scholarly journals Tibiotalocalcaneal arthrodesis in osteoarthritis deformation of ankle and subtalar joint – evaluation of treatment results

2020 ◽  
Author(s):  
Tomasz Stołtny ◽  
Bogdan Dugiełło ◽  
Jarosław Pasek ◽  
Karol Szyluk ◽  
Michał Pyda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Postoperative Period ◽  
Intramedullary Nail ◽  
Clinical Condition ◽  
Early Period ◽  
Early Postoperative Period ◽  
Tibiotalocalcaneal Arthrodesis ◽  
Quality Of Life Scale

Abstract Background Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities. Material and methods The study group consisted of 19 men who were subjected to intramedullary and intra-osseous arthrodesis using an intramedullary nail. The average age of patients was 46 years (19–68). The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group of patients, clinical condition was assessed using the AOFAS classification, quality of life using the SF-12 scale, and assessment of pain intensity using the VAS scale. The above parameters were evaluated before surgery in the early (under 2 years), intermediate (from 2–5 years) and late (over 5 years) postoperative period. Results Analysis of the results showed that the assessed clinical condition on the AOFAS scale improved from an average of 20.6 points before TTCA to 63.5 points after the procedure. The result was statistically significant (p < 0.0001). Analyzing the results obtained using the SF-12 quality of life scale, a statistically significant increase was found. In the physical sphere of quality of life PCS-12 increased from 26.5 points to 44.2 points (p = 0.0004) and in the mental sphere of quality of life MCS-12 from 46.1 points to 52.6 points (p = 0.030). The intensity of pain ailments, assessed in the VAS scale, decreased in all three periods of postoperative observation (in the early period p < 0.05, in the intermediate period p = 0.23, and in the late period p < 0.05), with the strongest analgesic effect (reduction of pain intensity by 4.3 points on the VAS scale) was observed in the early post-operative follow-up period. Conclusions Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement in the physical and mental quality of life assessed in the SF-12 scale and a significant reduction in the intensity of pain ailments assessed in the VAS scale, especially in the early postoperative period.

scholarly journals Tibiotalocalcaneal arthrodesis in osteoarthritis deformation of ankle and subtalar joint – evaluation of treatment results

2020 ◽  
Author(s):  
Tomasz Stołtny ◽  
Bogdan Dugiełło ◽  
Jarosław Pasek ◽  
Karol Szyluk ◽  
Michał Pyda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Postoperative Period ◽  
Intramedullary Nail ◽  
Clinical Condition ◽  
Early Period ◽  
Early Postoperative Period ◽  
Tibiotalocalcaneal Arthrodesis ◽  
Quality Of Life Scale

Abstract Background Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities. Methods The study group consisted of 19 men who were subjected to intramedullary and intra-osseous arthrodesis using an intramedullary nail. The average age of patients was 46 years (19–68). The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group of patients, clinical condition was assessed using the AOFAS classification, quality of life using the SF-12 scale, and assessment of pain intensity using the VAS scale. The above parameters were evaluated before surgery in the early (under 2 years), intermediate (from 2–5 years) and late (over 5 years) postoperative period. Results Analysis of the results showed that the assessed clinical condition on the AOFAS scale improved from an average of 20.6 points before TTCA to 63.5 points after the procedure. The result was statistically significant (p < 0.0001). Analyzing the results obtained using the SF-12 quality of life scale, a statistically significant increase was found. In the physical sphere of quality of life PCS-12 increased from 26.5 points to 44.2 points (p = 0.0004) and in the mental sphere of quality of life MCS-12 from 46.1 points to 52.6 points (p = 0.030). The intensity of pain ailments, assessed in the VAS scale, decreased in all three periods of postoperative observation (in the early period p < 0.05, in the intermediate period p = 0.23, and in the late period p < 0.05), with the strongest analgesic effect (reduction of pain intensity by 4.3 points on the VAS scale) was observed in the early post-operative follow-up period. Conclusions Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement in the physical and mental quality of life assessed in the SF-12 scale and a significant reduction in the intensity of pain ailments assessed in the VAS scale, especially in the early postoperative period.

scholarly journals Management of patients in the post-operative period after the hip joint replacement accessed by low-invasive access

2019 ◽  
Vol 1 (4) ◽  
pp. 32-38
Author(s):  
N S Nikolaev ◽  
A V Efimov ◽  
R V Petrova ◽  
D V Kovalev ◽  
M I Ivanov
Keyword(s):  
Quality Of Life ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Modified Rankin Scale ◽  
Surgical Access ◽  
Group I ◽  
Group Ii

Up to 1.5 million total hip arthroplasty is performed annually in the world. In Russia, at least 300 thousand patients a year need hip replacement surgery. High tissue invasiveness during surgical approaches presents special requirements for the rehabilitation process in the early postoperative period. Accelerating and making it more efficient is possible with the use of the least traumatic operating access. The purpose of the study is a comparative analysis of two models of the organization of rehabilitation in the postoperative period after hip arthroplasty: using standard Harding surgical access and the minimally invasive Rottinger access. Material of the study - patients operated on with standard Harding access (group I, n = 227) and front-external Rottinger access (group II, n = 266). Criteria for inclusion of patients in both groups are primary coxarthrosis without previous surgical interventions, exclusion criteria are connective tissue diseases, severe comorbidity. Group I patients underwent postoperative rehabilitation according to the standard protocol, group II - according to the rehabilitation concept "ERAS, fast-track". To assess the effectiveness of the rehabilitation at all stages in both groups, the rehabilitation potential was assessed on the rehabilitation routing scale (SRM), the dynamics of the pain syndrome on the visual analogue pain scale (VAS), the verticalization period was taken into account, the main assessment scales of the patient's motor functions and psychological status were used in hip arthroplasty: Harris scale, quality of life questionnaire (EQ - 5D), modified Rankin scale. Results and discussion. The proportion of hip arthroplasty using MIS access in the total number of operations increased from 0.7% in 2015 to 10.1% in 2018. The studied groups are comparable in terms of the ratio of men and women, average age, number of observations, BMI and the volume of blood loss. The surgeon duration and the duration of the stationary phase in group I exceeded the similar parameters of the II group. The modified Rankin scale at admission and discharge in all patients showed moderate disability, starting indicators and results after 3 months were more prosperous in group II. Both groups had an equivalent score on the Harris scale before surgery and after 3 months after it, more pronounced positive dynamics of the quality of life on the EQ-5D scale ("thermometer") was noted in group II. A decrease in pain after surgery compared with baseline, with regression to 0.8-1.0 points by 3 months after surgery, was noted in all patients. The assessment on the rehabilitation routing scale did not differ in both groups. At the stationary stage, group I patients walked with additional support on crutches (100%), group II - on a cane (92.5%). On long days 4-6, 82.8% of patients of group I and 91.7% of patients of group II passed long distances. At the end of stage I rehabilitation, 83.7% of group I patients and 92.5% of group II were sent to the outpatient rehabilitation stage, the rest were transferred to stage II of rehabilitation in a 24 - hour hospital. The third stage of rehabilitation, all patients went on an outpatient basis at the place of residence. At the follow-up stage, the data of a telephone survey of group II were analyzed (n = 68, 25.6% of the respondents). By 3 months, the Harris score exceeds 90 points, satisfaction with the operation is 97%. As a result of the use of surgical MIS access for hip arthroplasty, all patients had good rehabilitation indicators. Conclusions. The general approach to managing patients after hip arthroplasty is similar for all types of surgical access, however, MIS-access creates the most favorable conditions for the rehabilitation of patients in the early postoperative period: a positive attitude of the patient, reduced blood loss, reduced surgical incision, the possibility of early activation and transition to the general regime for 6-7 days. The results of the study showed the advantages of a model for the organization of rehabilitation in the postoperative period after hip arthroplasty using mini-invasive access over standard surgical access. Group II patients (MIS access) had a higher level of physical activity and a low level of pain in the early postoperative period.

scholarly journals Unicompartmental Knee Arthroplasty: Short-Term Results

2021 ◽  
Vol 27 (1) ◽  
pp. 153-165
Author(s):  
V. Yu. Murylev ◽  
N. E. Erokhin ◽  
P. M. Elizarov ◽  
G. A. Kukovenko ◽  
A. V. Muzychenkov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Outcome ◽  
Postoperative Period ◽  
Functional Results ◽  
Early Postoperative Period ◽  
X Rays ◽  
Operating Technique ◽  
Sf 36 ◽  
The Face

Background. Among the methods of surgical treatment of early stages medial knee osteoarthritis in the partial knee replacement (PKR) becomes more and more relevant. The relevance and increasing number of PKR are confirmed by data from various national registers.The aim of the study was to research the early functional results of PKR and to analyze the complications at various stages of the postoperative period.Material and Methods. Study design: a single-center prospective study. The results of 90 operations of PKR in the period from March 2018 to April 2020 are presented. Assessment of knee function and quality of life of patients was performed according to three scalesquestionnaires: KOOS, WOMAC, SF-36, which were filled in preoperatively and then at 3, 6, 9, 12, 18 months. after surgery. Patients within the reporting period provided X-rays and filled in the scales at the face-to-face examination and at remote contact.Results. The most significant improvement of quality of life and median values of the functional results observed after 3 months, and after 18 months. After replacement the best median functional outcome scales KOOS, WOMAC, SF-36 — 79,4 (73,6–84,3); 27,1 (24,8–30,6); 89,1 (85,3–92,6) compared with the functional results obtained before surgery 32,3 (22,8–38,4); 73,6 (63,6–78,8); 35,2 (31,3–42,1); p = 0,027; p = 0.023; p = 0,028, respectively. A negative correlation was obtained between BMI and functional outcome (p = 0.027, R = -0.7).Conclusion. PKR allowed us to achieve an improvement in the quality of life and functional results already in the early postoperative period (from 3 to 18 months after the operation). The improvement of the operating technique, the analysis of errors and the regularity of the performed PKR will improve the results of PKR and minimize the number of complications.

scholarly journals A study of patients` quality of life before and after resections of brain meningioma

2020 ◽  
Vol 26 (3) ◽  
pp. 64-69
Author(s):  
V. Yu. Cherebillo ◽  
M. Yu. Kurnukhina
Keyword(s):  
Quality Of Life ◽  
Postoperative Period ◽  
Laboratory Data ◽  
Early Postoperative Period ◽  
Before And After ◽  
Eortc Qlq C30 ◽  
Assess Quality ◽  
Eortc Qlq ◽  
Instrumental Methods

The objective was to analyze and evaluate patients` quality of life before and after resection of brain meningioma.Methods and materials. We performed study of 31 patients with brain meningioma. The diagnosis of the studied patients was based on clinical and laboratory data, data of radiation and instrumental methods of research. The analysis of patients` quality of life was carried out in the preoperative, early and late postoperative periods. The patient` age ranged from 37 to 65 years; the median age was 57 years. We chose a special questionnaire-EORTC QLQ-C30 to assess quality of life of the studied pre- and postoperative periods. The questionnaire has been tested in many international clinical studies.Results. In the early postoperative period, the severity of pain increased in the patients under study, nausea and vomiting, constipation occurred more often. However, patients assessed their General health in both early and late postoperative periods better than before the operation. In the late postoperative period, there was a positive dynamics in all scales of the questionnaire.Conclusion. On examination of various parameters of quality of life before and after surgery in patients with brain meningioma, it was found that surgical intervention led to an improvement in the quality of life of patients.

scholarly journals Can robot-assisted renal transplantation provide higher quality of life than open renal transplantation during the early postoperative period?

2021 ◽  
Author(s):  
Mithat Eksi ◽  
Selcuk Sahin ◽  
Ismail Evren ◽  
Yusuf Arıkan ◽  
Fatih Gokhan Ozbay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Transplantation ◽  
Renal Disease ◽  
Postoperative Period ◽  
End Stage Renal Disease ◽  
Early Postoperative Period ◽  
Robot Assisted ◽  
Stage Renal Disease ◽  
End Stage

Purpose: To investigate the quality of life (QoL) in patients with end-stage renal disease who underwent open or robot-assisted renal transplantation (ORT and RART). Materials and Methods: Patients who underwent ORT and RART at Bakirkoy Sadi Konuk Training and Research Hospital between June 2016 and December 2018 constituted the target population of this study. The patient group was divided into two groups as per the surgical technique (i.e., open vs. robot-assisted). Demographic data, preoperative and postoperative data of all patients were collected prospectively. The QoL of the patients was assessed preoperatively and on the postoperative 30th day. Results: 67 patients who underwent ORT and 60 patients who underwent RART were included. The mean patient age and BMI were calculated as 40,9 ± 11,6 years and 24,4 ± 2,9 kg/m2, respectively. While mean total ischemia time was shorter in the ‘open’ group, incision length, duration of surgical drainage and hospital stay were shorter in the ‘robot-assisted’ group. The physical component scores of the QoL questionnaire revealed that postoperative impairment of quality of life was more significant in the ORT than the RART. Conclusion: Patients who underwent RART have a higher QoL than the patients who were treated with ORT as per their self-reported QoL scores in the early postoperative period. Keywords: End-stage renal disease; Open renal transplantation; Robot-assisted renal transplantation; Quality of life

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