements, the bone tunnel and the appropriate graft tension, for the identification of the anatomic location during the surgery are not clearly stated. Methods The patients with chronic ankle instability who received arthroscopic anatomic lateral ligament complex reconstruction were retrospectively analyzed. The anatomical location of the bone tunnel was performed under arthroscopy combined with fluoroscopy for accurate location of the bone tunnel entrance. The graft tension and routing were controlled under arthroscopic visualization. The clinical outcomes were assessed using the Karlsson-Peterson score, Sefton articular stability scale, and Visual Analogue Scale (VAS). The complications were recorded during the follow-up. Results A total of 18 patients were enrolled in this study. The mean follow-up was 33.33 ± 3.69 (range from 24 to 36) months. No patient had recurrence of ankle instability after the operation. According to the Sefton articular stability scale, 94.5% of the patients had excellent/good function. The mean value of the anterior drawer tests and the talar tilt angle examination were decreased. The mean of the Karlsson-Peterson score and the Visual Analogue Scale(VAS) score were both improved significantly. Conclusions The anatomic reconstruction of the ankle lateral ligament complex to treat chronic ankle instability using the arthroscopy combined with the fluoroscopic technique could improve the clinical functions, satisfaction, and reduced pain of patients.

Arthroscopic-Assisted Versus All-Arthroscopic Ankle Stabilization Technique

2020 ◽  
Vol 41 (11) ◽  
pp. 1360-1367 ◽  
Author(s):  
Matteo Guelfi ◽  
Gustavo Araujo Nunes ◽  
Francesc Malagelada ◽  
Guillaume Cordier ◽  
Miki Dalmau-Pastor ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Clinical Results ◽  
Pain Scale ◽  
Chronic Ankle Instability ◽  
Percutaneous Technique ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Vas Score ◽  
The Mean

Background: Both the percutaneous technique with arthroscopic assistance, also known as arthroscopic Broström (AB), and the arthroscopic all-inside ligament repair (AI) are widely used to treat chronic lateral ankle instability. The aim of this study was to compare the clinical outcomes of these 2 arthroscopic stabilizing techniques. Methods: Thirty-nine consecutive patients were arthroscopically treated for chronic ankle instability by 2 different surgeons. The AB group comprised 20 patients with a mean age of 30.2 (range, 18-42) years and a mean follow-up of 19.6 (range, 12-28) months. The AI group comprised 19 patients with a mean age of 30.9 (range, 18-46) years and mean follow-up of 20.7 (range, 13-32) months. Functional outcomes using the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score and visual analog pain scale (VAS) were assessed pre- and postoperatively. Range of motion (ROM) and complications were recorded. Results: In both groups the AOFAS and VAS scores significantly improved compared with preoperative values ( P < .001) with no difference ( P > .1) between groups. In the AB group the mean AOFAS score improved from 67 (range, 44-87) to 92 (range, 76-100) and the mean VAS score from 6.4 (range, 3-10) to 1.2 (range, 0-3). In the AI group the mean AOFAS score changed from 60 (range, 32-87) to 93 (range, 76-100) and the mean VAS score from 6.1 (range, 4-10) to 0.8 (range, 0-3). At the final follow-up 8 complications (40%) were recorded in the AB group. In the AI group 1 complication (5.3%) was observed ( P < .05). Conclusion: Both the AB and AI techniques are suitable surgical options to treat chronic ankle instability providing excellent clinical results. However, the AB had a higher overall complication rate than the AI group, particularly involving a painful restriction of ankle plantarflexion and neuritis of the superficial peroneal nerve. Level of Evidence: Level III, retrospective comparative study.

Syndactyly release: a comparison of skin graft versus graftless techniques in the same patient

2019 ◽  
Vol 44 (8) ◽  
pp. 845-849 ◽  
Author(s):  
Angela A. Wang ◽  
Douglas T. Hutchinson
Keyword(s):  
Visual Analogue Scale ◽  
Skin Graft ◽  
Analogue Scale ◽  
Contralateral Side ◽  
Level Of Evidence ◽  
Tourniquet Time ◽  
The Mean ◽  
Scar Score

Syndactyly release may be done by skin graft or graftless techniques. We prospectively examined bilateral syndactyly releases in the same patient at one operation. The grafted side was randomized and the contralateral side was done graftless. Fourteen patients had surgery at a mean age of 27 months (range 7–166). The mean follow-up was 52 months (range 6–111). The mean tourniquet time was 97 minutes (range 66–135) for graft and 84 minutes (55–120) for graftless. The mean finger abduction was 57° (32°–80°) for graft and 54° (38°–80°) for graftless. The mean web creep score was 1.2 (0–3) for graft and 2.1 (0–3) for graftless. The mean scar score was 1.9 (1–3) bilaterally. The mean parents’ visual analogue scale for graft cosmesis was 7.1 (5–9) and 6.2 (4.3–8) for graftless. The surgeon’s visual analogue scale for graft was 7.9 (6.4–9.5) and 6.2 (4–8.7) for graftless. The therapist’s visual analogue scale was 7.9 (6.5–10) and 6.4 (4.7–8) for graftless. Although there is a longer tourniquet time with grafting, there may be advantages in appearance and web creep. Level of evidence: II

Efficacy of HA Block Kyphoplasty for Old Osteoporotic Spine Fractures

2006 ◽  
Vol 309-311 ◽  
pp. 1371-1374
Author(s):  
Taichi Nishimura ◽  
Hiromi Matsuzaki ◽  
Akihiro Okawa ◽  
Masashi Oshima
Keyword(s):  
Visual Analogue Scale ◽  
Vertebral Fractures ◽  
Neurological Disorder ◽  
Analogue Scale ◽  
Final Evaluation ◽  
Spine Fractures ◽  
Correction Loss ◽  
Pulmonary Infarction ◽  
The Mean

We have successfully treated osteoporotic spine fractures for about three years, by using transpedicular kyphoplasty with hydroxyapatite blocks (HA Block: PENTAX) (refer with: Fig. 1), The 13 patients, four men and nine women, ranged from 61 to 86 years in age (mean, 73 years). The mean Visual Analogue Scale (VAS) was 8.5 points before operation, improved to 2.7 points on the next day of operation, and improved significantly to 1.8 points at the final evaluation. The mean deformity rate (Anterior height / Posterior height x 100) was 66.3% before operation, but improved to 91.7% immediately after operation. At the time of follow-up, this rate was 78.6%, indicating that the correction loss was 13.1%. This procedure caused none of serious complications such as neurological disorder and pulmonary infarction. Kyphoplasty with HA blocks may be safe and effective in the treatment of chronic vertebral fractures.

Elektra prosthesis for trapeziometacarpal osteoarthritis: a follow-up of 39 consecutive cases

2012 ◽  
Vol 37 (7) ◽  
pp. 605-609 ◽  
Author(s):  
A. Klahn ◽  
M. Nygaard ◽  
R. Gvozdenovic ◽  
M. E. H. Boeckstyns
Keyword(s):  
Rheumatoid Arthritis ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Revision Rate ◽  
Gradual Increase ◽  
Biomechanical Properties ◽  
Fast Recovery ◽  
Trapeziometacarpal Osteoarthritis ◽  
The Mean

We present a prospective follow-up of 39 Elektra prostheses in 37 patients (32 women and five men), with a mean age of 56.5 (range 46–71) years; 34 patients had osteoarthritis and three had rheumatoid arthritis. Patients were followed using clinical examination, including measurement of pain on a visual analogue scale, mobility, and strength, after 6, 12, 26, and 52 weeks, and annually thereafter. Radiological examination was done preoperatively and after 6, 26, and 52 weeks, and annually thereafter. The mean follow-up time was 48 (range 3–91) months. Although we observed a fast recovery, including maintenance of mobility and a gradual increase in grip strength, there was a revision rate of 7/38 (24%) after 36 months, increasing to 17/38 (44%) after 72 months. The main reason for revision was loosening of the trapezial component, and biomechanical properties of the trapezial fixation may be the key problem in treating trapeziometacarpal osteoarthritis using a total prosthesis.

The Early Results of the Brunelli Procedure for Trapeziometacarpal Instability

1998 ◽  
Vol 23 (6) ◽  
pp. 758-761 ◽  
Author(s):  
S. N. J. ROBERTS ◽  
J. N. BROWN ◽  
M. G. HAYES ◽  
A. SAIES
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Joint Surface ◽  
Carpometacarpal Joint ◽  
Trapeziometacarpal Joint ◽  
Independent Observer ◽  
Abductor Pollicis Longus ◽  
Early Results ◽  
The Mean

We report the results of Brunelli’s abductor pollicis longus transfer for symptomatic instability of the trapeziometacarpal joint in 15 hands (14 patients) at a mean follow-up of 21 months. Patients were assessed subjectively, and objectively by an independent observer. All but one of the patients were very satisfied with the result of the operation, including the six patients who had significant degeneration of the carpometacarpal joint surface preoperatively. Four patients said they had no pain and the mean pain score overall on a visual analogue scale was 1.2 (out of a maximum of 10). Overall the outcome was rated good or excellent in 11 of the 15 thumbs.

scholarly journals Arthroscopic Lateral Ligament Repair Through Two Portals in Chronic Ankle Instability

2017 ◽  
Vol 11 (1) ◽  
pp. 617-632 ◽  
Author(s):  
Jorge Pablo Batista ◽  
Jorge Javier del Vecchio ◽  
Luciano Patthauer ◽  
Manuel Ocampo
Keyword(s):  
Ankle Instability ◽  
Medical Condition ◽  
Surgical Techniques ◽  
Clinical Success Rate ◽  
Chronic Ankle Instability ◽  
Tilt Test ◽  
Lateral Ligament ◽  
Return To Sports ◽  
Ligament Repair

Objectives:Injury to the lateral ligament complex of the ankle is one of the most common sports-related injury.Usually lateral ankle evolves with excellent clinical recovery with non surgical treatment, however, near about 30% develop a lateral chronic instability sequela.Several open and arthroscopic surgical techniques have been described to treat this medical condition.Material and Methods:Of the 22 patients who were treated; 18 males and 4 females, and aged from 17-42 years (mean 28 years).All patients presented a history of more than three ankle sprains in the last two years and presented positive anterior drawer and talar tilt test of the ankle in the physical examination.We perform an anterior arthroscopy of the ankle in order to treat asociated disease and then we performed“All inside¨lateral ligament repair through two portals (anteromedial and anterolateral) using an anchor knotless suture.Results:Clinical outcome evaluations were performed at a mean follow up of 25 months. (R: 17-31).Overall results has been shown by means of the American Orthopaedic Foot and Ankle Society (AOFAS). Mean AOFAS scores improved from 63 points (range 52–77) preoperatively to 90 points (range 73–100) at final follow up.No recurrences of ankle instability were found in the cases presented.Conclusion:Several surgical procedures have been described during the last years in order to treat chronic ankle instability.¨All inside¨lateral ligament reconstruction presents lower local morbidity than open procedures with few complications. Moreover, it is a reproductible technique, with high clinical success rate, few complications and relatively quick return to sports activities. A high knowledge of the anatomic landmarks should be essential to avoid unwated injuries.

Ten year follow-up of pyrocarbon implants for proximal interphalangeal joint replacement

2014 ◽  
Vol 39 (6) ◽  
pp. 582-586 ◽  
Author(s):  
L. Reissner ◽  
S. Schindele ◽  
S. Hensler ◽  
M. Marks ◽  
D. B. Herren
Keyword(s):  
Visual Analogue Scale ◽  
Migration Rate ◽  
Analogue Scale ◽  
Clinical Results ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
High Migration Rate ◽  
The Mean ◽  
High Migration

Results of anatomical resurfacing of the proximal interphalangeal joint using pyrocarbon implants showed reasonable clinical results with a high radiographic migration rate. The aim was to investigate the subjective, clinical, and radiographic results 10 years following surgery, and to compare them with our 2-year follow-up data. We re-evaluated 12 patients with 15 proximal interphalangeal implants on average 9.7 years after surgery. Pain significantly improved from 7.6 on a visual analogue scale pre-operatively to 1.4 at 2 years, and to 0.7 at the final follow-up. The mean total range of motion in all replaced joints was 36° pre-operatively and 39° at the 2-year follow-up, but had decreased significantly to 29° at 10 years. We saw one implant migration in addition to the eight migrated implants we already found 2 years after surgery. The moderate clinical results, combined with the high migration rate, mean that we no longer use this kind of implant.

scholarly journals PO 18079 - Arthroscopic medial and lateral ligament repair for multidirectional ankle instability

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 11S
Author(s):  
Nacime Salomão Barbachan Mansur ◽  
André Vitor Kerber Cavalcante Lemos ◽  
Lucas Furtado Fonseca ◽  
Tiago Soares Baumfeld ◽  
Daniel Soares Baumfeld ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Alternative Methods ◽  
Lateral Ligament ◽  
Rotational Instability ◽  
Safe Alternative ◽  
Multidirectional Instability ◽  
Number Of Patients ◽  
Osteochondral Injuries ◽  
The Mean

Introduction: The extremely high prevalence of sprains in the population has led to a large number of patients with lateral ankle instability. The persistence of this condition can lead to progressive loosening of the medial containment structures, generating multidirectional rotational instability. Treatment of the deltoid complex through ligamentoplasty of its components has been proposed as a solution for these patients, and the arthroscopic technique is a currently described alternative. Methods: This is a retrospective study of 10 patients (11 ankles) diagnosed with multidirectional instability who underwent ankle arthroscopy with medial and lateral ligament reconstruction (arthroscopic Brostrom technique) from January 2017 to January 2019. All patients filled out an epidemiological questionnaire and were assessed for ankle pain and function using the Pain Visual Analog Scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) scale at the last follow-up evaluation, at a mean of 12 months (6-24 months). Results: All patients showed signs of associated medial instability during the arthroscopy. Four ankles had associated osteochondral injuries. One ankle also had associated syndesmotic instability. The mean AOFAS score was 82.6 at the last follow-up evaluation, and the mean VAS score was 2.1. No patient had complications related to surgery or loss of ankle mobility greater than 5 degrees (ankle or subtalar joint). Eight patients described the outcome as excellent, and 2 described it as good. All patients returned to sports after 6 months of follow-up. No complaints of instability or positive ligament tests were observed. Conclusion: Combined medial and lateral arthroscopic ankle ligamentoplasty is an effective and safe alternative for the treatment of multidirectional instability refractory to conservative treatment. The inclusion of the deltoid complex and the reduced invasiveness of this technique may improve the clinical outcomes of these patients.

High Return to Sport in Patients Over 45 Years of Age Undergoing Osteochondral Allograft Transplantation for Isolated Chondral Defects in the Knee

Cartilage ◽  
2021 ◽  
pp. 194760352110460
Author(s):  
Danielle H. Markus ◽  
Eoghan T. Hurley ◽  
Jonathan D. Haskel ◽  
Amit K. Manjunath ◽  
Kirk A. Campbell ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Return To Sport ◽  
Osteochondral Allograft ◽  
Athletic Activity ◽  
Chondral Defects ◽  
Scale Scores ◽  
Osteochondral Injuries ◽  
The Mean

Objective: The purpose of this study was to evaluate the efficacy of osteochondral allograft (OCA) in patients older than 45 years of age, particularly with respect to return to sport. Design: A retrospective review was performed to evaluate patients greater than 45 who underwent an OCA for a symptomatic osteochondral defect of the knee between June 2011 and January 2019. Results: Overall, there were 18 patients (76% male) that met our inclusion and exclusion criteria. Follow-up was attained in 14 of these patients (78%). The mean age of patients included was 52.6 years (48-57) with a mean of 37 months of follow-up (18-60). Visual Analogue Scale scores decreased significantly from the preoperative baseline to final follow-up (7.7 ± 1.7 vs. 2.0 ± 2.0, P < 0.01). Furthermore, the mean Visual Analogue Scale while playing sport was 3.4 ± 3.2, and the mean Knee Injury and Osteoarthritis Outcome Score was 77.5 ± 12.7 at final follow-up. Overall, 11 patients (78.6%) were able to return to their desired sport. No clinical failures were identified during the follow-up period. Conclusion: In our series of patients 45 years and older who were treated with OCA for focal osteochondral injuries of the knee, we found a significant improvement in clinical outcome scores at a midterm follow-up of 37 months with no revision OCA procedures or conversion to any form of knee arthroplasty. In addition, a high percentage of patients were able to return to their preferred level of athletic activity.

Additional Inferior Extensor Retinaculum Augmentation After All-Inside Arthroscopic Anterior Talofibular Ligament Repair for Chronic Ankle Instability Is Not Necessary

2021 ◽  
pp. 036354652110080
Author(s):  
Sung Hyun Lee ◽  
Hyung Gyu Cho ◽  
Je Heon Yang
Keyword(s):  
Clinical Outcomes ◽  
Ankle Instability ◽  
Surgical Techniques ◽  
Chronic Ankle Instability ◽  
Anterior Talofibular Ligament ◽  
Extensor Retinaculum ◽  
Level Of Evidence ◽  
Group A ◽  
The Mean ◽  
Inferior Extensor Retinaculum

Background: Although several arthroscopic surgical techniques for the treatment of chronic ankle instability (CAI) have been introduced recently, the effect of inferior extensor retinaculum (IER) augmentation remains unclear. Purpose: To compare the clinical outcomes after arthroscopic anterior talofibular ligament (ATFL) repair according to whether additional IER augmentation was performed or not. Study Design: Cohort study; Level of evidence, 3. Methods: We performed a retrospective review of consecutive patients who underwent arthroscopic ATFL repair surgery for CAI between 2016 and 2018. The mean age of the patients was 35.2 years (range, 19-51 years), and the mean follow-up period was 32.6 months (range, 24-48 months). Patients were divided into 2 groups according to the surgical technique used for CAI: arthroscopic ATFL repair (group A; n = 37) and arthroscopic ATFL repair with additional IER augmentation (group R; n = 45). The pain visual analog scale, American Orthopaedic Foot & Ankle Society score, Foot and Ankle Outcome Score, and the Karlsson Ankle Function Score were measured as subjective outcomes, and posturographic analysis was performed using a Tetrax device as an objective outcome. Radiologic outcome evaluations were performed preoperatively and at 2 years postoperatively using stress radiographs and axial view magnetic resonance imaging (MRI). Results: Out of 101 patients, 19 (18.5%) were excluded per the exclusion criteria, and 82 were evaluated. We identified 6 retears (7.3%) based on postoperative MRI evaluation. All patients who had ATFL retear on MRI (8.1% [3/37] in group A and 6.7% [3/45] in group R) demonstrated recurrent CAI with functional discomfort and anterior displacement >3 mm as compared with the intact contralateral ankle. All clinical scores and posturography results were improved after surgery in both groups ( P < .001). However, there were no significant differences in the clinical results and radiologic findings between the groups. Conclusion: The clinical and radiologic outcomes of patients with CAI improved after all-inside arthroscopic ATFL repair. However, additional IER augmentation after arthroscopic ATFL repair did not guarantee better clinical outcomes.

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