scholarly journals New Cementless Total Hip Arthroplasty. A Multicentre Prospective Minimum 2 Year Follow-up Clinical Outcomes Study.

2021 ◽  
Vol 11 ◽  
Author(s):  
Rohit Pandey ◽  
Simon Coffey ◽  
Rami Sorial
Keyword(s):  
Clinical Outcomes ◽  
Primary Objective ◽  
Posterolateral Approach ◽  
Consecutive Series ◽  
X Rays ◽  
Early Results ◽  
Duration Of Surgery ◽  
Oxford Hip Score ◽  
Outcomes Study

Background: Cementless implants were introduced approximately three decades ago in order to address aseptic loosening of cemented hip prostheses with the aim of early mobilisation, better functional result and bone stock preservation. The primary objective of this study is to introduce a new cementless HA coated implant and report its minimum 2 year follow up results. Material & method: This is a prospective, multi-centre, consecutive series, clinical outcomes study with 75 patients. Inclusion criteria for the study were age 21- 85 years, BMI <40, osteoarthritis of the hip. Patients were operated using a standard posterolateral approach. The Paragon stem and the Global cup were implanted in a cementless method. Patients were reviewed at 6 weeks, 6 months and two years postoperative. At each visit AQoL 6D, VAS Pain, Oxford Hip Score were recorded. Post-operative X-Rays were reviewed at immediate post-operative, 6 months and two years. Results: Mean duration of surgery was 63.1 min with range of 40-120 min. AQoL over time changed from pre-op mean 50.51, at 6 weeks and at 2 years mean 35.06. Oxford hip score had upward trend from pre-op to post-op 6wks assessments and a plateau in following assessments. VAS pain trajectories, showing a clear downward trend from pre-op to post-op 6wks and a plateau in the following postoperative assessments. Discussion & conclusion: The combination of Paragon stem and Global cup incorporates proven features of successful implants. The unique feature of lateral tension grooves and progressive neck dimension with dual offset options. This combination has shown promising early results with early follow up of a minimum of 2 years, with a 100% survivorship of the stem and 98.7% survivorship overall for any reason and is a good cementless option in THA.

A Retrospective Study in the Treatment of a 2-Part Greater Tuberosity Fracture Using the F3 Biomet Plate

2016 ◽  
Vol 101 (9-10) ◽  
pp. 465-472
Author(s):  
Jun Ma ◽  
Liangyu Zhao ◽  
Tao Liu ◽  
Qiang Fu ◽  
Aimin Chen
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Constant Score ◽  
Shoulder Function ◽  
Open Reduction Internal Fixation ◽  
Dash Score ◽  
X Rays ◽  
Level Of Evidence ◽  
Greater Tuberosity

The purpose of this study was to evaluate the clinical efficacy of the F3 Biomet plate in the treatment of 2-part displaced humeral greater tuberosity fractures. We compared the clinical outcomes of patients with displaced greater tuberosity fractures who underwent surgical treatment using an F3 plate with those of patients who were treated nonsurgically. Eleven patients with 2-part displaced humeral greater tuberosity fractures were surgically treated with use of an F3 Biomet plate, whereas 12 patients with equal injuries were treated nonsurgically. Each patient underwent follow-up for at least 1 year. We retrospectively collected data and analyzed the clinical outcomes. The Constant score and DASH score were used to assess the shoulder function, and X-rays were taken to evaluate the fracture healing. X-rays of the patients in both groups showed that the fractures achieved union after the 1-year follow-up. Patients treated surgically with an F3 plate and open reduction internal fixation had better Constant score and DASH score results for shoulder function than those treated nonsurgically. In the present study, surgical treatment of displaced humeral greater tuberosity fractures with the use of an F3 plate led to a 100% union rate and good clinical outcomes. The F3 Biomet plate can be considered an effective implant for the treatment of displaced humeral greater tuberosity fractures. The level of evidence is therapeutic III.

scholarly journals Locking Dorsal Plate in Four-Bone Arthrodesis in SLAC and SNAC 3 Wrist

Joints ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 037-041
Author(s):  
Simona Odella ◽  
Amos Querenghi ◽  
Francesco Locatelli ◽  
Ugo Dacatra ◽  
Elia Creta ◽  
...  
Keyword(s):  
Grip Strength ◽  
Clinical Outcomes ◽  
Locking Plate ◽  
Case Series ◽  
Stage Iii ◽  
Dorsal Plate ◽  
Salvage Procedure ◽  
X Rays ◽  
Snac Wrist

Purpose The aim of this study was to evaluate the effectiveness and the safety of performing a four-bone arthrodesis (FBA) with dorsal locking plate in patients suffering from stage III scapholunate advanced collapse/scaphoid nonunion advance collapse (SLAC/SNAC) wrist. Methods We evaluated retrospectively 20 patients surgically treated by a FBA with the use of locking dorsal plate. All the patients were clinically evaluated at follow-up for grip strength, range of motion, and pain (visual analog scale), and with the Disability of the Arm, Shoulder and Hand score and the Mayo wrist score. Imaging evaluation was performed on standard X-rays. Results The mean follow-up was 6 years (range: 1–11 years). During follow-up, the patients showed good clinical outcomes in terms of pain relief and grip strength. Revision surgery was necessary only in one case because of screws loosening. In all cases, a solid bone fusion was achieved except in one patient, who presented a healing of lunocapitate joint. This condition did not affect the clinical outcomes. Conclusion FBA performed using a dorsal locking plate is a salvage procedure effective in treating stage III SLAC/SNAC wrist. In our study, this technique provided good clinical outcomes at mid-term follow-up with a very low complication rate. Level of Evidence Level IV, therapeutic case series.

scholarly journals Radial Column Excision and Four-Corner Fusion for the Treatment of Basal Thumb Arthritis and Scapholunate Advanced Collapse Wrist or Midcarpal Arthritis

2017 ◽  
Vol 06 (04) ◽  
pp. 294-300 ◽  
Author(s):  
Avanthi Mandaleson ◽  
Michael Wagels ◽  
Stephen Tham
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Clinical Outcomes ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Pinch Grip ◽  
The Mean ◽  
Therapeutic Study

Background The combination of trapeziometacarpal arthritis and intercarpal pattern of degenerative wrist arthritis is uncommon. Purpose To report on the clinical and radiologic results of patients who have undergone radial column excision (scaphoidectomy and trapeziectomy) (RCE) and four-corner fusion (4CF). We describe the patterns of disease that present with basal thumb and midcarpal arthritis and treatment outcomes of a single-surgeon series. Patients and Methods A consecutive series of seven patients underwent RCE and 4CF over a 2-year period, for basal thumb osteoarthritis with concurrent degenerative midcarpal wrist arthritis. Six patients were available for review. All six patients were women with a mean age of 73 years (range: 67–78; SD 4.6). Mean follow-up time was 48.2 months (34–59 months). Radiographic and clinical outcomes were recorded for all patients, to include wrist range of motion, key pinch, grip strength, and patient-rated wrist evaluation (PRWE). Results There were no failures or revision procedures. The mean range of motion was flexion of 40 degrees (range: 30–40 degrees), extension of 30 degrees (range: 20–42 degrees), radial deviation of 18 degrees (range: 10–30 degrees), and ulnar deviation of 15 degrees (range: 0–25 degrees). The mean key pinch was 4.2 kg (range: 0.5–10, SD ± 3.5) and mean grip strength was 9.4 kg (range: 0–19, SD ± 8.9). The PRWE results in four patients were within normal values. Conclusion RCE with 4CF resulted in acceptable clinical outcomes in four of six patients treated, with no failures at a mean follow-up of 48.2 months. Level of Evidence Level IV, therapeutic study.

Hip Resurfacing using the Trochanteric Flip Osteotomy

2009 ◽  
Vol 19 (2) ◽  
pp. 131-135 ◽  
Author(s):  
Vijay V. Killampalli ◽  
Andrew Hayes ◽  
Nick Parsons ◽  
Mathew L. Costa ◽  
Udai Prakash
Keyword(s):  
Femoral Head ◽  
Clinical Results ◽  
Hip Resurfacing ◽  
Component Failure ◽  
Ucla Activity Score ◽  
Resurfacing Arthroplasty ◽  
Early Results ◽  
Oxford Hip Score ◽  
Trochanteric Flip Osteotomy

We report the early results and complications of resurfacing arthroplasty using the ‘Trochanteric Flip Osteotomy’ approach to the hip. There are no published clinical results of this approach used for resurfacing arthroplasty. One hundred consecutive patients were assessed prospectively for a minimum follow-up of 2 years (range 2 - 5 years). The Oxford Hip Score fell from a median of 30 pre-operatively to 5 at two years. Similar improvement was found in the UCLA Activity Score. There were no cases of component failure or fractures. However, nine patients had minor complications related to the osteotomy. Resurfacing Arthroplasty of the hip may be successfully performed through a trochanteric flip osteotomy. This surgical approach may avoid some of the complications associated with avascular necrosis of the femoral head.

Durability and Failure Types of S2-Alar-Iliac Screws: An Analysis of 312 Consecutive Screws

2020 ◽  
Vol 20 (1) ◽  
pp. 91-97
Author(s):  
Seung-Jae Hyun ◽  
Jong-myung Jung ◽  
Ki-Jeong Kim ◽  
Tae-Ahn Jahng
Keyword(s):  
Clinical Outcomes ◽  
Screw Fixation ◽  
Patient Characteristics ◽  
Shaft Fracture ◽  
Consecutive Series ◽  
Computed Tomographic ◽  
Spinopelvic Fixation ◽  
Iliac Screws ◽  
Failure Types

Abstract BACKGROUND S2-alar-iliac (S2AI) screws improve stability across the lumbosacral junction in spinopelvic fixation procedures by crossing the cortical surfaces of the sacroiliac joint (SIJ), thereby increasing the biomechanical strength of the instrumentation. OBJECTIVE To investigate the durability and failure types of S2AI screws after spinopelvic reconstruction surgery. METHODS A single-center, single-surgeon consecutive series of patients who underwent spinopelvic fixation using bilateral S2AI screws with a ≥1-yr follow-up and at least 1 postoperative computed tomographic scan were retrospectively reviewed. Patient characteristics, radiographic parameters, operative data, clinical outcomes, and complications were analyzed. RESULTS In total, 312 S2AI screws in 156 patients were evaluated (mean follow-up, 26.1 mo; range 12-71 mo). There were no significant differences in screw diameter, length, or insertion angle between right-side and left-side screws. Visual analogue scale scores for back pain, ambulatory status, and Oswestry Disability Index scores significantly improved. A total of 10 patients (3.2%) experienced SIJ pain after S2AI screw installation. SIJ pain improved in 8 of them following SIJ block. In total, 7 screws (2.2%) showed partial periscrew lucency. Set screw dislodgement occurred in 7 screws (2.2%). Screw fracture occurred in 6 screws (1.9%): 5 neck fractures and 1 shaft fracture. A total of 5 patients (1.6%) underwent revision surgery for S2AI screw failure. Distal device (L4-pelvis region) breakage occurred in 5 patients. CONCLUSION The radiographic and clinical outcomes of S2AI screw fixation were acceptable. However, S2AI screw fixation has several drawbacks, including screw fracture and dislodgement of the set screw. SIJ irritation symptoms after S2AI screw fixation occurred with considerable frequency.

Early Clinical Experience with a Fresh Talar Transplant Inlay Allograft for the Treatment of Osteochondral Lesions of the Talus

2010 ◽  
Vol 100 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Leonard Janis ◽  
David B. Kaplansky ◽  
William T. DeCarbo
Keyword(s):  
Stage Iv ◽  
Osteochondral Lesions ◽  
Consecutive Series ◽  
Osteochondral Defects ◽  
Promising Alternative ◽  
Radiographic Outcomes ◽  
Early Results ◽  
Hardware Complications ◽  
Sport And Recreation

Background: Management of osteochondral defects of the talus remains a challenge, and many lesions do not respond to traditional treatments. The use of fresh allografts is a promising alternative. Methods: A freehand inlay surgical technique for reconstructing osteochondral defects of the talus with fresh osteochondral allografts fixated with bioresorbable chondral darts is described. A retrospective review of a consecutive series of 15 patients (eight males and seven females; mean age, 42.2 years) with stage IV osteochondral defects who underwent this procedure is presented. Seven patients reported a history of trauma. The mean lesion diameter was 1.7 cm. Results: Mean follow-up was 1.6 years. The Foot and Ankle Outcome Score subscale mean scores obtained at the most recent follow-up were as follows: 66.0 (pain), 64.8 (other symptoms), 71.2 (activities of daily living), 50.7 (sport and recreation function), and 42.1 (quality of life). Nine lesions had no evidence of lucency, and six demonstrated mild lucency, indicating that no allograft had been absorbed. Most patients exhibited no step-off deformity or arthrosis. No graft-related complications occurred. No subsequent surgical procedures were required. Conclusions: Early results suggest that this technique is a viable option for treating large osteochondral defects of the talus, as evidenced by the favorable patient assessment and radiographic outcomes and the lack of postoperative complications and subsequent procedures. Unlike previous allograft techniques, hardware complications did not occur. Based on these results, this technique will continue to be used. (J Am Podiatr Med Assoc 100(1): 25–34, 2010)

International integrative primary care outcomes study (IIPCOS-2): an international research project of homeopathy in primary care

2000 ◽  
Vol 89 (S 01) ◽  
pp. S10-S13 ◽  
Author(s):  
M Heger ◽  
DS Riley ◽  
M Haidvogl
Keyword(s):  
Primary Care ◽  
Conventional Treatment ◽  
Primary Treatment ◽  
Primary Objective ◽  
Lessons Learned ◽  
Homeopathic Treatment ◽  
Runny Nose ◽  
Related Quality ◽  
Outcomes Study

AbstractObjective: The primary objective is to evaluate the effectiveness of homeopathic treatment compared to conventional treatment for respiratory and ear complaints commonly seen in the primary care setting: runny nose, sore throat, ear pain, sinus pain, and cough.Method: This study is an international, multi-center, prospective, outcomes study on the effectiveness of homeopathic treatment compared to conventional treatment. The participating investigators will be divided into three groups:A total of 2400 patients will be recruited. Consecutive patients, age one month or older, presenting with one of the five chief complaints, and onset of symptoms less than seven days will be included into the study. Prior to enrolment into the trial each patient must provide written informed consent. Patient outcome will be measured using the Integrative Medicine Outcomes Scale (IMOS) at 7-, 14- and 28-d telephone follow-up. In addition, covariate data related to the following will be collected: patient demographics and medical history, patient preference for treatment and willingness to be randomized, health-related quality of life, primary treatment and adjunctive therapies prescribed, adverse events, type and length of consultation, follow-up recommendation, patient compliance, patient satisfaction with treatment, and patient willingness to choose therapy and health care provider again. The main outcome criterion will be the response rate according to the IMOS after 14 days of treatment.Results: Preliminary interim results will be presented.Conclusions: Lessons learned from the study will be discussed.

scholarly journals Comparative Effectiveness of Laterally Placed Expandable versus Static Interbody Spacers: A 1-Year Follow-Up Radiographic and Clinical Outcomes Study

2020 ◽  
Author(s):  
Yan Michael Li ◽  
Richard Francis Frisch ◽  
Zheng Huang ◽  
James Edward Towner ◽  
Yan Icy Li ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Comparative Effectiveness ◽  
Outcomes Study

Minimally invasive foramen magnum durectomy and obexostomy for treatment of craniocervical junction–related syringomyelia in adults: case series and midterm follow-up

2020 ◽  
Vol 33 (2) ◽  
pp. 148-157
Author(s):  
Mauricio Mandel ◽  
Igor Araújo Ferreira da Silva ◽  
Wellingson Paiva ◽  
Yiping Li ◽  
Gary K. Steinberg ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Chiari Malformation ◽  
Japanese Orthopaedic Association ◽  
Case Series ◽  
Craniocervical Junction ◽  
Foramen Magnum ◽  
Consecutive Series ◽  
Type I ◽  
Duration Of Surgery

OBJECTIVECraniocervical junction–related syringomyelia (CCJS) is the most common form of syringomyelia. Approximately 30% of patients treated with foramen magnum decompression (FMD) will show persistence, recurrence, or progression of the syrinx. The authors present a pilot study with a new minimally invasive surgery technique targeting the pathophysiology of CCJS in adult patients.METHODSThe authors retrospectively analyzed the clinical and radiological features of a consecutive series of patients treated for CCJS. An FMD and FM durectomy were performed through a 1.5- to 2-cm skin incision. Then arachnoid adhesions were cleared, creating a permanent communication from the fourth ventricle to the new paraspinal extradural cavity (obexostomy) and with the spinal subarachnoid space. The hypothesis was that the new CSF pouch acts like a pressure leak, interrupting the CCJS pathogenesis.RESULTSTwenty-four patients (13 female, 21–61 years old) were treated between 2014 and 2018. The etiology of CCJS was Chiari malformation type I (CM-I) in 20 patients (83.3%), Chiari malformation type 0 (CM-0) in 2 patients (8.3%), and CCJ arachnoiditis in 2 patients (8.3%). Two patients underwent reoperations after failed FMD for CM-I at other institutions. No major surgical complication occurred. One patient had postoperative meningitis with no CSF fistula. On postoperative MRI, shrinkage of the syrinx was seen in all patients. No patients experienced recurrence of the CCJS. No patient required a subsequent operation. The mean duration of surgery was 72 ± 11 minutes (mean ± SD), and blood loss was 35–80 ml (mean 51 ml). Follow-up ranged from 12 to 58 months. The average overall improvement in modified Japanese Orthopaedic Association scores was 10% (p < 0.001). The Odom scale showed that 19 patients (79.1%) were satisfied, 4 (16.7%) remained the same, and 1 (4.2%) reported a poor outcome. All patients experienced postoperative improvement in perception of quality of life (p < 0.001).CONCLUSIONSMinimally invasive FM durectomy and obexostomy is a safe and effective treatment for CCJS and for patients who have not responded to other treatment.

TREATMENT OF DISTAL RADIAL FRACTURES WITH THE DVR-A PLATE — THE EARLY BRISTOL EXPERIENCE

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 159-167 ◽  
Author(s):  
J. Loveridge ◽  
N. Ahearn ◽  
C. Gee ◽  
D. Pearson ◽  
S. Sivaloganathan ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Distal Radial Fracture ◽  
Consecutive Series ◽  
Dash Score ◽  
X Rays ◽  
Radial Inclination ◽  
Sagittal Tilt ◽  
Radial Length ◽  
The Mean

Aim: The aim of the study was to assess how adequately distal radial fracture reduction was reproduced and maintained with the distal volar radius anatomic DVR-A (Biomet, Inc) locking plate. Methods: We looked at a consecutive series of 111 patients treated with the DVR-A plate at our institution from 2007–2010. The preoperative, intra-operative, and postoperative films were reviewed. The AO and Frykman classification was recorded. The sagittal tilt, radial inclination, and radial length were measured on intra-operative X-rays and compared with final follow-up X-rays. The last recorded range of motion at follow-up and a functional assessment using the Disabilities of the Arm, Shoulder, and Hand (DASH) score was recorded. Results: At final follow-up a mean radial inclination of 22.22 degrees (11 to 38 degrees), radial height of 11.85 mm (6 to 18 mm), and sagittal tilt of 6.71 degrees volar (-9 to 19 degrees) was achieved. From initial post-operative films, to final follow-up X-rays there was a mean increase of 0.17 degrees in radial inclination, a mean loss of 0.36 mm radial height, and a mean loss of 2.17 degrees volar tilt. The mean extension was 46.8 degrees, flexion 48.3 degrees, pronation 77.4 degrees, supination 74.8 degrees, radial deviation 15.3 degrees and the ulnar deviation 19 degrees. The mean DASH score was 12.8 (0–68). Conclusion: The DVR-A plate achieved a highly satisfactory reduction of radial length and radial inclination, with a small loss of volar sagittal tilt at final follow-up. A good functional outcome was reported, with a satisfactory range of motion achieved. The DVR-A plate is a safe and effective treatment for unstable and intra-articular displaced distal radius fractures, particularly in younger patients, in the short term.

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