scholarly journals Use of a New Off-the-shelf 3D-printed Trabecular Titanium Acetabular Cup in Chinese Patients Undergoing Hip Revision Surgery: Short- to Mid-term Clinical and Radiological Outcomes

2021 ◽  
Author(s):  
Guangqian Shang ◽  
Shuai Xiang ◽  
Cuicui Guo ◽  
Jianjun Guo ◽  
Peng Wang ◽  
...  
Keyword(s):  
Bone Ingrowth ◽  
Chinese Patients ◽  
Control Group ◽  
Upward Movement ◽  
Observation Group ◽  
Acetabular Cup ◽  
Sf 36 ◽  
Revision Tha ◽  
3D Printed

Abstract Background: Revision total hip arthroplasty (THA) has been a challenge for surgeons. The purpose of this study was to explore the short-to mid-term clinical and radiological outcomes of Chinese patients who underwent revision THA using a new off-the-shelf three-dimensional (3D)-printed trabecular titanium (TT) acetabular cup by comparison with a conventional porous coated titanium acetabular cup, to provide a reference for the recommendation of this prostheses.Methods: A retrospective analysis of 57 patients (57 hips) who received revision THA was performed from January 2016 to June 2019. A total of 23 patients received 3D-printed cups (observation group) and 34 patients received non-3D-printed cups (control group). Clinical scores including Visual Analogue Scale (VAS), Harris Hip Score (HHS) and Short Form 36 (SF-36), upward movement of the hip center of rotation（HCOR）and limb-length discrepancy (LLD), stabilization and bone ingrowth of cups were compared between two groups. The multivariate linear regression was used to determine the factors potentially influencing the HHS score. Postoperative complications in the two groups were also recorded. Results: All 57 patients were routinely followed up. The average follow-up durations in the control and observation groups were 43.57 ± 13.68 (24–65) months and 41.82 ± 11.44 (24–64) months, respectively (p = 0.618). The postoperative clinical scores significantly improved in both groups compared to the preoperative scores (p < 0.05). The VAS score did not significantly differ between the groups at 3 or 12 months postoperatively, or at the last follow-up (p > 0.05). The HHS and SF-36 scores did not significantly differ between the groups at 3 months postoperatively (p > 0.05) but differed at 12 months postoperatively and the last follow-up (p < 0.05). Compared with the control group, the postoperative recovery of HCOR and LLD was better in the observation group (p < 0.05). All cups remained stable, with no loosening throughout the follow-up period. But the observation group had a significantly better rate of bone ingrowth compared to the control group (p = 0.037). Multivariate linear regression analysis showed that different cup types, upward movement of the HCOR, and LLD influenced the HHS score at the last follow-up (p < 0.05). None of the patients exhibited severe postoperative complications.Conclusion: The new off-the-shelf 3D-printed TT acetabular cup demonstrated encouraging short-to mid-term clinical outcomes in Chinese patients. It can effectively relieve pain, improve hip function, provide satisfactory biological fixation and high survival rate. But further follow up is necessary to assess its long-term outcomes.

scholarly journals Use of a New off-the-Shelf 3D-Printed Trabecular Titanium Acetabular Cup in Chinese Patients Undergoing Hip Revision Surgery: Short- to Mid-Term Clinical and Radiological Outcomes

2021 ◽  
Author(s):  
Guangqian Shang ◽  
Shuai Xiang ◽  
Cuicui Guo ◽  
Jianjun Guo ◽  
Peng Wang ◽  
...  
Keyword(s):  
Bone Ingrowth ◽  
Chinese Patients ◽  
Control Group ◽  
Upward Movement ◽  
Observation Group ◽  
Acetabular Cup ◽  
Sf 36 ◽  
Revision Tha ◽  
3D Printed

Abstract Background: Revision total hip arthroplasty (THA) has been a challenge for surgeons. The purpose of this study was to explore the short-to mid-term clinical and radiological outcomes of Chinese patients who underwent revision THA using a new off-the-shelf three-dimensional (3D)-printed trabecular titanium (TT) acetabular cup by comparison with a conventional porous coated titanium acetabular cup, to provide a reference for the recommendation of this prostheses.Methods: A retrospective analysis of 57 patients (57 hips) who received revision THA was performed from January 2016 to June 2019. A total of 23 patients received 3D-printed cups (observation group) and 34 patients received non-3D-printed cups (control group). Clinical scores including Visual Analogue Scale (VAS), Harris Hip Score (HHS) and Short Form 36 (SF-36), upward movement of the hip center of rotation（HCOR）and limb-length discrepancy (LLD), stabilization and bone ingrowth of cups were compared between two groups. The multivariate linear regression was used to determine the factors potentially influencing the HHS score. Postoperative complications in the two groups were also recorded. Results: All 57 patients were routinely followed up. The average follow-up durations in the control and observation groups were 43.57 ± 13.68 (24–65) months and 41.82 ± 11.44 (24–64) months, respectively (p = 0.618). The postoperative clinical scores significantly improved in both groups compared to the preoperative scores (p < 0.05). The VAS score did not significantly differ between the groups at 3 or 12 months postoperatively, or at the last follow-up (p > 0.05). The HHS and SF-36 scores did not significantly differ between the groups at 3 months postoperatively (p > 0.05) but differed at 12 months postoperatively and the last follow-up (p < 0.05). Compared with the control group, the postoperative recovery of HCOR and LLD was better in the observation group (p < 0.05). All cups remained stable, with no loosening throughout the follow-up period. But the observation group had a significantly better rate of bone ingrowth compared to the control group (p = 0.037). Multivariate linear regression analysis showed that different cup types, upward movement of the HCOR, and LLD influenced the HHS score at the last follow-up (p < 0.05). None of the patients exhibited severe postoperative complications.Conclusion: The new off-the-shelf 3D-printed TT acetabular cup demonstrated encouraging short-to mid-term clinical outcomes in Chinese patients. It can effectively relieve pain, improve hip function, provide satisfactory biological fixation and high survival rate. But further follow up is necessary to assess its long-term outcomes.

scholarly journals Influence of different kinds of surgical resection on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Tao Zhang ◽  
Hai Jiang ◽  
Chen Yu Ming ◽  
Yan Wang ◽  
Deng Mao ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Elderly Patients ◽  
Lymph Nodes ◽  
Inflammatory Cytokines ◽  
Operation Time ◽  
Control Group ◽  
Observation Group ◽  
Incision Length ◽  
Sf 36

Objective: To investigate the effects of two kinds of surgical resection schemes, a conventional open surgical scheme and a thoracolaparoscopic esophagectomy surgical scheme, on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer. Methods: A total of 100 elderly patients with esophageal cancer seen in the Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, from June 2014 to June 2016 were enrolled and randomly divided into two groups, including a control group (50 patients) with a conventional open surgical scheme and an observation group (50 patients) with a thoracolaparoscopic esophagectomy surgical scheme. The operation time, the amount of bleeding during the operation, the incision length, the number of lymph nodes dissected, the hospitalization time, the HAMA scores and HAMD scores before and after the operation, the PSQI scores, SF-36 scores and levels of PCT, CRP and IL-6 after the operation, the recurrence and metastasis rates and the mortality at follow-up and the incidence of related complications of both groups were compared. Results: The operation time, the amount of bleeding during the operation, the incision length and the hospitalization time in the observation group were significantly less than those in the control group (p<0.05). The number of lymph nodes dissected in the observation group was significantly higher than that in the control group (p<0.05). The HAMA scores and HAMD scores after the operation in the observation group were significantly lower than those in the control group and those before the operation (p<0.05). The PSQI scores and SF-36 scores after the operation in the observation group were significantly better than those in the control group and those before the operation (p<0.05). The levels of PCT, CRP and IL-6 after the operation in the observation group were significantly lower than those in the control group (p<0.05). The recurrence and metastasis rates at follow-up in the observation group were significantly lower than those in the control group (p<0.05). There was no significant difference in mortality at follow-up between the two groups (p>0.05). The complication incidence after the operation in the observation group was significantly lower than that in the control group (p<0.05). Conclusion: Compared with a conventional open surgical scheme, the thoracolaparoscopic esophagectomy surgical scheme possesses advantages in the treatment of elderly patients with esophageal cancer, including being a minimally invasive, simple operation, having a shorter recovery time, effectively relieving negative emotions, improving the quality of life, reducing the levels of inflammatory molecules and reducing the risk of related complications. doi: https://doi.org/10.12669/pjms.36.3.1465 How to cite this:Mahjoubi F, Hashemipour M, Moshiri F, Iranpour R, Amini M, . Genetic analysis of TTF2 gene in congenital hypothyroid infants with thyroid dysgenesis. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1465 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Mid-term Results of Hydroxyapatite-Coated Threaded Cup Implanted without Supplementary Supporting Screws

2009 ◽  
Vol 19 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Stergios J. Trapotsis ◽  
George E. Petsatodis ◽  
Petros D. Antonarakos ◽  
Panagiotis K. Givissis ◽  
Anastasios G. Christodoulou ◽  
...  
Keyword(s):  
Second Generation ◽  
Bone Ingrowth ◽  
Harris Hip Score ◽  
Radiographic Examination ◽  
Acetabular Cup ◽  
Osteolytic Lesions ◽  
The Stability ◽  
Hip Arthroplasties ◽  
Mid Term Results

We retrospectively reviewed the clinical, radiographic, and survivorship outcomes in a series of 180 patients that underwent 204 primary Total Hip Arthroplasties with the use of a second generation threaded hydroxyapatite-coated acetabular cup that was implanted without any supplementary supporting screws. At an average follow-up period of 10.2 (range: 8–14) years, one hundred and seventy-four patients (198 cups) were available for assessment. All patients underwent detailed physical and radiographic examination; their functional status was evaluated according to the Harris Hip Score (HHS). Following their digitization, all radiographs were further reviewed in order to determine the existence of any migration of the acetabular cup. Osteolytic lesions, radiolucent lines or zones of increased bone density were also recorded and classified according to the system of DeLee & Charnley. The modified Engh's criteria were used in order to evaluate the stability of the prosthesis. The patients' mean HHS at their latest follow-up visit (97.24 points) was statistically significantly better than the preoperative mean score of 40.31 points (p<0.001). Radiographic analysis showed “stable with bone ingrowth” fixation (modified Engh's criteria) of all implants with no significant migration of the cup (mean cranial migration: 0.597 mm, mean horizontal migration: 0.607 mm, mean observed difference of the cup's inclination angle: 0.26 degrees). No areas of significant osteolysis were found. The cumulative survival rate of the implants was 97.05%. Our results suggest that second generation hydroxyapatite-coated threaded acetabular cups can be successfully implanted (and achieve excellent results) without the use of any supplementary supporting screws.

scholarly journals The Use of Patient-Specific 3D Printed Titanium Implants for Complex Foot and Ankle Limb Salvage, Deformity Correction, and Arthrodesis Procedures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Samuel Adams ◽  
Travis Dekker ◽  
John Steele ◽  
Kamran Hamid
Keyword(s):  
Lower Extremity ◽  
Deformity Correction ◽  
Titanium Implants ◽  
Patient Specific ◽  
Allograft Bone ◽  
Foot And Ankle ◽  
Sf 36 ◽  
3D Printed ◽  
The Mean

Category: Ankle,Ankle Arthritis,Basic Sciences/Biologics,Trauma Introduction/Purpose: Large lower extremity bony defects, complex foot and ankle deformities, and high-risk arthrodesis situations can be difficult to treat. These challenging pathologies, often require a critical-sizes and/or shaped structural bone void filler which may not be available with allograft bone. The advancement of 3D printing technology has allowed for the use of custom designed implants for foot and ankle surgery. This study reports on the radiographic and functional outcomes of a case series of patients treated with patient-specific 3D printed titanium implants. Methods: Seven consecutive patients who were treated with custom designed 3D printed implant cages for severe bone loss, deformity correction, and arthrodesis procedures were included in this study. A minimum of 1-year follow-up was required. No patients were lost to follow-up. Patients completed preoperative and most recent follow-up VAS for pain, FAAM, and SF-36 outcomes questionnaires. All patients had post-operative radiographs and CT scans to assess bony incorporation. Results: The mean age of these patients was 54.6 (35-73 years of age). The mean follow-up of these seven patients was 17.1 months (range 12 to 31). Radiographic fusion with cage ingrowth and integration occurred in all seven patients verified by CT scan. There was statistically significant improvement in all functional outcome score measures (VAS for pain, FAAM, and SF-36). All patients returned were satisfied with surgery. There were no failures. Case examples are demonstrated in Figure 1. Conclusion: This cohort of patients demonstrated the successful use of custom 3D printed implants to treat complex large bony defects, deformities and arthrodesis procedures of the lower extremity. These implants offer the surgeon a patient specific approach to treat both pain and deformity that is not necessarily available with allograft bone.

scholarly journals The effectiveness of application of the standardized terminology for telephone follow-up model in discharge follow-up of patients with cancer pain.

2020 ◽  
Author(s):  
Xin PENG ◽  
Xing ZHANG ◽  
Yi REN ◽  
juan li XIONG
Keyword(s):  
Cancer Pain ◽  
Treatment Compliance ◽  
Control Group ◽  
Observation Group ◽  
Patients With Cancer ◽  
Management Ability ◽  
Communication Method ◽  
Standardized Terminology ◽  
Monitoring Treatment

Abstract Purpose This article aims to explore a standardized telephone follow-up model for patients with cancer pain, thus to promote standardized management of discharge follow-up of the patients with cancer pain.Method We have developed a flow chart of standard terminology for discharge follow-up of the patients with cancer pain. The 80 patients with cancer pain who have discharged from our hospital were divided into the control group (40 cases) and the observation group (40 cases), both groups were followed up by telephone within one week of discharge. The pain nurses have done the discharge follow up by telephone using the communication method of routine follow-up and the communication method of standardized terminology, self-monitoring, treatment compliance, adverse reaction management, self-management ability and satisfaction with telephone follow-up were compared between the two groups. Results The total scores of self-pain monitoring, treatment compliance, adverse reaction management and self-management ability in the observation group were higher than those in the control group (P<0.05). The satisfaction of the observation group was significantly higher than that of the control group (P<0.05).Conclusion The application of the standardized terminology telephone follow-up mode can promote effective communication between nurses and patients, standardize the process and content of telephone follow-up. It can effectively improve the effectiveness of telephone follow-up and the satisfaction of patients with nursing services, which is suitable for clinical reference.

scholarly journals The knee function of the soccer players after ACLR is comparable with non-injured controls: A case-control study

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110361
Author(s):  
Marcin E Domzalski ◽  
Filip Pieta ◽  
Katarzyna Przybylak
Keyword(s):  
Acl Reconstruction ◽  
Case Control Study ◽  
Case Control ◽  
Knee Function ◽  
Soccer Players ◽  
Control Group ◽  
Professional Soccer ◽  
Sf 36 ◽  
Control Study

Purpose: Many studies report a high primary success rate of ACL reconstruction (ACLR), with an increased risk of decline in knee performance correlating with the time passed since surgery. Only one study has compared male soccer players after ACLR to a matched control group of uninjured players in terms of their return to sport and performance. The purpose of this cross-sectional case-control study was to determine the knee performance between soccer players after ACLR and control group matched by age, sex, and professional experience. Methods: All the male professional soccer players aged 18–36 years at the time of injury, who sustained an ACL tear while playing league soccer in Poland between January 2008 and December 2011 were contacted and compared with age and experience-matched healthy control group selected from professional football players. KOOS, IKDC-2000, Lysholm and SF-36 scales were used for comparison. Results: The average follow-up was 7.9 years (range 6–9 years). The ACL-injured soccer players scored significantly lower in IKDC and Lysholm scores compared with the reference group but still were classified as normal knee function in both scales. In all five dimensions of the KOOS and subscales of SF-36 no apparent differences were noted. In all scales in the study group, no correlation was observed between the player’s age and follow-up time after ACLR. Conclusion: After ACL reconstruction and successful return to professional sport, knee function is as good as uninjured team members in the midterm follow-up. Level of evidence: III

scholarly journals Clinical Observation on the Effect of Systematic Nursing Intervention on Cognitive Function, Life Activity Ability, and Quality of Life of Senile Dementia Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yuan Zheng ◽  
Xiaoyan Xu ◽  
Birong Zheng
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Senile Dementia ◽  
Nursing Intervention ◽  
Control Group ◽  
Observation Group ◽  
Nursing Satisfaction ◽  
Dementia Patients ◽  
Sf 36

Objective. To explore the influence of systematic nursing intervention on the life ability and quality of senile dementia patients. Methods. Total of 82 senile dementia patients who were admitted to our hospital from January 2018 to January 2020 were divided into two groups according to the random number table, and the nursing intervention was analyzed. 41 patients in the control group were given routine nursing care, and 41 patients in the observation group were given systematic nursing intervention. Patients were assessed cognitively using the Montreal Cognitive Assessment Scale (MoCA). The Barthel index and SF-36 were used to evaluate the patients’ daily activity function and quality of life. A Symptom Checklist-90-Revised (SCL-90-R) was used to assess mental distress. The Social-Adaptive Function Rating Scale (SAFE) and Social Skills Inventory (SSC) were used to evaluate the patients’ social interaction ability before and after nursing intervention. Nursing satisfaction was distributed to patients in the form of a self-prepared nursing satisfaction questionnaire for scoring. Results. After the nursing intervention, the MoCA scores of patients in the two groups were higher than those before the nursing intervention, and the scores in the observation group were higher than those in the control group P < 0.05 . After the nursing intervention, the Barthel index scores of patients in the two groups were higher than those before the nursing intervention, and the scores in the observation group were higher than those in the control group P < 0.05 . After the nursing intervention, the SF-36 scores of patients in the two groups were higher than those before the nursing intervention, and the scores in the observation group were higher than those in the control group P < 0.05 . After nursing intervention, the SCL-90-R scores of patients in the two groups were lower than those before nursing intervention, and the scores in the observation group were lower than those in the control group P < 0.05 . After the nursing intervention, the SAFE scores of patients in the two groups were lower than those before the nursing intervention, and the safe scores of the observation group were lower than those of the control group P < 0.05 . After the nursing intervention, the SSC scores of patients in the two groups were lower than those before the nursing intervention, and the scores in the observation group were lower than those in the control group P < 0.05 . After nursing intervention, the total satisfaction degree of the control group (80.49%) was lower than that of the observation group (97.56%) P < 0.05 . Conclusion. The implementation of systematic nursing intervention is conducive to improve the cognitive function, activity of life, and quality of life of senile dementia patients who have a positive effect, and nursing satisfaction is higher.

scholarly journals Efficacy of Text Messaging and Personal Consultation by Pharmacy Students Among Adults With Hypertension: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Panpan Zhai ◽  
Khezar Hayat ◽  
Wenjing Ji ◽  
Qian Li ◽  
Li Shi ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Text Messaging ◽  
Controlled Trial ◽  
Intervention Group ◽  
Text Messages ◽  
Chinese Patients ◽  
Control Group ◽  
To Receive ◽  
Sms Text Messaging

BACKGROUND Hypertension is one of the leading risk factors for ischemic heart diseases, and high rates of hypertension prevalence have either remained the same or increased in developing countries in recent years. Unfortunately, about 20% to 50% of patients with chronic diseases have been nonadherent to their drug therapy. SMS text messaging and pharmacy student–led consultations have the potential to help patients manage their blood pressure (BP). OBJECTIVE The aim of this study was to assess the effectiveness, feasibility, and acceptability of SMS text messaging and consultation to manage the BP of Chinese patients with hypertension. METHODS We conducted a two-arm cluster randomized controlled trial among patients with hypertension in Xi’an City, Shaanxi Province, China, and recruited 384 patients from 8 community health care centers. Patients were randomized into an intervention group to receive SMS text messages and consultations or into a control group to receive usual care for 3 months. We sent SMS text messages at 3-day intervals and collected data at baseline (including demographics, clinical outcomes, medication complexity, side effects, patient behavior, knowledge about hypertension, BP, and medication adherence) and the 3-month follow-up (including BP, medication adherence, and knowledge about hypertension). RESULTS We assessed 445 patients with hypertension and excluded 61 patients who were not eligible or who had not filled out their questionnaires. The mean age of the patients was 68.5 (SD 7.9) years in the intervention group and 69.4 (SD 9.7) years in the control group, and the sample was primarily female (265/384, 69.0%). Patients in the intervention group showed significant improvements in systolic BP (SBP; mean 134.5 mm Hg, SD 15.5 mm Hg vs mean 140.7 mm Hg, SD 15.2 mm Hg; <i>P</i>=.001), medication adherence (mean 7.4, SD 1.2 vs mean 7.0, SD 1.3; <i>P</i>=.04), and knowledge about hypertension (mean 6.3, SD 0.9 vs mean 5.9, SD 1.2; <i>P</i>=.004) compared with those in the control group. In measures of diastolic BP (DBP), the two arms showed nonsignificant improvements (mean 78.2 mm Hg, SD 9.0 mm Hg vs mean 77.2 mm Hg, SD 10.3 mm Hg; <i>P</i>=.06). In total, 176 patients had controlled BP at the 3-month follow-up (98 patients in the intervention group vs 78 patients in the control group), but it was nonsignificant (<i>P</i>=.08). CONCLUSIONS The use of SMS text messaging and consultation to manage SBP and improve medication adherence is effective, feasible, and acceptable among Chinese patients with hypertension, although a significant difference was not observed with regard to DBP. It is important to maximize the potential of SMS text messaging and consultation by increasing the feasibility and acceptance of mobile interventions and conduct a cost-effectiveness analysis on this method. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900026862; http://www.chictr.org.cn/showproj.aspx?proj=42717.

scholarly journals Effectiveness of Physical Therapy for the Management of Chronic Spine Disorders: A Propensity Score Approach

2006 ◽  
Vol 86 (3) ◽  
pp. 381-394 ◽  
Author(s):  
Janet K Freburger ◽  
Timothy S Carey ◽  
George M Holmes
Keyword(s):  
Physical Therapy ◽  
Propensity Score ◽  
Short Form ◽  
Intervention Group ◽  
Control Group ◽  
Control Groups ◽  
Sf 36 ◽  
Spine Disorders ◽  
And Control

Abstract Background and Purpose. Evidence on the effectiveness of physical therapy for the management of chronic spine disorders is limited. The purpose of this study was to use a large current database, the National Spine Network database, to assess the effectiveness of physical therapy in the management of chronic spine disorders. Subjects. The participants were people who had spine problems lasting 3 months or longer and who were seen for an initial visit and a follow-up visit (N=4,479) at 1 of 17 US spine centers. Methods. A propensity score approach was used to create a matched sample of participants who received physical therapy (intervention group) and participants who did not receive physical therapy (control group). The 2 groups were similar with regard to more than 50 baseline characteristics. Outcomes were assessed with the Oswestry Disability Index (ODI) and the 36-Item Short-Form Health Survey (SF-36). Results. Both the intervention and control groups improved between the initial and the follow-up visits on ODI scores and on SF-36 physical function, role physical, and bodily pain scores. Although the amount of improvement in the outcome measures was significantly greater for the intervention group than for the control group, the differences were small (3–5 points). When the subgroup of participants who had the greatest propensity for receiving physical therapy was examined, differences in the amount of improvement between the intervention and control groups were larger (5–13 points). Discussion and Conclusion. Physical therapy was effective in the management of chronic spine disorders in participants with the greatest propensity for receiving physical therapy. When the entire sample was considered, differences in the amount of improvement between the intervention and control groups were not clinically relevant. [Freburger JK, Carey TS, Holmes GM. Effectiveness of physical therapy for the management of chronic spine disorders: a propensity score approach.

scholarly journals Talar Osteo-Periostic grafting from the Iliac Crest (TOPIC): 1-year Results of a New Press-fit Surgical Treatment for Large Talar Osteochondral Defects

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0004 ◽  
Author(s):  
Gino Kerkhoffs ◽  
Sjoerd Stufkens ◽  
Jari Dahmen ◽  
Nienke Altink
Keyword(s):  
Surgical Treatment ◽  
Iliac Crest ◽  
Bone Ingrowth ◽  
Osteochondral Defects ◽  
Short Term ◽  
Press Fit ◽  
Sf 36 ◽  
Grafting From ◽  
Large Primary

Category: Ankle Introduction/Purpose: The purpose of this study was to present the surgical technique and to evaluate the short-term clinical and radiological outcomes of a new press-fit OATS technique for large primary and secondary talar osteochondral defects of the talus, Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC). Methods: Twenty-eight underwent a press-fit TOPIC procedure. Mean age was 38 years (SD 4.6). Pre- and postoperative clinical assessment at 12 months follow-up included the American Orthopaedic Foot & Ankle Society (AOFAS) score, the Short-Form 36 (SF-36) Mental Component Scale (MCS) and Physical Component Scale (PCS), the Numeric Rating Scales (NRS) of pain at rest, during walking and stairclimbing, and the Foot and Ankle Outcome Score (FAOS) including accompanying subscales. Remodeling of the contour of the talus, bone ingrowth and consolidation of the implanted graft were assessed on computed tomography (CT) one year post-operatively. Results: 28 out of 29 patients were available for follow up. The AOFAS significantly improved from 45 to 92 (p=0.001). The NRS on pain during rest improved from 3 to 0 (p=0.001), the NRS during walking improved from 5 to 1 and the NRS during stairclimbing also improved from 5 to 1 (p=0.001). Both components of the SF-36 improved. The PCS improved from 34 to 47 (p=0.001) and the MCS improved from 37 to 66 (p=0.001). Finally all FAOS subscales significantly improved. All patients were satisfied with the procedure and indicated that the level of functioning was good or very good. On the post-operative CT scans, all patients showed remodeling of the talus and all grafts showed consolidation as well as bone ingrowth. No complications occurred. Conclusion: The TOPIC procedure appears to be a very promising surgical treatment option for large primary and secondary talar OCDs. Despite these good short-term clinical and radiological outcomes, a prospective study with longer follow-up is necessary to assess the clinical outcome and the progression of osteoarthritis at the long term.

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