scholarly journals Unilateral Biportal Endoscopy for Decompression of Extraforaminal Stenosis at the Lumbosacral Junction: Surgical Techniques and Clinical Outcomes

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 871-879
Author(s):  
Man-Kyu Park ◽  
Sang-Kyu Son ◽  
Weon Wook Park ◽  
Seung-Hyun Choi ◽  
Dae Young Jung ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Analogue Scale ◽  
Surgical Techniques ◽  
Transverse Process ◽  
Clinical Results ◽  
Leg Pain ◽  
Lumbosacral Junction ◽  
Significant Drop ◽  
The Mean

Objective: The aims of this study were to describe the unilateral biportal endoscopic (UBE) technique for decompression of extraforaminal stenosis at L5–S1 and evaluate 1-year clinical outcomes. Especially, we evaluated compression factors of extraforaminal stenosis at L5–S1 and described the surgical technique for decompression in detail.Methods: Thirty-five patients who underwent UBE decompression for extraforaminal stenosis at L5–S1 between March 2018 and February 2019 were enrolled. Clinical results were analyzed using the MacNab criteria, the visual analogue scale (VAS) for back and leg pain, and the Oswestry Disability Index (ODI). Compression factors evaluated pseudoarthrosis within the transverse process of L5 and ala of sacrum, disc bulging with or without osteophytes, and the thickened lumbosacral and extraforaminal ligament.Results: The mean back VAS was 3.7 ± 1.8 before surgery, which dropped to 2.3 ± 0.8 at 1-year postoperative follow-up (p < 0.001). There was a significant drop in postoperative mean VAS for leg pain from 7.2 ± 1.1 to 2.3 ± 1.2 at 1 year (p < 0.001). The ODI was 61.5 before surgery and 28.6 (p < 0.001). Pseudoarthrosis between the transverse process and the ala was noted in all cases (35 of 35, 100%). Pure disc bulging was seen in 12 patients (34.3%), and disc bulging with osteophytes was demonstrated in 23 patients. The thickened lumbosacral and extraforaminal ligament were identified in 19 cases (51.4%). No complications occurred in any of the patients.Conclusion: In the current study, good surgical outcomes without complications were achieved after UBE decompression for extraforaminal stenosis at L5–S1.

scholarly journals Short-term effectiveness of precise safety decompression via double percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral lumbar spinal canal stenosis: a prospective cohort study

2020 ◽  
Author(s):  
Yu Wang ◽  
Mingyan Deng ◽  
Hao Wu ◽  
Ye Wu ◽  
Chuan Guo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Spinal Canal ◽  
Leg Pain ◽  
Short Term ◽  
Postoperative Mri ◽  
The Mean ◽  
Lumbar Spinal

Abstract Purpose This prospective cohort study reports on a new technique, namely precise safety decompression via double percutaneous lumbar foraminoplasty (DPLF) and percutaneous endoscopic lumbar decompression (PELD) for lateral lumbar spinal canal (LLSC) stenosis, and its short-term clinical outcomes.Methods The study analyzed 69 patients with single-level LLSC stenosis simultaneously occurring in both zones 1 and 2 (defined as retrodiscal space and upper bony lateral recess respectively by new LLSC classification) who underwent DPLF–PELD from November 2018 to April 2019. Clinical outcomes were evaluated according to preoperative, three months postoperatively, and last follow-up, via leg pain/low back pain (LBP) visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression, and flexion-extension x-rays at the last follow-up were used to observe lumbar stability.Results All patients successfully underwent DPLF–PELD, and the stenosis was completely decompressed, confirmed by postoperative MRI and CT. The mean follow-up duration was 13 months (range: 8–17 months). The mean preoperative leg pain VAS score is 7.05 ± 1.04 (range 5–9), which decreased to 1.03 ± 0.79(range: 0–3) at three months postoperatively and to 0.75 ± 0.63 (range: 0–2) by the last follow-up visit(p < 0.05). The mean preoperative ODI was 69.8 ± 9.05 (range: 52–85), which decreased to 20.3 ± 5.52 (range: 10–35) at the third month postoperatively and to 19.6 ± 5.21 (range: 10–34) by the final follow-up visit(p < 0.05). The satisfactory (excellent or good) results were 94.2%. There was one patient with aggravated symptoms, which were relieved after an open surgery. Two patients had a dural tear, and two patients suffered postoperative LBP. No recurrence or segmental instability was observed at the final follow-up.Conclusion DPLF–PELD could be a good alternative for the treatment of LLSC stenosis patients whose stenosis occurred in both zones 1 and 2.Trial registration Chinese Clinical Trial Registry (ChiCTR1800019551). Registered 18 November 2018.

Extraforaminal approach of biportal endoscopic spinal surgery: a new endoscopic technique for transforaminal decompression and discectomy

2018 ◽  
Vol 28 (5) ◽  
pp. 492-498 ◽  
Author(s):  
Jae-Sung Ahn ◽  
Ho-Jin Lee ◽  
Dae-Jung Choi ◽  
Ki-young Lee ◽  
Sung-jin Hwang
Keyword(s):  
Clinical Outcomes ◽  
Disc Herniation ◽  
Spinal Surgery ◽  
Operative Time ◽  
Endoscopic Technique ◽  
Leg Pain ◽  
Vas Score ◽  
The Mean ◽  
Endoscopic Spinal Surgery

This study was performed to describe the extraforaminal approach of biportal endoscopic spinal surgery (BESS) as a new endoscopic technique for transforaminal decompression and discectomy and to demonstrate the clinical outcomes of this new procedure for the first time. Twenty-one patients (27 segments) who underwent the extraforaminal approach of BESS between March 2015 and April 2016 were enrolled according to the inclusion and exclusion criteria. The operative time (minutes/level) and complications after the procedure were recorded. The visual analog scale (VAS) score was checked to assess the degree of radicular leg pain preoperatively and at the time of the last follow-up. The modified Macnab criteria were used to examine the clinical outcomes at the time of the last follow-up. The mean duration of the follow-up period was 14.8 months (minimum duration 12 months). The mean operative time was 96.7 minutes for one level. The mean VAS score for radicular leg pain dropped from a preoperative score of 7.5 ± 0.9 to a final follow-up score of 2.5 ± 1.2 (p < 0.001). The final outcome according to the modified Macnab criteria was excellent in 5 patients (23.8%), good in 12 (57.2%), fair in 4 (19.0%), and poor in 0. Therefore, excellent or good results (a satisfied outcome) were obtained in 80.9% of the patients. Complications were limited to one dural tear (4.8%). The authors found that the extraforaminal approach of BESS was a feasible and advantageous endoscopic technique for the treatment of foraminal lesions, including stenosis and disc herniation. They suggest that this technique represents a useful, alternative, minimally invasive method that can be used to treat lumbar foraminal stenosis and disc herniation.

scholarly journals Meniscal Allograft Transplantation: results at 6-year Mean Follow-up

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0019
Author(s):  
Matías Costa-Paz ◽  
Carlos Yacuzzi ◽  
Franco Luis De-Cicco ◽  
Juan Ignacio Theaux ◽  
Juan Pablo Zicaro ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Meniscal Extrusion ◽  
Average Percentage ◽  
Meniscal Allograft ◽  
Imaging Results ◽  
The Mean ◽  
Grade 3

Objectives The purpose of this study was to evaluate the clinical and imaging results in a series of patients who underwent a meniscal allograft transplant (MAT). Methods A retrospective study was performed. The International Knee Documentation Committee (IKDC) score, Lysholm score, and physical examinations were reviewed to measure clinical outcomes after MAT. Osteoarthritic changes were assessed by Plain radiography according to Kellgren-Lawrence (KL) classification and meniscal extrusion by magnetic resonance imaging (MRI). Surgical technique and related procedures were analyzed. Complications were registered. The minimum follow-up was 2 years. Results Surgeries were performed in 41 patients, 36 fulfilled the inclusion criteria. Twenty-five were male and 11 women. The mean age was 35 years old (SD 8). The mean follow-up was 71 months (range 24 to 184). The mean time between meniscectomy and meniscal transplant was 12.8 years (SD 6,7). Twenty-three were lateral menisci. The following related procedures were performed: Seven ACL reconstructions, 3 ACL revisions, 19 mosaicplasties and 3 osteotomies. The mean preoperative results of IKDC and Lysholm scores were 30.3 (SD 15.5) and 43.8 (SD 16.8) respectively and postoperative results were 78.8 (SD 21.1) and 61.1 (SD 15) respectively. There were no significative radiographic changes at the end of the follow-up. Mean KL preoperative was 2 (IQR 1) and last follow up was 2 (IQR 1) p= 0.053. Preoperative KL grade 1: 33%, grade 2: 50% and grade 3: 17% and last follow up KL grade 1: 22%, grade 2 56% and grade 3 22%. The average percentage of extruded meniscus was 53% in 22 patients evaluated with MR (range 19% to 100%). Five presented arthrofibrosis that required mobilization under anesthesia and partial meniscectomy of the MAT was required in 6 patients. Two transplants failed. Conclusion Although 53% of meniscal extrusion was observed in the MR, we found no correlation with clinical outcomes. MAT achieved good clinical results without osteoarthritic changes after a mean of 6-years follow-up, with 5% of failure. MAT appears to be a safe and effective treatment, which should be considered as a suitable option in the clinical practice.

scholarly journals Radiographic and clinical outcomes following combined lateral lumbar interbody fusion and posterior segmental stabilization in patients with adult degenerative scoliosis

2014 ◽  
Vol 36 (5) ◽  
pp. E11 ◽  
Author(s):  
Zachary J. Tempel ◽  
Gurpreet S. Gandhoke ◽  
Christopher M. Bonfield ◽  
David O. Okonkwo ◽  
Adam S. Kanter
Keyword(s):  
Clinical Outcomes ◽  
Lumbar Lordosis ◽  
Hybrid Approach ◽  
Vertical Axis ◽  
Leg Pain ◽  
Degenerative Scoliosis ◽  
Sagittal Vertical Axis ◽  
Adult Degenerative Scoliosis ◽  
The Mean

Object A hybrid approach of minimally invasive lateral lumbar interbody fusion (LLIF) followed by supplementary open posterior segmental instrumented fusion (PSIF) has shown promising early results in the treatment of adult degenerative scoliosis. Studies assessing the impact of this combined approach on correction of segmental and regional coronal angulation, sagittal realignment, maximum Cobb angle, restoration of lumbar lordosis, and clinical outcomes are needed. The authors report their results of this approach for correction of adult degenerative scoliosis. Methods Twenty-six patients underwent combined LLIF and PSIF in a staged fashion. The patient population consisted of 21 women and 5 men. Ages ranged from 40 to 77 years old. Radiographic measurements including coronal angulation, pelvic incidence, lumbar lordosis, and sagittal vertical axis were taken preoperatively and 1 year postoperatively in all patients. Concurrently, the visual analog score (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and Short Form-36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were used to assess clinical outcomes in 19 patients. Results At 1-year follow-up, all patients who underwent combined LLIF and PSIF achieved statistically significant mean improvement in regional coronal angles (from 14.9° to 5.8°, p < 0.01) and segmental coronal angulation at all operative levels (p < 0.01). The maximum Cobb angle was significantly reduced postoperatively (from 41.1° to 15.1°, p < 0.05) and was maintained at follow-up (12.0°, p < 0.05). The mean lumbar lordosis–pelvic incidence mismatch was significantly improved postoperatively (from 15.0° to 6.92°, p < 0.05). Although regional lumbar lordosis improved (from 43.0° to 48.8°), it failed to reach statistical significance (p = 0.06). The mean sagittal vertical axis was significantly improved postoperatively (from 59.5 mm to 34.2 mm, p < 0.01). The following scores improved significantly after surgery: VAS for back pain (from 7.5 to 4.3, p < 0.01) and leg pain (from 5.8 to 3.1, p < 0.01), ODI (from 48 to 38, p < 0.01), and PCS (from 27.5 to 35.0, p = 0.01); the MCS score did not improve significantly (from 43.2 to 45.5, p = 0.37). There were 3 major and 10 minor complications. Conclusions A hybrid approach of minimally invasive LLIF and open PSIF is an effective means of achieving correction of both coronal and sagittal deformity, resulting in improvement of quality of life in patients with adult degenerative scoliosis.

scholarly journals Retrospective Study on Effectiveness of Activ L Total Disc Replacement

2020 ◽  
Author(s):  
Wenzhi Sun ◽  
Peng Wang ◽  
Hailiang Hu ◽  
Chao Kong ◽  
Yong Hai ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Sagittal Alignment ◽  
Total Disc Replacement ◽  
Clinical Results ◽  
Disc Replacement ◽  
Lateral Spine ◽  
Lumbar Total Disc Replacement ◽  
The Mean ◽  
Index Level

Abstract Background: The effectiveness of lumbar total disc replacement (TDR) with different prostheses for sagittal alignment has been reported previously. However, there are only few reports on Activ L TDR and no specific evidence regarding whether sagittal alignment affects the clinical outcomes.Methods: Thirty-six patients who underwent mono- or bi-segmental lumbar TDR with ActivL were studied. The films of upright anteroposterior and lateral spine in neutral, flexion, and extension positions were obtained before surgery and at 1 month, 1 and 3 years after surgery. The radiographic parameters such as lumbar lordosis (LL), index level lordosis (IL), segmental lordosis (SL) and sacral tilt (ST) were measured based on the lateral upright radiographs. Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) and visual analogue scale (VAS) pre- and post-operatively. Results: 87 patients with complete radiographic data were available for a 3-year follow-up period. Of these, 66 received a single-level TDR, and 21 received 2-level TDR. At 1 month, the mean LL was similar to the pre-operative data, and then was significantly increased to 45.1° at 3 years. On an average, the IL tended to significantly increase, while the mean SL at L4-5 was increased from 16.5° pre-operatively to 21.0° at 3 years. The mean SL at L1-2, L2-3, L3-4, and L5-S1 and the ST showed no obvious difference after 3 years. In contrast, VAS and ODI scores showed significant improvement after surgery. Conclusions: Activ L TDR showed favorable affect on sagittal alignment, enhancing the IL while preserving the LL and ST. However, satisfactory clinical results for over a 3-year follow-up were not affected by sagittal alignment.

scholarly journals Unintended facet fusions after Dynesys dynamic stabilization in patients with spondylolisthesis

2019 ◽  
Vol 30 (3) ◽  
pp. 353-361 ◽  
Author(s):  
Li-Yu Fay ◽  
Wen-Cheng Huang ◽  
Chih-Chang Chang ◽  
Hsuan-Kan Chang ◽  
Tzu-Yun Tsai ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Japanese Orthopaedic Association ◽  
Limited Range ◽  
Dynamic Stabilization ◽  
Leg Pain ◽  
Lumbar Spondylosis ◽  
Limited Range Of Motion ◽  
Vas Scores ◽  
The Mean

OBJECTIVEThe pedicle screw–based Dynesys dynamic stabilization (DDS) has reportedly become a surgical option for lumbar spondylosis and spondylolisthesis. However, it is still unclear whether the dynamic construct remains mobile or eventually fuses. The aim of this study was to investigate the incidence of unintended facet arthrodesis after DDS and its association with spondylolisthesis.METHODSThis retrospective study was designed to review 105 consecutive patients with 1- or 2-level lumbar spondylosis who were treated with DDS surgery. The patients were then divided into 2 groups according to preexisting spondylolisthesis or not. All patients underwent laminectomies, foraminotomies, and DDS. The clinical outcomes were measured using visual analog scale (VAS) scores for back and leg pain, Japanese Orthopaedic Association (JOA) scores, and Oswestry Disability Index (ODI) scores. All medical records, including pre- and postoperative radiographs, CT scans, and MR images, were also reviewed and compared.RESULTSA total of 96 patients who completed the postoperative follow-up for more than 30 months were analyzed. The mean age was 64.1 ± 12.9 years, and the mean follow-up duration was 46.3 ± 12.0 months. There were 45 patients in the spondylolisthesis group and 51 patients in the nonspondylolisthesis group. The overall prevalence rate of unintended facet fusion was 52.1% in the series of DDS. Patients with spondylolisthesis were older (67.8 vs 60.8 years, p = 0.007) and had a higher incidence rate of facet arthrodesis (75.6% vs 31.4%, p < 0.001) than patients without spondylolisthesis. Patients who had spondylolisthesis or were older than 65 years were more likely to have facet arthrodesis (OR 6.76 and 4.82, respectively). There were no significant differences in clinical outcomes, including VAS back and leg pain, ODI, and JOA scores between the 2 groups. Furthermore, regardless of whether or not unintended facet arthrodesis occurred, all patients experienced significant improvement (all p < 0.05) in the clinical evaluations.CONCLUSIONSDuring the mean follow-up of almost 4 years, the prevalence of unintended facet arthrodesis was 52.1% in patients who underwent DDS. Although the clinical outcomes were not affected, elderly patients with spondylolisthesis might have a greater chance of facet fusion. This could be a cause of the limited range of motion at the index levels long after DDS.

scholarly journals Short-term effectiveness of precise safety decompression via double percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral lumbar spinal canal stenosis: a prospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yu Wang ◽  
Mingyan Deng ◽  
Hao Wu ◽  
Ye Wu ◽  
Chuan Guo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Spinal Canal ◽  
Leg Pain ◽  
Short Term ◽  
Postoperative Mri ◽  
The Mean ◽  
Lumbar Spinal

Abstract Purpose This prospective cohort study reports on a modified technique, namely precise safety decompression via double percutaneous lumbar foraminoplasty (DPLF) and percutaneous endoscopic lumbar decompression (PELD) for lateral lumbar spinal canal (LLSC) stenosis, and its short-term clinical outcomes. Methods The study analyzed 69 patients with single-level LLSC stenosis simultaneously occurring in both zones 1 and 2 (defined as retrodiscal space and upper bony lateral recess respectively by new LLSC classification) who underwent DPLF–PELD from November 2018 to April 2019. Clinical outcomes were evaluated according to preoperative, 3 months postoperatively, and last follow-up, via leg pain/low back pain (LBP) visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression, and flexion-extension x-rays at the last follow-up were used to observe lumbar stability. Results All patients successfully underwent DPLF–PELD, and the stenosis was completely decompressed, confirmed by postoperative MRI and CT. The mean follow-up duration was 13 months (range: 8–17 months). The mean preoperative leg pain VAS score is 7.05 ± 1.04 (range 5–9), which decreased to 1.03 ± 0.79(range: 0–3) at 3 months postoperatively and to 0.75 ± 0.63 (range: 0–2) by the last follow-up visit (p < 0.05). The mean preoperative ODI was 69.8 ± 9.05 (range: 52–85), which decreased to 20.3 ± 5.52 (range: 10–35) at the third month postoperatively and to 19.6 ± 5.21 (range: 10–34) by the final follow-up visit (p < 0.05). The satisfactory (excellent or good) results were 94.2%. There was one patient with aggravated symptoms, which were relieved after an open surgery. Two patients had a dural tear, and two patients suffered postoperative LBP. No recurrence or segmental instability was observed at the final follow-up. Conclusion DPLF–PELD could be a good alternative for the treatment of LLSC stenosis patients whose stenosis occurred in both zones 1 and 2. Trial registration Chinese Clinical Trial Registry (ChiCTR1800019551). Registered 18 November 2018.

Analysis of Clinical Results of Three Different Routes of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for Lumbar Herniated Disk

2018 ◽  
Vol 1 (2) ◽  
pp. 8
Author(s):  
Farid Yudoyono ◽  
Rully Hanafi Dalan
Keyword(s):  
Analogue Scale ◽  
Clinical Results ◽  
Lumbar Discectomy ◽  
Excellent Outcome ◽  
Vas Score ◽  
Group A ◽  
Herniated Disk ◽  
The Mean ◽  
Group B

Objective: Percutaneous endoscopic transforaminal lumbar discectomy (PETLD) can be performed by using foraminal, intervertebral, and suprapedicular routes. The aim of this study was to assess clinical results of three different routes of PETLD.Methods: One hundred and eleven patients who underwent PETLD between January 2016 and October 2016 were included in this study. PETLD was performed using the foraminal (group A), intervertebral (group B), and suprapedicular (group C) routes in 32, 46, and 33 patients, respectively. Outcomes were evaluated using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and MacNab criteria.Results: Seventy-one men and 40 were women (mean age 53.33 ± 14.12 years). The mean follow-up period was 6.44 ± 3.26 months. The preoperative VAS score decreased significantly (P < 0.01) in all 3 groups, but the postoperative VAS score was higher for the foraminal route than the intervertebral (P<0.001) and suprapedicular routes (P< 0.001). Excellent outcome grade according to MacNab criteria was less in foraminal route (18.7%) than in intervertebral (52.2%) and suprapedicular (56.7%) routes. ODI improved significantly (P< 0.01) in all 3 groups.Conclusion: All 3 routes of PETLD resulted in good to excellent clinical results. Nevertheless, the postoperative VAS score was higher for the foraminal route than the intervertebral and suprapedicular routes, probably because of the neurologic characteristics of the disk location. The surgeon should consider this problem to alleviate pain postoperatively and to better counsel the patient before surgery.

scholarly journals Suprapedicular Circumferential Opening Technique of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for High Grade Inferiorly Migrated Lumbar Disc Herniation

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hyeun Sung Kim ◽  
Farid Yudoyono ◽  
Byapak Paudel ◽  
Ki Joon Kim ◽  
Jee-Soo Jang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Clinical Results ◽  
Outcome Evaluation ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
High Grade ◽  
The Mean

Purpose. To evaluate the efficacy of suprapedicular circumferential opening technique (SCOT) of percutaneous endoscopic transforaminal lumbar discectomy (PETLD) for high grade inferiorly migrated lumbar disc herniation. Material and Methods. Eighteen consecutive patients who presented with back and leg pain with a single-level high grade inferiorly migrated lumbar disc herniation were included. High grade inferiorly migrated disc was removed by the SCOT through PETLD approach. Outcome evaluation was done with visual analog scale (VAS) and Mac Nab’s criteria. Result. There were 14 males and 4 females. The mean age of patients was 53.3±14.12 years. One, 4, and 13 patients had disc herniation at L1-2, L3-4, and L4-5 levels, respectively, on MRI, which correlated with clinical findings. The mean follow-up duration was 8.4±4.31 months. According to Mac Nab’s criteria, 9 patients (50%) reported excellent and the remaining 9 patients (50%) reported good outcomes. The mean preoperative and postoperative VAS for leg pain were 7.36±0.73 and 1.45±0.60, respectively (p<0.001). Improvement in outcomes was maintained even at final follow-up. There was no complication. Conclusion. In this preliminary study we achieved good to excellent clinical results using the SCOT of PETLD for high grade inferiorly migrated lumbar disc herniation.

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.

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